Endocrine and Metabolic Science最新文献_第3页

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 : 2025-09-16 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

Clinical significance of uric acid, blood pressure anticipating proteinuria worsening in pregnant women of advanced age 尿酸、血压预测高龄孕妇蛋白尿恶化的临床意义

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-09-16 DOI: 10.1016/j.endmts.2025.100273

Hang Thi Thu Ho , Thuan Hoa Nguyen , Ha Hong Nguyen , Sam Phan Hai Nguyen , Kien Trung Nguyen

Background

Women of advanced maternal age are considered a high-risk obstetric population. Increases in serum uric acid levels, body mass index, and blood pressure have been associated with a higher likelihood of developing proteinuria. However, data on the predictive value of these factors for proteinuria progression specifically in this population remain limited.

Objectives

To determine the optimal cutoff values of serum uric acid, body mass index, systolic blood pressure, and diastolic blood pressure in predicting the progression of proteinuria in pregnant women of advanced maternal age.

Materials and methods

This was a cross-sectional descriptive study with longitudinal follow-up conducted among pregnant women who attended the Obstetrics Department of Vinh Long General Hospital from November 2022 to October 2023. Advanced maternal age was defined as maternal age of 35 years or older. Proteinuria was considered elevated when the 24-h urinary protein level reached ≥300 mg after the 20th week of gestation.

Results

A total of 100 pregnant women were enrolled, with a mean age of 38.6 ± 4.7 years. The proportions of active smoking and alcohol consumption were 18.0 % and 20.0 %, respectively. Overweight and obesity (OR = 6.06; 95 % CI: 1.97–18.59), smoking (OR = 3.89; 95 % CI: 1.30–11.59), and alcohol use (OR = 3.14; 95 % CI: 1.08–9.11) were significantly associated with the development of proteinuria. A pre-pregnancy body mass index (BMI) cut-off of 22.5 kg/m² showed the highest predictive value for proteinuria progression, with an area under the ROC curve (AUC) of 0.89 (95 % CI: 0.81–0.98), sensitivity of 86.2 %, and specificity of 92.3 %. Serum uric acid (AUC = 0.88), systolic blood pressure (AUC = 0.81), and diastolic blood pressure (AUC = 0.80) also demonstrated strong predictive performance.

Conclusion

Overweight/obesity, smoking, and alcohol consumption were identified as risk factors for increased proteinuria. In addition, pre-pregnancy BMI, serum uric acid levels, systolic blood pressure, and diastolic blood pressure all demonstrated strong predictive value for proteinuria progression in pregnant women of advanced maternal age.

高龄产妇被认为是高危产科人群。血清尿酸水平、体重指数和血压的升高与发生蛋白尿的可能性增高有关。然而，这些因素对蛋白尿进展的预测价值的数据仍然有限，特别是在这一人群中。目的确定血清尿酸、体重指数、收缩压和舒张压预测高龄孕妇蛋白尿进展的最佳临界值。材料和方法本研究是一项横断面描述性研究，对2022年11月至2023年10月在永隆总医院产科就诊的孕妇进行纵向随访。高龄产妇定义为35岁或以上的产妇。妊娠第20周后24小时尿蛋白≥300 mg为蛋白尿增高。结果共纳入100例孕妇，平均年龄38.6±4.7岁。吸烟和饮酒的比例分别为18.0%和20.0%。超重和肥胖（OR = 6.06; 95% CI: 1.97-18.59）、吸烟（OR = 3.89; 95% CI: 1.30-11.59）和饮酒（OR = 3.14; 95% CI: 1.08-9.11）与蛋白尿的发生显著相关。孕前体重指数（BMI）截止值为22.5 kg/m2，显示出蛋白尿进展的最高预测值，ROC曲线下面积（AUC）为0.89 (95% CI: 0.81-0.98)，敏感性为86.2%，特异性为92.3%。血清尿酸（AUC = 0.88）、收缩压（AUC = 0.81）和舒张压（AUC = 0.80）也显示出很强的预测能力。结论超重/肥胖、吸烟和饮酒被确定为蛋白尿增加的危险因素。此外，孕前BMI、血清尿酸水平、收缩压和舒张压均显示出对高龄孕妇蛋白尿进展有很强的预测价值。

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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 : 2025-08-15 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

The status of thyroid disorders among patients with type 2 diabetes mellitus in Guilan province, Iran 伊朗桂兰地区2型糖尿病患者甲状腺功能障碍状况调查

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-08-15 DOI: 10.1016/j.endmts.2025.100267

Maryam Yaseri , Haniyeh Sadat Fayazi , Fatemeh Mahdi , Faezeh Motevali , Seyedeh Sahereh Mortazavi Khatibani

Aims

This study aimed to investigate the prevalence of thyroid disorders and their associated risk factors in patients with type 2 diabetes mellitus.

