International Journal of Endocrinology最新文献

Metabolic syndrome (MetS) is a significant public health concern among middle-aged and elderly populations in China. This study evaluates the predictive value of four derived lipid indicators-lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose (TyG) index, and Chinese visceral adiposity index (CVAI) for MetS in Chinese adults aged ≥ 45 years. Data were sourced from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Participants were classified according to the International Diabetes Federation (IDF), National Cholesterol Education Program (NCEP ATP III, 2001), and China's 2020 Guidelines for Type 2 Diabetes Prevention and Treatment. Multivariate logistic regression and ROC curve analyses assessed the predictive performance of these indicators. Results demonstrated that LAP and CVAI showed the highest predictive accuracy for MetS under the IDF criteria (AUC = 0.903), while LAP and TyG were most effective under the NCEP ATP III and China 2020 guidelines (AUC = 0.860). Subgroup analyses revealed sex- and age-specific variations in indicator effectiveness. This study suggests that derived indicators, particularly LAP and TyG, enhance the screening and management of MetS in middle-aged and elderly Chinese populations. These findings support the adoption of LAP and TyG in clinical practice to improve early detection and targeted intervention strategies.

Introduction: The prostatitis syndrome is one of the most common entities encountered in urologic practice. One of the most common problems that patients with chronic prostatitis typically face is sexual dysfunction. This study aimed to determine the prevalence of sexual dysfunction in patients with chronic prostatitis.

Methods: The present study is a cross-sectional study on 400 patients aged 18 to 50 years who were treated for chronic prostatitis and for whom more than three months had passed since the onset of their prostatitis and treatment. The patients were included in the study through a census. The Changes in Sexual Functioning Questionnaire Short Form (CSFQ-14) was used to assess the sexual functioning status of the patients.

Result: In this study, a total of 400 patients who had referred to the medical centers and hospitals affiliated with Shiraz University of Medical Sciences in 2024 due to chronic prostatitis were examined. The mean age of the patients was 40.83 ± 8.77. The mean sexual function score among patients with chronic prostatitis was 35.62 ± 8, with 89.2% of these individuals exhibiting signs of sexual dysfunction. Based on the results of this study, there was a significant relationship between sexual dysfunction and the type of relationship with the spouse (p=0.01).

Conclusion: According to the findings of this study, sexual dysfunction is a common complication in men with chronic prostatitis. Most patients had a cold and weak relationship with their spouse.

Aims: At present, only a limited number of studies have investigated the association between muscle strength and insulin resistance. This study aimed to investigate the relationship between handgrip strength, a recognized indicator of overall muscle function and healthy aging, and triglyceride-glucose (TyG)-based indicators, including the TyG index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist-to-height ratio (TyG-WHtR), among middle-aged and older Chinese adults.

Methods: We utilized a cohort from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2011 and 2015, comprising a total of 3318 participants. Handgrip strength was assessed using absolute handgrip strength (measured by dynamometers), relative handgrip strength (absolute handgrip strength standardized by BMI), and defined weak handgrip strength. The relationships between the TyG index and its derived measures (TyG-BMI, TyG-WC, and TyG-WHtR) and different grip strength outcomes were examined using both multivariable logistic and linear regression approaches. To evaluate potential nonlinear patterns, restricted cubic spline (RCS) models were applied. Supplementary and robustness analyses encompassed receiver operating characteristic (ROC) curve evaluation, stratification by quartiles, subgroup comparisons, and handling of missing data via multiple imputation.

Results: Between 2011 and 2015, 610 participants developed weak handgrip strength. Among all TyG indices, only TyG-WHtR was significantly associated with grip strength indicators (absolute: β = -0.95, 95% CI: -1.56 and -0.33; relative: β = -0.06, 95% CI: -0.09 and -0.03; weak: OR = 1.34, 95% CI: 1.03 and 1.74). These associations remained robust when using cumulative TyG-WHtR. K-means clustering identified three TyG-WHtR trajectory subgroups. Compared to the stable low group, both moderate (β = -0.10) and sharply increasing groups (absolute: β = -1.19; relative: β = -0.15) showed a greater risk of muscle decline. ROC curves indicated similar diagnostic accuracy for baseline and cumulative TyG-WHtR.

