Minerva endocrinology最新文献

Introduction: The association between betatrophin level and type 2 diabetes mellitus (T2DM) is a subject of controversy, and the reasons for conflicting results have been poorly explained. To address this gap, we conducted a meta-analysis of relevant studies to obtain a more comprehensive estimate and draw a more accurate conclusion.

Evidence acquisition: This study included literature published up to June 2023. We searched for relevant studies in the Web of Science and PubMed databases. We utilized STATA 12.0 software to calculate the standard mean difference (SMD) and 95% confidence interval (CI) to compare circulating betatrophin levels between individuals with T2DM and healthy controls (HCs).

Evidence synthesis: The meta-analysis revealed a significantly higher circulating betatrophin level in individuals with T2DM compared to HC, using a random effects model [mean value of betatrophin level (T2DM vs. HC): 388,685.23 vs. 304,857.04 pg/mL; SMD=1.37; 95%CI: 1.01, 1.73]. Subgroup analysis indicated a higher circulating betatrophin level in T2DM compared to HC among Asian individuals, while no significant difference in circulating betatrophin level was observed between T2DM and HC among Caucasian individuals (Asian: SMD=1.65; 95%CI: 1.23, 2.06; Caucasian: SMD=0.50; 95%CI: -0.21, 1.20). Additionally, subgroup analysis revealed increased plasma and serum betatrophin levels in T2DM compared to HC (plasma: SMD=1.30; 95%CI: 0.72, 1.88; serum: SMD=1.47; 95%CI: 0.98, 1.96).

Conclusions: This meta-analysis provides evidence of elevated levels of betatrophin in individuals with T2DM, suggesting that betatrophin may serve as a potential diagnostic biomarker for T2DM.

Background: Ovarian senescence is associated with increased cardiovascular risk. We aimed to evaluate the association between menopausal symptoms and cardiometabolic risk factors in a cohort of apparently healthy middle-aged women.

Methods: The cohort included 2793 peri- and postmenopausal women not on menopausal hormone therapy. Demographic/anthropometric and biochemical/hormonal data were assessed. The severity of menopausal symptoms was evaluated by the Greene Climacteric Scale (GCS).

Results: GCS-Total Score was associated with BMI (b=0.12, 95% CI: 0.04 to 0.20), T2DM (b=2.10, 95% CI: 0.06 to 4.15), and late-postmenopause (b=-1.24, 95% CI: -2.17 to -0.33). GCS-psychological score was associated with BMI (b=0.06, 95% CI: 0.00 to 0.11). GCS-Physical Score was associated with BMI (b=0.06, 95% CI: 0.03 to 0.09), central obesity (b=0.18, 95% CI: 0.02 to 0.34), and postmenopause (early-/late-postmenopause vs. perimenopause, b=-0.36, 95% CI: -0.59 to -0.13 and b=-0.65, 95% CI: -0.97 to -0.34, respectively). All GCS-scores were negatively associated with age. GCS-Sexual Score was associated with early-postmenopause (incidence rate ratio (IRR)=1.53, 95% CI: 1.21 to 1.94), central obesity (IRR=1.18, 95% CI: 1.00 to 1.39), smoking, diastolic blood pressure, age. Cox-regression analysis showed that incident T2DM was positively associated with increasing age, BMI, daily alcohol consumption, moderate-to-severe vasomotor symptoms (VMS, OR=1.045, 95% CI: 1.011 to 1.079), and negatively with moderate-to-strenuous physical activity. These associations persisted in lean but not in obese women.

Conclusions: The severity of menopausal symptoms is associated with T2DM, obesity, and smoking in a cohort of peri-/postmenopausal women. VMS were associated with incident T2DM, especially in lean women. These associations must be considered in implementing primary and secondary prevention strategies.

Background: Oxidative stress has been implicated in the pathogenesis of autoimmune thyroiditis, also referred to as Hashimoto's thyroiditis (HT), and several biomarkers have been measured to evaluate the impact and clinical relevance of oxidative stress in this setting. Recently, advanced glycation end products (AGEs) have been proposed as reliable markers of oxidative stress in HT. In the present study, we investigated the relationship of AGEs with antioxidant paraoxonase (PON-1) activity as potential combined markers of oxidative stress.

Methods: We measured the levels of AGEs, and advanced oxidation protein products (AOPPs) and PON-1 activity by spectrophotometric methods, in the serum of 40 HT patients (36 F; mean age 35.4±11.5 year) and 38 age-, sex- and BMI-matched healthy controls. All subjects were euthyroid at recruitment and none was on LT-4 therapy.

Results: Serum levels of AGEs were significantly higher (median 378 vs 290 AU/g protein; P<0.001), while PON1 activity was significantly lower (median 165 vs. 201 U/L; P<0.05) in HT patients compared to controls: the two parameters were inversely correlated (P<0.01), clearly indicating a pro-oxidant imbalance in HT patients. At stepwise regression analysis, TPOAb positivity was an independent predictor of both PON-1 activity (P=0.002) and AGEs levels (P=0.000).

Conclusions: Increased formation and accumulation of AGEs contribute to enhanced oxidative stress, along with a decrease in PON-1 activity in HT. As a consequence, AGEs levels and alteration in PON 1 may serve as useful markers for monitoring the levels of oxidative stress in this disorder.

