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PCSK1N as a tumor size marker and an ER stress response protein in corticotroph pituitary adenomas. PCSK1N是皮质垂体腺瘤中的肿瘤大小标记物和ER应激反应蛋白。
Pub Date : 2024-09-17 DOI: 10.1210/clinem/dgae643
Merisa Abusdal,Kjersti R Normann,Tuula A Nyman,Kristin A B Øystese,Arvind Y M Sundaram,Daniel Dahlberg,Tove Lekva,Jens Bollerslev,Jens P Berg,Nicoleta C Olarescu
PURPOSESilent corticotroph adenoma (SCA) exhibits more tumor aggressiveness features than functioning adenomas (FCA). We aimed to investigate PCSK1N expression in CA and examine if ER stress-induced responses affect cell survival in a corticotroph tumor cell model.METHODSClinical and imaging characteristics were recorded in 33 patients with FCA (20 women, 11 macroadenomas) and 18 SCA (8 women, all macroadenomas). Gene expression of proopiomelanocortin (POMC), T-box transcription factor 19(TBX19)/TPIT, proprotein convertase subtilisin/kexin type 1(PCSK1)/PC1/3, and its inhibitor PCSK1N, was measured by RT-qPCR in adenoma tissue.Mouse pituitary corticotroph tumor (AtT-20) cells were treated with tanespimycin (17-AAG), a HSP90 chaperone inhibitor, to induce ER stress, followed by gene and protein analyses.RESULTSPOMC, TPIT, and PCSK1 expression were higher, whereas PCSK1N was lower in FCA compared to SCA. PCSK1N correlated with POMC (rs= -0.514, p <0.001), TPIT (rs= -0.386, p = 0.005), PCSK1 (rs= -0.3691, p = 0.008), and tumor largest diameter (rs= 0.645, p <0.001), in all CA. Induction of ER stress by 17-AAG in AtT-20 cells led to a decrease of POMC and an increase of PCSK1N gene expression at 24h. Moreover, a downregulation of cell cycle, apoptosis, and senescence pathways, and alterations in cell adhesion and cytoskeleton were observed at the protein level.CONCLUSIONSPCSK1N is higher in SCA compared with FCA, and associated with corticotroph cell markers and tumor size. PCSK1N is likely to be part of the adaptive response to ER stress, potentially conferring a survival advantage to the corticotroph tumor cell in conjunction with other proteins.
目的无症状皮质腺瘤(SCA)比功能性腺瘤(FCA)表现出更多的肿瘤侵袭性特征。我们的目的是调查 PCSK1N 在 CA 中的表达情况,并研究 ER 应激诱导的反应是否会影响皮质腺瘤细胞模型中细胞的存活。通过RT-qPCR测定了腺瘤组织中前绒毛膜促皮质素(POMC)、T-盒转录因子19(TBX19)/TPIT、1型潜血蛋白酶/kexin(PCSK1)/PC1/3及其抑制剂PCSK1N的基因表达。用 HSP90 合子抑制剂 tanespimycin(17-AAG)处理小鼠垂体促肾上腺皮质激素瘤(ATT-20)细胞以诱导 ER 应激,然后进行基因和蛋白质分析。结果与 SCA 相比,FCA 的 POMC、TPIT 和 PCSK1 表达较高,而 PCSK1N 较低。在所有CA中,PCSK1N与POMC(rs= -0.514,p <0.001)、TPIT(rs= -0.386,p = 0.005)、PCSK1(rs= -0.3691,p = 0.008)和肿瘤最大直径(rs= 0.645,p <0.001)相关。17-AAG 在 AtT-20 细胞中诱导 ER 应激会导致 24 小时后 POMC 基因表达的减少和 PCSK1N 基因表达的增加。此外,在蛋白质水平上还观察到细胞周期、细胞凋亡和衰老途径的下调,以及细胞粘附和细胞骨架的改变。PCSK1N可能是对ER应激的适应性反应的一部分,可能与其他蛋白一起赋予皮质营养肿瘤细胞生存优势。
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引用次数: 0
Precision medicine in Acromegaly: The Potential of Multimodal Therapy. 肢端肥大症的精准医疗:多模式疗法的潜力。
Pub Date : 2024-09-17 DOI: 10.1210/clinem/dgae636
Jens Bollerslev,Ansgar Heck
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引用次数: 0
Habitual Coffee, Tea, and Caffeine Consumption, Circulating Metabolites, and the Risk of Cardiometabolic Multimorbidity. 咖啡、茶和咖啡因的习惯性摄入量、循环代谢物与心脏代谢性多病风险。
Pub Date : 2024-09-17 DOI: 10.1210/clinem/dgae552
Xujia Lu,Xiaohong Zhu,Guochen Li,Luying Wu,Liping Shao,Yulong Fan,Chen-Wei Pan,Ying Wu,Yan Borné,Chaofu Ke
