Endocrine and Metabolic Science最新文献_第2页

Severe panhypopituitarism as the primary manifestation of suprasellar–pineal germinoma: A case report 以松果体上生殖细胞瘤为主要表现的严重全垂体功能低下1例

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2026-03-01 Epub Date: 2026-02-27 DOI: 10.1016/j.endmts.2026.100297

Reza Nuril Amifta , Hermina Novida , Dyah Fauziah , Rita Purnama Deu

Background

Suprasellar–pineal germinoma is a midline tumor that can cause disruption of the hypothalamic–pituitary axis through infiltration or compression of the pituitary stalk, leading to panhypopituitarism with broad metabolic manifestations. Involvement of the pineal region may also result in obstructive hydrocephalus, further worsening neuroendocrine dysfunction through increased intracranial pressure. Diagnosis is established through the integration of radiological findings, hormonal evaluation, and histological, while management requires a combination of oncologic therapy and long-term hormone replacement.

Case presentation

A 21-year-old man presented with a seizure and a six-month history of progressive endocrine symptoms, including fatigue, cold intolerance, decreased libido, and reduced body hair. Hormonal assessment revealed severe panhypopituitarism, and MRI demonstrated a bifocal suprasellar–pineal tumor with obstructive hydrocephalus. The patient underwent VP shunt placement, craniotomy, and histopathological examination, which confirmed germinoma with positive CD117 and PLAP expression. Radiotherapy at a total dose of 40 Gy resulted in complete radiological remission; however, endocrine dysfunction persisted, necessitating long-term hormone replacement therapy. Follow-up evaluation showed hormonal improvement and clinical stability without tumor recurrence.

Conclusion

This case highlights that suprasellar–pineal germinoma can present with severe panhypopituitarism and hydrocephalus as primary manifestations, underscoring the importance of vigilance toward progressive endocrine symptoms in young patients. Optimal management requires a multidisciplinary approach involving neurological stabilization, oncologic therapy, and long-term hormone replacement with careful metabolic monitoring to prevent complications and ensure sustained clinical stability.

松果体上生殖细胞瘤是一种中线肿瘤，可通过浸润或压迫垂体柄破坏下丘脑-垂体轴，导致具有广泛代谢表现的全垂体功能低下。累及松果体区也可导致梗阻性脑积水，颅内压升高使神经内分泌功能障碍进一步恶化。诊断是通过综合影像学表现、激素评估和组织学来建立的，而管理则需要肿瘤治疗和长期激素替代的结合。病例表现：21岁男性，癫痫发作，6个月进行性内分泌症状史，包括疲劳、不耐寒、性欲下降和体毛减少。激素评估显示严重的全垂体功能低下，MRI显示双灶松果体上肿瘤伴阻塞性脑积水。患者行静脉分流置管、开颅及组织病理学检查，证实生殖细胞瘤伴CD117和PLAP阳性表达。总剂量为40 Gy的放射治疗导致完全的放射缓解；然而，内分泌功能障碍持续存在，需要长期激素替代治疗。随访评价显示激素水平改善，临床稳定，无肿瘤复发。结论本病例提示松果体上生殖细胞瘤可以严重的全垂体功能低下和脑积水为主要表现，提示年轻患者警惕内分泌症状的进展。最佳治疗需要多学科的方法，包括神经稳定、肿瘤治疗和长期激素替代，并仔细监测代谢，以防止并发症和确保持续的临床稳定性。

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引用次数: 0

New insights into metabolism of desogestrel in humans using liver microsomes and an HPLC/UV method 利用肝微粒体和高效液相色谱/紫外分光光度法研究人体内去索孕酮代谢的新见解

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1016/j.endmts.2026.100294

Iman Ibrahim , Pierre Rousselot-Pailley , Akram Hijazi , Elias Baydoun , Marc Maresca , El Hassan Ajandouz