Methods

This cross-sectional study was conducted among 223 patients with type 2 diabetes mellitus (T2DM). Patients were categorized into two groups based on the presence or absence of thyroid disorders. Demographic, clinical, and laboratory data were collected, and risk factors associated with thyroid disorders were evaluated by comparing diabetic patients with and without thyroid dysfunction. Statistical analysis was performed using SPSS version 22, with the level of significance set at P < 0.05.

Results

The mean age of patients was 54.24 ± 9.73 years, and 72.6 % (n = 162) were female. The prevalence of thyroid disorders among patients with T2DM was 61.9 %, with hypothyroidism being the most common (45.7 %). Cardiovascular disease was the most frequent diabetes-related complication (43.9 %), while nephropathy had the lowest prevalence (40.8 %). Neuropathy, nephropathy, and cardiovascular disease were significantly more frequent in patients with thyroid disorders compared to those without (P < 0.05). A family history of thyroid disease was present in 40.4 % of patients, and 17.0 % were positive for anti-thyroid peroxidase antibodies. Thyroid disorders were more prevalent in females (67.9 %) compared to males (45.9 %) (P = 0.003). Female gender and a positive family history were significant risk factors for developing thyroid disorders (P < 0.05).

Conclusion

This study demonstrated that female gender and a positive family history of thyroid disease are significant predictors of thyroid dysfunction in patients with T2DM. These findings underscore the need for routine screening for thyroid disorders in this patient population.

目的探讨2型糖尿病患者甲状腺功能障碍的患病率及其相关危险因素。方法对223例2型糖尿病（T2DM）患者进行横断面研究。根据是否存在甲状腺疾病将患者分为两组。收集了人口统计学、临床和实验室数据，并通过比较有和无甲状腺功能障碍的糖尿病患者来评估与甲状腺疾病相关的危险因素。采用SPSS version 22进行统计分析，显著性水平设为P <；0.05.结果患者平均年龄54.24±9.73岁，女性占72.6% （n = 162）。T2DM患者中甲状腺疾病的患病率为61.9%，其中甲状腺功能减退最为常见（45.7%）。心血管疾病是最常见的糖尿病相关并发症（43.9%），而肾病的患病率最低（40.8%）。神经病变、肾病和心血管疾病在甲状腺疾病患者中的发生率明显高于无甲状腺疾病患者(P <；0.05)。40.4%的患者有甲状腺疾病家族史，17.0%的患者抗甲状腺过氧化物酶抗体阳性。甲状腺疾病在女性中的患病率（67.9%）高于男性（45.9%）（P = 0.003）。女性和阳性家族史是发生甲状腺疾病的重要危险因素(P <；0.05)。结论女性和甲状腺家族史是2型糖尿病患者甲状腺功能障碍的重要预测因素。这些发现强调了对这类患者进行甲状腺疾病常规筛查的必要性。

{"title":"The status of thyroid disorders among patients with type 2 diabetes mellitus in Guilan province, Iran","authors":"Maryam Yaseri , Haniyeh Sadat Fayazi , Fatemeh Mahdi , Faezeh Motevali , Seyedeh Sahereh Mortazavi Khatibani","doi":"10.1016/j.endmts.2025.100267","DOIUrl":"10.1016/j.endmts.2025.100267","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to investigate the prevalence of thyroid disorders and their associated risk factors in patients with type 2 diabetes mellitus.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted among 223 patients with type 2 diabetes mellitus (T2DM). Patients were categorized into two groups based on the presence or absence of thyroid disorders. Demographic, clinical, and laboratory data were collected, and risk factors associated with thyroid disorders were evaluated by comparing diabetic patients with and without thyroid dysfunction. Statistical analysis was performed using SPSS version 22, with the level of significance set at <em>P</em> < 0.05.</div></div><div><h3>Results</h3><div>The mean age of patients was 54.24 ± 9.73 years, and 72.6 % (<em>n</em> = 162) were female. The prevalence of thyroid disorders among patients with T2DM was 61.9 %, with hypothyroidism being the most common (45.7 %). Cardiovascular disease was the most frequent diabetes-related complication (43.9 %), while nephropathy had the lowest prevalence (40.8 %). Neuropathy, nephropathy, and cardiovascular disease were significantly more frequent in patients with thyroid disorders compared to those without (<em>P</em> < 0.05). A family history of thyroid disease was present in 40.4 % of patients, and 17.0 % were positive for anti-thyroid peroxidase antibodies. Thyroid disorders were more prevalent in females (67.9 %) compared to males (45.9 %) (<em>P</em> = 0.003). Female gender and a positive family history were significant risk factors for developing thyroid disorders (<em>P</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that female gender and a positive family history of thyroid disease are significant predictors of thyroid dysfunction in patients with T2DM. These findings underscore the need for routine screening for thyroid disorders in this patient population.</div></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":"19 ","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842289","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