Conclusions: Higher TyG-WHtR levels appear to be independently linked to poorer handgrip strength performance in midlife and elder adults. Maintaining a low TyG-WHtR may contribute to improving the health status of midlife and elderly adults by preserving handgrip strength.

Background: This study aimed to assess the relationship between serum lipopolysaccharide levels and subclinical hypothyroidism in a southern Chinese adult population.

Methods: This cross-sectional community-based study included 2577 participants. Fasting venous samples were taken to examine lipopolysaccharide, thyroid hormone, thyroglobulin antibody, and thyroid peroxidase antibody levels. The population was divided into quartiles according to serum lipopolysaccharide levels. A multivariable-adjusted logistic regression model was applied to test the association between lipopolysaccharide and subclinical hypothyroidism.

Results: Participants with increased serum levels of lipopolysaccharide had a higher prevalence of Hashimoto's thyroiditis (Q1: 10.4%, Q2: 14.3%, Q3: 17.8%, and Q4: 29.5%; p-trend < 0.001) and subclinical hypothyroidism (Q1: 2.2%, Q2: 4.7%, Q3: 7.5%, and Q4: 13.4%; p-trend < 0.001). The multivariable-adjusted odds ratios for subclinical hypothyroidism in the 2nd, 3rd, and 4th serum lipopolysaccharide quartiles were 1.979 (95% CI: 1.033-3.793), 2.867 (95% CI: 1.534-5.360), and 4.091 (95% CI: 2.198-7.613), p-trend < 0.001, respectively, compared to the 1st quartile.

Conclusions: Increased serum lipopolysaccharide levels were related to an increased prevalence of subclinical hypothyroidism in the southern Chinese adult population.

Objective: Hungry bone syndrome (HBS), marked by severe and persistent hypocalcemia, frequently occurs after parathyroidectomy for primary hyperparathyroidism (PHPT). Despite its prevalence, there is limited research on this complication. This study aimed to assess the impact of preoperative bisphosphonate treatment on the incidence of postoperative HBS in PHPT patients.

Design: This retrospective study analyzed hospital records of patients with PHPT who underwent parathyroidectomy from January 2010 to January 2020.

Patients: The study included 144 patients with PHPT who underwent curative parathyroidectomy at AL-Zahra University Hospital within the specified timeframe. Patients with secondary or tertiary hyperparathyroidism or unsuccessful surgeries were excluded.

Measurements: Data on bisphosphonate use, clinical, and laboratory parameters were reviewed. Logistic regression analyzed the relationship between preoperative bisphosphonate treatment and the occurrence of postoperative HBS.

Results: Of the total of 144 patients, 19 received preoperative bisphosphonate therapy. The incidence of HBS was significantly higher in the bisphosphonate group (57.9%) compared to the nontreated group (11.2%) (p < 0.001). However, logistic regression analysis revealed no significant reduction in HBS occurrence due to bisphosphonate treatment, either in the overall cohort or in patients with moderate to severe hypercalcemia (calcium level ≥ 12 mg/dL) (odds ratio: 3.4, 95% CI: 0.5-22.7, p=0.191; odds ratio: 15.0, 95% CI: 0.6-383.9, p=0.102, respectively).

Conclusion: Preoperative bisphosphonate therapy does not prevent the development of HBS following parathyroidectomy for PHPT. Continuous postoperative calcium monitoring is essential for effective management and mitigation of HBS.

Background: Diabetes mellitus (DM) is associated with a number of adverse effects on male reproductive health, including oxidative stress, testosterone deficiency, and spermatogenesis defects. Natural and probiotic-based therapies have gained popularity as a means of alleviating DM-related complications.

