Hormone and Metabolic Research最新文献

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.

Controversial results exist regarding the influence of exemestane on serum lipids in women affected with breast cancer. Since CVD remains the predominate cause of demise in women with breast cancer and considering the long-term use of exemestane in women with breast cancer, this meta-analysis holds significant value. Hence, we carried out the current meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of exemestane treatment on lipid parameters in women with breast cancer. PubMed/Medline, Web of Science, EMBASE, and Scopus databases were explored for articles published from inception till December 3, 2024. A random effect analysis was employed for result generation as weighted mean differences (WMD) with 95% confidence intervals (CI). Six eligible and relevant RCTs were incorporated in this meta-analysis. The comprehensive findings from random effect analysis indicated a reduction in TC (WMD: -8.13 mg/dl, 95% CI: -14.48 to -1.79, p=0.012), HDL-C (WMD: -6.60 mg/dl; 95% CI: -8.17 to -5.01, p<0.001) and an increase in LDL-C (WMD: 4.66 mg/dl; 95% CI: 0.26 to 9.06, p=0.038) after exemestane intervention. Additionally, a noteworthy decline in the levels of TG was noted in studies lasting less than 12 months duration (WMD: -16.18 mg/dl; 95% CI: -25.99 to -6.37, p=0.001). Exemestane influences the lipid parameters in women with breast cancer. It elevates LDL-C levels while decreasing TC, TG, and HDL-C concentrations.

The consumption of Western diet, characterized by high sugar and saturated fat content, often leads to weight gain and promotes oxidative stress. Intermittent fasting has emerged as a potential strategy to combat obesity, but its effects on redox homeostasis in white adipose tissue compartments remain unclear. In this study, male Wistar rats were fed a regular or Western diet ad libitum or subjected to an intermittent fasting regimen, consisting of 1-day fasting followed by 2 days of free access to food, over 12 weeks. Elevated superoxide anion levels were observed in visceral adipose tissue of both Western diet-fed groups, independent of the regimen, along with decreased nicotinamide adenine dinucleotide phosphate oxidase activity and increased catalase activity, suggesting an adaptive response to mitigate oxidative stress. In the same tissue, superoxide dismutase activity was reduced, indicating that impaired dismutation might be responsible for the increment of superoxide levels. Intermittent fasting increased the expression of catalase and superoxide dismutase, but this effect was not observed at activity levels. Thus, our data suggest that Western diet impaired the beneficial effect of intermittent fasting on antioxidant activity in visceral adipose tissue. Interleukin-6 mRNA levels were increased by Western diet ad libitum in visceral adipose tissue, but this effect was impaired by intermittent fasting, suggesting an anti-inflammatory effect of intermittent fasting. Redox balance in subcutaneous adipose tissue remained unchanged. In conclusion, intermittent fasting alone did not prevent the oxidative stress caused by Western diet in visceral adipose tissue, despite having an anti-inflammatory action.

Previous studies investigating the relationship between the triglyceride-glucose (TyG) index, a novel marker of insulin resistance (IR), and the risk of chronic kidney disease (CKD) in the general population have reported conflicting findings. Therefore, we conducted this meta-analysis to systematically evaluate the association between the TyG index and CKD risk. Cohort studies estimating the multivariate-adjusted association between TyG index and CKD were attained by thoroughly retrieving five databases including PubMed, Cochrane Library, Embase, Scopus, and Web of Science. A random-effects model was used to analyze the data. Eleven cohort studies comprising 86 038 participants without CKD at baseline were included. Results showed that higher TyG index were independently associated with a higher risk of CKD for highest versus lowest TyG index category [adjusted RR: 1.52, 95% CI: 1.38-1.67, I²=0%, p<0.001]. The results with the TyG index analyzed continuously showed consistent (adjusted RR per each unit increase of TyG index: 1.29, 95% CI 1.22-1.36, I²=0%, p<0.001). Findings of sensitivity analysis, which ruled out one dataset at a time, was similar (adjusted RR for categorical variables: 1.48-1.60, all p<0.001; adjusted R for continuous variables: 1.28-1.38, all p<0.001). Subgroup analyses suggested study features including ethnicity, sex, mean age, source of subjects, and the quality scores of studies had no significant effect on the association (all p>0.05). To summarize, a higher TyG index may be independently associated with a higher incidence of CKD in people without CKD at baseline.

Through alternative splicing, two isoforms of the glucocorticoid receptor (GR) gene are generated, termed GRα and GRβ. GRα is predominantly expressed and shows steroid binding activity, whereas GRβ is thought to be inactive as a result of its truncated ligand-binding domain. GRβ may only act as a dominant negative inhibitor when co-expressed with GRα. GRβ specifically binds RU486 and also exhibits intrinsic transcriptional activities to directly regulate the expression of a large number of genes via both GRα-dependent and GRα-independent mechanisms. Hypercortisolemia and hypocortisolemia show different effects on the expression profiles of GR isoforms. Inflammatory cytokines induce GRβ expression and lead to an increased GRβ/GRα ratio, which may be related to glucocorticoid resistance during inflammatory diseases. Because GRβ inhibits the activity of GRα, it has the potential to ameliorate glucocorticoid-induced abnormal metabolism, muscle loss or be used to treat tumors. While elevated GRβ expression has been found in some inflammatory diseases and may be relevant to glucocorticoid unresponsiveness, whether GRβ modulates glucocorticoid sensitivity in vivo is under debate because of its extremely low expression levels under physiological situations.

