Endocrinology, Diabetes and Metabolism最新文献_第3页

High-Protein Diet Exacerbates Insulin Resistance via the JNK/IKKβ-IRS-1 Pathway 高蛋白饮食通过JNK/IKKβ-IRS-1途径加剧胰岛素抵抗

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-12-12 DOI: 10.1002/edm2.70147

Junjun Li, Jinhua Xu, Jinmiao Tian, Lixia Chen, Lili Zhao, Yongming Yang, Jing Wang, Lei Yan, Yuxin Yang, Yuchen Jiang, Simin Chen, Binxuan Wang, Lulu Wang, Xihua Yang

Objective

To investigate the effects of a high-protein (HP) diet on insulin resistance in a type 2 diabetes (T2D) mouse model.

Methods

A high-fat diet combined with streptozotocin (STZ, 25 mg/kg) was used to induce a T2D model. Fasting blood glucose levels > 7 mmol/L were considered successful modelling. The models were further divided into three groups: the Normal-Protein-T2D (TN, n = 8), High-Protein-T2D (TH, n = 8), and High-Fat-T2D (TF, n = 8) groups. These groups were fed diets containing 20% protein, 60% protein, and 60% fat, respectively. Additionally, 24 Kunming (KM) mice, serving as non-T2D controls, were divided into a Normal-Protein-Control (N, n = 8), a High-Protein-Control (H, n = 8), and a Low-Protein-Control (L, n = 8), fed 20% protein, 60% protein, and 5% protein diets, respectively. After 6 weeks of dietary intervention, FBG, serum biochemical markers, hepatic inflammatory factors and pathological changes, and pancreatic immunohistochemistry were assessed. Expression of IRS-1, JNK, IKKβ, and their phosphorylated proteins were analysed.

Results

Mice in the H group exhibited significantly impaired glucose tolerance, exacerbated insulin resistance, and reduced liver function. In the T2D model, TH mice exhibited more severe hyperglycemia, insulin resistance, and β-cell dysfunction than TN mice, accompanied by increased hepatic TNF-α and IL-6 expression, enhanced lipid accumulation, suppressed IRS-1 phosphorylation, and enhanced JNK and IKKβ phosphorylation.

Conclusion

A HP diet induces insulin resistance in normal mice and further exacerbates glucose metabolism disorders in T2D models, suggesting that restricting HP intake may serve as a strategy for preventing T2D.

目的：探讨高蛋白饮食对2型糖尿病（T2D）小鼠胰岛素抵抗的影响。方法：采用高脂饲料联合链脲佐菌素（STZ, 25 mg/kg）诱导大鼠T2D模型。空腹血糖水平bbb70 mmol/L被认为是成功的建模。将模型进一步分为正常蛋白- t2d组（TN, n = 8）、高蛋白- t2d组（TH, n = 8）和高脂- t2d组（TF, n = 8）。各组分别饲喂蛋白质含量为20%、蛋白质含量为60%和脂肪含量为60%的饲粮。另外，24只昆明小鼠作为非t2d对照组，分为正常蛋白对照组（N, N = 8）、高蛋白对照组（H, N = 8）和低蛋白对照组（L, N = 8），分别饲喂蛋白质含量为20%、60%和5%的饲料。饮食干预6周后，评估空腹血糖、血清生化指标、肝脏炎症因子及病理变化、胰腺免疫组织化学。分析IRS-1、JNK、IKKβ及其磷酸化蛋白的表达。结果：H组小鼠糖耐量明显降低，胰岛素抵抗加重，肝功能下降。在T2D模型中，TH小鼠比TN小鼠表现出更严重的高血糖、胰岛素抵抗和β细胞功能障碍，并伴有肝脏TNF-α和IL-6表达升高，脂质积累增强，IRS-1磷酸化抑制，JNK和IKKβ磷酸化增强。结论：HP饮食可诱导正常小鼠胰岛素抵抗，并进一步加重T2D模型的糖代谢紊乱，提示限制HP摄入可能是预防T2D的一种策略。

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引用次数: 0

Association of the Endothelial Nitric Oxide Synthase (eNOS) G894T Gene Polymorphism With Type 2 Diabetes Mellitus in a Tunisian Population 突尼斯人群中内皮型一氧化氮合酶（eNOS） G894T基因多态性与2型糖尿病的关系

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-12-10 DOI: 10.1002/edm2.70122

Afif Ba, Manel Ayoub, Sana Aboulkacem, Mariem Belhedi, Zied Aouni, C. Mazigh

Background

Type 2 Diabetes Mellitus (T2D) is a multifactorial metabolic disorder with a significant genetic component. Endothelial dysfunction, characterised by reduced nitric oxide (NO) bioavailability, is a key pathological feature. The endothelial nitric oxide synthase (eNOS) gene (NOS3) contains several polymorphisms, with the G894T (Glu298Asp) variant being a prominent candidate for influencing disease susceptibility.