Peripheral vascular disease and its associated factors among diabetic patients on follow-up at Ras Desta Damtew Memorial Hospital, Addis Ababa, Ethiopia 在埃塞俄比亚亚的斯亚贝巴Ras Desta Damtew纪念医院随访的糖尿病患者外周血管疾病及其相关因素

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-08-10 DOI: 10.1016/j.endmts.2025.100271

Zerihun Chala Deme , Getchew Fekadu Feda , Dereje Tsegaye , Agumasie Semahegn

Objective

This study aimed to assess the prevalence of peripheral vascular disorders and associated factors among diabetic patients on follow-up at Ras Desta Damtew Memorial Hospital, Ethiopia.

Methods

An institutional-based cross-sectional study was conducted among 275 randomly selected Diabetes Mellitus patients attending follow-up at Ras Desta Damtew Memorial Hospital, Addis Ababa, Ethiopia, from July to August 2024. Data were collected using structured questionnaires, ankle-brachial index, and Edinburgh Claudication Questionnaire, IPAQ-SF. Data were entered into Epi-data version 4.6 and exported to SPSS version 25 for analysis. Bi-variable and multivariable binary logistic regression analyses were conducted to determine associations between dependent and independent variables. Adjusted odds ratios with 95 % confidence intervals were reported, and statistical significance was considered at p ≤ 0.05.

Results

The study found that 12 % (95 % CI: 8.15 %–15.85 %) of diabetic patients developed peripheral vascular disorders. Significant associations were found with smoking (AOR: 5.59; 3.42–8.63), alcohol use (AOR: 4.09; 2.56–7.74), hypertension (AOR: 3.55; 1.69–6.25), and physical inactivity (AOR: 3.80; 1.56–9.47).

Conclusions

Over one in ten diabetic patients developed peripheral vascular disease. Key associated factors include smoking, alcohol use, hypertension, and physical inactivity. Interventions targeting these risk factors are necessary to reduce related complications in diabetic patients.

目的本研究旨在评估在埃塞俄比亚Ras Desta Damtew纪念医院随访的糖尿病患者外周血管疾病的患病率及相关因素。方法对2024年7月至8月在埃塞俄比亚亚的斯亚贝巴Ras Desta Damtew纪念医院随访的275例糖尿病患者进行了一项基于机构的横断面研究。采用结构化问卷、踝臂指数和爱丁堡跛行问卷（IPAQ-SF）收集数据。数据输入Epi-data 4.6版本，导出到SPSS 25版本进行分析。进行双变量和多变量二元逻辑回归分析，以确定因变量和自变量之间的关联。校正优势比为95%置信区间，p≤0.05认为有统计学意义。结果研究发现，12% （95% CI: 8.15% - 15.85%）的糖尿病患者发生周围血管病变。与吸烟有显著相关性(AOR: 5.59；3.42-8.63)，酒精使用(AOR: 4.09；2.56-7.74)，高血压(AOR: 3.55；1.69-6.25)，缺乏身体活动(AOR: 3.80；1.56 - -9.47)。结论1 / 10以上的糖尿病患者发生周围血管病变。主要的相关因素包括吸烟、饮酒、高血压和缺乏身体活动。针对这些危险因素的干预措施对于减少糖尿病患者的相关并发症是必要的。

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引用次数: 0

Assessment of periostin in postmenopausal thyroid patients: A prospective case-control study 评估绝经后甲状腺患者的骨膜素：一项前瞻性病例对照研究

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-08-08 DOI: 10.1016/j.endmts.2025.100270

Ashok Kumar Gupta , Saba Faruqui , Ambika Nand Jha

Objective

To evaluate the relationship between periostin in postmenopausal hypothyroid women.