Desogestrel metabolites obtained from fungi were used as standards and an HPLC/UV method was newly developed for investigation of DSG metabolism in human liver microsomes. Steady-state kinetic conditions were followed for measurement of the initial velocities of formation of the metabolites 3-keto-DSG (Etonogestrel, M1), 6β-hydroxy-ETN (M5), 11-epoxy-ETN (M8), and an unidentified metabolite (Mx). So far, M5 and M8 are here identified for the first time in humans. The Michaelis-Menten constants of ENT, M5, M8, and Mx varied from 7 to 19 μM, whereas the maximal velocities for ENT, M5, M8 were found to be 123, 198, and 353 nM/min.mg proteins, respectively. The use of specific inhibitors of cytochrome P450 enzymes showed that CYP3A4 is major catalyzer of ETN oxidation (IC₅₀ of ketoconazole at 0.1–0.4 μM). CYP3A4 also is involved in DSG oxidation, at the same order of magnitude as CYP2C9 and CYP2C19, which in turn are similarly involved in ETN oxidation (IC₅₀ of inhibitors at 9–30 μM). CYP2D6 and CYP1A2 are involved as well, although at a lesser extent (IC₅₀ of inhibitors at 26–73 μM), while CYP2E1 is most likely not involved in the metabolism of desogestrel.

以真菌中去索孕酮代谢物为标准物，建立了HPLC/UV法研究人肝微粒体中DSG代谢的新方法。在稳态动力学条件下，测量了代谢产物3-酮- dsg （Etonogestrel, M1）、6β-羟基- etn （M5）、11-环氧- etn （M8）和一种未识别的代谢物（Mx）的初始形成速度。到目前为止，M5和M8是第一次在人类身上被发现。ENT、M5、M8和Mx的Michaelis-Menten常数变化范围为7 ~ 19 μM，而ENT、M5、M8的最大速度分别为123、198和353 nM/min。分别是Mg蛋白。细胞色素P450酶特异性抑制剂的使用表明，CYP3A4是ETN氧化的主要催化剂（酮康唑的IC50在0.1 ~ 0.4 μM）。CYP3A4也参与DSG的氧化，其量级与CYP2C9和CYP2C19相同，而后者又同样参与ETN的氧化（抑制剂的IC50在9-30 μM）。CYP2D6和CYP1A2也参与，尽管程度较小（抑制剂的IC50在26-73 μM），而CYP2E1很可能不参与去索孕酮的代谢。

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引用次数: 0

Prenatal exposure to endocrine disruptors and its effects on maternal–fetal health 产前接触内分泌干扰物及其对母胎健康的影响

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2026-03-01 Epub Date: 2026-03-08 DOI: 10.1016/j.endmts.2026.100298

Elisangela Souza Teixeira , Isabela Cardoso Santos , Sophia Alcantara Rodrigues , Izabela Fernanda Dal Bó , Laura Sterian Ward

Endocrine-disrupting chemicals (EDCs) are pervasive environmental contaminants that interfere with hormonal regulation and pose risks during pregnancy, a developmental period of heightened endocrine sensitivity. Prenatal exposure to major EDC classes, including bisphenols, phthalates, pesticides, and persistent organic pollutants, is associated with adverse maternal outcomes and long-term metabolic, neurodevelopmental, and reproductive effects in offspring. This review integrates the current evidence on the principal sources and pathways of prenatal EDC exposure and examines the mechanistic foundations of developmental toxicity, focusing on nuclear receptor perturbation, epigenetic reprogramming, and oxidative stress. Epidemiological and clinical findings linking EDCs to gestational diabetes, hypertensive disorders, preterm birth, and developmental origins of health and disease are summarized, with attention to sex-specific susceptibilities and emerging transgenerational effects of EDC exposure. Finally, we translate these insights into practical recommendations for prenatal care and discuss regulatory considerations that incorporate mixture toxicity, non-monotonic dose-response, and early life vulnerability. Collectively, these findings underscore the need for precautionary, evidence-based strategies to safeguard maternal and child health against widespread chemical exposure.

内分泌干扰化学物质（EDCs）是一种普遍存在的环境污染物，它会干扰激素调节，并在孕期（内分泌敏感性较高的发育时期）造成风险。产前暴露于主要的EDC类，包括双酚类、邻苯二甲酸盐、农药和持久性有机污染物，与不良的产妇结局和后代的长期代谢、神经发育和生殖影响有关。这篇综述整合了目前关于产前EDC暴露的主要来源和途径的证据，并研究了发育毒性的机制基础，重点是核受体扰动、表观遗传重编程和氧化应激。本文总结了EDCs与妊娠期糖尿病、高血压疾病、早产以及健康和疾病的发育起源之间的流行病学和临床研究结果，并关注了EDCs暴露的性别特异性易感性和新出现的跨代效应。最后，我们将这些见解转化为产前护理的实用建议，并讨论了包括混合物毒性、非单调剂量反应和早期生命脆弱性在内的监管考虑。总的来说，这些调查结果强调需要采取以证据为基础的预防性战略，以保护孕产妇和儿童健康，使其免受广泛的化学品接触。

