Minerva endocrinology最新文献

Introduction: There has been a dramatic increase in the practice of shift work throughout the world. It is known to associate with several adverse health outcomes including increased adiposity. The present study aims to systematically evaluate the literature to find the associations between exposure to shift work and body composition.

Evidence acquisition: Data were obtained using a stepwise search process using keywords in the following online medical databases; PubMed^®, Web of Science^® and Scopus^® for studies published before 31^st March 2020. Studies which compared the outcome related to the body composition of shift workers and regular day workers were included. A meta-analysis was performed on body fat percentage (BF%).

Evidence synthesis: Initial database searching indicated 2311 potentially eligible articles, of which seven studies satisfying the inclusion criteria were selected. The number of participants ranged between 17 to 7318, and the age range of the subjects was between 20-65 years. The studies reported diverse shift schedules including rotating shifts, night, evening shifts, alternate shifts, and regular shifts. Four out of seven studies revealed a higher BF% in shift workers when compared to the non-shift group. The pooled mean difference for BF% between shift workers and regular workers was 1.77% (95% CI: 0.18, 3.35; P=0.03; I²=52%, P>0.12).

Conclusions: The meta-analysis of the review showed a significant increase in BF% of shift workers when compared to the non-shift group. However, individual studies showed considerable heterogeneity. Therefore in order to further clarify the underlying mechanisms, more and better quality studies on this field are necessary.

Background: Uncontrolled increase in reactive oxygen species (ROS) leads to the release of free radicals. Additionally, when antioxidants go below a certain level, major molecules of our system such as DNA, proteins, and many other macromolecules get damaged, leading to cancer, heart diseases, and metabolic syndromes like diabetes. Therefore, in our study we focused on: 1) newly diagnosed type 2 diabetes mellitus (T2DM) patients and tried to evaluate the expression of antioxidant enzyme encoding genes; 2) superoxide dismutase 1 (SOD1) and superoxide dismutase 2 (SOD2) and DNA repair genes; and 3) X-ray repair cross-complementing 1(XRCC1) and 8-oxoguanine DNA glycosylase 1 (OGG1) in them.

Methods: Expression analysis was performed by RT-PCR on 60 subjects (30 T2DM cases and 30 non-diabetic controls). The level of the SOD enzyme was also estimated in a serum sample by the colorimetric method. Biochemical parameters such as fasting plasma glucose (FBG), glycated haemoglobin (HbA1c), high sensitivity C-reactive protein (hsCRP), and lipid profile were estimated in an auto analyzer. Receiver operating characteristic (ROC) curve analysis was done, the area under the curve for mRNA expression and enzyme level was calculated to determine their potential as markers in newly diagnosed T2DM.

Results: Down-regulation of both SOD1 (0.43 fold, P=0.02) and SOD2 (0.41 fold, P=0.13) and up-regulation of both XRCC1 (1.15 fold, P>0.05) and OGG1 (1.49 fold, P>0.05) was observed in patients with T2DM. We also observed a significant decrease (P=0.02) in SOD enzyme levels in diabetic cases than in controls (599.8±178.9 and 691.3±127.3).

Conclusions: We report that antioxidant repair genes are downregulated and DNA repair genes are upregulated in newly diagnosed T2DM patients. SOD levels and SOD1 gene expression can serve as informative biomarkers for identifying T2DM patients.

Introduction: Obesity is intricately linked with metabolic conditions that disrupt hormones and metabolism, often resulting in weight-related challenges. Given the heightened mortality rates associated with cardiovascular and metabolic disorders linked to obesity, there is a pressing call to mobilize medical professionals, researchers, and policymakers towards advocating for healthy lifestyles and preventing obesity. Traditionally, obesity prevention and treatment have been viewed as separate endeavors, with prevention primarily falling under public health initiatives and treatment within the purview of clinicians. However, this division has led to significant healthcare costs without a substantial reduction in obesity rates.

Evidence acquisition: Our search encompassed published articles focused on prevention, excluding any mention of "treatment". Data was gathered from diverse sources including academic databases, government health agency websites like the CDC, research organizations, clinical trials registries, and public health campaigns.