Objective

This study aimed to investigate the association between the eNOS G894T polymorphism and the risk of T2D in a sample of the Tunisian population.

Methods

We conducted a case–control study including 100 T2D patients and 100 non-diabetic controls recruited from the Military Hospital of Tunis. Anthropometric, clinical and biochemical parameters, including lipid profiles and high-sensitivity C-reactive protein (CRPus), were measured. Genotyping of the eNOS G894T polymorphism was performed using the Polymerase Chain Reaction–Restriction Fragment Length Polymorphism (PCR-RFLP) method with the BanII restriction enzyme.

Results

T2D patients exhibited significantly higher levels of triglycerides (1.99 ± 1.27 vs. 1.45 ± 0.65 mmol/L, p = 0.002) and CRPus (2.73 ± 2.47 vs. 1.63 ± 1.42 mg/L, p = 0.003) compared to controls. The frequency of the mutated T allele was significantly higher in the T2D group than in the control group (27.53% vs. 11.27%, p < 10⁻³). Consequently, the heterozygous GT genotype was more prevalent among patients (55.07% vs. 19.72%, p < 10⁻³). The presence of the T allele was associated with a significantly increased risk of T2D (Odds Ratio [OR] = 4.495, 95% Confidence Interval [CI] = 2.14–9.44).

Conclusion

The eNOS G894T polymorphism is a significant genetic risk factor for type 2 diabetes in the studied Tunisian population. The T allele appears to confer susceptibility, likely through mechanisms involving impaired eNOS function, reduced NO production and subsequent endothelial dysfunction.

背景：2型糖尿病（T2D）是一种多因素代谢紊乱，具有重要的遗传成分。内皮功能障碍，以降低一氧化氮（NO）的生物利用度为特征，是一个关键的病理特征。内皮型一氧化氮合酶（eNOS）基因（NOS3）包含多种多态性，其中G894T （Glu298Asp）变体是影响疾病易感性的重要候选基因。目的：本研究旨在调查突尼斯人群样本中eNOS G894T多态性与T2D风险之间的关系。方法：我们从突尼斯军队医院招募了100例T2D患者和100例非糖尿病对照组，进行了病例对照研究。测量人体测量学、临床和生化参数，包括脂质谱和高敏c反应蛋白（CRPus）。采用BanII限制性内切酶聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法对eNOS G894T多态性进行基因分型。结果：T2D患者的甘油三酯（1.99±1.27 vs. 1.45±0.65 mmol/L, p = 0.002）和CRPus（2.73±2.47 vs. 1.63±1.42 mg/L, p = 0.003）水平明显高于对照组。T2D组T等位基因突变频率显著高于对照组（27.53% vs. 11.27%, p -3）。因此，GT基因型杂合型在患者中更为普遍（55.07%比19.72%,p -3）。T等位基因的存在与T2D风险显著增加相关（优势比[OR] = 4.495, 95%可信区间[CI] = 2.14-9.44）。结论：eNOS G894T多态性是突尼斯人群2型糖尿病的重要遗传危险因素。T等位基因似乎赋予易感性，可能通过涉及eNOS功能受损、NO产生减少和随后内皮功能障碍的机制。

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引用次数: 0

Assessing Awareness and Knowledge Gaps in Diabetic Distress Among Qatar's Healthcare Providers: A Cross-Sectional Study 评估意识和知识差距在卡塔尔的医疗保健提供者糖尿病困扰：横断面研究。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-12-10 DOI: 10.1002/edm2.70117

Mutwakil Elbidairi, Tatiane Aparecida de Miranda, Camila María Martínez Marte, Ewerton Alves Portela dos Santos, Waseeim Raja, Aboobacher Kandakkeel, Yosria A. I. Ghorab

Background

Diabetes distress refers to the emotional burden associated with the ongoing management of diabetes. It affects up to 77% of patients with diabetes and is associated with poor glycemic control, reduced adherence to treatment, and lower quality of life. Despite its clinical relevance, diabetes distress (DD) remains under-recognised by healthcare professionals, particularly in the broader Middle East.

Objective

To assess the awareness and knowledge of diabetic distress among healthcare providers in a tertiary care hospital in Qatar and to identify demographic or professional factors influencing their responses.

Methods

A cross-sectional survey of 64 healthcare providers at Al Khor Hospital was conducted using an 18-item questionnaire assessing healthcare providers' Diabetes distress knowledge, consequences, and management familiarity. Associations between knowledge and factors such as specialty, experience, and prior Diabetes distress exposure were analysed using chi-square or Fisher's exact tests with Bonferroni adjustments for multiple comparisons.

Results

Only 60.3% of respondents had heard of diabetes distress. Significant knowledge gaps existed, particularly among non-endocrinology professionals and those without prior formal education on diabetes distress. Prior exposure through educational settings was significantly associated with improved knowledge (p < 0.05), while clinical experience alone was not.