Background: The aim of this retrospective study was the elaboration of a new diagnostic model that integrate cytological reports (2017 Bethesda System for Reporting Thyroid Cytopathology) with ultrasonographic features (based on ACR TI-RADS score) to achieve a more accurate definition of indeterminate thyroid nodule malignancy risk.

Methods: Ninety patients submitted to thyroidectomy were divided in three classes: low malignancy risk (AUS/FLUS with TI-RADS 2/TI-RADS 3 and FN/SFN with TI-RADS 2), intermediate malignancy risk (AUS/FLUS with TI-RADS 4/TI-RADS 5 and FN/SFN with TI-RADS 3/TI-RADS 4), and high malignancy risk (FN/SFN with TI-RADS 5).

Results: The surgical approach should be recommended in high-risk patients (81.82% of malignancies), carefully evaluated in intermediate risk (25.42%), whereas a conservative approach can be adopted in low-risk patients (0.00%).

Conclusions: The integration of these two multiparametric systems in a Cyto-US score has proven to be a feasible and reliable aid to achieve a more accurate definition of malignancy risk.

Background: Given the lack of a previous study assessing understandability and considering there is only one study assessing the readability and quality of online information related to thyroid nodules, we aimed to assess the readability, understandability, and quality of online patient education materials on thyroid nodules.

Methods: Materials were identified through an online search performed by inputting the term "thyroid nodule" into Google. A total of 150 websites were identified, 59 met the inclusion criteria. Websites were classified as academic and hospital (N.=29), physician and clinic (N.=7), organization (N.=12), and health information websites (N.=11). The readability was evaluated using an online system performing a group of validated readability tests. The Patient Education Materials Assessment Tool (PEMAT) was utilized to assess the understandability. The quality was evaluated through the Journal of the American Medical Association (JAMA) benchmark criteria.

Results: Among all websites, the mean reading grade level was 11.25±1.88 (range, 8-16), well above the recommended sixth grade reading level (P<0.001). The mean PEMAT Score was 57.4±14.5% (range, 31-88%). For all groups of types of websites, the understandability score was below 70%. There was no statistical difference between the groups for the average reading grade level or the PEMAT score (P=0.379 and P=0.26, respectively). The average JAMA benchmark score was 1.86±1.38 (range 0-4), health information-based websites scored the highest (P=0.007).

Conclusions: Online resources on thyroid nodules are written at grade levels above the recommended reading level. Most resources scored poorly using the PEMAT and varied in quality. Future work should focus on developing understandable, high-quality, and grade-level appropriate materials.

Background: Acromegaly is a disease that occurs as a result of excessive growth hormone caused by pituitary adenomas. Some acromegaly patients show resistance to somatostatin analog (SSA) treatment. Filamin-A (FLNA) and β-arrestins are thought to play a role in the response to SSAs. We aimed to investigate the relationship between FLNA-rs782079491 and β-arrestin-2-rs34230287 single-nucleotide polymorphisms and disease risk, as well as treatment response in patients with acromegaly in the Turkish population.

Methods: The genotypes of 110 acromegaly patients and 99 controls were determined by real-time PCR. The genotype distributions were compared with clinical data on the disease.

Results: There was no association between the β-arrestin-2 gene polymorphism and the response to SSA treatment in acromegaly patients. For responder patients to SSAs, the β-arrestin-2-rs34230287 CT+TT genotype was associated with higher microadenoma as compared with the CC genotype (P=0.017). The FLNA polymorphism was not observed in the study group.

Conclusions: We showed that there was no association between the polymorphic genotypes of FLNA and β-arrestin-2 genes with acromegaly disease and SSAs response in the Turkish population. However, there was a relationship between β-arrestin-2 and some of the clinical characteristics. Furthermore, the CC genotype and the C allele are risk factors associated with tumor growth rate in acromegaly patients.

Introduction: Male fertility relies on a complex physiology that may be negatively influenced by lifestyle, diet, and environment. The beneficial effect of nutraceuticals on male fertility is a debated claim. The aim of this study was to assess if the positive effect of nutraceuticals can counteract the negative effects of the environment on male fertility.

Evidence acquisition: PubMed^®/MEDLINE^®, Embase and Cochrane Database were searched (September-October 2023), along with crosschecking of references and search for ongoing studies of the effects of the environment and nutraceuticals on male fertility, in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Evidence synthesis: Several environmental factors such as microplastic and other endocrine-disrupting chemicals and climate changes may affect the sperm quality in terms of reduction of sperm count number, mobility and altered morphology and thereby reduce male fertility. On the other hand, new evidence demonstrates that a balanced diet rich in antioxidants and essential nutrients, together with minimized exposure to environmental toxins, may improve male fertility and reproductive health. Several nutraceutical compounds proved a protective role against negative environmental effects on male fertility.

Conclusions: Available evidence confirms that the environment may negatively impact male fertility, and this impact is estimated to rise in the forthcoming years. On the other hand, new data indicate that nutraceuticals may have a protective role against the negative impact of environmental factors on male fertility. The need for future studies to monitor and explore these aspects of men's health cannot be underestimated.