Hormone and Metabolic Research最新文献

The triglyceride-glucose index, an indicator of insulin resistance, has emerged as a potential predictor of various cardiovascular diseases. However, the association between the triglyceride-glucose index and peripheral artery disease remains unclear. This meta-analysis sought to clarify the relationship between the triglyceride-glucose index and the incidence or prevalence of peripheral artery disease. A comprehensive search of the PubMed, Embase, and Web of Science databases was carried out to identify relevant observational studies published up to June 1, 2024. Inclusion criteria included studies on adult populations that evaluated the triglyceride-glucose index and reported peripheral artery disease outcomes. To assess the association between the triglyceride-glucose index and peripheral artery disease, risk ratios and 95% confidence intervals were computed using a random-effects model incorporating the impact of heterogeneity. Nine studies with a total of 37,761 participants were involved in the meta-analysis. The analysis revealed that individuals with a high triglyceride-glucose index had significantly increased odds of peripheral artery disease (risk ratio: 1.42, 95% confidence interval: 1.21-1.67, p < 0.001; I ²=55%). Sensitivity analyses performed by excluding one study at a time confirmed the robustness of these findings. Subgroup analyses demonstrated consistent associations across different study designs, populations, and methodological quality. Diabetic patients exhibited a stronger association (risk ratio: 1.38) compared to non-diabetic participants (risk ratio: 1.06, p _{subgroup difference}=0.006). In conclusion, a high triglyceride-glucose index is linked to peripheral artery disease, especially in people with diabetes. These results suggest that the triglyceride-glucose index could be used as a valuable marker for assessing peripheral artery disease risk in clinical practice.

The metabolic score for visceral fat was a newly developed surrogate marker for evaluating visceral fat. This study aimed to investigate the relationship between the metabolic score for visceral fat and the mortality risk in US adults with diabetes or prediabetes. A cohort of 12,992 individuals with diabetes or prediabetes was identified from the US National Health and Nutrition Examination Survey (1999-2018). Baseline metabolic score for visceral fat measurements were recorded, and mortality outcomes were assessed by linking participants to the National Death Index records up to December 31, 2019. Multivariate Cox regression and restricted cubic spline models were employed to examine the relationship between the metabolic score for visceral fat and both all-cause mortality and cardiovascular mortality. Over a median follow-up of 97 months, a total of 2,438 all-cause deaths and 662 cardiovascular deaths were recorded. Multivariate Cox regression analysis indicated that individuals in the highest metabolic score for visceral fat quartile exhibited adjusted hazard ratios of 2.857 (95% confidence interval: 2.348-3.477) for all-cause mortality and 3.290 (95% confidence interval: 2.218-4.881) for cardiovascular mortality, compared to those in the lowest quartile. Additionally, a nonlinear relationship between the metabolic score for visceral fat and the mortality risk was observed, with inflection points identified at 7.093 for all-cause mortality and 7.220 for cardiovascular mortality. Elevated metabolic score for visceral fat levels are strongly associated with heightened risks of mortality among diabetic or prediabetic population, underscoring their potential utility as a prognostic indicator.

The interplay between liver fibrosis and thyroid function remains incompletely understood, particularly regarding thyroid hormone sensitivity. Thus, this study aims to explore the relationship between liver fibrosis and thyroid hormone sensitivity in euthyroid US individuals. This study involved 4,678 euthyroid participants from the National Health and Nutrition Examination Survey 2007-2012. Key clinical parameters were extracted, including thyroid-stimulating hormone, free and total thyroxine, and liver function-related data. Thyroid hormone sensitivity was assessed by three indices: the Thyroid Function Quotient Index, Thyroid-Stimulating Hormone Index, and Thyrotrophic Thyroxine Resistance Index. Multiple regression analyses and machine learning models were performed to evaluate the relationships between liver fibrosis and thyroid sensitivity indices. Participants with advanced liver fibrosis indicated by fibrosis index 4 (FIB-4) demonstrated significantly impaired thyroid hormone sensitivity indicated by Thyroid Function Quotient Index, Thyrotrophic Thyroxine Resistance Index, and Thyroid-Stimulating Hormone Index. Then, the logistic regression and restricted cubic spline analysis indicated that Thyroid Function Quotient Index, Thyrotrophic Thyroxine Resistance Index, and Thyroid-Stimulating Hormone Index were risk factors for liver fibrosis (odds ratio>1, p<0.05). Furthermore, we developed machine learning models using random forest and Boruta's algorithm identifying thyroid hormone sensitivity indices, Thyroid-Stimulating Hormone Index, Thyrotrophic Thyroxine Resistance Index, and Thyroid Function Quotient Index as key predictors for liver fibrosis. Mediation analysis indicates that uric acid is a weak mediator between thyroid hormone sensitivity and liver fibrosis. This study reveals that impaired thyroid hormone sensitivity is a risk factor for liver fibrosis progression in euthyroid individuals. These findings uncover a potential molecular link between thyroid hormone signaling and the development of liver fibrosis, warranting further investigation.