Conclusion

Substantial knowledge gaps persist in recognizing and managing diabetic distress among Qatar's healthcare providers. Educational exposure was a stronger determinant of knowledge than years of experience. Structured, interdisciplinary training programs are urgently needed.

背景：糖尿病困扰是指与糖尿病持续管理相关的情绪负担。它影响多达77%的糖尿病患者，并与血糖控制不良、治疗依从性降低和生活质量降低有关。尽管其临床相关性，糖尿病困扰（DD）仍未被卫生保健专业人员认识到，特别是在更广泛的中东地区。目的：评估卡塔尔一家三级医院医护人员对糖尿病窘迫的认识和知识，并确定影响其反应的人口统计学或专业因素。方法：对Al Khor医院64名医疗服务提供者进行横断面调查，采用18项问卷评估医疗服务提供者的糖尿病痛苦知识、后果和管理熟悉度。知识与专业、经验和既往糖尿病痛苦暴露等因素之间的关联采用卡方检验或Fisher精确检验，并采用Bonferroni调整进行多重比较。结果：只有60.3%的受访者听说过糖尿病困扰。存在显著的知识差距，特别是在非内分泌专业人员和没有接受过糖尿病困扰正规教育的人员中。通过教育环境的先前暴露与知识的提高显著相关(p结论：卡塔尔医疗保健提供者在认识和管理糖尿病困扰方面仍然存在实质性的知识差距。受教育程度对知识的影响比多年的经验更大。迫切需要结构化的、跨学科的培训项目。

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引用次数: 0

Corticotroph Tumour Type Influences Clinical Behaviour in Patients With Nonfunctioning Pituitary Neuroendocrine Tumours 促皮质性肿瘤类型对无功能垂体神经内分泌肿瘤患者临床行为的影响

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-12-05 DOI: 10.1002/edm2.70143

Nasrin Al-Shamkhi, Britt Edén Engström, Olafur Gudjonsson, Johan Wikström, Olivera Casar-Borota, Eva Rask

Introduction

This study aims to describe whether the clinical behaviour of nonfunctioning pituitary neuroendocrine tumours/nonfunctioning pituitary adenomas (NF-PitNETs/NFPAs) is affected by pituitary cell lineage differentiation, focusing on patients with silent corticotroph tumours (SCTs) and silent gonadotroph tumours (SGTs).

Methods

Patients (N = 101) who underwent primary surgery for NF-PitNETs/NFPAs from August 2014 to March 2020 at Uppsala University Hospital were included. Data on sex, age, MRI, pituitary function and immunohistochemical analysis of anterior pituitary hormone and transcription factor expression, were explored.

Results

Seventy-three patients had SGTs, and 18 had SCTs. Binary logistic regression revealed that having SCT versus SGT (OR 6.41 (CI: 1.20–34.42), p = 0.03), being older at the time of surgery (OR 1.07 (CI: 1.02–1.12), p = 0.01), and having a larger preoperative tumour volume (OR 1.17 (CI: 1.04–1.32), p = 0.01) were associated with an increased likelihood of postoperative pituitary failure. Patients with preoperative pituitary failure were older at the time of surgery (p = 0.01) and more often had preoperative elevation of prolactin levels (p = 0.01) than patients without preoperative pituitary failure. SCT patients were younger at the time of surgery than SGT patients (p = 0.003), but no significant difference in preoperative tumour volume was detected.

Conclusion

The results indicate that cell lineage differentiation in NF-PitNETs/NFPAs influences clinical behaviour. Patients with SCTs were younger at the time of surgery, and harbouring a SCT was associated with an increased likelihood of having postoperative pituitary failure. These findings emphasise the importance of routine immunohistochemical analyses of anterior pituitary hormone and transcription factor expression to identify silent corticotroph tumours.

本研究旨在描述无功能垂体神经内分泌肿瘤/无功能垂体腺瘤（NF-PitNETs/ nfpa）的临床行为是否受到垂体细胞谱系分化的影响，重点关注无症状促皮质瘤（SCTs）和无症状促性腺瘤（sgt）患者。方法纳入2014年8月至2020年3月在乌普萨拉大学医院接受NF-PitNETs/ nfpa初级手术的患者101例。探讨性别、年龄、MRI、垂体功能及垂体前叶激素和转录因子表达的免疫组化分析数据。结果sgt 73例，sct 18例。二元逻辑回归显示，SCT与SGT (OR 6.41 (CI: 1.20-34.42), p = 0.03)，手术时年龄较大（OR 1.07 (CI: 1.02-1.12), p = 0.01）和术前肿瘤体积较大（OR 1.17 (CI: 1.04-1.32), p = 0.01）与术后垂体功能衰竭的可能性增加相关。术前垂体功能衰竭患者手术时年龄较大（p = 0.01），术前催乳素水平升高较术前无垂体功能衰竭患者多（p = 0.01）。SCT患者手术时比SGT患者年轻（p = 0.003），但术前肿瘤体积无显著差异。结论NF-PitNETs/ nfpa的细胞系分化影响临床行为。SCT患者在手术时较年轻，并且SCT与术后垂体功能衰竭的可能性增加有关。这些发现强调了常规免疫组化分析垂体前叶激素和转录因子表达的重要性，以确定沉默的促皮质性肿瘤。