CONTEXTCardiometabolic multimorbidity (CM) is an increasing public health concern. Previous observational studies have suggested inverse associations between coffee, tea, and caffeine intake and risks of individual cardiometabolic diseases; however, their associations with CM and related biological markers are unknown.METHODSThis prospective study involved 172 315 (for caffeine analysis) and 188 091 (tea and coffee analysis) participants free of any cardiometabolic diseases at baseline from the UK Biobank; 168 metabolites were measured among 88 204 and 96 393 participants. CM was defined as the coexistence of at least 2 of the following conditions: type 2 diabetes, coronary heart disease, and stroke.RESULTSNonlinear inverse associations of coffee, tea, and caffeine intake with the risk of new-onset CM were observed. Compared with nonconsumers or consumers of less than 100 mg caffeine per day, consumers of moderate amount of coffee (3 drinks/d) or caffeine (200-300 mg/d) had the lowest risk for new-onset CM, with respective hazard ratios (95% CIs) of 0.519 (0.417-0.647) and 0.593 (0.499-0.704). Multistate models revealed that moderate coffee or caffeine intake was inversely associated with risks of almost all developmental stages of CM, including transitions from a disease-free state to single cardiometabolic diseases and subsequently to CM. A total of 80 to 97 metabolites, such as lipid components within very low-density lipoprotein, histidine, and glycoprotein acetyls, were identified to be associated with both coffee, tea, or caffeine intake and incident CM.CONCLUSIONHabitual coffee or caffeine intake, especially at a moderate level, was associated with a lower risk of new-onset CM and could play important roles in almost all transition phases of CM development. Future studies are warranted to validate the implicated metabolic biomarkers underlying the relation between coffee, tea, and caffeine intake and CM.
内容提要心脏代谢性多病(CM)是一个日益受到关注的公共卫生问题。方法:这项前瞻性研究涉及英国生物库中 172 315 名(咖啡因分析)和 188 091 名(茶和咖啡分析)基线无任何心脏代谢疾病的参与者;分别对 88 204 名和 96 393 名参与者的 168 种代谢物进行了测量。结果发现,咖啡、茶和咖啡因的摄入量与新发冠心病的风险呈非线性反比关系。与不喝咖啡或每天摄入咖啡因少于 100 毫克的人相比,喝适量咖啡(3 杯/天)或摄入咖啡因(200-300 毫克/天)的人患新发中风的风险最低,危险比(95% CIs)分别为 0.519(0.417-0.647)和 0.593(0.499-0.704)。多态模型显示,适量的咖啡或咖啡因摄入量与几乎所有心脏病发展阶段的风险都成反比,包括从无疾病状态过渡到单一的心脏代谢疾病,以及随后过渡到心脏病。结论习惯性摄入咖啡或咖啡因,尤其是适量摄入咖啡或咖啡因,与较低的新发CM风险相关,并可在CM发展的几乎所有过渡阶段发挥重要作用。未来的研究需要验证咖啡、茶和咖啡因摄入量与 CM 之间关系的代谢生物标志物。
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引用次数: 0
1-Hour Post-Load Glucose: Early Screening for High Risk of Type 2 Diabetes in Koreans with Normal Fasting Glucose. 负荷后 1 小时血糖:空腹血糖正常的韩国人 2 型糖尿病高风险的早期筛查。
Pub Date : 2024-09-14 DOI: 10.1210/clinem/dgae632
Min Jin Lee,Ji Hyun Bae,Ah Reum Khang,Dongwon Yi,Joo Yeon Kim,Su Hyun Kim,Dong Hee Kim,Dasol Kang,Sujin Park,Yun Kyung Jeon,Sang Soo Kim,Bo Hyun Kim,Mi Sook Yun,Yang Ho Kang
CONTEXTWith rising the prevalence of type 2 diabetes mellitus (T2DM) and prediabetes, the importance of 1-hour post-load plasma glucose (1-h PG) for early hyperglycemia screening is emphasized.OBJECTIVEThis study investigates the utility of 1-h PG in predicting T2DM in adults with normal fasting plasma glucose (FPG) levels.METHODS7,504 participants were categorized into three groups: normal glucose tolerance (NGT) with 1-h PG < 155 mg/dL, NGT with 1-h PG ≥ 155 mg/dL, and impaired glucose tolerance (IGT). Insulin sensitivity and secretion indices were compared between groups at baseline, and T2DM incidence was analyzed