Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.05.003
Objective
Examine body mass index (BMI) trajectories in American youth with type 1 diabetes (T1D) over the first 5 years following diagnosis.
Methods
Retrospective record review of BMI trajectories in youth with T1D diagnosed in 2015 to 2016.
Results
Near the time of diabetes diagnosis, 35.5% of youth had BMIs in the overweight/obesity range. These rates increased over time (P < .001), with 52.8% having overweight/obesity 5 years after diagnosis. Average age when BMI rose from healthy to overweight/obese or overweight to obese (rise group) was at 12.7 years, occurring 2.5 years after diagnosis. There were no differences between hemoglobin A1c, use of continuous glucose monitors, or use of insulin pumps between the rise group and those with healthy BMI throughout the study period.
Conclusions
Alarmingly high rates of overweight/obesity in youth were observed within 5 years following T1D diagnosis. Awareness and further research are necessary to address this independent risk factor for morbidities.
{"title":"Change in Body Mass Index in Youth in the First 5 Years After Type 1 Diabetes Mellitus Diagnosis","authors":"","doi":"10.1016/j.eprac.2024.05.003","DOIUrl":"10.1016/j.eprac.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>Examine body mass index<span> (BMI) trajectories in American youth with type 1 diabetes (T1D) over the first 5 years following diagnosis.</span></p></div><div><h3>Methods</h3><p>Retrospective record review of BMI trajectories in youth with T1D diagnosed in 2015 to 2016.</p></div><div><h3>Results</h3><p>Near the time of diabetes diagnosis, 35.5% of youth had BMIs in the overweight/obesity range. These rates increased over time (<em>P</em> < .001), with 52.8% having overweight/obesity 5 years after diagnosis. Average age when BMI rose from healthy to overweight/obese or overweight to obese (<em>rise group</em><span>) was at 12.7 years, occurring 2.5 years after diagnosis. There were no differences between hemoglobin A1c<span>, use of continuous glucose monitors, or use of insulin pumps between the </span></span><em>rise group</em> and those with healthy BMI throughout the study period.</p></div><div><h3>Conclusions</h3><p>Alarmingly high rates of overweight/obesity in youth were observed within 5 years following T1D diagnosis. Awareness and further research are necessary to address this independent risk factor for morbidities.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.05.007
Background
Patients with familial adenomatous polyposis (FAP) have an increased risk of thyroid nodular disease. Previous studies demonstrated that screening thyroid ultrasound (US) will allow detection of nodules in 38% and thyroid cancer in 2.6% of patients. The aim of this study is to define the value of serial US evaluation at identifying disease progression in patients with FAP.
Methods
Retrospective review from 2008 to 2023 at a single referral center. All patients with FAP and screening thyroid US were included. Patient demographics, initial US characteristics, follow-up regarding the development of new nodules and cancer were assessed using a Kaplan-Meier analysis.
Results
A total of 556 patients underwent screening. Fifty percent were male. Median age at first screening was 38 year old. Eighty percent underwent longitudinal follow-up for a median length of 7 years. At initial screening, 169 patients (30%) had nodules. For patients with normal baseline US, 14% developed a nodule overtime. A total of 20 patients (3.6%) were diagnosed with thyroid cancer. The cumulative incidence of initial and subsequent cancer was 4% by 5 years and 6% by 10 years, while the cumulative incidence of thyroid nodules was 40% and 48%, respectively.
Conclusions
Based on the Kaplan-Meier analysis, ongoing longitudinal screening is warranted for patients with FAP as they are prone to thyroid cancer and nodule development overtime even when presenting with a baseline normal US. Additionally, these data demonstrate a slow development of thyroid cancer from a normal US, thus it is reasonable to consider selectively extending the screening interval for this population.