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引用次数: 0

The Combined Effects of an Anti-Inflammatory Diet and Curcumin Supplementation on Thyroid Function and Lipid Profile in Patients With Hashimoto's Thyroiditis: A Double Blind Randomised Clinical Trial 抗炎饮食和姜黄素补充对桥本甲状腺炎患者甲状腺功能和血脂的联合影响：一项双盲随机临床试验

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-12-02 DOI: 10.1002/edm2.70138

Fatemeh Bourbour, Behnam Mahdavi, Niayesh Naghshi, Zahra Yari, Seyedsina Moghimnejad hosseini, Saeid Kalbasi, Golbon Sohrab

Background

Hashimoto's thyroiditis (HT) is an inflammatory autoimmune disease and patients with HT may benefit from interventions that incorporate anti-inflammatory components. This study aimed to assess the combined effects of an anti-inflammatory diet and curcumin supplementation on thyroid hormones and lipid profile in patients with HT.

Methods

This randomised controlled clinical trial was conducted on 57 patients with HT. Patients were randomly assigned to receive either an anti-inflammatory diet plus 1320 mg/day curcumin or an anti-inflammatory diet plus placebo for 12 weeks. Anthropometric indices, anti-thyroid peroxidase (anti-TPO), thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), and lipid profile parameters were assessed at baseline and after the 12-week intervention. The trial was registered in the Clinical Trials Database (registration number NCT05975866).

Results

After 12 weeks of intervention, both groups showed reductions in waist circumference and waist-to-hip ratio, with greater changes observed in the curcumin group. However, between-group differences were not statistically significant. A significant reduction in anti-TPO levels was observed in the curcumin group compared to placebo (p = 0.006). Although TSH and T3 levels significantly decreased within the curcumin group (p = 0.014 and p = 0.001, respectively), between-group differences were not statistically significant after adjustment. Additionally, HDL-C levels showed a non-significant trend toward improvement in the curcumin group (p = 0.053), whereas other lipid parameters remained unchanged.

Conclusion

Curcumin may have possible benefits for thyroid autoimmunity, but further studies are required before any clinical use.

Trial Registration

The trial was registered in the Clinical Trials Database (Registration number: NCT05975866, 08 August 2023). National Nutrition and Food Technology Research Institute NCT0597586 https://www.clinicaltrials.gov/study/NCT05975866?term=NCT05975866&rank=1

背景：桥本甲状腺炎（HT）是一种炎症性自身免疫性疾病，HT患者可能受益于纳入抗炎成分的干预措施。本研究旨在评估抗炎饮食和姜黄素补充对HT患者甲状腺激素和血脂的联合影响。方法：对57例HT患者进行随机对照临床试验。患者被随机分配接受抗炎饮食加1320毫克/天姜黄素或抗炎饮食加安慰剂12周。在基线和干预12周后评估人体测量指标、抗甲状腺过氧化物酶（anti-TPO）、促甲状腺激素（TSH）、甲状腺素（T4）、三碘甲状腺原氨酸（T3）和血脂参数。该试验已在临床试验数据库中注册（注册号NCT05975866）。结果：干预12周后，两组患者腰围和腰臀比均有所下降，其中姜黄素组变化更大。但组间差异无统计学意义。与安慰剂相比，姜黄素组抗tpo水平显著降低（p = 0.006）。虽然姜黄素组TSH和T3水平显著降低（p = 0.014和p = 0.001），但调整后组间差异无统计学意义。此外，姜黄素组HDL-C水平无显著改善趋势（p = 0.053），而其他脂质参数保持不变。结论：姜黄素可能对甲状腺自身免疫有益，但在临床应用前需要进一步研究。试验注册：该试验已在临床试验数据库中注册（注册号：NCT05975866, 2023年8月8日）。国家营养与食品技术研究所NCT0597586 https://www.Clinicaltrials: gov/study/NCT05975866?term=NCT05975866&rank=1。

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引用次数: 0

Sumac (Rhus coriaria L.) and Human Metabolic Health: A Systematic Review and Meta-Analysis 漆树（Rhus coriaria L.）与人体代谢健康：系统综述和meta分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-12-02 DOI: 10.1002/edm2.70135

Ali Jafari, Bahare ParsiNezhad, Minoo AhmadianMoghaddam, Motahareh Hasani, Niloufar Rasaei, Ali Saeedi-Boroujeni, Gholamreza Roshandel, Sima Besharat, Mahla Chambari, Alireza Alaghi

Background

Rhus coriaria L. (Anacardiaceae), known as Sumac, is a commonly used spice, which is rich in various classes of phytochemicals including flavonoids, tannins, polyphenolic compounds, organic acids, and may be beneficial for cardiovascular disease risk factors. This comprehensive systematic review and meta-analysis aimed to assess the impact of Sumac supplementation on cardiovascular disease risk factors, including anthropometric measures, glycemic profile, inflammatory markers, and lipid profile. Additionally, we explored the dose-response relationship and optimal duration of Sumac supplementation for its effects on cardiovascular risk factors.