Methodology

A prospective case-control study was conducted at Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) Hospital, Agamkuan, Patna, India. The study includes 38 postmenopausal hypothyroid women as case and 38 healthy women as control. Demographic details and anthropometric measurements were included. Biochemical parameters like triiodothyronine (T3), tetraiodothyronine (T4), thyroid stimulating hormone (TSH), calcitonin, calcium, phosphorous, creatinine and albumin were determined. Serum periostin level was measured in case as well as in control subjects. Statistical Package for the Social Sciences (SPSS) version 22 was used to perform statistical analysis.

Results

Significant differences were noted in hip circumference (HC), waist hip ratio (WHR), white blood cells (WBC), T3, TSH, creatinine, calcium, phosphorous, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and periostin levels between hypothyroid and euthyroid patients. Euthyroid patients had lower TSH and higher T3 levels, while periostin was higher in hypothyroid subjects. Correlation analysis showed periostin shows positive correlation with height and WBC, and negative correlation with T3, T4, and creatinine. Whereas, TSH shows positive correlation with creatinine in hypothyroid cases and shows negative correlation with weight and body mass index (BMI).

Conclusion

Hypothyroid patients observed with higher serum periostin levels in comparison to euthyroid individuals. Further research on periostin in large population is required in hypothyroid cases along with bone mineral density (BMD) to be explored as a possible biomarker.

目的探讨绝经后甲状腺功能减退妇女血清骨膜素与甲状腺功能减退的关系。方法在印度巴特那Agamkuan的Rajendra纪念医学科学研究所（rrimms）医院进行了一项前瞻性病例对照研究。该研究包括38名绝经后甲状腺功能减退妇女作为病例和38名健康妇女作为对照。包括人口统计细节和人体测量数据。测定三碘甲状腺原氨酸（T3）、四碘甲状腺原氨酸（T4）、促甲状腺激素（TSH）、降钙素、钙、磷、肌酐、白蛋白等生化指标。测定病例组和对照组血清骨膜蛋白水平。使用社会科学统计软件包（SPSS）第22版进行统计分析。结果甲状腺功能低下患者与甲状腺功能正常患者的臀围（HC）、腰臀比（WHR）、白细胞（WBC）、T3、TSH、肌酐、钙、磷、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯、骨膜蛋白水平均有显著差异。甲状腺功能正常的患者TSH水平较低，T3水平较高，而甲状腺功能低下的患者骨膜素水平较高。相关性分析显示，骨膜蛋白与身高、WBC呈正相关，与T3、T4、肌酐呈负相关。甲状腺功能减退患者TSH与肌酐呈正相关，与体重、体质指数（BMI）呈负相关。结论甲状腺功能减退患者血清骨膜蛋白水平高于甲状腺功能正常者。在甲状腺功能减退病例中，骨密度（BMD）作为一种可能的生物标志物，需要在大人群中进一步研究骨膜蛋白。

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引用次数: 0

The predictive value of the TG/HDL index for metabolic syndrome and its components: A cross-sectional study in the PERSIAN Guilan Cohort Population TG/HDL指数对代谢综合征及其组成部分的预测价值：波斯桂兰队列人群的横断面研究

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-08-06 DOI: 10.1016/j.endmts.2025.100269

Amirali Ebrahimi , Farahnaz Joukar , Kourosh Mojtahedi , Saman Maroufizadeh , Soheil Hassanipour , Mohammad Reza Naghipour , Mehrnaz Asgharnezhad , Fariborz Mansour-Ghanaei

Background

Metabolic syndrome (MetS) is a global health concern linked to cardiovascular disease and type 2 diabetes. The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has emerged as a promising biomarker for MetS due to its strong correlation with insulin resistance and atherogenic dyslipidemia. However, its utility in Middle Eastern populations, particularly in Iran, remains underexplored.

Objectives

This study aims to evaluate the association between the TG/HDL-C ratio and MetS in the Guilan Cohort Study (GCS), a population-based survey in northern Iran, and to identify sex-specific cutoff values for MetS prediction.

Methods

This cross-sectional analysis included 10,520 adults aged 35–70 from the GCS. Data were collected through structured questionnaires, anthropometric measurements, and biochemical studies. MetS was defined using NCEP ATP-III criteria. Receiver operating characteristic (ROC) curves were used to assess the predictive performance of the TG/HDL-C ratio, and logistic regression models were employed to examine its association with MetS, adjusting for confounders such as age, gender, BMI, and lifestyle factors.