Methods: Streptozotocin (60 mg/kg) was employed to induce diabetes in male Sprague-Dawley rats, which were then divided into eight groups, each receiving hydroalcoholic Cynara scolymus (Cynara) extract, Bifidobacterium longum (BBL) probiotic or a combination of both. The following parameters were measured: Fasting blood sugar (FBS), serum malondialdehyde (MDA), serum sexual hormones, and testicular MDA and total antioxidant capacity (TAC), as well as mRNA expressions of steroidogenesis enzymes Star, Cyp11a1, and Hsd17b3. Histopathological study and modified Johnson scoring system were performed.

Results: Rats with diabetes treated with Cynara, BBL, and their combination showed a substantial reduction in FBS and MDA levels as well as an increase in TAC when compared to the diabetic group. The combined treatment demonstrated a greater elevation in serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels in comparison to individual treatments. The mRNA expressions of Star, Cyp11a1, and Hsd17b3 increased significantly in the combined treatment group. Histological assessments revealed improved testicular architecture and germ cell populations in the combination therapy group.

Conclusion: Cynara and BBL treatments in diabetic rats in combination produced a powerful protective effect on male reproductive function. The results showed that Cynara and BBL could be considered as promising therapeutic agents able to reduce the detrimental effects of diabetes on male reproductive health. Further research is needed to define their precise mechanisms and potential clinical uses.

Metabolic disorders are closely associated with thyroid dysfunction and the activity of thyroid-stimulating hormone (TSH). Previously, we found that subclinical hypothyroidism aggravates Toll-like receptor 4 (TLR4) signaling and interferes with glucose metabolism in rat liver tissue. Here, we explored the underlying mechanisms by which TSH affected TLR4 and glucose metabolism on hepatocytes in vitro. Hepatocytes were stimulated with TSH (0, 5, 10, and 20 mIU/mL) for 12 h and mRNA level of its receptor, thyroid-stimulating hormone receptor (TSHR), was increased. In contrast, glucose metabolism was blocked. After blocking TSHR, glucose metabolism in hepatocytes was rescued. Additionally, TSH treatment also activated TLRs signaling, and the expression of TLR4 and its downstream partners all decreased after TSHR was silenced, which indicated that TSH promotes TLR4 signaling through a TSHR-dependent mechanism. For the exploitation of the underlying relationship between TLR4 and glucose metabolism, siRNA was utilized to silence TLR4. After silencing TLR4, glucose metabolism was significantly rescued, which indicated that TLR4 was involved in the TSH-mediated downregulation of glucose metabolism in hepatocytes. Furthermore, as for the inhibitor of TLRs, Tollip was also measured. Under TSH treatment, the expression level of Tollip decreases. After silencing Tollip, TLR4 and its partners significantly increased and glucose metabolism was reduced. Our study indicated that TSH/TSHR regulated hepatocellular glucose metabolism via the TLR4/Tollip pathway.

Objective: Melatonin (Mel) plays a significant role in maintaining bodily homeostasis and regulating insulin resistance (IR) associated with Type 2 diabetes mellitus (T2DM). Neu-P11 is a novel Mel receptor agonist that has been reported to play a critical role in immune function in T2DM. This study aims to investigate the impact of Neu-P11 on the immune function in individuals with T2DM and its potential regulatory pathways.

Material and methods: After inducing IR in 3T3-L1 cells, the study examined the impact of piromelatine (Neu-P11) and XMU-MP-1 (a Hippo pathway inhibitor) on the levels of Hippo pathway proteins, cell viability, extracellular glucose, and GLUT4 expression. After establishing T2DM in rats by a high-fat diet and streptomycin, the effects of Neu-P11 and XMU-MP-1 on glucose metabolism and serum levels of insulin, IgA, IgG, and IgM were investigated. Primary splenocytes isolated from experimental rats were analyzed for the number of immune cells and reactive oxygen species (ROS).