背景家族性腺瘤性息肉病（FAP）患者罹患甲状腺结节疾病的风险较高。以往的研究表明，甲状腺超声筛查（US）可发现 38% 的患者有甲状腺结节，2.6% 的患者有甲状腺癌。本研究旨在确定连续性甲状腺超声评估在识别FAP患者疾病进展方面的价值：方法：对一家转诊中心2008-2023年的研究进行回顾性分析。纳入了所有接受甲状腺 US 筛查的 FAP 患者。采用 Kaplan-Meier 分析法评估了患者的人口统计学特征、最初的 US 特征、有关新结节和癌症发展的随访情况：结果：共有556名患者接受了筛查。结果：共有 556 名患者接受了筛查，其中 51% 为男性。首次筛查的中位年龄为 38 岁。81%的患者接受了纵向随访，中位随访时间为 7 年。初次筛查时，169 名患者（30%）有结节。在基线 US 值正常的患者中，有 14% 的人在超时后出现了结节。共有 20 名患者（3.6%）被确诊为甲状腺癌。甲状腺结节的累积发病率分别为40%和48%：根据Kaplan-Meier分析，FAP患者即使在US检查基线正常的情况下也很容易发生甲状腺癌和甲状腺结节，因此有必要对FAP患者进行持续的纵向筛查。此外，这些数据还表明，甲状腺癌从正常的甲状腺组织检查发展而来的速度很慢，因此有理由考虑有选择性地延长这一人群的筛查间隔。
{"title":"Progression of Nodular Thyroid Disease in Familial Adenomatous Polyposis Syndrome: Refined Surveillance Recommendations","authors":"","doi":"10.1016/j.eprac.2024.05.007","DOIUrl":"10.1016/j.eprac.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><p>Patients with familial adenomatous polyposis (FAP) have an increased risk of thyroid nodular disease. Previous studies demonstrated that screening thyroid ultrasound (US) will allow detection of nodules in 38% and thyroid cancer in 2.6% of patients. The aim of this study is to define the value of serial US evaluation at identifying disease progression in patients with FAP.</p></div><div><h3>Methods</h3><p>Retrospective review from 2008 to 2023 at a single referral center. All patients with FAP and screening thyroid US were included. Patient demographics, initial US characteristics, follow-up regarding the development of new nodules and cancer were assessed using a Kaplan-Meier analysis.</p></div><div><h3>Results</h3><p>A total of 556 patients underwent screening. Fifty percent were male. Median age at first screening was 38 year old. Eighty percent underwent longitudinal follow-up for a median length of 7 years. At initial screening, 169 patients (30%) had nodules. For patients with normal baseline US, 14% developed a nodule overtime. A total of 20 patients (3.6%) were diagnosed with thyroid cancer. The cumulative incidence of initial and subsequent cancer was 4% by 5 years and 6% by 10 years, while the cumulative incidence of thyroid nodules was 40% and 48%, respectively.</p></div><div><h3>Conclusions</h3><p>Based on the Kaplan-Meier analysis, ongoing longitudinal screening is warranted for patients with FAP as they are prone to thyroid cancer and nodule development overtime even when presenting with a baseline normal US. Additionally, these data demonstrate a slow development of thyroid cancer from a normal US, thus it is reasonable to consider selectively extending the screening interval for this population.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X24005299/pdfft?md5=d892eafe7e137a861ea27ace02cef9ce&pid=1-s2.0-S1530891X24005299-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.04.020
Objective
Obesity is the most prevalent chronic disease in the United States with over 70% of the American population suffering from overweight/obesity. Recently, the popularity of plant-based diets (PBDs) has grown, with individuals adopting these diets for ethical, health and environmental reasons. Our aim is to evaluate the effect of a PBD on weight loss among patients who are overweight or obese.
Methods
A literature review of PBDs for the treatment of obesity was conducted using PubMed and Scopus. Our search yielded 27 intervention trials (3361 participants) and 6 metanalyses (9168 participants, 61 trials).
Results
Among the intervention trials evaluated, 75% showed a significant increase in weight loss or decrease in weight in the intervention group, on average −5.0 kg (range −1.8 to −12.1 kg). Other outcomes included energy intake (−420 Kcal/d), systolic blood pressure (−3.78 mmHg), fasting plasma glucose (−2.0 mmol/L), hemoglobin A1c (−0.5%, −3.4 mmol/L), total cholesterol (−0.40 mmol/L), low-density lipoprotein (−0.38 mmol/L), triglyceride levels (+0.13 mmol/L), and fiber intake (+10.8 g/d). The 6 meta-analyses showed weight loss (average −2.9 kg, range −2.02 kg to −4.1 kg), body mass index reduction, and improvements in hemoglobin A1c, low-density lipoprotein, and total cholesterol.
Conclusion
PBDs result in significant weight loss and improve metabolic outcomes. PBDs offer a sustainable approach to long-term weight loss maintenance. Health care providers should encourage open discussions with their patients regarding their dietary habits to assist them in setting feasible lifestyle goals and consider shared medical appointments to support patients in transitioning to PBDs.
