Frontiers in Endocrinology最新文献

Objective: Recurrent spontaneous abortion (RSA) presents a significant challenge in the field of reproductive medicine, as effective treatments remain limited despite extensive research efforts. A comprehensive understanding of current RSA clinical trials is essential for enhancing trial design and identifying existing research gaps. The aim of this study is to characterize RSA related clinical trials registered on Clinical Trials.gov.

Methods: A thorough search was conducted to identify and review clinical trials focusing on RSA that were registered on Clinical Trials.gov up to March2, 2024.

Results: A total of 138 trials were identified in the analysis, with 72 (52.17%) classified as intervention trials and 66 (47.83%) as observational trials. Approximately half of the studies (67,48.55%) had an enrollment of 100 participants or fewer. The majority of trials included only female participants. Asia hosted the highest number of clinical trials (46,33.33%), followed by Europe (36,26.09%), Africa (29,21.01%), America (13,9.42%). The majority of trials (61,44.20%) focused on individuals with unexplained recurrent spontaneous abortion (URSA). The predominant intervention types examined in the reviewed studies were drug interventions (49,62.82%), with a notable rise in behavioral intervention trials.

Conclusion: Our research findings suggest that existing research efforts in the realm of RSA are inadequate for the progression of prevention and treatment strategies. The majority of clinical trials have primarily targeted individuals with URSA, with a particular emphasis on drug interventions, notably anticoagulants.

Purpose: The aim is to provide new insights for researchers studying the pathogenesis of diabetic cognitive dysfunction and promoting the wider use of natural products in their treatment.

Method: First, the Web of Science Core Collection was selected as the data source for a computerized literature search on oxidative stress and diabetic cognitive dysfunction (DCD). Next, Biblimetrix and VOSviewer performed statistical analysis focusing on publication countries, institutions, authors, research hotspots, and emerging directions in the field. Then, through the analysis of keywords and key articles, the forefront of the field is identified. Finally, we discussed the pathogenesis of DCD, the influence of oxidative stress on DCD and the antioxidant effect of natural products on DCD.

Result: 293 valid papers were obtained. Bibliometrics showed that oxidative stress, diabetes, Alzheimer's disease (AD), cognitive decline, insulin resistance and quercetin were the key words of the symbiotic network.

Conclusion: The antioxidant effects of natural products in improving DCD have been extensively studied in preclinical studies, providing potential for their treatment in DCD, but their evaluation in clinical trials is currently uncommon.

Objectives: The study will evaluate the effectiveness and safety of finerenone in patients diagnosed with diabetic kidney disease (DKD).

Methods: Various databases including PubMed, Sinomed, Web of Science, Embase, Clinical Trials, and Cochrane Library were systematically reviewed for pertinent studies published from the beginning to February 2024.This meta-analysis utilized RevMan 5.3 and Stata 15.1.

Results: The analysis of 4 randomized controlled trials involving 13,943 participants found that finerenone treatment significantly decreased the urine albumin-to-creatinine ratio compared to placebo. Additionally, the risk of COVID-19, cardiovascular events, and estimated glomerular filtration rate(eGFR) reduction of at least 40% were all significantly lower in the finerenone treatment group. However, the finerenone group did experience higher baseline increases in serum potassium levels. The meta-analysis revealed that there was no variation in the likelihood of general negative outcomes (RR 1.00, 95% CI 0.98, 1.01, I² = 0%) and the occurrence of cancers (RR 0.99, 95% CI 0.83, 1.18,I² = 0%) among the two categories.

Conclusion: Our study demonstrates that finerenone has the potential to lower the chances of end-stage kidney disease, renal failure and cardiovascular mortality in individuals with diabetic kidney disease. It is important to monitor for hyperkalemia risk. The administration of finelidone among individuals with diabetic kidney disease may potentially mitigate the susceptibility to contracting COVID-19.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024536612.

Background: The debate persists regarding whether metabolic dysfunction-associated steatotic liver disease (MASLD) actively contributes to coronary heart disease or merely acts as a passive indicator.

Objective: This research aims to clarify the relationship between liver fat accumulation, as quantified by FLI, and the risk of developing coronary heart disease.