using Cox proportional hazards models. The predictive abilities of 1-h PG and 2-hour post-load plasma glucose (2-h PG) were assessed with receiver operating characteristic analysis.RESULTSAt baseline, the composite insulin sensitivity index in the NGT & 1-h PG ≥ 155 mg/dL group was similarly reduced as in the IGT group (P = .076). Over a mean follow-up of 7.4 years, T2DM developed in 960 patients (12.8%). The highest risk was in the IGT group (hazard ratio [HR] 5.47), followed by the NGT & 1-h PG ≥ 155 mg/dL group (HR 2.74), compared to the NGT & 1-h PG < 155 mg/dL group. The 1-h PG level had a higher area under the curve (0.772) than other glycemic parameters, including 2-h PG.CONCLUSIONEven with normal FPG, a 1-h PG ≥ 155 mg/dL indicates lower insulin sensitivity similar to IGT and increased T2DM risk, making it a more effective early screening tool than 2-h PG.
背景随着 2 型糖尿病(T2DM)和糖尿病前期患病率的上升,负荷后 1 小时血浆葡萄糖(1-h PG)在早期高血糖筛查中的重要性得到了强调。本研究调查了 1 小时 PG 在预测空腹血浆葡萄糖(FPG)水平正常的成人 T2DM 中的作用。方法将 7,504 名参与者分为三组:1 小时 PG < 155 mg/dL 的糖耐量正常(NGT)组、1 小时 PG ≥ 155 mg/dL 的糖耐量正常(NGT)组和糖耐量受损(IGT)组。比较了各组基线时的胰岛素敏感性和分泌指数,并使用 Cox 比例危险模型分析了 T2DM 的发病率。结果基线时,NGT & 1-h PG ≥ 155 mg/dL 组的胰岛素敏感性综合指数与 IGT 组相似(P = 0.076)。在平均 7.4 年的随访期间,960 名患者(12.8%)患上了 T2DM。IGT 组的风险最高(危险比 [HR] 5.47),其次是 NGT & 1-h PG ≥ 155 mg/dL 组(HR 2.74),而 NGT & 1-h PG < 155 mg/dL 组的风险最低。结论即使 FPG 正常,1-h PG ≥ 155 mg/dL 也表明胰岛素敏感性降低,类似于 IGT,T2DM 风险增加,因此是比 2-h PG 更有效的早期筛查工具。
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引用次数: 0
Topiramate added to metformin for obesity control in women with polycystic ovary syndrome: a randomized clinical trial. 多囊卵巢综合征妇女在二甲双胍基础上加用托吡酯控制肥胖:随机临床试验。
Pub Date : 2024-09-14 DOI: 10.1210/clinem/dgae637
Lucas Bandeira Marchesan,Thais Rasia da Silva,Poli Mara Spritzer
CONTEXTPolycystic ovary syndrome (PCOS) is often linked with obesity, and weight management can improve endocrine and cardiometabolic features.OBJECTIVETo evaluate the effects of adding topiramate (TPM) to metformin (MTF) on weight control, hormonal and metabolic outcomes in women with PCOS.METHODSIn a randomized, double-blind, placebo-controlled trial, participants with PCOS and body mass index ≥30 kg/m² or ≥27 kg/m² associated with hypertension, type 2 diabetes, or dyslipidemia followed a 20 kcal/kg diet in addition to 850 mg of MTF or a previous MTF regimen. They were randomized to receive either TPM or placebo (P) alongside MTF. Anthropometric measurements, blood pressure, modified Ferriman-Gallwey score (mFGS), and adverse events were assessed every 4 weeks for 6 months.MAIN OUTCOME MEASURESThe primary endpoint was the percent change in body weight from baseline in both groups. Secondary endpoints included changes in clinical, cardiometabolic, and hormonal parameters and psychosocial features.RESULTSThirty-one participants were in the MTF+P group and 30 in the MTF+TPM group. The MTF+TPM group showed greater mean weight loss at 3 months (-3.4% vs. -1.6%, p=0.03) and 6 months (-4.5% vs. -1.4%, p=0.03). Both groups improved androgens, lipids, and psychosocial scores. Participants with ≥3% weight loss at 6 months improved mFGS (8.4 to 6.5, p=0.026). Paresthesia was more common in the MTF+TPM group (23.3% vs. 3.2%, p=0.026).CONCLUSIONSCombining TPM with MTF and a low-calorie diet may be an effective, low-cost, easy-to-use, and safe strategy for weight management in women with PCOS, with mild adverse effects.