{"title":"A Review of Plant-Based Diets for Obesity Management","authors":"","doi":"10.1016/j.eprac.2024.04.020","DOIUrl":"10.1016/j.eprac.2024.04.020","url":null,"abstract":"<div><h3>Objective</h3><p>Obesity is the most prevalent chronic disease in the United States with over 70% of the American population suffering from overweight/obesity. Recently, the popularity of plant-based diets (PBDs) has grown, with individuals adopting these diets for ethical, health and environmental reasons. Our aim is to evaluate the effect of a PBD on weight loss among patients who are overweight or obese.</p></div><div><h3>Methods</h3><p>A literature review of PBDs for the treatment of obesity was conducted using PubMed and Scopus. Our search yielded 27 intervention trials (3361 participants) and 6 metanalyses (9168 participants, 61 trials).</p></div><div><h3>Results</h3><p>Among the intervention trials evaluated, 75% showed a significant increase in weight loss or decrease in weight in the intervention group, on average −5.0 kg (range −1.8 to −12.1 kg). Other outcomes included energy intake (−420 Kcal/d), systolic blood pressure (−3.78 mmHg), fasting plasma glucose (−2.0 mmol/L), hemoglobin A1c (−0.5%, −3.4 mmol/L), total cholesterol (−0.40 mmol/L), low-density lipoprotein (−0.38 mmol/L), triglyceride levels (+0.13 mmol/L), and fiber intake (+10.8 g/d). The 6 meta-analyses showed weight loss (average −2.9 kg, range −2.02 kg to −4.1 kg), body mass index reduction, and improvements in hemoglobin A1c, low-density lipoprotein, and total cholesterol.</p></div><div><h3>Conclusion</h3><p>PBDs result in significant weight loss and improve metabolic outcomes. PBDs offer a sustainable approach to long-term weight loss maintenance. Health care providers should encourage open discussions with their patients regarding their dietary habits to assist them in setting feasible lifestyle goals and consider shared medical appointments to support patients in transitioning to PBDs.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X24005135/pdfft?md5=597f4fc3d2d38ed73e2402f3f60fc0e1&pid=1-s2.0-S1530891X24005135-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.05.006
{"title":"Achieving Digital Health Equity in Diabetes Care","authors":"","doi":"10.1016/j.eprac.2024.05.006","DOIUrl":"10.1016/j.eprac.2024.05.006","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.05.001
Objective
COVID-19 infection and immunizations have been implicated in developing a range of thyroid diseases, including subacute thyroiditis (SAT). This study aimed to evaluate the association between COVID-19 infection and/or COVID-19 vaccination with SAT.
Methods
A population of 3 million adults insured by Clalit Health Services was evaluated from March 2020 to September 2022. Patients with a new diagnosis of SAT were identified and matched in a 1:10 ratio to a control group. Each control was assigned an index date that was identical to that of their matched case, defined as the date of SAT diagnosis. Multivariate conditional logistic regression models were used to evaluate the association between COVID-19 infection, vaccine, and thyroiditis.
Results
A total of 3221 patients with SAT were matched with 32 210 controls. Rates of COVID-19 vaccination (first, second, or third dose) and COVID-19 infection were evaluated prior to the date of SAT diagnosis (disease group) or index date (control group) to detect a possible association. No difference was detected between the groups in relation to vaccinations at the 30 days, 60 days, and 90 days of time points (P = .880/0.335/0.174, respectively). No difference was found between groups in relation to COVID-19 infection at these time points (P = .735/0.362/0.956, respectively). There was higher use of medications for the treatment of thyroiditis, including nonsteroidal anti-inflammatory drugs (28.6% vs 7.9%, P < .01), steroids (10.3% vs 1.8%, P < .01), and beta-blockers (18.3% vs 5.4%, P < .01).
Conclusion
Based on this large population study, no association was found between COVID-19 infection and/or the COVID-19 vaccine and SAT.