Results: In our study, Mel, Neu-P11, and XMU-MP-1 reduced the levels of phospho-MST1/2, phospho-LATS1/LATS1, phospho-YAP/YAP, and phospho-TAZ/TAZ in the Hippo pathway and enhanced cell viability and glucose uptake capability. This effect was more evident in the Neu-P11+XMU-MP-1 group. After treatment with Mel, Neu-P11, and XMU-MP-1, respectively, T2DM rats showed slower weight gain and a decreased spleen index, suppressed splenic ROS, downregulated phosphorylated Hippo pathway proteins, decreased IgA, and increased IgG and IgM, with improved glucose and insulin tolerance. Mel, Neu-P11, and XMU-MP-1 increased the immune cell number (CD3+, CD16+, and CD19+) in T2DM rats. Notably, co-treatment of Neu-P11 and XMU-MP-1 demonstrated superior restoration across all parameters, indicating the efficacy of combinatorial targeting.

Conclusion: Neu-P11 improves immune function and increases insulin sensitivity in T2DM by inhibiting the Hippo signaling pathway, offering a novel therapeutic avenue for T2DM.

Introduction: Prediabetes represents a critical stage in the progression towards diabetes. However, there is a scarcity of studies examining the specific impact of body mass index (BMI) on prediabetes risk among the Chinese population. This study aims to analyze the association between BMI and the risk of prediabetes in Chinese adults.

Methods: In this cross-sectional analytical study, we analyzed data from 11,847 participants in the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011. For both univariate and multivariate analyses, logistic regression models were employed. Using a BMI range of 18.5-23.9 kg/m² as the reference, we calculated the odds ratio (OR) and 95% confidence interval (95% CI) for different BMI categories and their associated outcomes.

Results: Significant differences were observed in the distribution of variables such as gender, age, education level, marital status, smoking and drinking habits, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), hypertension, dyslipidemia, heart disease, kidney disease, and prediabetes across different BMI groups (p < 0.05). Furthermore, when BMI was treated as a continuous variable, curve fitting analysis indicated that the risk of prediabetes increased when BMI exceeded 22.9 kg/m².

Conclusion: Obesity is a significant risk factor for prediabetes, with the prevalence of prediabetes increasing among overweight and obese individuals in China.

Thyroid tumors are the most prevalent malignant neoplasms of the endocrine system, with an incidence approximately ten times higher than that of other endocrine tumors, accounting for 0.2%-1.0% of all malignant tumors (Zhu and Zhang, 2012 and Liu and Liao, 2017). Papillary thyroid microcarcinoma (PTMC) is a distinct subtype of papillary thyroid carcinoma (PTC), characterized by a maximum diameter of ≤ 10 mm. In recent decades, the incidence of PTC has tripled (Howlader, 2020). According to the 2014 World Health Organization (WHO) cancer report, over 50% of newly diagnosed thyroid cancer cases are PTMC (Soares et al., 2014). Furthermore, advancements in ultrasound (US) diagnostic techniques and the widespread adoption of US-guided fine-needle aspiration biopsy (US-FNAB) have led to a continued rise in the detection rate of PTMC (Bi, 2019). Among the various treatment modalities for PTMC, minimally invasive thermal ablation techniques offer substantial advantages over traditional surgical interventions, including enhanced safety, efficacy, minimal invasiveness, improved cosmetic outcomes, cost-effectiveness, ease of operation, and reduced anesthesia requirements. Moreover, these procedures are not confined to operating rooms and can be effectively performed in outpatient settings. Given these benefits, thermal ablation techniques hold great promise for widespread adoption in primary healthcare settings in China (primary healthcare facilities are critical for equitable access in resource-limited regions), as they not only reduce patient treatment costs but also optimize healthcare resource allocation, aligning with the national hierarchical medical system reform. This study aims to assess the feasibility of promoting the application of minimally invasive thermal ablation for PTMC in primary healthcare settings.