背景多囊卵巢综合征(PCOS)通常与肥胖有关,控制体重可改善内分泌和心脏代谢特征。目的评估在二甲双胍(MTF)中添加托吡酯(TPM)对多囊卵巢综合征女性患者控制体重、激素和代谢结果的影响。方法在一项随机、双盲、安慰剂对照试验中,患有多囊卵巢综合征且体重指数≥30 kg/m²或≥27 kg/m²并伴有高血压、2 型糖尿病或血脂异常的参与者在服用 850 毫克二甲双胍或之前的二甲双胍治疗方案的同时,遵循 20 千卡/千克的饮食方案。他们被随机分配在接受 MTF 的同时接受 TPM 或安慰剂 (P)。在为期 6 个月的时间里,每 4 周对人体测量、血压、改良费里曼-高尔维评分 (mFGS) 和不良事件进行一次评估。次要终点包括临床、心脏代谢、激素参数和社会心理特征的变化。结果MTF+P组31人,MTF+TPM组30人。MTF+TPM 组在 3 个月(-3.4% vs. -1.6%, p=0.03)和 6 个月(-4.5% vs. -1.4%, p=0.03)的平均体重减轻幅度更大。两组患者的雄激素、血脂和社会心理评分均有所改善。6 个月时体重下降≥3% 的参与者的 mFGS 有所改善(从 8.4 降至 6.5,p=0.026)。结论将 TPM 与 MTF 和低热量饮食相结合可能是一种有效、低成本、易于使用且安全的多囊卵巢综合症女性体重管理策略,不良反应轻微。
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引用次数: 0
Data-Driven Strategies for Carbimazole Titration: Exploring Machine Learning Solutions in Hyperthyroidism Control. 卡比马唑滴定的数据驱动策略:探索甲亢控制中的机器学习解决方案。
Pub Date : 2024-09-13 DOI: 10.1210/clinem/dgae642
Thilo Reich,Rashid Bakirov,Dominika Budka,Derek Kelly,James Smith,Tristan Richardson,Marcin Budka
BACKGROUNDUniversity Hospitals Dorset (UHD) has over 1,000 thyroid patient contacts annually. These are primarily patients with autoimmune hyperthyroidism treated with Carbimazole titration. Dose adjustments are made by a healthcare professional (HCP) based on the results of thyroid function tests, who then prescribes a dose and communicates this to the patient via letter. This is time-consuming and introduces treatment delays. This study aimed to replace some time-intensive manual dose adjustments with a machine learning model to determine Carbimazole dosing. This can in the future serve patients with rapid and safe dose determination and ease the pressures on HCPs.METHODSData from 421 hyperthyroidism patients at UHD were extracted and anonymised. A total of 353 patients (83.85%) were included in the study. Different machine-learning classification algorithms were tested under several data processing regimes. Using an iterative approach, consisting of an initial model selection followed by a feature selection method the performance was improved. Models were evaluated using weighted F1 scores and Brier scores to select the best model with the highest confidence.RESULTSThe best performance is achieved using a random forest (RF) approach, resulting in good average F1 scores of 0.731. A model was selected based on a balanced assessment considering the accuracy of the prediction (F1 = 0.751) and the confidence of the model (Brier score = 0.38).CONCLUSIONTo simulate a use-case, the accumulation of the prediction error over time was assessed. It was determined that an improvement in accuracy is expected if this model was to be deployed in practice.
