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Associations between metabolic phenotypes and diabetes risk: A systematic review and meta-analysis 代谢表型与糖尿病风险之间的关联:一项系统综述和荟萃分析
Q3 Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.endmts.2023.100142
V. Vera-Ponce, Joan A. Loayza-Castro, Fiorella E. Zuzunaga-Montoya, J. R. Torres-Malca, Rosa A. García-Lara, Cori Raquel Iturregui Paucar, Eder Jesús Orihuela Manrique, Mario J. Valladares-Garrido, J. A. De La Cruz-Vargas
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引用次数: 0
Association of new obesity markers with symptoms of depression: Analysis of a 4-year Peruvian national survey 新的肥胖标志物与抑郁症症状的相关性:一项为期4年的秘鲁全国调查分析
Q3 Medicine Pub Date : 2023-08-26 DOI: 10.1016/j.endmts.2023.100141
Víctor Juan Vera-Ponce , Gianella Zulema Zeñas-Trujillo , Joan A. Loayza-Castro , Jamee Guerra Valencia , Fiorella E. Zuzunaga-Montoya , Mario J. Valladares-Garrido , Cori Raquel Iturregui Paucar , Jhony A. De La Cruz-Vargas

Introduction

Although body mass index (BMI) and waist circumference (WC) are the most commonly used obesity markers in clinical practice regarding depression, some studies suggest that other obesity markers such as waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) may be more accurate in identifying patients with depression.

Objective

To determine the relationship between different markers of obesity and the presence of symptoms of depression.

Methods

Analytical cross-sectional study. A secondary analysis was conducted on the Demographic and Family Health Survey (ENDES) from 2018 to 2021. The main variable of the present study was the depression score. Numerical variables were presented as mean and confidence interval at 95 % (CI 95 %). A generalized linear model of the Gaussian family and Identity link function was performed to evaluate the strength of association between the variables of interest.

Results

The average depression score in the study population was 2.61 (95 % CI 2.56–2.65). In the multivariable analysis, the depression score increased for each unit that increased the BMI by 0.011 points (β = 0.011; 95 % CI 0.002–0.020), the WHtR by 0.207 points (β = 0.207; 95 % CI 0.145–0.267), the ABSI by 0.158 points (β = 0.158; IC95% 0.047–0.269), the BRI by 0.096 points (β = 0.096; IC95% 0.069–0.122), and the CI by 0.010 points (β = 0.010; IC95% 0.004–0.016). There was no statistically significant association for WC.

Conclusions

The WHtR may be a better marker of obesity for identifying patients with depressive symptoms compared to other markers.

虽然身体质量指数(BMI)和腰围(WC)是抑郁症临床实践中最常用的肥胖指标,但一些研究表明,腰高比(WHtR)、体型指数(ABSI)、身体圆度指数(BRI)和圆度指数(CI)等其他肥胖指标可能更准确地识别抑郁症患者。目的探讨不同肥胖指标与抑郁症状的关系。方法分析性横断面研究。对2018年至2021年人口与家庭健康调查(ENDES)进行了二次分析。本研究的主要变量为抑郁评分。数值变量以95% (CI 95%)的平均值和置信区间表示。采用高斯族和恒等链接函数的广义线性模型来评估感兴趣的变量之间的关联强度。结果研究人群的平均抑郁评分为2.61分(95% CI 2.56 ~ 2.65)。在多变量分析中,BMI每增加0.011分,抑郁评分就会增加(β = 0.011;95% CI 0.002-0.020), WHtR降低0.207点(β = 0.207;95% CI 0.145-0.267), ABSI下降0.158点(β = 0.158;IC95%为0.047-0.269),BRI为0.096点(β = 0.096;IC95%为0.069 ~ 0.122),CI为0.010点(β = 0.010;IC95% 0.004 - -0.016)。与WC的相关性无统计学意义。结论与其他指标相比,WHtR可能是识别抑郁症状的较好肥胖指标。
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引用次数: 0
Switching to a hybrid minimed 780G closed handle system: Real-life experience in Central Latin America 切换到混合最小化780G封闭式手柄系统:中拉丁美洲的真实体验
Q3 Medicine Pub Date : 2023-07-01 DOI: 10.1016/j.endmts.2023.100139
Guillermo Edinson Guzmán Gómez, Karen Milena Feriz Bonelo, Víctor Manuel Blanco Pico, María Angélica Guerra, Oriana Arias-Valderrama, Valentina Marin Betancourth, Andrés Octavio García Trujillo
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引用次数: 0
Neighborhood social cohesion and obesity in the United States 美国社区社会凝聚力与肥胖
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100129
Dana M. Alhasan , Symielle A. Gaston , Lauren R. Gullett , W. Braxton Jackson II , Fatima Cody Stanford , Chandra L. Jackson