Methods

Relevant randomized clinical trials were identified through electronic database searches (PubMed, Scopus, Web of Science, CENTRAL, and EMBASE) up to March 2025. The Cochrane risk-of-bias tool was employed to evaluate study quality. Standardized mean differences (SMDs) in changes between intervention and placebo groups were calculated. A random-effects model, meta-regression, and non-linear modeling explored heterogeneity, dose-response relationships, and the overall impact of Sumac supplementation.

Results

Fifteen trials, with interventions ranging from 4 to 12 weeks and involving 917 participants, were included. Sumac supplementation demonstrated significant improvements in glycemic and lipid profile. Conversely, no significant effects were observed on other cardiovascular risk factors.

Conclusions

Sumac supplementation improved lipid profile, and glycemic parameters suggesting potential benefits in addressing cardiovascular risk factors, despite no significant effects on inflammatory parameters.

背景：马鞭草。（漆树科），被称为漆树，是一种常用的香料，它富含各种类型的植物化学物质，包括类黄酮，单宁，多酚化合物，有机酸，并可能对心血管疾病的危险因素有益。这项全面的系统综述和荟萃分析旨在评估漆树补充剂对心血管疾病危险因素的影响，包括人体测量、血糖谱、炎症标志物和脂质谱。此外，我们还探讨了漆树补充剂对心血管危险因素的影响的剂量-反应关系和最佳持续时间。方法：通过截至2025年3月的电子数据库检索（PubMed、Scopus、Web of Science、CENTRAL和EMBASE）确定相关的随机临床试验。采用Cochrane风险偏倚工具评价研究质量。计算干预组和安慰剂组之间变化的标准化平均差异（SMDs）。随机效应模型、元回归和非线性模型探讨了异质性、剂量-反应关系和漆树补充剂的总体影响。结果：纳入了15项试验，干预时间从4周到12周，涉及917名参与者。补充漆树可显著改善血糖和脂质状况。相反，对其他心血管危险因素没有显著影响。结论：尽管对炎症参数没有显著影响，但漆树补充剂改善了血脂和血糖参数，这表明在解决心血管危险因素方面有潜在的益处。

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引用次数: 0

Impact of Preoperative Calcium and Magnesium Supplementation on Quality of Life and Hypocalcemia Post-Thyroidectomy 术前补充钙镁对甲状腺切除术后生活质量和低钙血症的影响。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-30 DOI: 10.1002/edm2.70129

Navid Tabriz, Dennis Fried, Verena Uslar, Dirk Weyhe

Objective

Postoperative hypocalcemia and hypoparathyroidism are common complications after thyroidectomy, often impairing quality of life (QoL). This study investigates the impact of preoperative calcium and magnesium supplementation on postoperative QoL and hypocalcemia in patients undergoing total thyroidectomy for symptomatic nodular goitre or Graves' disease.

Methods

A total of 62 patients undergoing thyroidectomy for benign thyroid diseases were randomised into two groups. The intervention group (IG, n = 31) received 500 mg calcium carbonate thrice daily and 300 mg magnesium carbonate once daily for 2 weeks preoperatively, while the control group (CG, n = 31) received no supplementation. Laboratory parameters (Ca, Mg, PTH, 25-OH-Vitamin D) were measured at study enrolment (T₁), preoperatively (T₂), immediately postoperatively (T₃) and 6 weeks post-discharge (T₄). QoL was assessed using EQ-5D and ThyPro39de questionnaires.

Results

QoL significantly improved postoperatively in both groups. Patients with Graves' disease in the IG reported earlier QoL improvements immediately post-surgery (T₃). Postoperative hypocalcemia occurred in 19.4% of IG patients and 25% of CG patients, with hypoparathyroidism in 16% and 23%, respectively. The IG demonstrated higher postoperative calcium levels and fewer hypocalcemia symptoms, especially in Graves' disease patients (not significant). Vitamin D deficiency was prevalent (66.7%) but showed no correlation with hypocalcemia.

Discussion

Preoperative calcium and magnesium supplementation might have positive effects on postoperative QoL, especially in Graves' disease patients, and may reduce hypocalcemia symptoms. This simple, inexpensive and low-risk intervention may be beneficial in the preoperative setting prior to thyroidectomy. Although the observed effect did not reach statistical significance, it could still be of clinical relevance. The additional benefit of preoperative magnesium supplementation seems to be of minor significance, while the effect of pre-existing vitamin D deficiency remains uncertain.