Type 2 Diabetes Mellitus (T2DM) remains a significant global health challenge, necessitating more effective therapeutic strategies. This study was to observe the impact of semaglutide on the C-Peptide levels and glycemic variability. This retrospective evaluation was conducted from January 2020 to January 2023 at our hospital, involving 172 patients diagnosed with T2DM. Patients were stratified into two groups: the observation group (86 patients) received semaglutide injections plus metformin, and the control group (86 patients) received only metformin. Treatment efficacy was assessed using changes in HbA1c, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h BG), and C-Peptide levels. Additional evaluations included changes in glycemic variability indicators such as standard deviation of blood glucose (SDBG), mean of daily differences (MODD), and mean amplitude of glycemic excursions (MAGE). The observation group showed significantly greater improvements in glycemic control and C-Peptide levels compared to the control group. Specifically, the observation group achieved a significant reduction in HbA1c from 70 mmol/mol to 53 mmol/mol, FBG from 10.91 mmol/l to 6.12 mmol/l, and increased C-Peptide levels in both fasting and postprandial states. Improvements in glycemic variability were also more pronounced in the observation group. There was no significant difference in the incidence of adverse events between the two groups. Semaglutide combined with metformin significantly enhances the efficacy of treatment in T2DM patients, with marked improvements in C-Peptide levels, glycemic control, and reduction in glycemic variability. This combination therapy not only offers superior glucose management but also appears to bolster pancreatic function.

The aim of the study was to explore the relationship between hormone levels and coagulation indicators in patients with Cushing's syndrome, providing insights into disease progression and treatment. We recruited 640 patients diagnosed with ACTH-independent Cushing's syndrome with adrenocortical tumors, conducting comprehensive physical and laboratory examinations, and analyzing data using logistic regression models. We found that compound F at 8 AM (F8AM) and ACTH had better correlation with coagulation characteristics. We revealed negative association between F8AM levels and PLT or APTT, while ACTH exhibited opposite trends. With F8AM increasing, Fbg declined significantly, while ACTH had the opposite association. In patients with Cushing's syndrome, chronic cortisol elevations may lead to consumptive coagulopathy, characterized by decreased PLT and Fbg levels, apart from the hypercoagulable state implied by decreased APTT.

The data on the use of 68Ga-NODAGA-exendin-4 PET/CT in localizing multiple endocrine neoplasia type 1 (MEN1)-related insulinomas is evolving; however, surgical outcomes data are not available. We describe our cohort of patients with MEN1-related endogenous hyperinsulinemic hypoglycemia (EHH), where 68Ga-NODAGA-exendin-4 PET/CT was used to guide conservative surgery. A retrospective record review of MEN1-related EHH cases managed between 2000 and 2024 was performed for clinical features, imaging, and management. Outcomes were assessed for patients whose surgical extent was determined by 68Ga-NODAGA-exendin-4 PET/CT versus conventional imaging (CECT and 68Ga-DOTATATE PET/CT). Five patients with a median age of 17 (15.5-18.5 years) with EHH underwent laparoscopic, single lesion enucleation based on 68Ga-NODAGA-exendin-4 PET/CT. On preoperative imaging, CT identified culprit lesion in four, while 68Ga-DOTATATE PET/CT localized in one, and had one false positive uptake in non-functioning NET. The median duration of hospital stay was 6 (5.5-9) days. Over a median follow-up of 48 (3.5-84.5) months, none had EHH recurrence or exocrine/endocrine pancreatic insufficiency. On follow-up, one patient had an uneventful pregnancy and delivery. In the remaining 15, who underwent surgery based on conventional imaging, 12 (80%) required extensive surgery beyond enucleation, of which two needed intraoperative ultrasound localization. This group had a postoperative hospital stay of 11 (8-23) days, one recurrence after 84 months, and pancreatic insufficiency in 5 (33%). Our center observation suggests that GLP1R-based PET/CT-guided conservative insulinoma surgery in MEN1 patients is effective and safe and needs further validation.

Several studies have linked low levels of testosterone with increased symptoms of cardiac disease and cardiovascular mortality; however, the effects of testosterone deficiency on cardiac systolic function and morphology are still not completely elucidated. The present study aims to evaluate the influence of testosterone deprivation on cardiac systolic function and morphology. Male Wistar rats were divided into two groups: Sham operation group (Sham): animals underwent sham operation and Orchiectomized group (Orchiec): animals underwent bilateral orchiectomy. The experimental protocol lasted 60 days after the surgery. All animals were weighted and blood samples collected to serum testosterone analysis, determined by chemiluminescence, on first (before orchiectomy) and on 60th days. One day before euthanasia (on the 59th day) echocardiographic parameters were assessed to evaluate left ventricle (LV) systolic function and morphology. Statistical significant difference was set at≤0.05. Orchiec rats presented reduced LV fractional shortening (p=0.032), increased myocardial performance index (MPI) (p=0.043), prolonged mitral valve closure time (p=0.013) and decreased heart rate (p=0.049) when compared to Sham. No statistically significant difference was found in the ejection fraction (p=0.666) between groups. Besides that, heart weight was lower in Orchiec group (p=0.035) when compared to Sham group. Testosterone deprivation reduced cardiac systolic function, changing contraction and relaxation parameters. Testosterone deficiency also changed heart rate and heart weight. The present study demonstrated for the first time that castrated levels of testosterone could alter parameters such as mitral valve closing time and MPI.