Low neighborhood social cohesion (nSC) has been associated with obesity. Still, few studies have assessed the nSC-obesity relationship among a large, nationally representative, and racially/ethnically diverse sample of the United States population. To address this literature gap, we examined cross-sectional associations among 154,480 adult participants of the National Health Interview Survey (NHIS) from 2013 to 2018. We also determined if associations varied by race/ethnicity, sex/gender, age, annual household income, and food security status. Based on a 4-item scale from the Project on Human Development in Chicago Neighborhoods Community Survey, we categorized nSC as low, medium, and high. Based on body mass index (BMI) recommendations, we categorized obesity as ≥30 kg/m2. We used Poisson regression with robust variance to directly estimate prevalence ratios (PRs) and 95 % confidence intervals (CIs) while adjusting for sociodemographic characteristics, such as annual household income, educational attainment, and marital status, along with other confounders. Study participants' mean age ± standard error was 47.1 ± 0.1 years; most (69.2 %) self-identified as Non-Hispanic (NH)-White; and 51.0 % were women. NH-Black and Hispanic/Latinx adults comprised more of the population in neighborhoods with low nSC (14.0 % NH-Black, 19.1 % Hispanic/Latinx, and 61.8 % NH-White) versus high nSC (7.7 % NH-Black, 10.4 % Hispanic/Latinx and 77.0 % NH-White). Low vs. high nSC was associated with a 15 % higher prevalence of obesity (PR = 1.15 [95 % CI: 1.12–1.18]), and the magnitude of the association was more substantial among NH-White adults (PR = 1.21 [95 % CI: 1.17–1.25]) compared to associations among Hispanic/Latinx (PR = 1.04 [95 % CI: 0.97–1.11]) and NH-Black (PR = 1.01 [95 % CI: 0.95–1.07]) adults. Low vs. high nSC was associated with a 20 % higher prevalence of obesity in women (PR = 1.20 [95 % CI: 1.16–1.24]) compared to a 10 % higher prevalence in men (PR = 1.10 [95 % CI: 1.06–1.14]). Low vs. high nSC was associated with a 19 % higher prevalence of obesity among adults ≥50 years old (PR = 1.19 [95 % CI: 1.15–1.23]) compared to a 7 % higher prevalence of obesity among adults <50 years old (PR = 1.07 [95 % CI: 1.03–1.11]). Efforts to address nSC may improve health and address health disparities.

社区社会凝聚力低(nSC)与肥胖有关。尽管如此,很少有研究评估美国人口中具有全国代表性和种族/民族多样性的大样本中nSC与肥胖的关系。为了解决这一文献空白,我们调查了2013年至2018年全国健康访谈调查(NHIS)154480名成年参与者的横断面关联。我们还确定了种族/民族、性别/性别、年龄、家庭年收入和粮食安全状况是否存在差异。根据芝加哥社区人类发展项目调查的4项量表,我们将nSC分为低、中和高。根据体重指数(BMI)的建议,我们将肥胖分类为≥30 kg/m2。我们使用具有稳健方差的泊松回归来直接估计患病率(PR)和95%置信区间(CI),同时调整社会人口特征,如家庭年收入、教育程度和婚姻状况,以及其他混杂因素。研究参与者的平均年龄±标准误差为47.1±0.1岁;大多数(69.2%)自称为非西班牙裔(NH)-白人;女性占51.0%。NH黑人和西班牙裔/拉丁裔成年人在低nSC社区的人口中所占比例更大(14.0%的NH黑人、19.1%的西班牙族裔/拉丁族裔和61.8%的NH白人),而在高nSC社区(7.7%的黑人、10.4%的西班牙裔/拉丁裔和77.0%的白人)。与高nSC相比,低nSC与高15%的肥胖患病率相关(PR=1.15[95%CI:1.12–1.18]),与西班牙裔/拉丁裔(PR=1.04[95%CI:0.97–1.11])和黑人(PR=1.01[95%CI:0.95–1.07])成年人的关联相比,NH白人成年人的关联程度更大(PR=1.21[95%CI:1.17–1.25])。低nSC与高nSC相比,女性肥胖患病率高出20%(PR=1.20[95%CI:1.16–1.24]),而男性肥胖患病率则高出10%(PR=1.10[95%CI=1.06–1.14])在成年人中<;50岁(PR=1.07[95%CI:1.03–1.11])。努力解决nSC可能会改善健康状况并解决健康差距。
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引用次数: 2
Ethylene glycol and plantain peel fraction ripened with calcium carbide inhibit reproductive mediators in male rats 电石催熟的乙二醇和车前草皮对雄性大鼠生殖介质的抑制作用
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100130
J.K. Akintunde , S.A. Lateef , C.J. Amadi , O.S. Okoh