Result

The overall prevalence of MetS was 41.8 %, with significant gender disparities (56.3 % in women vs. 25.0 % in men). Central obesity (58.0 %) and dyslipidemia were highly prevalent, particularly among women. The TG/HDL-C ratio demonstrated strong predictive power for MetS, with AUC values of 0.828 for men and 0.832 for women. Sex-specific optimal cutoffs were identified at 3.42 (men) and 2.80 (women), with high sensitivity (83.6 % and 72.2 %) and specificity (69.0 % and 80.9 %). Logistic regression revealed a significant association between the TG/HDL-C ratio and MetS risk, with adjusted odds ratios of 1.49 (men) and 3.02 (women) per unit increase.

Conclusion

The TG/HDL-C ratio is a robust and cost-effective biomarker for predicting MetS, particularly in resource-limited settings. The study highlights significant gender disparities in MetS prevalence and risk factors, underscoring the need for gender-tailored interventions. These findings support the integration of the TG/HDL-C ratio into routine clinical practice for early detection and management of MetS. Future research should focus on longitudinal studies and multiethnic validation to further establish the ratio's applicability across diverse populations.

代谢综合征（MetS）是与心血管疾病和2型糖尿病相关的全球性健康问题。甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值由于与胰岛素抵抗和动脉粥样硬化性血脂异常密切相关，已成为一种有前景的MetS生物标志物。然而，它在中东人口中的效用，特别是在伊朗，仍未得到充分开发。本研究旨在评估Guilan队列研究（GCS）中TG/HDL-C比值与MetS之间的关系，GCS是伊朗北部一项基于人群的调查，并确定性别特异性的MetS预测临界值。方法横断面分析包括来自GCS的10520名35-70岁的成年人。数据通过结构化问卷调查、人体测量和生化研究收集。MetS采用NCEP ATP-III标准定义。受试者工作特征（ROC）曲线用于评估TG/HDL-C比值的预测性能，并采用逻辑回归模型来检查其与MetS的关系，调整混杂因素如年龄、性别、BMI和生活方式因素。结果met的总体患病率为41.8%，性别差异显著（女性56.3%，男性25.0%）。中心性肥胖（58.0%）和血脂异常非常普遍，尤其是在女性中。TG/HDL-C比值对MetS具有很强的预测能力，男性的AUC值为0.828，女性为0.832。性别特异性最佳截止值分别为3.42（男性）和2.80（女性），具有较高的灵敏度（83.6%和72.2%）和特异性（69.0%和80.9%）。Logistic回归显示TG/HDL-C比值与met风险之间存在显著关联，校正比值比为每单位增加1.49（男性）和3.02（女性）。结论TG/HDL-C比值是预测MetS的可靠且具有成本效益的生物标志物，特别是在资源有限的环境中。该研究强调了MetS患病率和风险因素的显著性别差异，强调了针对性别的干预措施的必要性。这些发现支持将TG/HDL-C比值纳入met早期检测和管理的常规临床实践。未来的研究应侧重于纵向研究和多民族验证，以进一步建立该比率在不同人群中的适用性。

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引用次数: 0

Mineralocorticoid receptor antagonists reduce inflammatory signaling independent of myofiber mineralocorticoid receptor 矿化皮质激素受体拮抗剂减少独立于肌纤维矿化皮质激素受体的炎症信号

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-07-31 DOI: 10.1016/j.endmts.2025.100266

Jeovanna Lowe , Arden B. Piepho , Chetan K. Gomatam , Peyton Debell , Megan N. Ballinger , Jill A. Rafael-Fortney

Chronic inflammation is a feature of Duchenne muscular dystrophy (DMD), a degenerative striated muscle disease. Mineralocorticoid receptor (MR) antagonists (MRAs) have demonstrated clinical benefit on later onset DMD cardiomyopathy, and preclinical studies in mouse models have demonstrated efficacy on multiple steps of skeletal muscle pathology. MRA treatment of the mdx mouse model reduces pro-inflammatory gene expression from skeletal muscle myeloid immune cells and represses muscle cytokine signaling and fibrosis. Myofiber-specific knockout of MR in mdx mice improves muscle force and reduces fibrosis, but inflammation in this model had not been investigated. In this study we investigated muscle inflammation at the cellular level using flow cytometry and at the protein signaling level using an unbiased cytokine assay. Numbers and proportions of myeloid cells were the same in mdx mice and those lacking myofiber MR, similar to the absence of cell type differences previously observed with either MRA treatment or myeloid MR knockout. MRA treatment, but not myofiber MR deletion alone, led to reductions in numerous cytokines and chemokines also previously observed in mdx mice. These data suggest that the beneficial reduction of inflammatory signaling from MRAs is largely independent of myofiber MR and occurs through another mechanism.