Evidence synthesis: Due to the diverse range of interventions (encompassing dietary modifications, physical activity promotion, policy initiatives, education, and community-based programs, either independently or in combination), and the variability in study design and population demographics, we conducted a narrative review to systematically present and critically analyze evidence on preventing overweight and obesity across different age groups.

Conclusions: Effectively addressing obesity prevention necessitates a comprehensive, multidisciplinary approach that establishes an environment where healthier choices are accessible and viable for all. This requires collaborative efforts between individuals, communities, healthcare providers, policymakers, and industries to institute enduring change. Furthermore, there remains a critical need for national and international guidelines tailored to age-related risk factors, paving the way for innovative precision medicine approaches centered on salutogenesis rather than pathogenesis.

Introduction: Linagliptin is a convenient and effective drug approved for glycemic management in type 2 diabetes mellitus (T2DM). However, the effectiveness and safety evidence of linagliptin remains unclear with the increasing prevalence of T2DM in elderly patients. The aim of this study was to evaluate the effectiveness and safety of linagliptin within T2DM cases who aged ≥60 years.

Evidence acquisition: The researchers pooled 4903 cases aged ≥60 years with T2DM from 5 published randomized clinical trials obtained from multiple databases. The safety was evaluated by the incidence and severity of adverse events which mainly focused on hypoglycemia. The major effectiveness end point was the change of glycated hemoglobin (HbA1c). Then the researchers made the qualitative and quantitative assessments of the investigation.

Evidence synthesis: The level of HbA1c and fasting plasma glucose was significantly reduced by linagliptin (WMD=-0.63%, 95% CI: -0.81, -0.44; P<0.00001; Z=6.70) and (WMD=-15.58 mg/dL, 95% CI: -22.34, -8.82; P<0.00001; Z=4.52) relative to that in the placebo cohort. The incidences of overall (OR=1.01, 95% CI: 0.82, 1.25; P=0.91) and severe negative events (OR=0.88, 95% CI: 0.61, 1.25; P=0.46) were not significant increased in linagliptin cohorts compared to the placebo cohorts. There is insignificant difference in hypoglycemia between linagliptin and placebo cohorts for the 24 weeks' study (OR=1.12, 95% CI: 0.85, 1.48; P=0.41). Severe hypoglycemia had slightly descended incidence, whereas insignificant difference was shown in the linagliptin cohorts in contrast to placebo cohorts (OR=0.95, 95% CI: 0.68, 1.32, P=0.76).

Conclusions: Linagliptin is an effective drug with excellent safety for elderly T2DM.

Background: The Mediterranean diet (MD) is recognized as a cultural heritage by UNESCO, thus, is a nutritional model widely spread in all Mediterranean countries. As already demonstrated by several studies, high adherence to MD is a protective factor against many chronic diseases. Conversely, poor adherence to the diet is correlated with an increased prevalence of these pathologies. The aim of the current study was to investigate the relationship between the adherence to MD and the prevalence of benign and malignant thyroid disease.

Methods: We analyzed the health status of 60 patients, referred to total thyroidectomy and histological examination, due to nodular thyroid disease. Eating habits were evaluated according to the PREDIMED questionnaire, and patients' results were evaluated according to histological findings of benign or malignant disease.

Results: PREDIMED Score was lower in patients with malignant thyroid disease (MTD) than those with benign thyroid disease (BTD) (5.27±0.87 vs. 7.00±1.23, respectively; P value <0.001). A significant correlation was found between poor adherence to MD and diagnosis of MTD (r=0.454; P<0.001). Excessive consumption of butter and sugary drinks, along with low consumption of pasta, white meat, and rice were found to be predictive factors of MTD.

Conclusions: In our cohort, a PREDIMED Score ≤7 resulted significantly related to MTD diagnosis, while a good adherence to MD resulted associated with BTD. Moreover, high consumption of sweetened beverages seemed to predict MTD histologic diagnosis, while, conversely, low consumption resulted predictor of BTD. Nevertheless, more studies are needed to evaluate the effective impact of MD on MTD incidence on larger cohorts.