The application of artificial fruit ripeners has become a great burden to the public health clinicians. This study assessed the toxicity effect of ethylene glycol (EOGH) and plantain peel fraction ripened with calcium carbide (CaC2) on male reproductive functions. Forty male rats were divided into five groups (n = 8). Group 1 received distilled water only; group 2 received 200 mg/m3 ethylene glycol; group 3 received 1000 mg/kg of CaC2; group 4 received 200 mg/kg plantain peel extract (PPE) and group 5 received 200 mg/kg plantain-peel extract ripened with CaC2 (PPECC). The exposure via oral route lasted for 14 days. Sub-acute exposure of male rats to ethylene glycol, CaC2 and PPECC elicited spermatogenic lesions through significant (p < 0.05) depletion of testosterone level, daily sperm production, sperm motility, live sperm and sperm count with elevated sperm deformity and testicular 51-nucleotidase activity upon exposure to ethylene-glycol, CaC2 and PPECC in relation to PPE. Also, exposure to ethylene glycol, CaC2 and PPECC remarkably increased testicular MDA content and serum AST, ALT and ALP activities which predisposes to spermatogenic abnormalities. Altogether, application of PPECC is suggested as one of the risk factors of liver failure associated with reproductive disruption in rat model.

人工水果催熟剂的应用已成为公共卫生临床医生的一大负担。本研究评价了电石(CaC2)熟化的大车前草皮和乙二醇对雄性生殖功能的毒性作用。40只雄性大鼠分为5组(n = 8),第一组只给予蒸馏水;2组注射200 mg/m3乙二醇;3组给予1000 mg/kg的CaC2;第4组给予200 mg/kg大蕉皮提取物(PPE),第5组给予200 mg/kg CaC2熟化大蕉皮提取物(PPECC)。经口暴露14 d。亚急性暴露于乙二醇、CaC2和PPECC的雄性大鼠通过显著的(p <0.05)暴露于乙二醇、CaC2和PPECC后,与PPE相关的睾酮水平、每日精子产量、精子活力、活精子和精子数量的减少以及精子畸形和睾丸51-核苷酸酶活性的升高。此外,暴露于乙二醇、CaC2和PPECC显著增加睾丸丙二醛含量和血清AST、ALT和ALP活性,易导致生精异常。综上所述,PPECC的应用可能是大鼠肝衰竭伴生殖障碍的危险因素之一。
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引用次数: 0
The association of aldosterone and endothelin-1 with incident diabetes among African Americans: The Jackson Heart Study 非裔美国人醛固酮和内皮素-1与糖尿病的关系:杰克逊心脏研究
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100128
Joshua J. Joseph , Bjorn Kluwe , Songzhu Zhao , David Kline , Divya Nedungadi , Guy Brock , Willa A. Hsueh , Sherita H. Golden

Introduction

African Americans (AAs) have the highest prevalence of hypertension among United States racial/ethnic groups. Regulators of blood pressure, such as aldosterone and endothelin-1, impact glucose regulation. The relationship between these factors and incident diabetes is not well elucidated among AAs.

Methods

Among 3914 AA participants without prevalent diabetes in the Jackson Heart Study, linear regression models were used to examine cross-sectional associations of exposures (aldosterone, endothelin-1, and a combined aldosterone-endothelin-1 score [2–8]) with glycemic measures (fasting plasma glucose [FPG], HbA1c, homeostatic model assessments of beta cell function [HOMA-β] and insulin resistance [HOMA-IR]). Longitudinal associations of exposures with incident diabetes were examined using Cox proportional hazard models. Models were adjusted for age, sex, education, occupation, systolic blood pressure, smoking, physical activity, dietary intake, alcohol use and adiponectin.