This study aims to clarify the relationship between body mass index, body composition indices, and the risk of insulin resistance. From November 2019 to January 2020, 573 employees aged 40-60 years from Anhui Hong Sifang Co., Ltd, underwent physical and biochemical assessments. We analyzed fasting glucose, serum insulin, and homeostasis model assessment of insulin resistance differences across body mass index and body composition, and examined associations with insulin resistance risk. Among 573 participants (mean age 48.3 years, 67.4% men), 20.8% had insulin resistance. Overweight/obesity, central obesity, high visceral adipose index, high fat mass%, limb/trunk fat%, and elevated fat-muscle-ratio were significantly associated with higher fasting serum insulin, homeostasis model assessment of insulin resistance, and insulin resistance prevalence (all p<0.05). The increase in these factors corresponded with increased insulin resistance risk, with odds ratios and 95% confidence intervals of 4.71 (2.88-7.72), 5.80 (3.60-9.35), 4.88 (3.07-7.74), 4.25 (2.71-6.69), 3.48 (2.19-5.52), 5.72 (3.45-9.47), and 4.41 (2.73-7.13). Conversely, lower muscle mass%, limb/trunk muscle%, bone mineral content%, total body water%, extracellular water%, and intracellular water% were linked to higher fasting serum insulin and homeostasis model assessment of insulin resistance, indicating a protective effect against insulin resistance with odds ratios and 95% confidence intervals of 4.34 (2.67-7.08), 3.53 (2.21-5.62), 3.49 (2.20-5.53), 5.35 (3.24-8.85), 4.73 (2.91-7.70), 4.99 (3.06-8.16), and 4.98 (3.04-8.14). The findings suggest a significant association between body composition indices and insulin resistance risk. Increased fat mass raises the risk of insulin resistance, while higher muscle mass, bone mineral content, and body water content have a protective effect. Additionally, the balance between fat and muscle influences insulin resistance levels.

Primary aldosteronism is a common cause of hypertension. Distinguishing between unilateral and bilateral primary aldosteronism is mandatory and remains a challenge. The upright posture test has been debated, whereas adrenal venous sampling remains the gold standard for subtyping. We conducted a retrospective nationwide study of 49 adult patients who underwent both the posture test and adrenal venous sampling and were diagnosed with primary aldosteronism in Iceland between 2007 and 2016. The diagnostic utility of the posture test in predicting adrenal venous sampling-confirmed laterality was assessed, along with an adrenal venous sampling success rate. The posture test demonstrated 81% sensitivity and 45% specificity for detecting bilateral primary aldosteronism. The optimal s-aldosterone increase cut-off for detecting bilateral primary aldosteronism using the posture test was 74%, yielding 59% specificity. The adrenal venous sampling success rate was 86%, and adrenal computed tomography correctly predicted laterality in all patients under 35 years of age. These findings indicate that the posture test can be a useful tool, although its limited specificity reduces its clinical utility in centers with access to reliable adrenal venous sampling. The high adrenal venous sampling success rate in Iceland reflects expertise in the procedure. Adrenal computed tomography appeared to be accurate in younger patients, supporting The Endocrine Society guideline recommendations.