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引用次数: 0

Systolic interarm blood pressure difference in West Africans with diabetes 西非糖尿病患者的收缩期臂间血压差异

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2026-03-01 Epub Date: 2026-02-17 DOI: 10.1016/j.endmts.2026.100296

Matthan Fayia Saa , Justice Apaw , Charles Frederick Hayfron-Benjamin

Background

Increased systolic interarm blood pressure difference (sIAD) typically reflects vascular pathology and is a known indicator of earlier death. In diabetes, the burden and predictors of elevated sIAD vary by ethnicity, but data in Africans are extremely limited. This study examined sIAD and associated in West Africans with diabetes.

Methods

In this cross-sectional study among 745 Ghanaians [aged 27–88 years (mean [SD], 59.92 [±10.11] years); 76.8% women] with diabetes [mean diabetes duration [SD], 8.5 [±4.47] years], sIAD was measured using the simultaneous measurement method.

Results

The prevalence of sIADH≥5 mmHg, sIADH≥10 mmHg, sIADH≥15 mmHg, and sIADH≥20 mmHg were 52.1%, 22.6%, 10.6%, and 5.0% respectively. In an age-sex adjusted model, obesity [odds ratio 1.86, 95% confidence interval 1.29–2.66, p = 0.001] and CKD [1.54(1.08–2.18), 0.017] were associated with sIAD≥10 mmHg; the associations of hypertension [1.50 (1.00–2.27), 0.053] tended towards statistical significance. In a model that further adjusted for diabetes duration and systolic blood pressure, the association remained significant for obesity [1.86(1.28–2.69), 0.001].

Conclusions

Elevated sIAD is prevalent in West Africans with diabetes. Future studies could characterize the clinical significance of this high prevalence.

收缩期臂间血压差（sIAD）升高通常反映血管病理，是已知的早期死亡指标。在糖尿病中，sIAD升高的负担和预测因素因种族而异，但非洲人的数据极为有限。这项研究调查了西非与糖尿病相关的sIAD。方法对745名加纳人进行横断面研究，年龄27-88岁（平均[SD]， 59.92[±10.11]岁）；76.8%女性糖尿病患者[平均糖尿病病程[SD]， 8.5[±4.47]年]，sIAD采用同期测量法。结果sIADH≥5 mmHg、sIADH≥10 mmHg、sIADH≥15 mmHg和sIADH≥20 mmHg的患病率分别为52.1%、22.6%、10.6%和5.0%。在年龄-性别调整模型中，肥胖[优势比1.86,95%可信区间1.29-2.66,p = 0.001]和CKD[1.54(1.08-2.18)， 0.017]与sIAD≥10 mmHg相关；高血压的相关性[1.50(1.00-2.27)，0.053]趋于有统计学意义。在进一步调整糖尿病病程和收缩压的模型中，肥胖的相关性仍然显著[1.86(1.28-2.69),0.001]。结论sIAD水平升高在西非糖尿病患者中普遍存在。未来的研究可以描述这种高患病率的临床意义。

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引用次数: 0

Progression to type 2 diabetes mellitus after gestational diabetes: An umbrella review of 15 systematic reviews and assessment of causal frameworks 妊娠期糖尿病后进展为2型糖尿病：对15项系统综述和因果框架评估的综述

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2026-03-01 Epub Date: 2025-12-08 DOI: 10.1016/j.endmts.2025.100285

Jhosmer Ballena-Caicedo , Lupita Ana Maria Valladolid-Sandoval , Fiorella E. Zuzunaga-Montoya , Víctor Juan Vera-Ponce

Background

Gestational diabetes mellitus (GDM) confers a markedly elevated risk of progression to type 2 diabetes mellitus (T2DM), although the precise magnitude of this risk and its temporal evolution remain inadequately characterized for clinical decision-making.

Objective

To systematically synthesize reviews on glycemic alterations following GDM, quantifying prevalence, incidence, and risk estimates, and to critically assess the use of causal frameworks for inference regarding risk factors.

Methods

We conducted an umbrella review with searches in PubMed/MEDLINE, Embase, Web of Science, and Scopus through September 2025. For reviews that synthesized risk factors, we assessed whether they employed directed acyclic graphs to guide adjustment for confounders.