Results

Aldosterone and the combined aldosterone-endothelin score were positively associated with FPG, HOMA-IR, and HOMA-β (all p < 0.05). Endothelin-1 was negatively associated with FPG but positively associated with HOMA-β (both p < 0.05). Only the aldosterone-endothelin score was positively associated with HbA1c (p < 0.01). A 1-SD higher serum aldosterone and endothelin-1 was associated with a 22 % and 14 % higher risk of incident diabetes, respectively, while a 1-point higher aldosterone-endothelin score was associated with a 13 % higher risk of incident diabetes after adjustment for diabetes risk factors (all p < 0.01).

Conclusions

Aldosterone and endothelin-1, factors integral in blood pressure regulation, may play a significant role in the development of diabetes among AAs.

引言非裔美国人(AAs)在美国种族/族裔群体中高血压患病率最高。血压调节因子,如醛固酮和内皮素-1,影响葡萄糖调节。这些因素与AA发病率之间的关系尚不清楚。方法在杰克逊心脏研究中3914名未患糖尿病的AA参与者中,使用线性回归模型来检查暴露(醛固酮、内皮素-1和醛固酮-内皮素-1综合评分[2-8])与血糖测量(空腹血糖[FPG]、HbA1c、β细胞功能的稳态模型评估[HOMA-β]和胰岛素抵抗[HOMA-IR])的横截面关联。使用Cox比例风险模型检验暴露与糖尿病事件的纵向相关性。模型根据年龄、性别、教育程度、职业、收缩压、吸烟、体育活动、饮食摄入、饮酒和脂联素进行了调整。结果醛固酮及醛固酮-内皮素综合评分与FPG、HOMA-IR、ALD呈正相关,内皮素-1与FPG呈负相关,但与HOMA-β呈正相关(均p<0.05)。只有醛固酮-内皮素评分与HbA1c呈正相关(p<0.01)。血清醛固酮和内皮素-1升高1-SD分别与糖尿病发病风险高22%和14%相关,而调整糖尿病危险因素后,醛固酮-内皮素评分高1分与糖尿病发生风险高13%相关(均p<0.01)。
{"title":"The association of aldosterone and endothelin-1 with incident diabetes among African Americans: The Jackson Heart Study","authors":"Joshua J. Joseph ,&nbsp;Bjorn Kluwe ,&nbsp;Songzhu Zhao ,&nbsp;David Kline ,&nbsp;Divya Nedungadi ,&nbsp;Guy Brock ,&nbsp;Willa A. Hsueh ,&nbsp;Sherita H. Golden","doi":"10.1016/j.endmts.2023.100128","DOIUrl":"10.1016/j.endmts.2023.100128","url":null,"abstract":"<div><h3>Introduction</h3><p>African Americans (AAs) have the highest prevalence of hypertension among United States racial/ethnic groups. Regulators of blood pressure, such as aldosterone and endothelin-1, impact glucose regulation. The relationship between these factors and incident diabetes is not well elucidated among AAs.</p></div><div><h3>Methods</h3><p>Among 3914 AA participants without prevalent diabetes in the Jackson Heart Study, linear regression models were used to examine cross-sectional associations of exposures (aldosterone, endothelin-1, and a combined aldosterone-endothelin-1 score [2–8]) with glycemic measures (fasting plasma glucose [FPG], HbA1c, homeostatic model assessments of beta cell function [HOMA-β] and insulin resistance [HOMA-IR]). Longitudinal associations of exposures with incident diabetes were examined using Cox proportional hazard models. Models were adjusted for age, sex, education, occupation, systolic blood pressure, smoking, physical activity, dietary intake, alcohol use and adiponectin.</p></div><div><h3>Results</h3><p>Aldosterone and the combined aldosterone-endothelin score were positively associated with FPG, HOMA-IR, and HOMA-β (all p &lt; 0.05). Endothelin-1 was negatively associated with FPG but positively associated with HOMA-β (both p &lt; 0.05). Only the aldosterone-endothelin score was positively associated with HbA1c (p &lt; 0.01). A 1-SD higher serum aldosterone and endothelin-1 was associated with a 22 % and 14 % higher risk of incident diabetes, respectively, while a 1-point higher aldosterone-endothelin score was associated with a 13 % higher risk of incident diabetes after adjustment for diabetes risk factors (all p &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Aldosterone and endothelin-1, factors integral in blood pressure regulation, may play a significant role in the development of diabetes among AAs.</p></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":"11 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/87/nihms-1911035.PMC10358435.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effects of calcitonin on quality of life in hypothyroid patients – A pilot study 降钙素对甲状腺功能减退患者生活质量的影响-一项初步研究
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100125
Wedad Rahman , Simona Stefan , Amiya Ahmed , Muhammad Siddiqi , Rana Malek , Elizabeth M. Lamos , Kashif M. Munir