The aim of this cross-sectional study was to compare and test associations between inflammatory profiles and liver steatosis/fibrosis in individuals with different degrees of adiposity with or without metabolic syndrome. Forty-six patients (82.6% females, aged 38.3±7.8 yr, body mass index of 32.6±5.1 kg/m²) were allocated into three groups according to body adiposity and the presence or absence of metabolic syndrome: normal-weight controls, patients with obesity or with obesity and metabolic syndrome. Between-group comparisons were performed for clinical history, anthropometry, biochemical, metabolic, and inflammatory profiles, and degree of liver stiffness and steatosis by transient elastography. As expected, obesity and obesity and metabolic syndrome had greater body mass index and waist circumference than controls. No significant differences between groups in lipid profile, aspartate aminotransferase, ferritin, adiponectin, and retinol-binding protein-4 were noted. Obesity and metabolic syndrome had significantly higher fasting glucose levels compared to controls and obesity. A more significant proportion of patients with hypertension, higher insulinemia, HOMA-IR, glycated hemoglobin, aspartate aminotransferase, gamma-glutamyltransferase, tumor necrosis factor-alpha, interleukin-6, and leptin were observed in obesity and metabolic syndrome compared to controls. Obesity had higher alkaline phosphatase, interleukin-6, and leptin levels than controls. Liver stiffness and steatosis were higher in obesity and metabolic syndrome than in controls, while hepatic fibrosis degree F2 occurred more frequently in obesity and metabolic syndrome (p≤0.03). No associations were detected between liver stiffness and steatosis and inflammatory biomarkers in the studied groups (p≥0.07). Our findings highlight the impact of metabolic conditions on liver health but also suggest that systemic inflammation might not be directly linked to liver stiffness and steatosis.

⁶⁸Ga-Pentixafor positron emission tomography/computed tomography has shown potential in primary aldosteronism subtyping, but analysis of its diagnostic accuracy based on contrast-enhanced computed tomography concordance and positron emission tomography/computed tomography avidity patterns is lacking. The objective of this study was to evaluate the diagnostic accuracy of ⁶⁸Ga-Pentixafor positron emission tomography/computed tomography for subtyping primary aldosteronism and to assess its performance based on concordance with contrast-enhanced computed tomography and positron emission tomography/computed tomography avidity patterns. Clinical, biochemical, radiological, functional imaging, treatment, histopathological, and follow-up details of 30 patients with primary aldosteronism who underwent positron emission tomography/computed tomography over 2 years at a tertiary center in India were retrospectively analyzed. Diagnostic accuracy of positron emission tomography/computed tomography for primary aldosteronism subtyping was evaluated in the whole cohort and in subgroups based on contrast-enhanced computed tomography-positron emission tomography/computed tomography concordance and positron emission tomography/computed tomography avidity patterns. Out of the 30 patients, final subtype classification was achieved in 15 (9 unilateral and 6 bilateral) based on surgical outcomes and/or adrenal venous sampling. Positron emission tomography/computed tomography correctly subtyped 14/15 (93.3%) patients. Contrast-enhanced computed tomography and positron emission tomography/computed tomography concordance was seen in 10 patients, and positron emission tomography/computed tomography accuracy was 100% (10/10) in this subgroup. Contrast-enhanced computed tomography and positron emission tomography/computed tomography discordance (contrast-enhanced computed tomography bilateral and positron emission tomography/computed tomography unilateral) was seen in five patients, and positron emission tomography/computed tomography accuracy in this subgroup was 80% (4/5). Positron emission tomography/computed tomography avidity patterns in the 15 patients having final subtype classification were unilateral avid (n=10), bilateral avid (n=2), and bilateral nonavid (n=3). Diagnostic accuracy of positron emission tomography/computed tomography was 90% (9/10) in patients with unilateral avidity, and 100% in those with bilateral avidity or nonavidity. Preliminary analysis suggests that positron emission tomography/computed tomography demonstrates higher accuracy in certain subgroups, potentially guiding the triage for adrenal venous sampling.