Results

Fifteen reviews with data from more than 3 million women were included. Prior GDM conferred a 6- to 13-fold increased risk of T2DM compared with normoglycemic pregnancies, with cumulative incidence of 9–32 % depending on ethnicity, follow-up duration, and diagnostic criteria. The incidence rate was 26.20 per 1000 person-years, projecting to 20 % at 10 years. Twenty-seven percent presented glycemic alterations at 6–12 weeks postpartum. The most consistent predictors included glycemic markers during pregnancy, insulin requirement, elevated body mass index, family history, and non-White ethnicity. Critically, no review employed directed acyclic graphs to support confounder adjustment, introducing substantial risk of residual bias in the reported point estimates, although the direction of associations showed robust consistency across temporal windows and independent reviews.

Conclusions

GDM substantially increases T2DM risk, with glycemic burden evident from early postpartum. The universal absence of DAGs limits causal inference regarding point estimates, although the direction of associations is robust.

背景：妊娠期糖尿病（GDM）可显著增加进展为2型糖尿病（T2DM）的风险，尽管这种风险的确切程度及其时间演变仍未充分表征临床决策。目的系统地综合关于GDM后血糖改变的综述，量化患病率、发病率和风险估计，并批判性地评估因果框架对危险因素推断的使用。方法我们对截至2025年9月的PubMed/MEDLINE、Embase、Web of Science和Scopus进行了总结性综述。对于综合危险因素的综述，我们评估了它们是否使用有向无环图来指导混杂因素的调整。结果纳入了15篇综述，数据来自300多万女性。与血糖正常妊娠相比，先前的GDM使T2DM的风险增加6- 13倍，根据种族、随访时间和诊断标准，累积发病率为9 - 32%。发病率为每1000人年26.20例，预计10年后为20%。27%的人在产后6-12周出现血糖改变。最一致的预测因素包括怀孕期间的血糖指标、胰岛素需求、体重指数升高、家族史和非白人种族。关键的是，没有一篇综述采用有向无环图来支持混杂因素调整，这在报告的点估计中引入了大量残留偏倚的风险，尽管关联的方向在时间窗口和独立综述中显示出强大的一致性。结论妊娠期糖尿病显著增加2型糖尿病风险，产后早期血糖负荷明显增加。尽管关联的方向是稳健的，但普遍缺乏dag限制了关于点估计的因果推断。

{"title":"Progression to type 2 diabetes mellitus after gestational diabetes: An umbrella review of 15 systematic reviews and assessment of causal frameworks","authors":"Jhosmer Ballena-Caicedo , Lupita Ana Maria Valladolid-Sandoval , Fiorella E. Zuzunaga-Montoya , Víctor Juan Vera-Ponce","doi":"10.1016/j.endmts.2025.100285","DOIUrl":"10.1016/j.endmts.2025.100285","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes mellitus (GDM) confers a markedly elevated risk of progression to type 2 diabetes mellitus (T2DM), although the precise magnitude of this risk and its temporal evolution remain inadequately characterized for clinical decision-making.</div></div><div><h3>Objective</h3><div>To systematically synthesize reviews on glycemic alterations following GDM, quantifying prevalence, incidence, and risk estimates, and to critically assess the use of causal frameworks for inference regarding risk factors.</div></div><div><h3>Methods</h3><div>We conducted an umbrella review with searches in PubMed/MEDLINE, Embase, Web of Science, and Scopus through September 2025. For reviews that synthesized risk factors, we assessed whether they employed directed acyclic graphs to guide adjustment for confounders.</div></div><div><h3>Results</h3><div>Fifteen reviews with data from more than 3 million women were included. Prior GDM conferred a 6- to 13-fold increased risk of T2DM compared with normoglycemic pregnancies, with cumulative incidence of 9–32 % depending on ethnicity, follow-up duration, and diagnostic criteria. The incidence rate was 26.20 per 1000 person-years, projecting to 20 % at 10 years. Twenty-seven percent presented glycemic alterations at 6–12 weeks postpartum. The most consistent predictors included glycemic markers during pregnancy, insulin requirement, elevated body mass index, family history, and non-White ethnicity. Critically, no review employed directed acyclic graphs to support confounder adjustment, introducing substantial risk of residual bias in the reported point estimates, although the direction of associations showed robust consistency across temporal windows and independent reviews.</div></div><div><h3>Conclusions</h3><div>GDM substantially increases T2DM risk, with glycemic burden evident from early postpartum. The universal absence of DAGs limits causal inference regarding point estimates, although the direction of associations is robust.</div></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":"20 ","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711809","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

