International Journal of Endocrinology最新文献

Purposes: To treat large benign thyroid nodules (BTNs), radiofrequency ablation (RFA) and transarterial embolization (TAE) combined with RFA are both used. This study aimed to compare the effectiveness of both treatments.

Methods: Nineteen subjects with 20 BTNs received two sessions of RFA, while eight patients with 10 BTNs underwent TAE followed by RFA in a single medical center. Propensity score matching (PSM) was utilized to control for inherent potential biases by matching similar characteristics between the two groups.

Results: Prior to treatment, a larger median nodule volume was observed in the TAE with the RFA group (150.75 ± 202.61 mL) compared to that of the double-session RFA group (81.44 ± 58.00 mL). The volume reduction ratio (VRR) was found to be 74.60 ± 14.49% in the TAE/RFA group and 83.93 ± 12.70% in the double-session RFA group. To account for follow-up duration, we calculated the variation of VRR (ΔVRR, %) divided by the follow-up time in days. The TAE with the RFA group showed a median reduction of 0.17 ± 0.05%/day, while the double-session RFA group showed 0.13 ± 0.05%/day, with a p value of 0.040. The TAE with the RFA group exhibited a relatively higher daily VRR after treatment. Additionally, a higher nodular volume reduction was observed in the TAE with the RFA group due to the larger pretreatment nodular volume.

Conclusions: Our findings suggest that TAE combined with RFA may be a more effective treatment option for large BTNs compared to two sessions of RFA alone, thus providing an alternative treatment approach.

Background: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease frequently observed in populations along the Eastern Mediterranean coast, characterized by recurrent fever, abdominal pain, and joint inflammation. The disease results from mutations in the MEFV gene, which plays a critical role in regulating IL-1β secretion. Mutations in pyrin lead to uncontrolled IL-1β release, driving FMF's inflammatory symptoms. IL-1 inhibitors, such as anakinra, rilonacept, and canakinumab, have been introduced as adjunctive treatments. This paper aims to investigate the effects of IL-1 inhibitors on pituitary functions in FMF patients.

Methods: The study was conducted at Sivas Cumhuriyet University Hospital and included patients who had been using IL-1 inhibitors for at least 6 months. The control group consisted of patients receiving colchicine treatment only. Blood samples were collected to measure various pituitary and endocrine hormones. Patients with conditions like corticosteroid use, cancer, or hemodialysis were excluded. Hormonal levels were analyzed, and cortisol-deficient patients underwent a Synacthen test.

Results: No significant differences were found in TSH, ACTH, cortisol, LH, estradiol, IGF-1, or PRL levels between the groups. However, differences were noted in FSH, total testosterone, and GH levels, with higher FSH and GH in the control group and higher testosterone in the experimental group.

Conclusions: Although IL-1 plays a role in hormone secretion pathways, further studies are needed to better understand the effect of IL-1 antagonists on pituitary function, as no significant adrenal or pituitary insufficiencies were observed.

[This corrects the article DOI: 10.1155/ije/5878361.].

Objective: Clinical features of primary hyperparathyroidism (PHPT) differ between developed and developing countries. In past decades, patterns of PHPT have changed while there are currently few data on large cohorts in Chinese. Therefore, this study aims to describe changes in clinical features of Chinese patients with PHPT.

Materials and methods: 685 patients with PHPT were collected and divided into several subgroups by time periods, symptoms, and pathological types. Clinical characteristics were compared among subgroups.

Results: Patients were divided into 177 cases (25.8%) in group A (2013-2018) and 508 cases (74.2%) in group B (2019-2024). Compared with group A, parathyroid hormone (PTH) was significantly lower and clinical manifestations were milder, and the percentage of asymptomatic patients was higher in group B. Bone pain (46.8%), nephrolithiasis (37.3%), and fatigue (36.2%) were the most common symptoms in symptomatic patients. Serum PTH, calcium, osteocalcin, and urine pH levels in symptomatic patients were higher than those in asymptomatic patients, while serum phosphate and bone density levels were lower. In addition, among 417 surgical patients, benign parathyroid tumor was in 373 cases (89.4%), atypical parathyroid tumor was in 34 cases (8.2%), and parathyroid carcinoma was in 10 cases (2.4%). Compared with benign PHPT, serum PTH, calcium, alkaline phosphatase, and bone turnover marker (BTM) levels were significantly increased, and serum phosphate level was decreased in malignant PHPT.