Allergic rhinitis (AR) is a widespread chronic condition caused by immune responses involving immunoglobulin E (IgE) when exposed to airborne allergens. It frequently coexists with conditions such as asthma and eye inflammation and represents a major public health issue due to its significant burden and associated disabilities across the globe. Key contributing factors include exposure to airborne or workplace-related allergens and hereditary predispositions. AR negatively impacts daily life, including social interactions, academic performance, and productivity at work, while also leading to considerable economic expenses. The ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines categorize AR based on duration (intermittent or persistent) and severity (mild or moderate/severe). Diagnosis primarily relies on clinical evaluation, and in patients with uncontrolled or long-term symptoms, confirmation may involve skin prick testing or detecting specific IgE antibodies in the blood. Common treatments include oral, nasal, or eye-drop antihistamines (H1-blockers), nasal corticosteroids, or a combination of both delivered intranasally. Allergen-specific immunotherapy, administered by qualified specialists and using standardized extracts, is beneficial for individuals with ongoing symptoms. Insights from real-life data collected through mobile applications are enhancing understanding of AR types and their management. Future developments aim to improve recognition of complex overlapping conditions, utilize health technology evaluations, and promote patient-involved treatment decisions.

Parathyroid hormone (PTH) assays are not standardized and therefore PTH results are interpreted using manufacturer-provided assay-specific reference intervals. Assay-specific PTH reference intervals, however, do not account for between-assay differences and lead to discordance in the diagnosis of normocalcaemic primary hyperparathyroidism (NCPHPT). PTH increases with age independent of vitamin D, renal function, phosphate and ionized calcium. The observed variations in age-nonspecific PTH reference intervals may, in part, be attributed to the varying proportions of individuals from different age sub-sets included in the direct sampling reference interval studies. We assessed the impact of recently derived age-specific reference intervals for Abbott and Roche PTH assays on the diagnosis and diagnostic concordance of previously identified NCPHPT individuals. Of the 46 NCPHPT individuals identified using elevated Abbott PTH, only 16 (35%) were concordant for NCPHPT whereas 30 (65%) had normal PTH when samples were analysed by the Roche method and results were interpreted using the manufacturer-provided reference intervals for both methods. However, interpreting results using the method-specific age-related PTH reference intervals resulted in 31 (67%) individuals having a concordant normal PTH, eight (17%) having concordant NCPHPT and only seven (15%) remaining discordant (NCPHPT by Abbott and normal by Roche methods). Application of assay- and age-specific reference intervals decreases the diagnosis of NCPHPT and improves diagnostic concordance between PTH assays. We suggest that the diagnosis of NCPHPT should be based on assay- and age-specific PTH reference intervals. Until PTH assays are harmonized, subsequent PTH measurements for NCPHPT patients should ideally be performed using the same assay.

Metyrapone and osilodrostat are both steroidogenic inhibitors targeting the 11β-hydroxylase, yet their safety profile has not been comprehensively analyzed. The objective of this study is to compare the adverse events (AEs) associated with osilodrostat and metyrapone based on the Food and Drug Administration Adverse Event Reporting System (FAERS). AEs were classified according to the System Organ Class (SOC) in the Medical Dictionary for Regulatory Activities (MedDRA) version 26.1. Adverse event (AE) signals of osilodrostat and metyrapone were determined by calculating reporting odds ratios (ROR). A total of 1380 and 449 AE reports were retrieved from osilodrostat and metyrapone, respectively, involving 26 and 27 SOC categories. Unexpected AEs such as asthenia, decrease of blood potassium, myalgia, increase of blood pressure, abdominal distension, increase of blood testosterone, nephrolithiasis, and hunger were associated with osilodrostat. while metyrapone was linked with respiratory failure, deep vein thrombosis, interstitial lung disease, liver function test abnormal, and respiratory distress. Among osilodrostat-treated patients, those aged between 18 to 65 years old were more likely to develop adrenal insufficiency, fatigue, tachycardia, than those older than 65. Male patients treated with metyrapone have the significantly higher incidence of the increased blood corticotrophin, muscular weakness and acute respiratory distress syndrome compared to females. During treatment with osilodrostat and metyrapone, clinicians need to monitor the effects of AEs varied by gender and age and to pay more attention to new AE signals.