Ramadan fasting intentions and IDF-DAR risk stratification among Nigerian patients with diabetes mellitus: A multicentre, cross-sectional study 尼日利亚糖尿病患者斋月禁食意向和IDF-DAR风险分层：一项多中心横断面研究

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2026-03-01 Epub Date: 2026-03-10 DOI: 10.1016/j.endmts.2026.100299

Tajudin Adesegun Adetunji , Akinyele Taofiq Akinlade , Raliyatu Aliyu Habibu , Umar Faruk Abdullahi , Muhammad Arabi Saad , Kabiru Bello Sada , Yakubu Lawal , Olayode Olajide , Yetunde Akuma , Ummulkhair Funke Adetunji , Olayinka Olomooba Saliu , Samson Adedeji Afolabi , Ibrahim Danjummai Gezawa

Background

Diabetes mellitus (DM) is a major public health problem in Nigeria, which has one of the largest Muslim populations in sub-Saharan Africa. Many Muslims with DM choose to fast during Ramadan despite medical exemptions. The International Diabetes Federation-Diabetes and Ramadan Alliance (IDF-DAR) risk stratification tool was developed to guide safe fasting, but has not been previously applied in Nigeria.

Objective

To apply the IDF-DAR 2021 risk calculator to evaluate fasting intentions and classify risk levels among Nigerian Muslims with diabetes.

Methods

In this cross-sectional study, 532 Muslim patients with type 1 or type 2 DM were recruited from seven tertiary hospitals in Northern and Southwestern Nigeria, 2–4 weeks before and during the first week of Ramadan in 2024 and 2025. After exclusions, 518 were analyzed. Sociodemographic and clinical data were collected, participants were risk-stratified using the IDF-DAR tool, and fasting intention was recorded. Data were analyzed with descriptive statistics and chi-square tests.

Results

Participants' mean age was 57.9 ± 13.0 years; 61.2% were female. Most had type 2 DM (96.3%), with 51.0% having disease duration >10 years. By IDF-DAR classification, 31.7% were low risk, 31.9% moderate risk, and 36.5% high risk. Despite this, 404 participants (78.0%) intended to fast. Among high-risk individuals, 74.6% planned to fast, though risk category was not significantly associated with intention (p = 0.177).

Conclusion

The study demonstrates the feasibility of applying the IDF-DAR tool in Nigeria, with many high-risk patients intending to fast, though predictive accuracy and clinical outcomes were not assessed.

尼日利亚是撒哈拉以南非洲穆斯林人口最多的国家之一，糖尿病（DM）是尼日利亚的一个主要公共卫生问题。许多患有糖尿病的穆斯林选择在斋月期间禁食，尽管有医疗豁免。国际糖尿病联合会-糖尿病和斋月联盟（IDF-DAR）的风险分层工具是为指导安全禁食而开发的，但此前尚未在尼日利亚应用。目的应用IDF-DAR 2021风险计算器评估尼日利亚穆斯林糖尿病患者的斋戒意向并对其风险水平进行分类。方法在这项横断面研究中，在2024年和2025年斋月前2 - 4周和第一周期间，从尼日利亚北部和西南部的7家三级医院招募了532名1型或2型糖尿病的穆斯林患者。排除后，对518例进行分析。收集社会人口学和临床数据，使用IDF-DAR工具对参与者进行风险分层，并记录禁食意图。数据分析采用描述性统计和卡方检验。结果参与者平均年龄57.9±13.0岁；61.2%为女性。多数为2型糖尿病（96.3%），其中51.0%病程≥10年。按IDF-DAR分类，低危31.7%，中危31.9%，高危36.5%。尽管如此，仍有404名参与者（78.0%）打算禁食。在高危人群中，74.6%的人计划禁食，但风险类别与意图无显著相关（p = 0.177）。结论该研究证明了在尼日利亚应用IDF-DAR工具的可行性，尽管没有评估预测的准确性和临床结果，但许多高危患者打算禁食。

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引用次数: 0

Maternal thrombophilia and intrauterine growth restriction: A review of current evidence and clinical implications 母体血栓病和宫内生长限制：当前证据和临床意义的回顾

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-12-01 Epub Date: 2025-09-16 DOI: 10.1016/j.endmts.2025.100274

