International Journal of Endocrinology and Metabolism最新文献

Background: Calorie restriction without malnutrition is likely to improve cardiovascular risk factors.

Objectives: The aim of this study was to investigate calorie restriction on markers of cardiometabolic risk in overweight/obese adults with cardiovascular risk factors.

Methods: In a parallel controlled trial, patients with overweight or obesity and one or more cardiovascular risk factor were randomized to a modest reduced-calorie diet (75% of the total calculated energy requirements) or control (no calorie restriction) groups and followed up for two months. Body weight, dietary intake, fasting plasma levels of C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), brain-derived neurotrophic factor (BDNF), neuropeptide Y (NPY), lipids, and glycemic factors were measured at baseline, and after two months. The differences were analyzed with analysis of covariance (ANCOVA).

Results: Sixty-six participants (33 in each group) completed the study. Body weight changed in the reduced-calorie diet group (- 3.05 ± 2.65 kg), and blood pressure was improved (systolic -6.96 ± 12.04 and diastolic - 3.90 ± 8.97 mmHg). The reduced-calorie diet improved plasma ICAM-1 (change from baseline - 0.45 ± 1.99 ng/mL, P = 0.033, ANCOVA), MCP-1 (change from baseline - 0.50 pg/mL, P = 0.011, ANCOVA), low-density lipoprotein cholesterol (change from baseline - 9.35 ± 19.61 mg/dL, P < 0.001, ANCOVA), and triglyceride (change from baseline -33.66 ± 49.08, P = 0.001, ANCOVA), but BDNF, NPY, and other cardiometabolic factors were not different.

Conclusions: In overweight/obese subjects with cardiovascular risk factors which have been under medical treatment with risk-reducing medications, a modest weight loss induced by a reduced-calorie diet improved lipid profile, blood pressure, and reduced ICAM-1 and MCP-1 levels but had no effect on plasma BDNF or glycemic factors.

Context: The ability of self-manage was important for type 2 diabetes mellitus (T2DM) patients and it was supported and depend on the method used. We aimed to summarize the potential method of self-management to improve self-empowerment.

Evidence acquisition: To obtain the related data, 5 databases, including Scopus, Science Direct, ProQuest, CINAHL, and SAGE, were comprehensively searched. The search was done in advance using the Boolean operator. The full texts of articles presenting data on self-management methods were screened and retrieved.

Results: A total of 22 studies were included in this review. Various self-management techniques were covered with primary and secondary outcomes. Primary outcomes included blood pressure, fasting blood glucose (FBG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Secondary outcomes included knowledge, self-efficacy, lifestyle habits, physical activity, diet, smoking, medical treatment, support, and health behavior. A goal-setting-oriented approach was effective in setting targets and gaining support from family members. A family-centered approach was effective in taking care of and taking good care of patients with T2DM. Strength training exercises provide patients with a choice of physical activity that can help them manage their blood sugar and blood pressure. Acceptance and commitment therapy (ACT) is a stress-reduction technique. The patient's acceptance of the disease and treatment for diabetes is aided by education.

Conclusions: A successful self-management method was one which balances and adapts to the patient's condition. Regardless of the age of the patients, the overall findings from the review suggest that self-management methods can help patients become healthier and improve their quality of life by controlling their hemoglobin A1c (HbA1c) level.

Background: Accurate evaluation of response to treatment in differentiated thyroid cancer (DTC) is the sine qua non of preventing over-treatment in low-risk patients and implementing appropriate interventions in high-risk individuals.

Objectives: This study aimed to assess the response to therapy in DTC patients based on dynamic stratification method.

Methods: In this cross-sectional study, 154 medical records of subjects with DTC (with at least 6 months after total thyroidectomy) and referred to endocrinology clinics in Ahvaz, Iran, from April 2020 to May 2021 were examined. Patients were stratified according to a dynamic risk stratification system (informed by their specific clinical, histopathological, and ultrasonography findings, and other diagnostic imagines) into four groups: Excellent response (ER), indeterminate response (IR), biochemical incomplete response (BIR), and structural incomplete response (SIR).

Results: For a mean follow-up period of 28.59 months, excellent response to treatment was observed in 92 patients (59.7%), indeterminate response to treatment was found in 32 patients (20.8%), biochemical incomplete response was detected in 2 patients (1.3%), and structural incomplete response was seen in 28 patients (18.2%). In the group with low risk of recurrence, ER and IR were observed in 79.2% and 15.6% of the patients, respectively (P < 0.0001). In the group with an intermediate risk of recurrence, ER was found in 32% of the patients, while IR and SIR + BIR were seen in 34% and 34% of the patients, respectively (P < 0.0001). No cases of ER or IR were observed in the group with high risk (P = 0.001).

Conclusions: In sum, response to treatment significantly varied based on dynamic risk stratification, with ER being highest in the low-risk group, less likely in moderate risk group, and undetected in the high-risk group.

