Minerva endocrinology最新文献

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.

Background: There is no clear consensus on whether a cranial MRI should be performed in all cases of central precocious puberty (CPP). In this study, we aimed to evaluate the incidence of intracranial lesions and to analyze cranial imaging results in females with CPP.

Methods: In the retrospective study medical records of the case, the age at the time of admission, anthropometric measurements, bone age, Tanner stages, serum follicle-stimulating hormone (FSH), serum luteinizing hormone (LH), serum estradiol (E2) levels, the peak LH level during the gonadotropin-releasing hormone (GnRH) stimulation test and the cranial MRI findings at the time of the diagnosis of CPP were collected.

Results: The mean age diagnosis of the 154 girls included in the study was 6.9±1.08. Nine (5.8%) of 154 patients were diagnosed with organic-caused CPP. Four of the nine cases diagnosed with organic CPP had a previously known CNS pathology. The other five cases did not have any neurological finding at the time of diagnosis. Incidental lesions were detected at cranial MRI of nine of the 145 cases diagnosed with idiopathic CPP. The basal E2, basal LH, basal FSH, peak LH and peak LH/FSH levels of the cases with organic CPP were higher than those with idiopathic CPP.

Conclusions: In our study, approximately 90% of organic CPP due to intracranial lesions were between 6-8 years old. Therefore, we believe that cranial imaging should be performed in all females with CPP.

Background: Predicting a multiple gland disease (MGD) in primary hyperparathyroidism (pHPT) remains challenging. This study aimed to evaluate predictive factors for MGD.

Methods: A retrospective chart review was performed of 1211 patients with histologically confirmed parathyroid adenoma or hyperplasia between 2007-2016. Localization diagnostics, laboratory parameters, and the weight of the resected parathyroid glands were evaluated concerning their predictive value of a multiple-gland disease.

Results: A number of 1111 (91.7%) had a single-gland disease (SGD), and 100 (8.3%) a multiple-gland disease (MGD). US and MIBI scans were comparable for either negative or positive adenoma localization and suspected MGD. While the PTH level was similar, the calcium level was higher in SGD (2.8 mmol/L versus 2.76 mmol/L, P=0.034). MGD had a significantly lower gland weight (0.78 g versus 0.31 g; P<0.001). A gland weight of 0.418 grams was a predictive factor for MGD with a sensitivity of 72% and a specificity of 66%.

Conclusions: Only the weight of the resected parathyroid adenoma was meaningful in predicting MGD. A cut-off value of 0.418 g can differentiate SGD from MGD.

Introduction: A growing amount of evidence has suggested that 1,25-dihydroxyvitamin D [1,25(OH)2D]-mediated hypercalcemia can be found not only in lymphoma and granulomatous disorders, but also in solid organ malignancies. Using systematic review technique, we aimed to summarize all available evidence of possible 1,25(OH)2D-mediated hypercalcemia in patients with solid organ malignancies.

Evidence acquisition: Potentially eligible articles were identified from MEDLINE and EMBASE databases from inception to December 2020 using search strategy consisting of terms related to "Vitamin D," "Hypercalcemia" and "Malignancy." Eligible article must be either case report or case series that reports individual level data of a patient or patients with hypercalcemia associated with solid organ malignancy and elevated 1,25(OH)2D without concomitant conditions that may otherwise explain 1,25(OH)2D-mediated hypercalcemia. Characteristics of the patients were extracted from each study. Eligible cases were categorized into three groups, including "definite," "probable" and "possible" cases, using the criteria to assess the strength of evidence that hypercalcemia observed in the eligible cases was caused by the presence of tumor that resulted in the increased production of 1,25(OH)2D.

Evidence synthesis: A total of 1673 articles were identified. After systematic review, 17 articles reporting 17 patients with 11 different types of solid organ malignancies associated with hypercalcemia secondary to elevated 1,25(OH)2D were identified. Based on the criteria to assess the strength of evidence of hypercalcemia mediated by tumor-associated increased production of 1,25(OH)2D, there were 4 definite cases and 13 probable cases.

Conclusions: This systematic review of case reports and case series revealed 17 patients with 11 different types of solid organ malignancies associated with hypercalcemia and elevated 1,25(OH)2D.