Rajalakshmi A S , Anarghya Ananda Murthy , Sree Lakshmi K

Intrauterine growth restriction (IUGR) is a significant contributor to perinatal illness and death, arising from a variety of complex and multifactorial causes. Increasing evidence suggests that maternal thrombophilia, particularly deficiencies in natural anticoagulants such as Protein C, Protein S, and Antithrombin III, is a key factor in placental dysfunction and impaired fetal growth. These effects are thought to occur via placental thrombosis, impaired spiral artery remodelling, and reduced placental perfusion, which can compromise fetal growth. This systematic review, covering studies published between 1963 and 2025 and compiles and evaluates existing research on the association between thrombophilic conditions and IUGR. Although several studies have reported an increased prevalence of thrombophilia markers in pregnancies affected by IUGR, the overall evidence is inconclusive. Variability in study design, patient populations, and diagnostic definitions of both thrombophilia and IUGR contributes to conflicting findings and hinders firm conclusions regarding their role in diagnosis or intervention. Additionally, the review explores the role of anticoagulant therapies, including low molecular weight heparin, in enhancing pregnancy outcomes for women with these conditions. However, the evidence is limited by small study sizes, design constraints, and regional biases, underscoring the necessity for larger, multicenter investigations. Current findings highlight the importance of further research into the contribution of thrombophilia in IUGR. While thrombophilia screening may hold potential for risk stratification in selected high-risk populations, current evidence does not support universal screening in routine prenatal care. Larger, multicentred studies are needed before screening strategies can be formally recommended.

宫内生长受限（IUGR）是围产期疾病和死亡的一个重要因素，由各种复杂和多因素的原因引起。越来越多的证据表明，母体血栓症，特别是天然抗凝血剂如蛋白C、蛋白S和抗凝血酶III的缺乏，是胎盘功能障碍和胎儿生长受损的关键因素。这些影响被认为是通过胎盘血栓形成、螺旋动脉重塑受损和胎盘灌注减少而发生的，这可能会损害胎儿的生长。本系统综述涵盖了1963年至2025年间发表的研究，并汇编和评估了关于血栓性疾病与IUGR之间关系的现有研究。尽管有几项研究报道了受IUGR影响的妊娠中血栓形成标志物的患病率增加，但总体证据尚无定论。研究设计、患者人群以及血栓和IUGR的诊断定义的差异导致了相互矛盾的结果，并阻碍了关于其在诊断或干预中的作用的确切结论。此外，本综述探讨了抗凝治疗，包括低分子肝素，在提高这些疾病妇女妊娠结局中的作用。然而，证据受到小型研究规模、设计限制和区域偏差的限制，强调了进行更大规模、多中心调查的必要性。目前的研究结果强调了进一步研究血栓形成在IUGR中的作用的重要性。虽然血栓病筛查可能在选定的高危人群中具有风险分层的潜力，但目前的证据并不支持在常规产前护理中进行普遍筛查。在正式推荐筛查策略之前，需要进行更大规模的多中心研究。

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引用次数: 0

The role of micronutrients in gut microbiota and metabolic health 微量营养素在肠道微生物群和代谢健康中的作用

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-12-01 Epub Date: 2025-11-15 DOI: 10.1016/j.endmts.2025.100281

Samer Younes

Developing healthier food products and dietary habits to combat non-communicable diseases (NCDs) globally requires a deeper understanding of how nutrients interact with the gut microbiota. Emerging studies in humans and model organisms suggest that gut microbes play a crucial role in shaping an individual's micronutrient status by influencing their synthesis, bioavailability, and metabolic effects.

Micronutrients can modulate the symbiotic relationship between gut bacteria and the host, impacting endocrine pathways that regulate glucose metabolism. Minerals and trace elements, for example, can alter gut microbiota composition, strengthen intestinal barrier function, mitigate metabolic inflammation, and influence cellular glucose uptake, as well as insulin and thyroid hormone activity. Similarly, dietary vitamins affect microbial populations, while gut bacteria themselves can modify and produce vitamins. These interactions have downstream effects on immunity, lipid and glucose metabolism, and pancreatic beta-cell function.

Despite these insights, the precise mechanisms linking micronutrient deficiencies or excesses to gut microbiota shifts and their subsequent impact on metabolic disease risk remain unclear. Additionally, the causal relationships between vitamins and microbial function require further investigation. This review explores the interplay between micronutrients and gut microbiota, shedding light on their collective role in metabolic health.