Scientific publishing, with about 350-year historical background, has played a central role in advancing science by disseminating new findings, generalizing accepted theories, and sharing novel ideas. The number of scientific journals has exponentially grown from 10 at the end of the 17th century to 100,000 at the end of the 20th century. The publishing landscape has dramatically changed over time from printed journals to online publishing. Although scientific publishing was initially non-commercial, it has become a profitable industry with a significant global financial turnover, reaching $28 billion in annual revenue before the COVID-19 pandemic. However, scientific publishing has encountered several challenges and is suffering from unethical practices and some negative phenomena, like publish-or-perish, driven by the need to survive or get a promotion in academia. Developing a global landscape with collaborative non-commercial journals and platforms is a primary proposed model for the future of scientific publishing. Here, we provide a brief history of the foundation and development of scientific journals and their evolution over time. Furthermore, current challenges and future perspectives of scientific publishing are discussed.

Introduction: A female patient, 48 years of age, with a complaint of recurrent episodes of diffuse chest pain, vertigo, and shortness of breath in the last five years, presented needing immediate medical attention.

Case presentation: The patient was evaluated and suspected of severe hypotension, cold hands, and feet with distended neck veins and muffled heart sounds. ECG revealed low voltage complexes and large pericardial effusion with a collapse in the diastole of the right auricle and ventricle. The provisional diagnosis was kept as pericardial effusion with hemodynamic compromise. Detailed history disclosed that she had suffered similar events five years before, during which a pericardial tap was performed, and the patient was on anti-tuberculosis treatment for nine months. The symptoms continued despite the treatments. She had a history of severe postpartum hemorrhage, failure of lactation, and early menopause with a history of hysterectomy dated ten years back. The biochemical study indicated decreased LH, FSH, TSH, ACTH, and serum cortisol levels. MRI brain revealed empty sella. The hormonal replacement was started with clinical improvement.

Conclusions: Although hypothyroidism is an extremely rare cause of pericardial effusion, detailed history and further investigations are imperative to form a definitive diagnosis.

Background: Obesity is a multifactorial, chronic, progressive disease associated with decreased health-related quality of life, comorbidities, and increased mortality risk. Lifestyle interventions, focusing on dietetics, physical exercise, and behavioral therapy, are a cornerstone of therapy. Despite this very multidisciplinary treatment approach, the definition of treatment success is often based only on a weight loss of ≥ 5%. However, the heterogeneous nature of obesity may necessitate a more comprehensive approach to assessing treatment effects.

Objectives: Here, we describe changes in physiological, psychological, and behavioral health after a multidisciplinary combined lifestyle intervention (CLI). Additionally, we investigated whether these changes were related to weight loss.

Methods: This prospective observational longitudinal study comprised 96 adults with obesity (73 women, 81 Caucasian) participating in a CLI at the Obesity Center CGG, Erasmus University Medical Center, Rotterdam, the Netherlands. The 1.5-year intervention comprised multidisciplinary professional guidance towards a healthy diet, increased physical activity, and included cognitive behavioral therapy. Physiological health outcomes, psychological well-being, eating behavior, and physical activity were assessed after ten weeks and 1.5 years and compared to baseline.

Results: An average of 5.2% weight loss (-6.0 kg) was accompanied by a mean 9.8% decrease in fat mass (-5.9 kg; both P < 0.001) and significant improvements in metabolism, hormonal status, and immune parameters (all P < 0.05). Moreover, we observed decreased psychopathology, increased quality of life, and decreased disordered eating (all P < 0.05). Weight loss correlated with most metabolic changes (all P < 0.05) but not with most psychological/behavioral changes.

Conclusions: Combined lifestyle intervention in patients with obesity was accompanied by significant improvements in body weight and body composition along with cardiometabolic, endocrine, immunological, psychological, and behavioral improvements. Interestingly, most changes in psychological and behavioral health occurred independently of weight loss. Obesity treatment success should be evaluated based on a combination of physical and patient-reported outcomes rather than weight loss alone.

Background: The newborn screening program for diagnosing and treating children with congenital hypothyroidism (CH) in Iran was established in 2004.

Objectives: This study aimed to evaluate the national program's success in maintaining the physical development and anthropometric indexes of children with CH.

Methods: This historical cohort study was carried out in five provinces located in five different geographical regions of Iran. The anthropometric indexes, including weight, height, and head circumference of 240 children diagnosed with transient congenital hypothyroidism (TCH) (n = 131) and permanent congenital hypothyroidism (PCH) (n = 109) were measured and compared with those of 240 healthy children aged six.

Results: Mean ± standard deviation (SD) of weight, height, and head circumference of children with CH aged six were 20304.8 ± 4457.9 g, 115.6 ± 5.9 cm, and 50.8 ± 1.7 cm, respectively. Mean ± SD of height (116.7 ± 6.1 cm) and head circumference (51.1 ± 1.7 cm) in the control (healthy) group were significantly higher than those of the CH children group (P < 0.05). Mean ± SD weight in the control group (20741.2 ± 4337.3 g) was higher than that in the CH group (20304.8 ± 4457.9 g). However, the difference was not statistically significant (P = 0.3). No significant difference was observed between TCH and PCH children in the subgroup analysis (P > 0.05).

