Hormone and Metabolic Research最新文献

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.

The non-insulin-based metabolic score for insulin resistance (METS-IR) is a recently developed index aimed at being a practical and efficient alternative biomarker of insulin resistance (IR). This study aimed to investigate the association between METS-IR in euthyroid women in the first trimester of pregnancy and pregnancy outcomes. A total of 1810 participants who gave birth at Fujian Maternity and Child Health Hospital from November 2018 to November 2019 were included in this study. Thyroid function, fasting blood glucose (FPG) levels, lipid profiles, and anthropometric parameters were collected during the first trimester of pregnancy. METS-IR was calculated by FPG, total triglyceride, high-density lipoprotein cholesterol, and body mass index. Pregnancy outcomes were collected. There were 75 (4.1%) cases of macrosomia and 433 (23.9%) cases of gestational diabetes mellitus (GDM). Participants were divided into four groups based on METS-IR, with a median and interquartile range of METS-IR levels of 23.91 (22.83, 24.67), 26.53 (25.88, 27.17), 29.13 (28.47, 30.00), and 33.59 (32.10, 36.21), respectively. The higher METS-IR quartile was significantly associated with macrosomia and GDM (p<0.05). The risk of macrosomia and GDM increased with the increased METS-IR levels when METS-IR was a continuous variable, particularly METS-IR levels reaching 27.84 and higher (overall p<0.05). We found no correlation between METS-IR and low birth weight, cesarean section, and preterm delivery (p>0.05). Increasing METS-IR in euthyroid women in the first trimester of pregnancy may predict macrosomia and GDM.

We conducted this study to compare the anthropometric and metabolic outcomes and nutritional status, after sleeve gastrostomy (SG) and gastric bypass (GB) in adolescents with severe obesity. We selected 219 adolescents with severe obesity (Body Mass Index>99th percentile or 95th≤BMI<99th percentile) among the participants of Tehran Obesity Treatment Study and assessed them for anthropometric and metabolic outcomes and nutritional status at baseline and during 1 year follow up after the surgery. Out of the total, 182 participants were in the SG group and 37 were in the GB group. BMI was lower in SG patients compared to GB group (38.5±4.8 kg/m ² vs. 36.1±4.0 kg/m ², p-value<0.05), 3 months after surgery. Metabolic profiles such as aspartate transaminase and alanine transaminase were lower in SG group compared to GB after 6 months of follow up, while high-density lipoprotein was higher in SG patients compered to GB patients (41.6±8.4 mg/dl vs. 48.0±9.2 mg/dl, p-value<0.05). After one year, total cholesterol and low-density lipoprotein were higher in adolescents who underwent SG compared to those in GB group. There was no significant difference in micronutrient status between SG and GB groups. It seems that SG in adolescents with obesity and fatty liver disease, is more appropriate but GB may be preferred in patients with a history of lipid profile abnormalities. More studies are needed to draw conclusions about nutritional status and long-term outcomes after surgery.

This study aimed to compare continuous glucose monitoring (CGM) parameters in children and adolescents with Type 1 diabetes (T1D) who transitioned from glargine U100 to glargine U300 to evaluate efficacy and safety. A total of 52 participants aged 6-18 years using CGM were analyzed before and after transitioning from glargine U100 to glargine U300. For each individual, a 2-week CGM data collection was conducted after optimizing the glargine U100 dose. Participants then switched to glargine U300 at the same dose, with doses adjusted based on CGM graphs every three days. One week after the final dose adjustment, a second 2-week CGM period was recorded. Additionally, nighttime (00:00-08:00 h) data were analyzed, with glucose fluctuations measured by coefficient of variation (CV) and root mean squared error (RMSE). All parameters were compared between glargine U100 and U300. No significant differences were observed in glucose management indicator (GMI) or time in range (TIR) between glargine U100 and U300. However, glargine U300 was associated with significantly reduced hypoglycemia frequency and duration across 24-hour and nocturnal periods. Lower CV and RMSE values during nighttime further indicated reduced glycemic variability with glargine U300. An average 10% increase in basal insulin dose was required following the transition. The study provides real-world, CGM-based evidence suggesting that glargine U300 offers a safer, more stable option for managing T1D in children, particularly in reducing hypoglycemia. These findings highlight glargine U300's potential advantages in glycemic stability, supporting its use in pediatric diabetes care.