目的：低钙血症和甲状旁腺功能减退是甲状腺切除术后常见的并发症，常影响患者的生活质量。本研究探讨术前补钙和镁对症状性甲状腺结节或Graves病全甲状腺切除术患者术后生活质量和低钙血症的影响。方法：62例甲状腺良性病变行甲状腺切除术患者随机分为两组。干预组（IG, n = 31）术前给予碳酸钙500 mg每日3次，碳酸镁300 mg每日1次，持续2周；对照组（CG, n = 31）不给予补充。在研究入组时（T1）、术前（T2）、术后立即（T3）和出院后6周（T4）测量实验室参数（Ca、Mg、PTH、25- oh -维生素D）。采用EQ-5D和ThyPro39de问卷评估生活质量。结果：两组患者术后生活质量均有明显改善。IG组Graves病患者报告术后即刻（T3）早期生活质量改善。术后低钙血症发生率为19.4%的IG患者和25%的CG患者，甲状旁腺功能低下发生率分别为16%和23%。IG表现出较高的术后钙水平和较少的低钙血症症状，特别是Graves病患者（无统计学意义）。维生素D缺乏症普遍存在（66.7%），但与低钙血症无关。讨论：术前补充钙镁可能对术后生活质量有积极影响，尤其是Graves病患者，并可能减轻低钙血症症状。这种简单、廉价和低风险的干预措施在甲状腺切除术前的术前设置中可能是有益的。虽然观察到的效果没有达到统计学意义，但仍可能具有临床意义。术前补充镁的额外好处似乎意义不大，而预先存在的维生素D缺乏的影响仍不确定。

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引用次数: 0

Type 1 Diabetes and Other Autoimmune Diseases—Epidemiology, Pathophysiology and Screening 1型糖尿病和其他自身免疫性疾病——流行病学、病理生理学和筛查

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-29 DOI: 10.1002/edm2.70119

George J. Kahaly, Thomas Forst, Monika Kellerer, Stefanie Lanzinger, René D. Rötzer, Matthias Schott, Petra-Maria Schumm-Draeger

Introduction

The interplay between type 1 diabetes (T1D) and concomitant autoimmune diseases (AID) is both clinically and scientifically relevant. In this review, we delineate the epidemiological, pathophysiological and practical aspects underlying polyautoimmunity with a focus on T1D.

Method

A comprehensive review of literature on T1D and associated AID was conducted, with the aim of drawing informed conclusions relevant to clinical practice. It draws on a targeted PubMed search conducted March–May 2025, emphasising recent peer-reviewed articles in English.

Results

Epidemiological data consistently indicate that individuals with T1D exhibit a significantly increased prevalence of additional AID. Familial aggregation of discordant AID and the concept of polyglandular autoimmune syndromes (PAS) or autoimmune polyendocrinopathy highlight that multiple AID can cluster and occur in a sequential and overlapping fashion, with T1D frequently acting as either an early or a subsequent manifestation. Thereby, genetic susceptibility, environmental triggers and epigenetic factors are pivotal in the initiation and progression of autoimmunity. Clinically, the coexistence of T1D with other AID poses significant challenges in disease management, often necessitating adjustments in therapeutic regimens and careful monitoring to mitigate complications. Early detection via stratified autoantibody testing is important for timely intervention and improved long-term outcomes.

Conclusions

Accordingly, screening for T1D-associated autoantibodies in individuals with a personal or family history of AIDs, and vice versa, should be implemented in clinical practice.

1型糖尿病（T1D）与伴发自身免疫性疾病（AID）之间的相互作用具有临床和科学意义。在这篇综述中，我们描述了多自身免疫的流行病学、病理生理和实践方面，重点是T1D。方法对T1D及相关AID的相关文献进行综述，以期得出与临床实践相关的结论。它利用了2025年3月至5月进行的PubMed目标搜索，强调了最近的同行评议的英文文章。结果流行病学数据一致表明，T1D患者的额外艾滋病患病率显著增加。不一致AID的家族聚集性和多腺体自身免疫综合征（PAS）或自身免疫性多内分泌病的概念强调，多种AID可以聚集并以顺序和重叠的方式发生，T1D经常作为早期或随后的表现。因此，遗传易感性、环境触发因素和表观遗传因素在自身免疫的发生和发展中起着关键作用。临床上，T1D与其他艾滋病的共存给疾病管理带来了重大挑战，通常需要调整治疗方案并仔细监测以减轻并发症。通过分层自身抗体检测进行早期检测对于及时干预和改善长期预后非常重要。因此，在临床实践中，应该对有艾滋病个人或家族史的个体进行t1d相关自身抗体的筛查，反之亦然。