背景多塞特郡大学医院(UHD)每年接触的甲状腺患者超过 1000 人。这些患者主要是接受卡比马唑滴定治疗的自身免疫性甲状腺功能亢进症患者。专业医护人员(HCP)根据甲状腺功能检测结果调整剂量,然后开出剂量处方,并通过信件告知患者。这种做法既耗时又会延误治疗。这项研究旨在用机器学习模型来确定卡比马唑的剂量,从而取代一些耗时的人工剂量调整。方法提取并匿名化了日内瓦大学附属医院421名甲状腺功能亢进症患者的数据。研究共纳入 353 名患者(83.85%)。在几种数据处理机制下对不同的机器学习分类算法进行了测试。采用迭代方法,包括初始模型选择和特征选择方法,提高了性能。使用加权 F1 分数和布赖尔分数对模型进行评估,以选出置信度最高的最佳模型。结果使用随机森林(RF)方法取得了最佳性能,平均 F1 分数达到 0.731。在平衡评估预测准确性(F1 = 0.751)和模型置信度(布赖尔得分 = 0.38)的基础上选出了一个模型。结果表明,如果在实践中使用该模型,准确度有望得到提高。
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引用次数: 0
11-oxygenated androgens originate from the adrenals. Period! And now? 11-氧雄激素源自肾上腺。时期!现在呢?
Pub Date : 2024-09-13 DOI: 10.1210/clinem/dgae638
Martin Bidlingmaier,Nicole Reisch
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引用次数: 0
The effect of SGLT2 inhibition on brain-related phenotypes and aging: a drug target Mendelian randomization study. SGLT2 抑制剂对大脑相关表型和衰老的影响:一项药物靶点孟德尔随机化研究。
Pub Date : 2024-09-13 DOI: 10.1210/clinem/dgae635
Zhihe Chen,Xueyan Wu,Qianqian Yang,Huiling Zhao,Hui Ying,Haoyu Liu,Chaoyue Wang,Ruizhi Zheng,Hong Lin,Shuangyuan Wang,Mian Li,Tiange Wang,Zhiyun Zhao,Min Xu,Yuhong Chen,Yu Xu,Jieli Lu,Guang Ning,Weiqing Wang,Shan Luo,Shiu Lun Au Yeung,Yufang Bi,Jie Zheng
INTRODUCTIONObservational study suggested SGLT2 inhibitors might promote healthy aging. However, whether brain-related phenotypes mediate this association. We applied Mendelian randomization (MR) to investigate the effect of SGLT2 inhibition on chronological, biological age and cognition and explore the mediation effects of brain imaging-derived phenotypes (IDPs).METHODSWe selected genetic variants associated with both expression levels of SLC5A2 (GTEx and eQTLGen data; N=129 to 31,684) and HbA1c levels (UK Biobank; N=344,182) and used them to proxy the effect of SGLT2 inhibition. Aging related outcomes, including parental longevity (N=389,166) and epigenetic clocks (N=34,710), and cognitive phenotypes, including cognitive function (N=300,486) and intelligence (N= 269,867) were derived from genome-wide association studies. Two-step MR were conducted to explore the associations between SGLT2 inhibition, IDPs, and aging outcomes, cognition.RESULTSSGLT2 inhibition was associated with longer father's attained age (years of life increase per SD (6.75 mmol/mol) reduction in HbA1c levels = 6.21, 95%CI 1.95 to 11.15), better cognitive function (beta = 0.17, 95%CI 0.03 to 0.31) and higher intelligence (beta = 0.47, 95%CI 0.19 to 0.75). Two-step MR identified two IDPs as mediators linking SGLT2 inhibition with chronological age (total proportion of mediation = 22.6%), where four and five IDPs were mediators for SGLT2 inhibition on cognitive function and intelligence respectively (total proportion of mediation = 61.6% and 68.6% respectively).CONCLUSIONSOur study supported that SGLT2 inhibition increases father's attained age, cognitive function and intelligence, which was mediated through brain images of different brain regions. Future studies are needed to investigate whether similar effect could be observed for users of SGLT2 inhibitors.