Evidence for obesity and vitamin D deficiency as components of a data phenotype for primary hyperparathyroidism (pHPT) is critical to understanding primary hyperparathyroidism. This study examined the association between vitamin D, body mass index (BMI), albumin total calcium, parathyroid hormone (PTH) and data from National Health and Nutrition Examination Survey (NHANES). Associations of 25-hydroxyvitamin D, albumin adjusted calcium, and BMI with elevated PTH were evaluated, with elevated PTH being defined as>9.02 pmol/l. Outcomes were PTH (pmol/l), 25-hydroxyvitamin D (nmol/l), albumin adjusted calcium (mmol/l), and BMI. A weighted multivariable logistic regression model estimated the associations. A total of 9740 survey respondents were included in the study, 3.5% had elevated PTH. Mean vitamin D level was 57.7 (SD=22.6) nmol/l and BMI was 28.6 (SD=6.5) kg/m2. A one unit increase in BMI was associated with higher odds of elevated PTH [adjusted odds ratio (aOR)=1.04; 95% confidence interval (CI): 1.02, 1.06] whereas a one unit increase in vitamin D (aOR=0.97; 95% CI: 0.96, 0.98) or calcium (aOR=0.51; 95% CI: 0.29, 0.89) had decreased odds of elevated PTH. Higher BMI and lower levels of 25-hydroxyvitamin D are components of the primary hyperparathyroidism data phenotype. A refined data phenotype may improve detection/management of pHPT.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder with diverse metabolic and hormonal manifestations. Insulin-like peptide 5 (INSL5), a gut-derived hormone of the relaxin/insulin family, is expressed in the central nervous system, colonic and reproductive tissues, but its clinical significance in PCOS remains unclear. This study aimed to evaluate circulating INSL5 levels in PCOS and explore their associations with key hormonal and metabolic parameters. In this prospective cross-sectional study, 45 women with newly diagnosed PCOS and 35 age-matched healthy controls (18-35 years) were evaluated. Clinical characteristics, hormonal profiles, and metabolic markers - including serum anti-Müllerian hormone (AMH) and INSL5 - were assessed. INSL5 levels were measured using enzyme-linked immunosorbent assay (ELISA). Median serum INSL5 levels did not differ significantly between PCOS and control groups (12.5 vs. 15.5 ng/ml; p=0.103). However, within the PCOS group, INSL5 was inversely correlated with body mass index, insulin, HOMA-IR, total and LDL cholesterol, triglycerides, fat mass, and free androgen index, and positively correlated with sex hormone-binding globulin (p<0.05 for all). AMH was significantly higher in the PCOS group and demonstrated a diagnostic cut-off of 5.04 ng/ml (AUC: 0.808; sensitivity: 75.6%; specificity: 74.3%). Although INSL5 did not show diagnostic utility for PCOS, its consistent associations with insulin resistance, androgenic activity, and lipid metabolism suggest a potential role in metabolic regulation. These findings support its relevance as a candidate marker for metabolic phenotyping and warrant further investigation into its physiological role within the PCOS spectrum.

Serum creatine kinase (CK) elevation can occur in some patients with Graves' disease treated with antithyroid drugs (ATDs). This study retrospectively investigated clinical characteristics and biochemical data of patients with Graves' disease who experienced serum CK elevation during ATD treatment. CK elevation was observed in 29.6% (37/125) of patients, with 11.2% (14/125) being symptomatic. This incidence is higher than previously reported (13.5%). There were no differences in pre-treatment characteristics between patients with and without CK elevation. The intervals between the initiation of ATD treatment or normalization of thyroid function and the onset of CK elevation were 11.3±8.0 and 5.8±6.6 weeks, respectively, and peak serum CK levels averaged 441.9±394.0 IU/l. Markedly elevated serum CK were accompanied by increased serum myoglobin levels. Serum CK elevation occurred either continuously or intermittently, or as a single episode during the course of treatment. Thyroid function at the time of CK elevation varied from hyperthyroid to normal to hypothyroid. In conclusion, serum CK elevation in patients with Graves' disease treated with ATDs is not uncommon, with symptomatic cases accounting for approximately 10%, and the frequency increasing to around 30% when asymptomatic cases are included. The characteristics observed in our patients suggest the involvement of alternative, as yet unknown mechanisms beyond the relative hypothyroidism theory and the ATD side-effect theory in the development of CK elevation during ATD treatment in patients with Graves' disease.

Immunoglobulin G4 (IgG4)-related diseases are a group of inflammatory conditions in which antibodies against IgG4 play a major role. IgG4-related diseases can affect thyroid gland. Our aim was to investigate whether there is a difference in IgG4 levels among different thyroid disease groups and to examine the relationship between IgG4 levels and thyroid function tests, thyroid autoantibodies and thyroid volume. Our study included 151 patients and 48 healthy volunteers. The patients were divided into groups such as Graves' disease, Hashimoto's thyroiditis, autoantibody negative thyroid nodules, and control group. These four main groups were subdivided according to IgG4 level and IgG4/IgG ratio and included in the statistical evaluation. There was no statistically significant difference between IgG4 and IgG4/IgG ratio in four main groups. The free T3, T4, and Hertel values in Graves' disease group were statistically significantly higher in the groups with IgG4≥135 mg/dl and IgG4/IgG ratio≥8%. Our study suggests that IgG4 may play an important role in the pathology of thyroid diseases and its elevation may exacerbate the course of Graves' disease and Graves' ophthalmopathy. Further research is needed to elucidate the clinical implications of IgG4 in thyroid disease management and progression.