{"title":"Type 1 Diabetes and Other Autoimmune Diseases—Epidemiology, Pathophysiology and Screening","authors":"George J. Kahaly, Thomas Forst, Monika Kellerer, Stefanie Lanzinger, René D. Rötzer, Matthias Schott, Petra-Maria Schumm-Draeger","doi":"10.1002/edm2.70119","DOIUrl":"https://doi.org/10.1002/edm2.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The interplay between type 1 diabetes (T1D) and concomitant autoimmune diseases (AID) is both clinically and scientifically relevant. In this review, we delineate the epidemiological, pathophysiological and practical aspects underlying polyautoimmunity with a focus on T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive review of literature on T1D and associated AID was conducted, with the aim of drawing informed conclusions relevant to clinical practice. It draws on a targeted PubMed search conducted March–May 2025, emphasising recent peer-reviewed articles in English.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Epidemiological data consistently indicate that individuals with T1D exhibit a significantly increased prevalence of additional AID. Familial aggregation of discordant AID and the concept of polyglandular autoimmune syndromes (PAS) or autoimmune polyendocrinopathy highlight that multiple AID can cluster and occur in a sequential and overlapping fashion, with T1D frequently acting as either an early or a subsequent manifestation. Thereby, genetic susceptibility, environmental triggers and epigenetic factors are pivotal in the initiation and progression of autoimmunity. Clinically, the coexistence of T1D with other AID poses significant challenges in disease management, often necessitating adjustments in therapeutic regimens and careful monitoring to mitigate complications. Early detection via stratified autoantibody testing is important for timely intervention and improved long-term outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Accordingly, screening for T1D-associated autoantibodies in individuals with a personal or family history of AIDs, and vice versa, should be implemented in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626875","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 Effect of Aronia melanocarpa (Chokeberry) on Body Weight and Fasting Blood Sugar: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 黑莓对体重和空腹血糖的影响：随机对照试验的系统回顾和荟萃分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-29 DOI: 10.1002/edm2.70139

Negin Lohrasbi, Mahsa Elahikhah, Masoomeh Gholizadeh, Farhang Djafari, Nazgol Bahreini, Fatemeh Sheikhhossein, Gholamreza Askari, Mohammad Reza Amini

Background

Plant derivatives, particularly anthocyanin-rich phytochemicals, have been shown to positively influence metabolic parameters. This study aimed to systematically review and meta-analysis the effects of Aronia melanocarpa consumption on body weight and fasting blood sugar (FBS) levels.

Methods

A systematic search was conducted in PubMed/Medline, Scopus, ISI Web of Science, Embase, Cochrane Library, and Google Scholar up to January 2025. Results were reported as weighted mean differences (WMDs) with 95% confidence intervals (CIs) using a random effects model. Heterogeneity among studies was evaluated with the Cochrane Q test and I-squared (I²), and subgroup analysis was performed to identify specific sources of heterogeneity.

Results

Seven studies were identified and included in this meta-analysis. The findings revealed no significant reductions in FBS (WMDs: 0.05 mmol/L, 95% CI: −0.05 to 0.16, p = 0.341), body weight (BW) (WMDs: −0.66 kg, 95% CI: −2.54, 1.22, p = 0.494), body mass index (BMI) (WMDs: 0.18 kg/m², 95% CI: −0.17, 0.53, p = 0.494), and waist circumference (WC) (WMDs: 0.63 cm, 95% CI: −1.18 to 2.44, p = 0.493) in the Aronia melanocarpa treatment group. Additionally, subgroup analysis of the included randomised controlled trials showed no significant effects of Aronia melanocarpa consumption on BW and BMI.

Conclusion

The present meta-analysis indicates that Aronia berry consumption does not affect the aforementioned variables. However, further clinical data and research into the mechanisms of Aronia melanocarpa are needed to better understand its potential benefits on glycemic markers and anthropometric measures.

植物衍生物，特别是富含花青素的植物化学物质，已被证明对代谢参数有积极影响。本研究旨在系统回顾和荟萃分析食用黑檀对体重和空腹血糖（FBS）水平的影响。方法系统检索截至2025年1月的PubMed/Medline、Scopus、ISI Web of Science、Embase、Cochrane Library和谷歌Scholar。使用随机效应模型以加权平均差（wmd）和95%置信区间（ci）报告结果。采用Cochrane Q检验和i²（I2）评估研究间的异质性，并进行亚组分析以确定异质性的具体来源。结果本荟萃分析确定并纳入了7项研究。结果显示，黑莓治疗组的FBS （wmd: 0.05 mmol/L, 95% CI: - 0.05至0.16,p = 0.341）、体重（BW）（wmd: - 0.66 kg, 95% CI: - 2.54, 1.22, p = 0.494）、体重指数（BMI）（wmd: 0.18 kg/m2, 95% CI: - 0.17, 0.53, p = 0.494）和腰围（wmd: 0.63 cm, 95% CI: - 1.18至2.44,p = 0.493）均无显著降低。此外，纳入的随机对照试验的亚组分析显示，食用黑桫椤对体重和体重指数没有显著影响。结论本荟萃分析表明，食用野樱莓对上述变量没有影响。然而，需要进一步的临床数据和机制研究，以更好地了解其对血糖指标和人体测量的潜在益处。