简介:观察研究表明,SGLT2 抑制剂可促进健康老龄化。然而,大脑相关表型是否介导了这种关联。方法我们选择了与SLC5A2表达水平(GTEx和eQTLGen数据;N=129-31,684)和HbA1c水平(英国生物库;N=344,182)相关的遗传变异,并用它们来替代SGLT2抑制剂的作用。与衰老相关的结果,包括父母寿命(N=389,166)和表观遗传时钟(N=34,710),以及认知表型,包括认知功能(N=300,486)和智力(N=269,867),均来自全基因组关联研究。结果SGLT2抑制与父亲达到的年龄延长(每SD(6.HbA1c 水平每降低 75 mmol/mol = 6.21,95%CI 1.95 至 11.15)、更好的认知功能(β = 0.17,95%CI 0.03 至 0.31)和更高的智力(β = 0.47,95%CI 0.19 至 0.75)相关。)两步磁共振成像确定了两个IDPs为SGLT2抑制与年龄的中介(中介总比例=22.6%),其中4个和5个IDPs分别为SGLT2抑制对认知功能和智力的中介(中介总比例分别为61.6%和68.6%)。未来的研究还需要调查 SGLT2 抑制剂的使用者是否也能观察到类似的效果。
{"title":"The effect of SGLT2 inhibition on brain-related phenotypes and aging: a drug target Mendelian randomization study.","authors":"Zhihe Chen,Xueyan Wu,Qianqian Yang,Huiling Zhao,Hui Ying,Haoyu Liu,Chaoyue Wang,Ruizhi Zheng,Hong Lin,Shuangyuan Wang,Mian Li,Tiange Wang,Zhiyun Zhao,Min Xu,Yuhong Chen,Yu Xu,Jieli Lu,Guang Ning,Weiqing Wang,Shan Luo,Shiu Lun Au Yeung,Yufang Bi,Jie Zheng","doi":"10.1210/clinem/dgae635","DOIUrl":"https://doi.org/10.1210/clinem/dgae635","url":null,"abstract":"INTRODUCTIONObservational study suggested SGLT2 inhibitors might promote healthy aging. However, whether brain-related phenotypes mediate this association. We applied Mendelian randomization (MR) to investigate the effect of SGLT2 inhibition on chronological, biological age and cognition and explore the mediation effects of brain imaging-derived phenotypes (IDPs).METHODSWe selected genetic variants associated with both expression levels of SLC5A2 (GTEx and eQTLGen data; N=129 to 31,684) and HbA1c levels (UK Biobank; N=344,182) and used them to proxy the effect of SGLT2 inhibition. Aging related outcomes, including parental longevity (N=389,166) and epigenetic clocks (N=34,710), and cognitive phenotypes, including cognitive function (N=300,486) and intelligence (N= 269,867) were derived from genome-wide association studies. Two-step MR were conducted to explore the associations between SGLT2 inhibition, IDPs, and aging outcomes, cognition.RESULTSSGLT2 inhibition was associated with longer father's attained age (years of life increase per SD (6.75 mmol/mol) reduction in HbA1c levels = 6.21, 95%CI 1.95 to 11.15), better cognitive function (beta = 0.17, 95%CI 0.03 to 0.31) and higher intelligence (beta = 0.47, 95%CI 0.19 to 0.75). Two-step MR identified two IDPs as mediators linking SGLT2 inhibition with chronological age (total proportion of mediation = 22.6%), where four and five IDPs were mediators for SGLT2 inhibition on cognitive function and intelligence respectively (total proportion of mediation = 61.6% and 68.6% respectively).CONCLUSIONSOur study supported that SGLT2 inhibition increases father's attained age, cognitive function and intelligence, which was mediated through brain images of different brain regions. Future studies are needed to investigate whether similar effect could be observed for users of SGLT2 inhibitors.","PeriodicalId":22632,"journal":{"name":"The Journal of Clinical Endocrinology & Metabolism","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Somapacitan in Children Born SGA: 52-week Efficacy, Safety, and IGF-I Response Results from the Phase 2 REAL5 Study. 索马帕西坦对妊高症新生儿的治疗:REAL5 2 期研究的 52 周疗效、安全性和 IGF-I 反应结果。
Pub Date : 2024-09-13 DOI: 10.1210/clinem/dgae616
Anders Juul,Philippe Backeljauw,Michael Højby,Jan Frystyk,Masanobu Kawai,Rasmus Juul Kildemoes,Anders Krogh Lemminger,Agnès Linglart,Nehama Zuckerman-Levin,Reiko Horikawa
