Hormone and Metabolic Research最新文献

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.

This study aimed to investigate the correlation between cortisol secretion and the prevalence of type 2 diabetes (T2D) and hypertension in patients with adrenal tumors. A total of 164 patients with benign adrenal tumors were recruited between January 2019 and December 2024. Cortisol levels were assessed using a 1 mg overnight dexamethasone suppression test, classifying patients into three groups: non-functional adrenal tumors (group A, n=73), minimal autonomous cortisol secretion (MACS, group B, n=64), and MACS with confirmed Cushing's syndrome (group C, n=27). Statistical analyses compared the prevalence of hypertension and T2D across groups. Cortisol concentrations were measured using high-performance liquid chromatography (HPLC) and ELISA. Logistic regression identified factors influencing hypertension and T2D. The prevalence of hypertension and T2D was significantly higher in group C compared to groups A and B (p<0.05). Cortisol concentrations were higher in groups C and B than in group A (p<0.05), with group C showing the highest levels. Elevated cortisol in MACS patients was associated with increased hypertension risk (p<0.05) and higher rates of T2D (p<0.05). Age was a significant predictor, with a 9% increase in risk for each additional year. Cortisol secretion in adrenal tumor patients is linked to T2D and hypertension. As cortisol levels and age increase, so does the risk of these conditions, highlighting cortisol as a potential biomarker for managing these comorbidities.

The study explores the vital role of gut microbiota in regulating neurotransmitters and its subsequent effects on brain function and mental health. It aims to unravel the mechanisms by which microbial metabolites influence neurotransmitter synthesis and signaling. The ultimate goal is to identify potential therapeutic strategies targeting gut microbiota for the management and treatment of neurological disorders, such as depression, autism spectrum disorder (ASD), anxiety, and Parkinson's disease. The review synthesizes current research on the gut-brain axis, focusing on the influence of gut microbial metabolites on key neurotransmitters, including dopamine, serotonin, and gamma-aminobutyric acid (GABA). It incorporates a multidisciplinary approach, linking microbiology, neurobiology, and clinical research. Each section presents an in-depth review of scientific studies, clinical trials, and emerging therapeutic strategies. The findings highlight the intricate interplay between gut microbiota and the central nervous system. Gut microbes significantly impact the synthesis and signaling of crucial neurotransmitters, which play a pivotal role in neurological health. Evidence supports the hypothesis that modulating gut microbiota can alter neurotransmitter output and alleviate symptoms associated with neurological disorders. Notable therapeutic potentials include microbiota-targeted interventions for managing depression, ASD, anxiety, and Parkinson's disease. This comprehensive analysis underscores the critical connection between gut microbiota and neurological health. By bridging gaps between microbiology, neurobiology, and clinical practice, the study opens avenues for innovative therapeutic approaches. It provides a valuable resource for researchers, clinicians, and students, emphasizing the need for continued investigation into gut microbiota's role in neurological disorders and its therapeutic potential.

Thyroid function undergoes significant alterations during pregnancy due to changes in hormone levels and higher metabolic demands. The thyroid gland in pregnancy enlarges by 10%; however, in iodine-deficient areas, this growth might reach 40%. Elevated levels of human chorionic gonadotropin (hCG) in early pregnancy leads to increased thyroid hormone production. While triiodothyronine (T3) and thyroid-stimulating hormone (TSH) do not cross the placenta, thyroxine (T4) does. Thyroid hormone demands peaks between weeks 16 and 20 of pregnancy and remains high until delivery. There is a rise in the levels of thyroxine-binding globulin (TBG), during the period of pregnancy, raising total T4 and T3 levels while TSH levels usually decrease. Pregnancy-related thyroid disorders, such as hypothyroidism, hyperthyroidism, and autoimmune thyroid diseases (AITD), carry the potential to impair the well-being of both the child as well as the mother. A range of 5-20% of women belonging to the reproductive age group have AITD, which can be associated with the possibility of infertility, miscarriages, and/or poor pregnancy outcomes. If improperly managed, overt hypothyroidism can cause severe complications such as developmental delay and preeclampsia. Effective management requires regular monitoring and appropriate treatment adjustment. Treatment for hypothyroidism involves levothyroxine, whereas cautious use of antithyroid medications is advised for hyperthyroidism. Postpartum thyroiditis (PPT), an autoimmune condition occurring after childbirth, requires careful management to address both hyperthyroid and hypothyroid phases. A comprehensive understanding and management of these conditions are critical for optimizing maternal and fetal health outcomes. Thyroid disorders are common in women of reproductive age group.

GLP-1 receptor agonists have emerged as important therapeutic agents for type 2 diabetes mellitus (T2DM), but their comparative efficacy and broader applications remain subjects of ongoing research. The aim of the study was to evaluate and compare the efficacy, safety, and clinical applications of three GLP-1 receptor agonists - Semaglutide, Dulaglutide, and Exenatide - through systematic review and meta-analysis. A comprehensive search of PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science (2015-2023) identified 20 randomized controlled trials and observational studies. Primary outcomes included changes in HbA1c and body weight. Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Semaglutide demonstrated superior efficacy with mean HbA1c reduction of 1.45% and weight loss of 1.44 kg. Dulaglutide showed consistent reductions in HbA1c (1.1%) and weight (1.2 kg). while Exenatide exhibited moderate effects. Meta-analysis revealed a significant pooled effect estimate favoring GLP-1 receptor agonists. with a mean HbA1c difference of -0.81 (95% CI: -0.92 to -0.70). Gastrointestinal side effects were most common, with Semaglutide showing the highest incidence. This meta-analysis establishes Semaglutide as the most effective GLP-1 receptor agonist for glycemic control and weight reduction, while Dulaglutide and Exenatide offer viable alternatives with fewer side effects. These findings support evidence-based decision-making in T2DM management and highlight the potential broader therapeutic applications of GLP-1 receptor agonists beyond diabetes care.

We aimed to examine if serum lipoprotein(a) [Lp(a)] values could be used to predict the risk of diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM). English-language observational studies available as full-texts on PubMed, Embase, Scopus, and Web of Science databases up to 28th November 2024 were included in the review. Studies were to assess the association between Lp(a) and DN and report adjusted effect size. Random-effects meta-analysis was conducted. Five cross-sectional, two case-control, and eight studies prospective cohort were included. Six studies used Lp(a) as a continuous variable while eight used it as a categorical variable. Two studies used Lp(a) as both. Meta-analysis showed that an incremental increase in Lp(a) was associated with a small increase in the risk of DN (OR: 1.03 95% CI: 1.01, 1.04 I²=86%). Meta-analysis also showed that high levels of Lp(a) were associated with a significant increase in the risk of DN (OR: 1.64 95% CI: 1.24, 2.17 I²=67%). Subgroup analysis based on study design, location, sample size, T2DM duration, baseline HbA1c, and definition of DN yielded mixed results. Lp(a) could be a potential marker for DN in T2DM. Further investigations may provide better evidence.