Conclusion: Clinical features of PHPT changed during 2013-2024 with remarkably increasing asymptomatic PHPT patients, whose clinical manifestations were milder, and complications were less.

Objective: The long-term outcomes of discontinuing thyroxine replacement therapy in patients with persistent hypothyroidism following subacute thyroiditis are unknown. This study involved an extended follow-up of a cohort of patients who participated in a clinical trial of prednisone for the treatment of subacute thyroiditis.

Methods: This retrospective cohort study included 52 patients with moderate to severe scores who were hospitalized between August 2013 and December 2014. Patients previously received prednisone for 1 week, followed by nonsteroidal anti-inflammatory drugs for 1 week, and prednisone was administered for 6 weeks, after which the patients completed follow-up to Week 24. Thyroid-stimulating hormone, free triiodothyronine, and free thyroxine levels of the participants were measured 9 years after enrollment.

Results: Of the 52 participants randomly assigned to receive prednisone for 1 or 6 weeks, 50 completed the core trial, and 48 were eligible for extended follow-up, with a median duration of 8.61 years (IQR 8.29-8.77). Thirty participants were assessed at 9 years, 15 could not be contacted, and three refused follow-up tests. Among the 30 participants, 28 were euthyroid and 2 had subclinical hypothyroidism at 9 years. The median TSH level was 3.46 mIU/L (IQR 2.12-5.15) at 24 weeks and 2.17 mIU/L (IQR 1.83-3.77) at 9 years (p = 0.001). The median FT4 level was 14.27 pmol/L (IQR 12.15-15.72) at 24 weeks and 15.28 pmol/L (IQR 12.53-16.22) at 9 years (p = 0.959). Among the three participants diagnosed with persistent hypothyroidism at 24 weeks, one participant was diagnosed with subclinical hypothyroidism without thyroxine replacement therapy at 9 years, and two participants were diagnosed with subclinical hypothyroidism and euthyroidism after gradually withdrawing from thyroxine.

Conclusion: Thyroid function remains stable in patients with persistent hypothyroidism following subacute thyroiditis after careful dose reduction and discontinuation of thyroxine replacement therapy. This finding may have implications for the individualized management of hypothyroidism.

Background: The systemic immune-inflammation index (SII), an emerging inflammatory biomarker, has been associated with various diseases, but its relationship with thyroid function remains unclear. Our study aimed to investigate the potential connections between SII and thyroid function in the U.S. population.

Methods: We conducted a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 2007-2012 data to evaluate the association between SII and thyroid function, including free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH). Furthermore, the correlation was evaluated using multiple linear regression, smooth curve fitting, and threshold effect analysis.

Results: After multivariable linear regression, higher lgSII levels were independently associated with lower FT3 (β = -0.17, p < 0.0001), TT3 (β = -3.06, p = 0.0149), and TSH (β = -0.38, p = 0.0204), whereas TT4 levels were positively associated with lgSII after full adjustment (β = 0.27, p = 0.0016). Smooth curve fitting revealed an L-shaped relationship between lgSII and FT3 and TSH. Threshold effect analysis identified an inflection point at lgSII = 2.29 (log-likelihood ratio, P < 0.001).

Conclusion: In U.S. adults, lgSII was negatively associated with FT3 and TSH and positively associated with TT4. These findings highlight a potential link between systemic inflammation and thyroid function, warranting further prospective studies to investigate causal relationships.

Background: Childhood and adolescence are critical periods for skeletal development, yet the sex- and age-specific relationships between body composition and bone mineral density (BMD) remain inadequately explored.

Methods: This study analyzed data from 6328 participants aged 8-19 years from the NHANES (2011-2018) using dual-energy X-ray absorptiometry to assess visceral adipose tissue area (VATA), skeletal muscle mass (SMM), and total BMD. Multivariate linear regression models were employed to examine the associations, accounting for potential confounders.