Introduction

Hypothyroidism is a very common endocrine disorder routinely treated with levothyroxine replacement therapy. Despite treatment to biochemical euthyroidism, some individuals continue to have hypothyroidism-related symptoms. Many individuals with hypothyroidism also have low levels of calcitonin. Our aim was to evaluate the effects of calcitonin treatment on quality of life in hypothyroid individuals treated with levothyroxine.

Methods

Adult, hypothyroid individuals were treated with nasal calcitonin spray, 200 international units daily for 6 weeks. Participants completed a modified City of Hope Quality of Life questionnaire prior to initiating calcitonin and after completing 6 weeks of therapy. Perception of quality-of-life benefit with calcitonin was also assessed.

Results

Improvements in quality-of-life scores with calcitonin treatment from 184.77 to 148.44 (p = 0.342) were not statistically significant. Also, only one individual perceived any benefit with calcitonin therapy.

Conclusion

Treatment with nasal calcitonin spray in individuals with hypothyroidism on levothyroxine replacement therapy did not result in quality-of-life benefit.

甲状腺功能减退是一种非常常见的内分泌疾病,常规左甲状腺素替代疗法治疗。尽管治疗生化甲状腺功能亢进,一些人继续有甲状腺功能减退相关症状。许多甲状腺功能减退症患者的降钙素水平也很低。我们的目的是评估降钙素治疗对接受左甲状腺素治疗的甲状腺功能减退患者生活质量的影响。方法对成人甲状腺功能低下患者给予降钙素鼻喷雾剂,每日200国际单位,连用6周。参与者在开始降钙素治疗前和完成6周治疗后完成了一份修改后的希望之城生活质量问卷。还评估了降钙素对生活质量的益处。结果降钙素组患者生活质量评分从184.77分提高至148.44分(p = 0.342),差异无统计学意义。此外,只有一个人认为降钙素治疗有任何好处。结论左旋甲状腺素替代治疗的甲状腺功能减退患者鼻用降钙素喷雾剂治疗不能提高患者的生活质量。
{"title":"The effects of calcitonin on quality of life in hypothyroid patients – A pilot study","authors":"Wedad Rahman ,&nbsp;Simona Stefan ,&nbsp;Amiya Ahmed ,&nbsp;Muhammad Siddiqi ,&nbsp;Rana Malek ,&nbsp;Elizabeth M. Lamos ,&nbsp;Kashif M. Munir","doi":"10.1016/j.endmts.2023.100125","DOIUrl":"10.1016/j.endmts.2023.100125","url":null,"abstract":"<div><h3>Introduction</h3><p>Hypothyroidism is a very common endocrine disorder routinely treated with levothyroxine replacement therapy. Despite treatment to biochemical euthyroidism, some individuals continue to have hypothyroidism-related symptoms. Many individuals with hypothyroidism also have low levels of calcitonin. Our aim was to evaluate the effects of calcitonin treatment on quality of life in hypothyroid individuals treated with levothyroxine.</p></div><div><h3>Methods</h3><p>Adult, hypothyroid individuals were treated with nasal calcitonin spray, 200 international units daily for 6 weeks. Participants completed a modified City of Hope Quality of Life questionnaire prior to initiating calcitonin and after completing 6 weeks of therapy. Perception of quality-of-life benefit with calcitonin was also assessed.</p></div><div><h3>Results</h3><p>Improvements in quality-of-life scores with calcitonin treatment from 184.77 to 148.44 (<em>p</em> = 0.342) were not statistically significant. Also, only one individual perceived any benefit with calcitonin therapy.</p></div><div><h3>Conclusion</h3><p>Treatment with nasal calcitonin spray in individuals with hypothyroidism on levothyroxine replacement therapy did not result in quality-of-life benefit.</p></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":"11 ","pages":"Article 100125"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43175291","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
Age-related thyroid hormone resistance: A friend or foe 与年龄相关的甲状腺激素抵抗:是敌是友
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100132
Arshag D. Mooradian