{"title":"Subacute Thyroiditis Following COVID-19 and COVID-19 Vaccination","authors":"","doi":"10.1016/j.eprac.2024.05.001","DOIUrl":"10.1016/j.eprac.2024.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>COVID-19 infection and immunizations have been implicated in developing a range of thyroid diseases, including subacute thyroiditis (SAT). This study aimed to evaluate the association between COVID-19 infection and/or COVID-19 vaccination with SAT.</p></div><div><h3>Methods</h3><p>A population of 3 million adults insured by Clalit Health Services was evaluated from March 2020 to September 2022. Patients with a new diagnosis of SAT were identified and matched in a 1:10 ratio to a control group. Each control was assigned an index date that was identical to that of their matched case, defined as the date of SAT diagnosis. Multivariate conditional logistic regression models were used to evaluate the association between COVID-19 infection, vaccine, and thyroiditis.</p></div><div><h3>Results</h3><p>A total of 3221 patients with SAT were matched with 32 210 controls. Rates of COVID-19 vaccination (first, second, or third dose) and COVID-19 infection were evaluated prior to the date of SAT diagnosis (disease group) or index date (control group) to detect a possible association. No difference was detected between the groups in relation to vaccinations at the 30 days, 60 days, and 90 days of time points (<em>P</em> = .880/0.335/0.174, respectively). No difference was found between groups in relation to COVID-19 infection at these time points (<em>P</em> = .735/0.362/0.956, respectively). There was higher use of medications for the treatment of thyroiditis, including nonsteroidal anti-inflammatory drugs (28.6% vs 7.9%, <em>P</em> < .01), steroids (10.3% vs 1.8%, <em>P</em> < .01), and beta-blockers (18.3% vs 5.4%, <em>P</em> < .01).</p></div><div><h3>Conclusion</h3><p>Based on this large population study, no association was found between COVID-19 infection and/or the COVID-19 vaccine and SAT.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X24005093/pdfft?md5=c90ad513180cd077360d6049f86d3302&pid=1-s2.0-S1530891X24005093-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.05.004
Objective
White matter lesions (WMLs) increase the risk of stroke, stroke recurrence, and death. Higher plasma aldosterone concentration (PAC) increases the risk of stroke, acute myocardial infarction, and hypertension. The objective is to evaluate the relationship between PAC and cerebrovascular events in patients with hypertension and WMLs.
Methods
We conducted a retrospective cohort study that included 1041 participants hospitalized. The outcome was new-onset cerebrovascular events including intracerebral hemorrhage and stroke. A Cox regression model was used to evaluate the relationship between baseline PAC and the risk of cerebrovascular events.
Results
The mean age of participants was 60.9 ± 10.2 years and 565 (53.4%) were males. The median follow-up duration was 42 months (interquartile range: 25-67), and 92 patients experienced new-onset cerebrovascular events. In a multivariate-adjusted model, with PAC as a continuous variable, higher PAC increased the risk of cerebrovascular events; patient risk increased per 1 (hazard ratio [HR: 1.03], 95% confidence interval [CI]: 1.01-1.06, P < .01), per 5 (HR: 1.17, 95% CI: 1.06-1.31, P < .01), and per 10 ng/dL (HR: 1.41, 95%: 1.14-1.75, P < .01) increase in PAC. When PAC was expressed as a categorical variable (quartile: Q1-Q4), patients in Q4 (HR: 2.12, 95% CI: 1.18-3.79, P < .05) exhibited an increased risk of cerebrovascular events compared to Q1. Restrictive spline regression showed a linear association between PAC and the risk of new-onset cerebrovascular events after adjusting for all possible variables.
Conclusions
Our study identified a linear association between PAC and the risk of new-onset cerebrovascular events in patients with hypertension and WMLs.
{"title":"Aldosterone is Associated With New-onset Cerebrovascular Events in Patients With Hypertension and White Matter Lesions: A Cohort Study","authors":"","doi":"10.1016/j.eprac.2024.05.004","DOIUrl":"10.1016/j.eprac.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><p><span>White matter lesions (WMLs) increase the risk of stroke, stroke recurrence, and death. Higher plasma </span>aldosterone<span> concentration (PAC) increases the risk of stroke, acute myocardial infarction, and hypertension. The objective is to evaluate the relationship between PAC and cerebrovascular events in patients with hypertension and WMLs.</span></p></div><div><h3>Methods</h3><p><span>We conducted a retrospective cohort study that included 1041 participants hospitalized. The outcome was new-onset cerebrovascular events including </span>intracerebral hemorrhage<span> and stroke. A Cox regression model was used to evaluate the relationship between baseline PAC and the risk of cerebrovascular events.</span></p></div><div><h3>Results</h3><p>The mean age of participants was 60.9 ± 10.2 years and 565 (53.4%) were males. The median follow-up duration was 42 months (interquartile range: 25-67), and 92 patients experienced new-onset cerebrovascular events. In a multivariate-adjusted model, with PAC as a continuous variable, higher PAC increased the risk of cerebrovascular events; patient risk increased per 1 (hazard ratio [HR: 1.03], 95% confidence interval [CI]: 1.01-1.06, <em>P</em> < .01), per 5 (HR: 1.17, 95% CI: 1.06-1.31, <em>P</em> < .01), and per 10 ng/dL (HR: 1.41, 95%: 1.14-1.75, <em>P</em> < .01) increase in PAC. When PAC was expressed as a categorical variable (quartile: Q1-Q4), patients in Q4 (HR: 2.12, 95% CI: 1.18-3.79, <em>P</em> < .05) exhibited an increased risk of cerebrovascular events compared to Q1. Restrictive spline regression showed a linear association between PAC and the risk of new-onset cerebrovascular events after adjusting for all possible variables.</p></div><div><h3>Conclusions</h3><p>Our study identified a linear association between PAC and the risk of new-onset cerebrovascular events in patients with hypertension and WMLs.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.05.009
Background
Despite the growing literature, the effectiveness of liraglutide in weight management among individuals with prediabetes and in preventing the disease remains controversial. This study aims to critically evaluate the extent of liraglutide’s impact on weight management in this population and assess the heterogeneity among extant studies.