慢性炎症是一种退行性横纹肌疾病杜氏肌营养不良症（DMD）的特征。矿盐皮质激素受体（MR）拮抗剂（MRAs）已被证明对晚发性DMD心肌病有临床益处，小鼠模型的临床前研究已证明对骨骼肌病理的多个步骤有效。mdx小鼠模型的MRA治疗降低骨骼肌髓系免疫细胞的促炎基因表达，抑制肌肉细胞因子信号传导和纤维化。mdx小鼠肌纤维特异性敲除MR可改善肌力并减少纤维化，但该模型中的炎症尚未研究。在这项研究中，我们在细胞水平上使用流式细胞术研究肌肉炎症，在蛋白质信号水平上使用无偏倚细胞因子测定。mdx小鼠和缺乏肌纤维MR的小鼠的髓细胞数量和比例相同，类似于之前在MRA治疗或髓细胞MR敲除中观察到的细胞类型差异的缺失。MRA治疗，而不是单独的肌纤维MR缺失，导致先前在mdx小鼠中观察到的许多细胞因子和趋化因子的减少。这些数据表明，来自mra的炎症信号的有益减少在很大程度上独立于肌纤维MR，并通过另一种机制发生。

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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 : 2025-07-24 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

Diabetic nephropathy: Pathophysiology and potential therapeutic role of plant extracts 糖尿病肾病：植物提取物的病理生理和潜在治疗作用

Q3 Medicine

Endocrine and Metabolic Science

Pub Date : 2025-07-22 DOI: 10.1016/j.endmts.2025.100263

Mehak Naseer Mir , Ishfaq Ahmad Malik , Rayees Ahmad Naik , Sonalika Singh , Aabid Rashid Hurra , Zahid Ahmad Wani , Rakhmat Shah , Yaqoob Lone

Objective

This review aims to explore the molecular mechanisms underlying diabetic nephropathy (DN), with a particular focus on the role of oxidative stress. Additionally, it evaluates the therapeutic potential of plant-based extracts rich in bioactive compounds for the management of diabetes and its associated renal complications.

Results

Oxidative stress is identified as a key contributor to DN pathogenesis. Several major pathways are involved, including hypoxia-inducible factor-1 (HIF-1), transforming growth factor-beta (TGF-β), mitochondrial dysfunction, renin-angiotensin-aldosterone system (RAAS) activation, and endothelial nitric oxide synthase (eNOS) uncoupling. These mechanisms collectively lead to podocyte injury, tubular damage, extracellular matrix accumulation, disrupted renal hemodynamics, and glomerular hyperfiltration. Plant-derived compounds have shown potential in modulating these pathways, thereby offering renal protective effects.

Conclusion

Plant-based remedies enriched with bioactive compounds represent promising adjunct therapies for managing diabetes and its renal complications. Their integration into conventional treatment regimens may provide a holistic approach to glycemic control and reduction of oxidative stress-induced kidney damage. This review underscores the importance of multifaceted therapeutic strategies targeting both metabolic dysregulation and oxidative stress to effectively prevent and manage diabetic nephropathy.

目的探讨糖尿病肾病（DN）的分子机制，特别是氧化应激的作用。此外，它还评估了富含生物活性化合物的植物提取物对糖尿病及其相关肾脏并发症的治疗潜力。结果氧化应激是DN发病的关键因素。其中包括缺氧诱导因子-1 （HIF-1）、转化生长因子-β (TGF-β)、线粒体功能障碍、肾素-血管紧张素-醛固酮系统（RAAS）激活和内皮型一氧化氮合酶（eNOS）解偶联。这些机制共同导致足细胞损伤、小管损伤、细胞外基质积累、肾血流动力学破坏和肾小球高滤过。植物源性化合物已显示出调节这些途径的潜力，从而提供肾脏保护作用。结论富含生物活性化合物的植物性药物是治疗糖尿病及其肾脏并发症的有希望的辅助疗法。将它们整合到常规治疗方案中，可能为血糖控制和减少氧化应激引起的肾损伤提供一种全面的方法。这篇综述强调了针对代谢失调和氧化应激的多方面治疗策略对有效预防和管理糖尿病肾病的重要性。

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引用次数: 0