开发更健康的食品和饮食习惯以在全球范围内抗击非传染性疾病，需要更深入地了解营养素如何与肠道微生物群相互作用。对人类和模式生物的新研究表明，肠道微生物通过影响它们的合成、生物利用度和代谢作用，在塑造个体微量营养素状态方面起着至关重要的作用。微量营养素可以调节肠道细菌与宿主之间的共生关系，影响调节葡萄糖代谢的内分泌途径。例如，矿物质和微量元素可以改变肠道微生物群组成，增强肠道屏障功能，减轻代谢性炎症，影响细胞葡萄糖摄取以及胰岛素和甲状腺激素活性。同样，膳食维生素影响微生物种群，而肠道细菌本身可以修饰和产生维生素。这些相互作用对免疫、脂质和糖代谢以及胰腺β细胞功能有下游影响。尽管有这些见解，但将微量营养素缺乏或过量与肠道微生物群变化及其随后对代谢性疾病风险的影响联系起来的确切机制仍不清楚。此外，维生素和微生物功能之间的因果关系需要进一步研究。这篇综述探讨了微量营养素和肠道微生物群之间的相互作用，揭示了它们在代谢健康中的集体作用。

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引用次数: 0

Association between dyslipidemia and elevated liver enzymes: A cross-sectional study from the PERSIAN Guilan cohort study 血脂异常与肝酶升高之间的关系：来自波斯桂兰队列研究的横断面研究

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-12-01 Epub Date: 2025-08-15 DOI: 10.1016/j.endmts.2025.100272

Milad Shahdkar , Mahdi Orang Goorabzarmakhi , Mahdi Shafizadeh , Farahnaz Joukar , Saman Maroufizadeh , Niloofar Faraji , Tahereh Zeinali , Fariborz Mansour-Ghanaei

Background

Dyslipidemia is associated with several health complications that put a heavy burden on the healthcare system and society due to its adverse outcomes. Abnormal lipid profile is known to cause complications in hepatic systems. The aim of this study was to examine the associations of elevated liver enzymes with dyslipidemia and its components in the Prospective Epidemiological Research Studies (PERSIAN) Guilan Cohort study (PGCS) population.

Methods

This cross-sectional study was conducted on data from 10,520 participants in PGCS, Guilan province, Iran. The demographic data and clinical characteristics of the participants were recorded. Lipid profile of the participants, including total cholesterol (Chol), triglycerides (TG), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL); and liver enzymes levels including alanine and aspartate aminotransferase (ALT, AST), γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) were measured. Statistical analyses were performed using SPSS version 16 based on a significant level < 0.05.

Results

Of 10,520 participants, 53.6 % (n = 5633) were female, and 36.6 % were aged 45–54. The mean BMI of the participants was 28.14 kg/m². The prevalence of alcohol consumption, fatty liver disease, hepatitis, lipid-lowering medication use, and hepatotoxic drug use were 13.3 %, 0.6 %, 0.3 %, 15.1 %, and 16.5 %, respectively. Abnormal levels of Chol, TG, LDL, HDL, ALT, AST, GGT, and ALP were reported in 40.3 %, 43.1 %, 29.0 %,41.5 %, 19.4 %, 4.6 %, 11.6 %, and 5.1 % individuals, respectively. Dyslipidemia significantly increased the likelihood of elevated ALT, AST, and GGT (P < 0.05), but showed no statistically significant association with elevated ALP (P > 0.05). High Chol, TG, and LDL were strongly associated with elevated liver enzymes, particularly ALT and GGT, while low HDL was less impactful.

Conclusion

These results underscore the significant impact of lipid abnormalities on liver function tests, especially for ALT and GGT.

背景：血脂异常与多种健康并发症相关，由于其不良后果，给医疗保健系统和社会带来沉重负担。脂质异常可引起肝系统并发症。本研究的目的是在前瞻性流行病学研究（波斯）桂兰队列研究（PGCS）人群中研究肝酶升高与血脂异常及其组成部分的关系。方法本横断面研究的数据来自伊朗桂兰省PGCS的10,520名参与者。记录参与者的人口学资料和临床特征。参与者的脂质谱，包括总胆固醇（Chol）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL）和高密度脂蛋白胆固醇（HDL）；测定肝酶水平，包括丙氨酸和天冬氨酸转氨酶（ALT、AST）、γ-谷氨酰转移酶（GGT）和碱性磷酸酶（ALP）。采用SPSS version 16进行统计学分析，基于显著水平<；0.05.结果10520名参与者中，53.6% （n = 5633）为女性，36.6%年龄在45-54岁之间。参与者的平均BMI为28.14 kg/m2。饮酒、脂肪肝、肝炎、使用降脂药物和使用肝毒性药物的患病率分别为13.3%、0.6%、0.3%、15.1%和16.5%。胆固醇、TG、LDL、HDL、ALT、AST、GGT和ALP的异常水平分别为40.3%、43.1%、29.0%、41.5%、19.4%、4.6%、11.6%和5.1%。血脂异常显著增加ALT、AST和GGT升高的可能性(P <；0.05)，但与ALP升高无统计学意义(P >；0.05)。高胆固醇、TG和LDL与肝酶升高密切相关，尤其是ALT和GGT，而低HDL影响较小。结论脂质异常对肝功能检测，尤其是ALT和GGT检测有显著影响。