Methods
A systematic literature search was conducted across MEDLINE, Embase, ClinicalTrials.gov, and the reference list of retrieved studies to identify eligible English language randomized controlled trials evaluating liraglutide’s effect on weight in individuals with pre-diabetes. Non-randomized studies, studies not reporting relevant outcomes, and those conducted on patients with type 2 diabetes were excluded from this review. Outcomes included a change from baseline in absolute body weight in kg, body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), and low-density lipoprotein cholesterol levels. Additional safety outcomes were also reported. Data were analyzed using R statistical software version 4.3.1. A fixed-effect model was used when pooling crude numbers for study outcomes. Moreover, a sensitivity analysis using random-effect model was performed and heterogeneity was assessed using I2 statistics.
Results
Five eligible studies were included, with a total of 1604 subjects in the liraglutide arm and 859 subjects in the control arm. Participants exposed to liraglutide showed a decrease in body weight (mean difference [MD] = −4.95 kg; 95% CI –5.16, −4.73; I2 = 93%), BMI (MD = −2.06 kg/m2; 95%CI –2.22, −1.89; I2 = 97%), waist circumference (MD = −4.61 cm; 95% CI –4.79, −4.43; I2 = 82%), HbA1c (MD = −0.33%; 95%CI –0.34, −0.31; I2 = 100%), and low-density lipoprotein cholesterol levels (MD = −0.36 mmol/L; 95% CI –0.39, −0.33; I2 = 99%). The overall effect size remained similar when using a random-effects model for all outcomes. In addition, the rate of adverse events was higher with liraglutide when compared to the control; however, the dropout rates were relatively lower in the former arm.
Conclusion
While our meta-analysis suggests that liraglutide can reduce body weight, BMI, waist circumference, and HbA1c levels in individuals with pre-diabetes, the findings should be interpreted cautiously due to limitations such as the small number of trials and their short duration, and variability in dosages. Further randomized controlled trials examining long-term outcomes are essential to validate these findings and address the high heterogeneity among the studies included in this analysis.