Clinical experience shows that older people with hyperthyroidism display fewer signs or symptoms compared to younger people with hyperthyroidism. Moreover, older people with normal thyroid function tests display several clinical features of hypothyroidism. These observations suggest that there may be an age-related resistance to the actions of thyroid hormones (TH). Indeed, laboratory experiments have consistently documented an age –related blunting of response to exogenously administered TH. This resistance to TH action has been attributed to reduced cellular transport of TH, possibly reduced nuclear receptors of TH and reduced cytosolic deiodinase activity. In light of these observations, along with epidemiologic studies, the diagnosis and treatment of thyroid disease in older people differ from the current treatment guidelines of younger people with thyroid disease. It is noteworthy that the age-related resistance to TH is distinct from the congenital TH resistance syndromes where plasma TH levels are increased. This distinction is explained by the age-related changes in pituitary responsiveness to the feedback inhibition by TH and reduced thyroid gland response to thyrotropin. The current evidence suggests that the age-related resistance to TH is an adaptive process to prolong life span. At the present time, it is not known if younger people can also experience premature resistance to TH and may have symptoms of hypothyroidism in the face of normal plasma TH concentrations.

临床经验表明,与年轻甲亢患者相比,老年甲亢患者表现出较少的体征或症状。此外,甲状腺功能检查正常的老年人表现出甲状腺功能减退的几个临床特征。这些观察结果表明,可能存在与年龄相关的对甲状腺激素(TH)作用的抵抗。事实上,实验室实验一致地记录了外源性给予TH的反应与年龄相关的钝化。这种对TH作用的抗性归因于TH的细胞运输减少,可能是TH的核受体减少和胞质脱碘酶活性降低。根据这些观察结果以及流行病学研究,老年人甲状腺疾病的诊断和治疗不同于目前针对年轻人甲状腺疾病的治疗指南。值得注意的是,年龄相关的TH抵抗与先天性TH抵抗综合征不同,先天性TH抵抗综合征的血浆TH水平升高。这种差异可以用年龄相关的垂体对TH反馈抑制的反应性变化和甲状腺对促甲状腺素反应的降低来解释。目前的证据表明,年龄相关的TH抗性是一种延长寿命的适应性过程。目前,尚不清楚年轻人是否也会经历对TH的过早抵抗,并且在面对正常血浆TH浓度时可能出现甲状腺功能减退的症状。
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引用次数: 0
Comprehensive evaluation of adrenal cortical cancer: Single-center 22-year experience 肾上腺皮质癌症的综合评价:22年单中心经验
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100133
Basem Al Achras , Joud Zakhour , Aditya Chauhan , James Bena , Divya Yogi-Morren , Kevin M. Pantalone , Pratibha Rao

Background

Adrenocortical carcinoma (ACC) is a rare malignancy with a reported incidence of 0.5–2 cases per million population per year. Literature is scarce on this malignancy with poor prognosis and limited treatment options. The objective of this report was to report a single-center experience of this rare malignancy.

Methods

A retrospective chart review (1997–2019) was performed on patients diagnosed with ACC via surgical pathology. Data were subsequently split into two time periods defined by the date of initial presentation: 1996–2007 and 2008–2019.

Results

52 patients were identified, 55.8 % were female, and the mean age at the time of surgery was 53 years. Most common presentations (25 % each) were: incidentalomas, abdominal pain, or hormonal hypersecretion. Laboratory evidence of hormonal hypersecretion was identified in 40.4 %. Among those patients, elevated 24-hour urinary free cortisol was the most common finding in both time periods.

The overall 5-year survival rate was 53.1 % and showed significant improvement in recent years when compared between the two time periods, 85.7 % vs 40.0 %. P = 0.004.

Conclusion

Overall, the most common presentation of ACC was found to be equally distributed among incidentaloma, hormonal hypersecretion, and abdominal pain. Hypercortisolism, a recognized poor prognosticator, was the most frequent form of hormonal hypersecretion. The 5-year survival rate for ACC was noted to be poor in general; however, it was observed to be substantially higher in more recent years. More research is necessary to further understand this malignancy in order to optimize management and improve outcomes.