CONTEXTSomapacitan, a once-weekly reversible albumin-binding GH derivative, is evaluated in short children born small for gestational age (SGA).OBJECTIVEEvaluate efficacy, safety, tolerability as well as total and bioactive insulin-like growth factor-I (IGF-I) response of once-weekly somapacitan compared to daily GH in children born SGA.METHODSREAL5 is a randomized, multi-center, open-label, controlled phase 2 study comprising a 26-week main phase, 26-week extension, and an ongoing 4-year safety extension (NCT03878446).SETTINGThirty-eight sites across 12 countries.PATIENTSSixty-two GH-treatment-naïve, prepubertal short children born SGA were randomized; 61 completed 52-weeks of treatment.INTERVENTIONSPatients randomized (1:1:1:1:1) to somapacitan (0.16, 0.20 or 0.24 mg/kg/week) or daily GH (0.035 or 0.067 mg/kg/day), all administered subcutaneously.RESULTSEstimated mean height velocity (HV; cm/year) at week 52 was 8.5, 10.4 and 10.7 cm/year for somapacitan 0.16, 0.20 and 0.24 mg/kg/week, respectively, and 9.3 and 11.2 cm/year for daily GH 0.035 and 0.067 mg/kg/day, respectively. Dose-dependent increases in total IGF-I as well as peak IGF-I bioactivity were observed for both treatments and were similar between comparator groups. For somapacitan, exposure-response modelling indicated highest efficacy with 0.24 mg/kg/week after 52 weeks of treatment. Similar safety and tolerability were demonstrated across all groups.CONCLUSIONSA sustained dose-dependent growth response was demonstrated for somapacitan after 52 weeks of treatment. Overall, somapacitan 0.24 mg/kg/week provides similar efficacy, safety, and tolerability, as well as comparable bioactive and total IGF-I response, as daily GH (0.067 mg/kg/day) in children born SGA.
目的 评价与每日 GH 相比,每周一次索马帕西坦对 SGA 出生儿童的疗效、安全性、耐受性以及总胰岛素样生长因子-I (IGF-I) 和生物活性胰岛素样生长因子-I (IGF-I) 的反应。方法REAL5是一项随机、多中心、开放标签、对照的2期研究,包括26周的主要阶段、26周的扩展阶段和持续4年的安全扩展阶段(NCT03878446)。设置12个国家的38个研究机构。患者62名未经GH治疗、青春期前出生的SGA矮小儿童被随机分配;61名完成了52周的治疗。结果第52周时,估计平均身高速度(HV;厘米/年)分别为:索马帕奇坦0.16、0.20和0.24毫克/千克/周,8.5、10.4和10.7厘米/年;每日GH 0.035和0.067毫克/千克/天,9.3和11.2厘米/年。两种治疗方法都能观察到 IGF-I 总量和 IGF-I 生物活性峰值的剂量依赖性增加,而且各对比组之间的情况相似。对于索马帕坦,暴露-反应模型显示,治疗 52 周后,0.24 毫克/公斤/周的疗效最高。结论经过52周的治疗后,索马帕坦显示出持续的剂量依赖性生长反应。总体而言,索马帕坦 0.24 毫克/千克/周的疗效、安全性和耐受性与每日 GH(0.067 毫克/千克/天)相似,生物活性和总 IGF-I 反应也与每日 GH(0.067 毫克/千克/天)相似。
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引用次数: 0
Thyroid autoimmunity is associated with dietary fat consumption. 甲状腺自身免疫与膳食脂肪摄入量有关。
Pub Date : 2024-09-12 DOI: 10.1210/clinem/dgae629
Lulian Xu,Zhenzhen Liu,Xu Xu,Qiwen Wan,Juanying Zhen,Li Jiang,Bernard Man Yung Cheung,Chao Li
CONTEXTDietary factors are crucial in the onset and development of autoimmune thyroid disease (AITD), but the relationship between specific fatty acids and AITD remains unexplored.METHODSWe analyzed the US National Health and Nutrition Examination Survey (NHANES) 2007-2012 data on 3949 men and 3964 women aged 20 years and over with valid data on TPOAb, TgAb and details of fat intake, using multivariable regression models to examine the relationship of fat intake and specific fatty acid intake with thyroid autoimmunity.RESULTSOf the 7913 participants, 7.5% had TgAb seropositivity and 11.9% had TPOAb seropositivity. The seropositivity of TgAb and TPOAb was more common in low-fat intake participants. In the overall population and men, fats were associated with thyroid autoimmunity before and after full adjustment for age, ethnicity, body mass index, smoking status and urine iodine concentration (total fat: OR=0.64, 95% CI 0.49 to 0.83; SFA: OR=0.65, 95% CI 0.51 to 0.84; MUFA: OR=0.65, 95% CI 0.50 to 0.85; PUFA: OR=0.76, 95% CI 0.57 to 0.995, after full adjustment in men). Some specific fatty acids followed a similar pattern. The association between fats and TgAb seropositivity was significant in the overall population and men. The association between fats and TPOAb seropositivity was only found in the overall population.CONCLUSIONWe found a strong association between fat consumption and thyroid autoimmunity in the overall population and men from the nationally representative population-based survey. Fat and fatty acid consumption may be of benefit to individuals with thyroid autoimmunity.