Background: Chronic back pain (CBP) in patients with type 2 diabetes (T2DM) is twice as high among age-and-gender-matched controls. The presence of both conditions impacts negatively on both quality of life and physical function, which might negatively affect mood.

Methods: We aimed to determine the prevalence of CBP among patients with T2DM by using the Lattinen Index (LI) and to assess whether the presence of CBP had any influence on clinical or psychological outcomes.

Results: 13.5% out of 299 patients had significant CBP. The percentage of patients with less than 150 minutes per week of exercise was higher in the group of patients with significant CBP (70% vs. 51.4%; P=0.04). The proportion of patients who met criteria for food addiction was greater among subjects with CBP (47.5% vs. 26.6%; P=0.009). The percentage of patients with criteria for depression was higher among the CBP group (82.5% vs. 29.7%; P<0.0001), as well as the prescription of antidepressants (45% vs. 17.4%; P<0.0001). However, no significant differences were seen regarding glycemic control, or the frequency of complications related to T2DM.

Conclusions: CBP is prevalent among subjects with T2DM, and it constitutes an important limiting factor of both self-care behaviors and psychological well-being.

Background: Dysfunction of the nervous system is well-known in diabetes and among patients with prediabetes, obesity, and hypertension. However, there is only a limited amount of data available on the changes in neuronal function in polycystic ovary syndrome (PCOs), even though this condition is also accompanied by metabolic and vascular abnormalities. The aim of our study was to assess the cardiovascular autonomic and peripheral sensory function in patients with PCOs.

Methods: The study involved 27 women with PCOs, and 24 healthy women as control subjects. Autonomic neuropathy (AN) was assessed using the four standard cardiovascular reflex tests. Peripheral sensory function was determined using the Neurometer (Neurotron Incorporated, Baltimore, MD, USA). Electric stimulation was applied transcutaneously and the current perception threshold (CPT) values were determined on the median and peroneal nerves.

Results: No significant differences were found between the PCOs patients and the control group regarding the cardiovascular autonomic reflex tests and the AN scores. The CPT values of PCOs patients in the median and peroneal nerves were lower at all frequencies in comparison to controls.

Conclusions: The cardiovascular autonomic nerve function was normal in the patients with PCOs. The current perception thresholds were consequently lower in the PCOs patients both in the upper and lower extremities at all frequencies, which serves as an early sign of neuropathy. As a novel observation, our results suggest that early neuronal damage manifests in the form of sensory hyperesthesia in patients with PCOs.

Background: The significant risks of hypothyroidism during pregnancy can be mitigated through timely diagnosis and initiation of thyroxine to achieve a maternal euthyroid state. This study aimed to evaluate the efficiency of hospital endocrine services by assessing the rate of thyroxine commencement before the initial clinic appointment, the median gestational age at the first consultation, the rate of guideline-appropriate investigations, perinatal outcomes, and the proportion of referred patients who achieved their target thyroid-stimulating hormone (TSH) levels before and after implementing a dedicated referral and management pathway.

Methods: A retrospective clinical audit was conducted using electronic medical records for the first fifty consecutive patients with hypothyroidism referred to the hospital clinic during two-time intervals: from April 1 to September 1, 2020 (pre-intervention) and from April 1 to September 1, 2021 (postintervention).

Results: Following the pathway implementation, there was no significant difference in the proportion of women with initially raised TSH who were prescribed thyroxine prior to the first clinic appointment (P=0.83). However, the first TSH measurement occurred earlier (median 5.5 vs. 6.5 weeks, P=0.011), and specialist reviews were conducted sooner (median 19 vs. 22 weeks, P=0.032). Significantly more women with elevated TSH underwent thyroid autoantibody testing postintervention (78% vs. 55.5%, P=0.035). There was no significant difference in perinatal outcomes. All women achieved their target TSH levels, with a median final TSH of 1.6 mIU/L (IQR: 1.2 to 2.3).

Conclusions: While the proportion of referred patients achieving target TSH levels during pregnancy remained unchanged, certain measures of service efficiency improved. These included earlier TSH measurement, earlier endocrinologist review, and increased detection of thyroid autoantibodies.