Conclusions: Although the mean of anthropometric indexes in CH patients was slightly lower than that in healthy children aged six, the difference between the two groups was insignificant. The physical development of children with CH was evaluated as good. Our results suggested that the newborn screening program for identifying and treating children with CH in Iran may have improved the growth outcomes.

Background: Thyroid hormones are essential for the growth and maintenance of hair follicles. Numerous studies have evaluated the relationship between thyroid disorders and hair loss. However, no study has assessed the dermoscopic results in patients with hypothyroidism and hair loss.

Objectives: This study aimed to investigate dermoscopic findings of alopecia in patients with hypothyroidism.

Methods: This analytic cross-sectional study was performed on patients with hair loss referred to dermatology clinics of Guilan University of Medical Sciences, Iran. Hypothyroid patients and an equal number of euthyroid individuals were compared. After recording the demographic and clinical characteristics, all patients were subjected to hair dermoscopy.

Results: A total of 164 patients with and without hypothyroidism with hair loss were studied. The frequency of hair shaft abnormalities (P < 0.001) and vellus hair (P < 0.001) significantly differed between the two groups. Dermoscopic findings related to scale abnormalities (P = 0.002) and their perifollicular type (P < 0.001) significantly differed between the groups. Vascular changes (P < 0.001), perifollicular concentric type (P = 0.012), and interfollicular red loops type (P = 0.005) were significantly higher in patients with hypothyroidism. Also, based on the multiple logistic regression model, the chance of abnormalities of the hair shaft, scales, and vascular changes increased by 3.24, 2.73, and 3.53, respectively, in hypothyroidism compared to euthyroidism.

Conclusions: Regarding the promising results of this study, we could detect possible dermoscopic signs of inflammation in hypothyroid patients with hair loss. Further investigations are needed because there is a shortage of evidence on this novel diagnostic method.

Background: Noninvasive risk prediction models have been widely used in various settings to identify individuals with undiagnosed diabetes.

Objectives: We aimed to evaluate the discrimination, calibration, and clinical usefulness of the Finnish Diabetes Risk Score (FINDRISC) and Australian Diabetes Risk Assessment (AUSDRISK) to screen undiagnosed diabetes in Kerman, Iran.

Methods: We analyzed data from 2014 to 2018 in the second round of the Kerman Coronary Artery Disease Risk Factors Study (KERCADRS), Iran. Participants aged 35 - 65 with no history of confirmed diabetes were eligible. The area under the receiver operating characteristic curve (AUROC) and decision curve analysis were applied to evaluate the discrimination power and clinical usefulness of the models, respectively. The calibration was assessed by the Hosmer-Lemeshow test and the calibration plots.

Results: Out of 3262 participants, 145 (4.44%) had undiagnosed diabetes. The estimated AUROCs were 0.67 and 0.62 for the AUSDRISK and FINDRISC models, respectively (P < 0.001). The chi-square test results for FINDRISC and AUSDRISC were 7.90 and 16.47 for the original model and 3.69 and 14.61 for the recalibrated model, respectively. Based on the decision curves, useful threshold ranges for the original models of FINDRIS and AUSDRISK were 4% to 10% and 3% to 13%, respectively. Useful thresholds for the recalibrated models of FINDRISC and AUSDRISK were 4% to 8% and 4% to 9%, respectively.

Conclusions: The original AUSDRISK model performs better than FINDRISC in identifying patients with undiagnosed diabetes and could be used as a simple and noninvasive tool where access to laboratory facilities is costly or limited.

Background: Type 2 diabetes (T2D) screening should be performed continuously at the primary care level in order to prevent disabling complications. Due to the high prevalence of undiagnosed T2D in the Republic of Uzbekistan, a decision was made to implement a nationwide screening program for T2D.

Objectives: The current study, taking into account the limited resources of Uzbekistan's health care system, aimed to offer the most effective, simple, and economical option required for the actual implementation of regular T2D screening in the country's primary care.

Methods: The screening was conducted from December 2018 to March 2019. There were four different scenarios, which differed in terms of eligibility criteria and the methodology adopted for detecting dysglycemia.

Results: A total of 2,430 patients were examined in four months. The T2D diagnosis was established by an endocrinologist in 9.3% of the cases with one eligibility criterion and 15.9% of the cases with three eligibility criteria. The diagnosis of T2D was established by an endocrinologist in 11.7% of the cases with HbA1c screening and 13.5% of the cases with glucose screening.

Conclusions: The screening was feasible in Uzbekistan only in limited conditions. The reasonable strategy was found to be the screening for incidental glycemia in all patients with at least one T2D risk factor. It was recommended that patients with incidental glycemia ≥ 7.8 mmol/L should be tested for fasting glycemia.