摘要饮食因素对自身免疫性甲状腺疾病(AITD)的发生和发展至关重要,但特定脂肪酸与 AITD 之间的关系仍未得到探讨。方法我们分析了2007-2012年美国国家健康与营养调查(NHANES)中3949名20岁及以上男性和3964名20岁及以上女性的数据,其中包括TPOAb、TgAb和脂肪摄入量的有效数据,并使用多变量回归模型研究脂肪摄入量和特定脂肪酸摄入量与甲状腺自身免疫的关系。结果在7913名参与者中,7.5%的人TgAb血清阳性,11.9%的人TPOAb血清阳性。TgAb和TPOAb血清阳性在低脂肪摄入的参与者中更为常见。在总体人群和男性中,在对年龄、种族、体重指数、吸烟状况和尿碘浓度进行全面调整之前和调整之后,脂肪与甲状腺自身免疫相关(总脂肪:OR=0.64,95%,TPOAb血清阳性:OR=0.5,95%,TPOAb血清阳性):OR=0.64,95% CI为0.49至0.83;SFA:OR=0.65,95% CI为0.51至0.84;MUFA:OR=0.65,95% CI为0.50至0.85;PUFA:OR=0.76,95% CI为0.57至0.995,在对男性进行全面调整后)。一些特定的脂肪酸也遵循类似的模式。在总体人群和男性中,脂肪与 TgAb 血清阳性率之间的关系显著。结论我们发现,在具有全国代表性的人群调查中,总体人群和男性的脂肪摄入量与甲状腺自身免疫之间存在密切联系。脂肪和脂肪酸的摄入可能对甲状腺自身免疫患者有益。
{"title":"Thyroid autoimmunity is associated with dietary fat consumption.","authors":"Lulian Xu,Zhenzhen Liu,Xu Xu,Qiwen Wan,Juanying Zhen,Li Jiang,Bernard Man Yung Cheung,Chao Li","doi":"10.1210/clinem/dgae629","DOIUrl":"https://doi.org/10.1210/clinem/dgae629","url":null,"abstract":"CONTEXTDietary factors are crucial in the onset and development of autoimmune thyroid disease (AITD), but the relationship between specific fatty acids and AITD remains unexplored.METHODSWe analyzed the US National Health and Nutrition Examination Survey (NHANES) 2007-2012 data on 3949 men and 3964 women aged 20 years and over with valid data on TPOAb, TgAb and details of fat intake, using multivariable regression models to examine the relationship of fat intake and specific fatty acid intake with thyroid autoimmunity.RESULTSOf the 7913 participants, 7.5% had TgAb seropositivity and 11.9% had TPOAb seropositivity. The seropositivity of TgAb and TPOAb was more common in low-fat intake participants. In the overall population and men, fats were associated with thyroid autoimmunity before and after full adjustment for age, ethnicity, body mass index, smoking status and urine iodine concentration (total fat: OR=0.64, 95% CI 0.49 to 0.83; SFA: OR=0.65, 95% CI 0.51 to 0.84; MUFA: OR=0.65, 95% CI 0.50 to 0.85; PUFA: OR=0.76, 95% CI 0.57 to 0.995, after full adjustment in men). Some specific fatty acids followed a similar pattern. The association between fats and TgAb seropositivity was significant in the overall population and men. The association between fats and TPOAb seropositivity was only found in the overall population.CONCLUSIONWe found a strong association between fat consumption and thyroid autoimmunity in the overall population and men from the nationally representative population-based survey. Fat and fatty acid consumption may be of benefit to individuals with thyroid autoimmunity.","PeriodicalId":22632,"journal":{"name":"The Journal of Clinical Endocrinology & Metabolism","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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The Journal of Clinical Endocrinology & Metabolism
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