Methods: Conducted from April to November 2011, the REACTION project, spearheaded by the Endocrinology Branch of the Chinese Medical Association, focused on Chinese adults aged 40 and above. Comprehensive data collection employed both questionnaires and specialized medical equipment, covering physical measurements, blood pressure, and pertinent biochemical markers. The study population excluded those with pre-existing coronary heart disease and acute myocardial infarction. Based on the initial data, participants were segmented and grouped into three categories. Analytically, the study utilized Cox proportional hazards models, further enhanced by stratified analyses to identify variations within predefined demographic groups.

Results: In this study, we enrolled 8,647 participants, comprising 2,887 males and 5,760 females. Over the 10-year non-interventional follow-up period, 433 participants (5%) passed away due to various reasons, with 55 deaths attributed to coronary heart disease/myocardial infarction, accounting for 12.7% of total deaths. Additionally, 484 participants were diagnosed with new-onset coronary heart disease, resulting in an incidence rate of 5.5%. Spearman correlation analysis revealed a positive correlation between FLI and traditional risk factors for coronary heart disease, including age, male gender, abnormal glucose metabolism, hypertension, smoking, TG, TC, LDL-C, etc. The Log-rank test indicated a rising cumulative incidence of coronary heart disease with increasing FLI groupings (P<0.01). Moreover, Cox regression analysis highlighted a notable correlation between FLI levels as a risk factor and the onset of coronary heart disease. After adjusting for other risk factors, individuals in the 30≤FLI<60 group exhibited a 1.203-fold higher risk of coronary heart disease compared to those in the FLI<30 group (p=0.126), while participants in the FLI≥60 group had a 1.386-fold higher risk than those in the FLI<30 group (p=0.041).

Conclusion: Elevated FLI values are strongly associated with an increased susceptibility to coronary heart disease, indicating its potential value as a prognostic marker for the condition.

Introduction: Excess weight during pregnancy is a condition that can affect both mother and fetus, through the maternal-fetal interface, which is constituted by the placenta and umbilical cord. The umbilical vein is responsible for transporting oxygen and nutrients to the fetus, and its proper functioning depends on the integrity of its structure. The remodeling of the umbilical vein represents one of the causes of inadequate transport of nutrients to the fetus, being potentially harmful. This study aims to evaluate whether maternal overweight alters the structural characteristics of the umbilical vein.

Methods: Umbilical cords were collected from eutrophic and overweight pregnant women and were processed according to histological routine. We analyzed morphometry parameters, collagen and elastin fibers deposition, glycosaminoglycan level, and cell proliferation.

Results: Veins from overweight pregnant women were found to have greater total area, wall area, wall thickness, and diameter. There was higher collagen labeling in the perivascular region of the overweight group and a higher amount of type III collagen in the vascular smooth muscle. The proliferation of muscle and perivascular cells was higher in overweight pregnant women. A positive, although weak, correlation was observed between BMI and vessel thickness and with type III collagen deposition in vascular smooth muscle.

Discussion: With this study, we show that being overweight can structurally alter the umbilical vein, causing vascular remodeling of the vessel, through hypertrophy and hyperplasia.

The placenta is a temporary organ that forms during pregnancy and is essential for fetal development and maternal health. As an endocrine organ, proper placental function requires continual production, folding, and transport of proteins and lipids. Central to these processes is the endoplasmic reticulum (ER), a dynamic organelle responsible for maintaining cellular protein and lipid synthesis and processing. ER stress occurs when there is an accumulation of unfolded or misfolded proteins, which triggers the activation of cellular pathways collectively called the unfolded protein response. Unfolded protein response pathways act to alleviate the misfolded protein burden and restore ER homeostasis, or if unresolved, initiate cell death. While prolonged ER stress has been linked to deficient placental function and adverse pregnancy outcomes, basal activation of unfolded protein response pathways is required for placental development and function. This review explores the importance of ER homeostasis in placental development and function, examining how disruptions in ER stress responses may contribute to adverse pregnancy outcomes.