Results: Initial analyses indicated a positive correlation between VATA and BMD, which reversed after covariate adjustment. SMM consistently showed positive correlations with BMD, particularly in girls aged 8-11 years. The visceral adipose tissue to SMM ratio exhibited significant negative correlations with BMD, especially in boys aged 12-19 years.

Conclusions: These findings highlight the critical importance of balanced body composition for skeletal health during development, suggesting that targeted interventions to optimize muscle mass and reduce visceral fat may enhance bone density in children and adolescents.

Objective: Diabetic nephropathy (DN) occurs in nearly 40% of Type 2 diabetes mellitus (T2DM) patients, and there is a positive correlation between DN and terminal renal disease. Thus, exploring novel biomarkers is vital to facilitate early diagnosis and intervention in DN patients; however, indicators of DN are still scant. Since the microRNA-126 (miR-126) may be related to the occurrence of diabetes, we aim to assess the association between miR-126 and DN.

Methods: This is a prospective cohort design and a nested case-control approach study that enrolled 300 individuals (100 T2DM patients, 100 DN patients, and 100 controls). miR-126 expression was analyzed by quantitative real-time PCR (qPCR) and compared among three groups. The overall survival (OS) was presented by Kaplan-Meier analysis. The area under the curve (AUC) was used to evaluate the potential of miR-126 as a biomarker for DN.

Result: DN patients, compared with T2DM and controls, had lower miR-126 content (p < 0.001), and miR-126 levels significantly decreased following a decreasing estimated glomerular filtration rate (eGFR) (r = 0.65, p < 0.001). Moreover, significant differences were also found in OS among quartiles of serum miR-126 level (p for trend < 0.001). In addition, the AUC for diagnosis DN from T2DM patients was found to be 0.804 (95% CI, 0.745-0.863), with a sensitivity of 83.0% and a specificity of 63.0%.

Conclusion: This study provides evidence to clarify that decreased levels of miR-126 were linked to an increased susceptibility to developing DN compared with healthy volunteers. More importantly, the diagnostic role of miR-126 remained significant in differentiating DN from T2DM patients.

Objective: To evaluate the efficacy of combined therapy of compound betamethasone periocular injection and oral mycophenolate mofetil (MMF) in treating active thyroid-associated ophthalmopathy (TAO).

Methods: A retrospective study was conducted on 17 patients with active TAO treated with compound betamethasone periocular injection combined with oral MMF from February 2022 to August 2023, involving a total of 31 eyes.

Results: In one eye, the Clinical Activity Score (CAS) decreased by less than two points, while in the remaining eyes, the CAS decreased by two points or more. Patients exhibited decreased proptosis, a reduction in average extraocular muscle thickness, and improvement in diplopia in six cases. Subgroup analysis indicated that this regimen showed no significant difference in efficacy for patients treated with radioactive iodine therapy or oral methimazole medication at baseline.

Conclusion: Combined therapy of compound betamethasone periocular injection and oral MMF is an effective approach for treating active TAO.

Background: Idiopathic nephrotic syndrome (NS) is a common cause of glomerulonephritis in children, often complicated by relapses and steroid dependence or resistance. Emerging evidence underscores the interplay between vitamin D metabolism and NS pathophysiology, particularly during relapse episodes.

Objective: To investigate the prevalence of vitamin D deficiency in pediatric patients aged 2-12 years with relapsing idiopathic NS and to evaluate associations with proteinuria severity, relapse frequency, and steroid exposure.

Methods: This cross-sectional study included 100 children diagnosed with idiopathic NS and at least one documented relapse. We enrolled all NS patients with completed follow-up for 1 year. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured during relapse and six months later. Clinical and biochemical data, including proteinuria, albumin, creatinine, and corticosteroid usage, were analyzed.

Results: At relapse, 84% of patients were vitamin D deficient, with only 7% reaching sufficiency after 6 months. A significant inverse correlation was observed between 25(OH)D levels and both proteinuria (r = -0.62, p < 0.001) and relapse frequency (r = -0.48, p < 0.01). Corticosteroid dosage was not significantly associated with vitamin D recovery.

Conclusion: Vitamin D deficiency is highly prevalent among children with relapsing idiopathic NS and correlates with greater disease activity. Routine monitoring and timely supplementation of vitamin D may be essential components in managing NS flares and preventing long-term complications.