Clinical relevance

This report provides a valuable contribution and expands the knowledge base for this important yet rare malignancy. The objective of this study was to report a single-center experience of ACC by characterizing patients diagnosed with this rare disease and managed at our institution and assessing their outcomes.

背景肾上腺皮质癌(ACC)是一种罕见的恶性肿瘤,据报道其发病率为每年每百万人口0.5-2例。关于这种预后不良、治疗选择有限的恶性肿瘤的文献很少。本报告的目的是报告这种罕见恶性肿瘤的单中心经验。方法对1997~2019年经手术病理诊断为ACC的患者进行回顾性分析。随后,数据被分为两个时间段,根据首次就诊日期确定:1996-2007年和2008-2019年。结果共确定52名患者,55.8%为女性,手术时的平均年龄为53岁。最常见的表现(各占25%)是:偶发性牙瘤、腹痛或激素分泌过多。40.4%的患者有激素分泌过多的实验室证据。在这些患者中,24小时尿游离皮质醇升高是这两个时期最常见的发现。总的5年生存率为53.1%,与这两个时间段相比,近年来有显著改善,分别为85.7%和40.0%。P=0.004。结论总体而言,ACC最常见的表现在偶发性牙瘤、激素分泌过多和腹痛中平均分布。皮质醇增多症是公认的预后不佳的疾病,是激素分泌过多的最常见形式。ACC的5年生存率普遍较差;然而,据观察,近年来这一数字明显更高。需要更多的研究来进一步了解这种恶性肿瘤,以优化管理并改善结果。临床相关性本报告为这种重要但罕见的恶性肿瘤提供了宝贵的贡献,并扩大了知识库。本研究的目的是通过描述在我们机构诊断和治疗的ACC患者的特征,并评估他们的结果,报告ACC的单中心经验。
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引用次数: 0
Diabetic retinal neurodegeneration associated with synaptic proteins and functional defects: A systematic review 糖尿病视网膜神经变性与突触蛋白和功能缺陷相关:系统综述
Q3 Medicine Pub Date : 2023-06-30 DOI: 10.1016/j.endmts.2023.100127
Siddhita Jadhav , Tos T.J.M. Berendschot , Govindasamy Kumaramanickavel , Eline E.B. De Clerck , Carroll A.B. Webers

Diabetic retinopathy (DR) is the most common ophthalmological complication of diabetes mellitus (DM) and a leading cause of preventable visual impairment. In DM, retinal neurodegenerative changes precede microvascular changes which can be assessed by electrophysiological and advanced imaging techniques. Studies measuring retinal neurodegenerative changes in DM were systematically evaluated in this review. Included studies have assessed retinal neurodegeneration in diabetic rodents by combining clinically used diagnostic techniques and molecular assays. Significant impairment was noticed in electrophysiology data in the diabetic retina as compared to the non-diabetic retina. Also, a significant reduction in synaptic protein levels was noticed in the diabetic retina compared to the non-diabetic retina. Even though retinal neurodegeneration was noticed, no vascular abnormalities were seen in the diabetic retina. However, little is known about molecular mechanisms behind diabetic retinal neurodegeneration (DRN), which explains the need for further investigation to detect DR in the early stages of diabetes.

糖尿病视网膜病变(DR)是糖尿病(DM)最常见的眼科并发症,也是可预防的视力损害的主要原因。在糖尿病中,视网膜神经退行性改变先于微血管改变,这可以通过电生理和先进的成像技术来评估。本综述对测量糖尿病视网膜神经退行性改变的研究进行了系统评价。纳入的研究通过结合临床使用的诊断技术和分子分析来评估糖尿病啮齿动物的视网膜神经变性。与非糖尿病视网膜相比,糖尿病视网膜的电生理数据明显受损。此外,与非糖尿病视网膜相比,糖尿病视网膜中突触蛋白水平显著降低。虽然视网膜神经变性被发现,但在糖尿病视网膜中未见血管异常。然而,关于糖尿病视网膜神经变性(DRN)的分子机制知之甚少,这就解释了在糖尿病早期发现DR的必要性。
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引用次数: 0
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Endocrine and Metabolic Science
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