{"title":"Liraglutide’s Effect on Weight Management in Subjects With Pre-diabetes: A Systematic Review & Meta-Analysis","authors":"","doi":"10.1016/j.eprac.2024.05.009","DOIUrl":"10.1016/j.eprac.2024.05.009","url":null,"abstract":"<div><h3>Background</h3><p>Despite the growing literature, the effectiveness of liraglutide in weight management among individuals with prediabetes and in preventing the disease remains controversial. This study aims to critically evaluate the extent of liraglutide’s impact on weight management in this population and assess the heterogeneity among extant studies.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted across <em>MEDLINE</em>, <em>Embase</em>, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and the reference list of retrieved studies to identify eligible English language randomized controlled trials evaluating liraglutide’s effect on weight in individuals with pre-diabetes. Non-randomized studies, studies not reporting relevant outcomes, and those conducted on patients with type 2 diabetes were excluded from this review. Outcomes included a change from baseline in absolute body weight in kg, body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), and low-density lipoprotein cholesterol levels. Additional safety outcomes were also reported. Data were analyzed using R statistical software version 4.3.1. A fixed-effect model was used when pooling crude numbers for study outcomes. Moreover, a sensitivity analysis using random-effect model was performed and heterogeneity was assessed using I<sup>2</sup> statistics.</p></div><div><h3>Results</h3><p>Five eligible studies were included, with a total of 1604 subjects in the liraglutide arm and 859 subjects in the control arm. Participants exposed to liraglutide showed a decrease in body weight (mean difference [MD] = −4.95 kg; 95% CI –5.16, −4.73; I<sup>2</sup> = 93%), BMI (MD = −2.06 kg/m<sup>2</sup>; 95%CI –2.22, −1.89; I<sup>2</sup> = 97%), waist circumference (MD = −4.61 cm; 95% CI –4.79, −4.43; I<sup>2</sup> = 82%), HbA1c (MD = −0.33%; 95%CI –0.34, −0.31; I<sup>2</sup> = 100%), and low-density lipoprotein cholesterol levels (MD = −0.36 mmol/L; 95% CI –0.39, −0.33; I<sup>2</sup> = 99%). The overall effect size remained similar when using a random-effects model for all outcomes. In addition, the rate of adverse events was higher with liraglutide when compared to the control; however, the dropout rates were relatively lower in the former arm.</p></div><div><h3>Conclusion</h3><p>While our meta-analysis suggests that liraglutide can reduce body weight, BMI, waist circumference, and HbA1c levels in individuals with pre-diabetes, the findings should be interpreted cautiously due to limitations such as the small number of trials and their short duration, and variability in dosages. Further randomized controlled trials examining long-term outcomes are essential to validate these findings and address the high heterogeneity among the studies included in this analysis.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X24005317/pdfft?md5=b936c57c4463c1a9bc44f2b3ff282acd&pid=1-s2.0-S1530891X24005317-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.06.005
{"title":"Corrigendum to “Paraganglioma of the Head and Neck: A Review” [Endocrine Practice 29(2) (2023) Pages 141-147]","authors":"","doi":"10.1016/j.eprac.2024.06.005","DOIUrl":"10.1016/j.eprac.2024.06.005","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X24005603/pdfft?md5=568b765394d4bc841caa82035384898c&pid=1-s2.0-S1530891X24005603-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.eprac.2024.04.017
Objective
Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer.
Methods
A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted.
Results
The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction.
Conclusion
The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients’ quality of life.
目的：尽管 I-131 相对安全，但人们对放射性碘 (RAI) 治疗后可能出现的与眼睛相关的副作用关注有限。因此，我们旨在为 I-131 的不良后果提供证据，尤其是针对甲状腺癌患者：方法：根据 PRISMA 指南设计了一项系统性综述，以研究 RAI 治疗的眼部并发症。在 2023 年 10 月之前，使用特定的 MeSH 术语对包括 PubMed、Scopus 和 Web of Science 在内的数据库进行了检索。经过全面筛选和审查，提取了相关数据：结果：通过数据库搜索，共获得 3434 篇文章，最终确定了 28 项符合条件的研究。这些研究调查了 RAI 治疗后的眼科症状，并将其分为阻塞性疾病（如鼻泪管阻塞 [NLDO；中位数发生率：6.8%]）、炎症症状（中位数发生率：13%）和白内障（中位数发生率：2.5% 和 5%）。RAI 治疗与症状出现之间最常见的时间间隔是在最初的 12 个月内，然后在随后的几年中逐渐缩短。观察发现，I-131 剂量超过 100-150 mCi（3.7-5.55 GBq）与症状发生风险之间存在很强的正相关性。年龄超过45岁也与NLDO有显著关联：结论：眼科并发症的风险与多种因素有关，包括使用高剂量的I-131、年龄超过45岁以及在最初12个月内发生事件的时间。考虑到这些情况有助于加强对患者的护理，防止出现可能限制患者生活质量的不良后果。
{"title":"Eye-Related Adverse Events After I-131 Radioiodine Therapy: A Systematic Review of the Current Literature","authors":"","doi":"10.1016/j.eprac.2024.04.017","DOIUrl":"10.1016/j.eprac.2024.04.017","url":null,"abstract":"<div><h3>Objective</h3><p>Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer.</p></div><div><h3>Methods</h3><p>A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted.</p></div><div><h3>Results</h3><p>The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction.</p></div><div><h3>Conclusion</h3><p>The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients’ quality of life.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X2400507X/pdfft?md5=88d1d75033a80a3e12f7d5f2648339a6&pid=1-s2.0-S1530891X2400507X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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