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引用次数: 0

Utility of visceral fat rating, measured using bioelectrical impedance analysis, for screening metabolic syndrome in patients diagnosed with obesity in Vietnam 利用生物电阻抗分析测量内脏脂肪等级，在越南诊断为肥胖的患者中筛选代谢综合征

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-12-01 Epub Date: 2025-07-24 DOI: 10.1016/j.endmts.2025.100264

Chi Khanh Hoang , Thang Viet Tran , Hieu Ngoc Thi Tran , Bao Hoang Le , Tat Thang Dinh Ngo , Mai Ngoc Thi Tran , Luong Dai Ly , Diem Ngoc Thi Nguyen , Duy Le Nguyen , Nam Quang Tran

Background

Metabolic syndrome (MetS) is associated with increased risk for cardiovascular morbidity and mortality, particularly among patients with obesity. This study aimed to establish diagnostic visceral fat rating (VFR) cut-off values using non-invasive bioelectrical impedance analysis (BIA) to screen for MetS in patients with obesity in Vietnam.

Methods

This multicenter, cross-sectional study recruited patients with obesity (body mass index ≥25 kg/m²) ≥18 years of age from outpatient clinics at the University Medical Center Ho Chi Minh City and My Duc General Hospital (Ho Chi Minh, Vietnam) between July 2023 and January 2024. MetS was diagnosed based on joint consensus criteria from the International Diabetes Federation, American Heart Association, and the National Heart, Lung, and Blood Institute.

Results

In total, 502 patients with obesity (86 % diagnosed with MetS), were included. VFR was significantly higher in obese patients with MetS (p < 0.001). The optimal VFR cut-off for predicting MetS in patients with obesity was 10, with an area under the curve (AUC) of 0.7 (95 % confidence interval [CI] 0.61–0.80) for males and 0.74 (95 % CI 0.64–0.84) for females. Stratified analysis according to sex and obesity class revealed that VFR demonstrated the highest predictive utility for MetS in females (AUC 0.83) and males (AUC 0.76) with class I obesity.

Conclusions

VFR was a useful screening tool for MetS, particularly among females with class I obesity. Assessing VFR using BIA may facilitate early detection and prompt intervention to reduce risk for the development of cardiometabolic diseases before further invasive diagnostic procedures are considered.

代谢综合征（MetS）与心血管疾病发病率和死亡率增加有关，特别是在肥胖患者中。本研究旨在利用无创生物电阻抗分析（BIA）建立诊断性内脏脂肪评级（VFR）临界值，以筛查越南肥胖患者的MetS。方法本多中心横断面研究招募了2023年7月至2024年1月期间在胡志明市大学医学中心和越南胡志明市人民总医院门诊就诊的肥胖（体重指数≥25 kg/m2）≥18岁的患者。MetS是根据国际糖尿病联盟、美国心脏协会和国家心脏、肺和血液研究所的联合共识标准诊断的。结果共纳入502例肥胖患者（86%诊断为MetS）。肥胖met患者的VFR显著增高(p <；0.001)。预测肥胖患者met的最佳VFR截止值为10，男性曲线下面积（AUC）为0.7(95%可信区间[CI] 0.61-0.80)，女性为0.74（95%可信区间[CI] 0.64-0.84）。根据性别和肥胖类别的分层分析显示，VFR对I类肥胖女性（AUC 0.83）和男性（AUC 0.76）的met预测效用最高。结论svfr是一种有用的met筛查工具，尤其适用于ⅰ类肥胖女性。在考虑进一步的侵入性诊断程序之前，使用BIA评估VFR可能有助于早期发现和及时干预，以降低发生心脏代谢疾病的风险。

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引用次数: 0