Telemedicine (TM) has emerged as a valuable tool in managing pediatric type 1 diabetes (T1D), particularly during the COVID-19 pandemic when traditional in-person visits were limited. This narrative review examines the impact of TM on patient-provider relationships, glycemic control, and overall diabetes management in children and adolescents with T1D. Studies consistently demonstrate high levels of patient and provider satisfaction with TM, citing increased consultation frequency, reduced travel burdens, and lower associated costs. However, results regarding the effect of TM on glycemic control, as measured by HbA1c levels, are inconsistent. Some studies show significant reductions in HbA1c levels with TM use, while others report outcomes comparable to or less effective than traditional care. The effectiveness of TM also appears to be influenced by the concurrent use of advanced diabetes technologies, such as continuous glucose monitors and automated insulin delivery systems. Furthermore, TM's impact on quality of life and other clinical outcomes beyond glucose management remains underexplored. Methodological limitations, including inconsistent randomization strategies and lack of long-term follow-up, hinder definitive conclusions. Despite these uncertainties, TM offers several advantages, such as improved accessibility and patient engagement, which may justify its broader implementation. Future research should focus on optimizing TM approaches to enhance glycemic control and quality of life, identifying the most effective strategies for specific patient groups, and addressing technological and economic barriers. This review highlights the need for comprehensive, long-term studies to fully understand TM's potential in pediatric T1D management and its integration into standard care practices.

Objective: The objective of this study is to investigate the clinical presentation and underlying genetic etiology of a Chinese child diagnosed with idiopathic central precocious puberty (ICPP).

Methods: Clinical data from a pediatric patient with ICPP, including medical history, physical examination findings, laboratory results, and imaging studies, were collected and analyzed. Whole exome sequencing (WES) was performed to identify potential pathogenic genetic variants underlying the patient's ICPP.

Results: A 4 ¾-year-old female patient presented with precocious puberty, characterized by accelerated growth, Tanner stage II breast development, and Tanner stage I pubic hair. A café-au-lait macule was observed on the patient's right flank. WES revealed a novel makorin RING finger protein 3 (MKRN3) gene heterozygous frameshift pathogenic variant c.1219delA (p.R407Gfs*75), which was inherited from the patient's asymptomatic father, and leading to a truncated protein 73 amino acids downstream from the mutation site.

Conclusion: This case underscores the genetic heterogeneity of ICPP and further implicates MKRN3 gene mutations in its pathogenesis. The identification of this novel pathogenic variant expands the known mutational spectrum associated with ICPP, particularly within the Chinese pediatric population. Comprehensive genetic testing should be considered in pediatric patients presenting with early-onset ICPP to facilitate accurate diagnosis, inform genetic counseling, and guide personalized management strategies.

Purpose: This research investigates the influence of personal income, the likelihood of pregnancy from cryopreserved oocytes, and the risk of infertility, on the decision-making process of women. The study employs the economic stated preference framework alongside the Theory of Planned Behavior in order to comprehend the process of decision-making.

Design/methodology/approach: The data had been collected from women between the ages of 18 and 65 via questionnaire employing conjoint analysis (CA). Through the utilization of this methodology, the factors influencing women's choices concerning oocyte cryopreservation were quantified.

Findings: The study identified crucial factors that impact the determination to cryopreserve oocytes, such as personal financial resources, the likelihood of achieving a successful pregnancy using frozen oocytes, and the potential for infertility. The analysis reveals that a considerable number of participants perceive cryopreservation as a feasible alternative for augmenting their prospects for future procreation.

Research implications: The results validate the patterns and the ways in which personal and socioeconomic elements impact choices regarding fertility. This has the potential to inform forthcoming health policies and educational initiatives that aim to provide more comprehensive support for women's fertility decisions.

Social implications: The research highlights the necessity of policy and societal support for women who are contemplating oocyte cryopreservation. It is recommended that public health policies incorporate provisions for state financing of cryopreservation in order to safeguard reproductive autonomy and alleviate the fertility risk linked to the aging process.

Originality/value: His research is unique in that it employs the Theory of Planned Behavior and an economic stated-preference framework to analyze the dynamics of oocyte cryopreservation decisions. This work enhances the existing body of literature by drawing attention to the socio-economic persona factors that influence choices regarding fertility preservation.