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引用次数: 0

Efficacy and Safety of Orforglipron in Obese Adults With or Without Diabetes: A Systematic Review and Meta-Analysis 奥福列酮治疗伴有或不伴有糖尿病的肥胖成人的疗效和安全性：一项系统综述和荟萃分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-26 DOI: 10.1002/edm2.70134

Ravi Kumar Pandey, Mahnoor Jan, Aqsa Mohammad, Khawaja Arham Jawaid, Mawra Naveed, Muhammad Ali Abid, Abdullah Bin Amir, Shafique Ahmed, Muhammad Safiullah, Muhammad Imaz Bhatti, Sana Iftikhar, Muhammad Nabeel Saddique, Widyan Alfalh, Rihab Mohammed bin Omar, Husam Abu Dawood

Background

Obesity represents a major global health challenge, contributing substantially to cardiovascular disease and metabolic complications. Orforglipron, a novel oral non-peptide GLP-1 receptor agonist, has emerged as a promising therapeutic option for weight management and glycemic control. This meta-analysis evaluated the efficacy and safety of orforglipron in obese patients with or without type 2 diabetes mellitus (T2DM).

Methods

A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library and ClinicalTrials.gov from inception to October 2025 to identify randomised controlled trials (RCTs) evaluating orforglipron in obese patients. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models.

Results

Five RCTs comprising 4410 participants were included. Orforglipron demonstrated dose-dependent reductions in body weight from 2.48% at 3 mg to 9.8% at 45 mg, BMI from 0.89 to 3.62 kg/m², waist circumference from 1.57 to 6.9 cm, and HbA1c from 0.76% to 1.04% compared with placebo. Favourable lipid changes included reductions in total cholesterol (MD: −4.51% [95% CI: −6.91 to −2.11]), LDL-C (MD: −5.34% [95% CI: −7.10 to −3.58]), and triglycerides (MD: −10.07% [95% CI: −12.33 to −7.80]), with increased HDL-C (MD: 2.94% [95% CI: 1.38 to 4.49]). However, gastrointestinal adverse events were significantly more frequent at doses of 12 mg or higher and treatment discontinuation rates were highest at 24 mg (RR:4.61 [95% CI:1.6 to 13.33]) and 36 mg (RR:3.68 [95% CI:2.48 to 5.44]) doses. Serious adverse events and mortality rates were comparable to those with placebo.

Conclusion

Orforglipron significantly improved glycemic and lipid parameters in patients with obesity, demonstrating dose-dependent efficacy with maximal benefits at higher doses. While gastrointestinal tolerability remains a clinically important limitation requiring mitigation strategies, orforglipron represents a promising oral therapeutic option for comprehensive obesity and metabolic management.

肥胖是一项重大的全球健康挑战，在很大程度上导致心血管疾病和代谢并发症。Orforglipron是一种新型口服非肽GLP-1受体激动剂，已成为体重管理和血糖控制的有前途的治疗选择。本荟萃分析评估了奥利福列酮治疗伴有或不伴有2型糖尿病（T2DM）的肥胖患者的疗效和安全性。方法综合检索PubMed、Embase、Cochrane Library和ClinicalTrials.gov从成立到2025年10月的文献，以确定评估orforglipron在肥胖患者中的作用的随机对照试验（RCTs）。采用随机效应模型计算95%置信区间（ci）的平均差异（md）和风险比（rr）。结果共纳入5项随机对照试验，共4410名受试者。与安慰剂相比，Orforglipron显示出剂量依赖性，体重从3 mg时的2.48%降低到45 mg时的9.8%，BMI从0.89降至3.62 kg/m2，腰围从1.57降至6.9 cm， HbA1c从0.76%降至1.04%。有利的脂质变化包括总胆固醇（MD: - 4.51% [95% CI: - 6.91至- 2.11]）、LDL-C （MD: - 5.34% [95% CI: - 7.10至- 3.58]）和甘油三酯（MD: - 10.07% [95% CI: - 12.33至- 7.80]）的降低，HDL-C （MD: 2.94% [95% CI: 1.38至4.49]）的增加。然而，胃肠道不良事件在12 mg或更高剂量时明显更频繁，并且在24 mg （RR:4.61 [95% CI:1.6至13.33]）和36 mg （RR:3.68 [95% CI:2.48至5.44]）剂量时停药率最高。严重不良事件和死亡率与安慰剂组相当。结论奥福列酮可显著改善肥胖患者的血糖和脂质指标，且具有剂量依赖性，且剂量越大获益最大。虽然胃肠道耐受性仍然是临床上重要的限制，需要缓解策略，但奥福glipron代表了一种有希望的口服治疗选择，用于全面肥胖和代谢管理。

{"title":"Efficacy and Safety of Orforglipron in Obese Adults With or Without Diabetes: A Systematic Review and Meta-Analysis","authors":"Ravi Kumar Pandey, Mahnoor Jan, Aqsa Mohammad, Khawaja Arham Jawaid, Mawra Naveed, Muhammad Ali Abid, Abdullah Bin Amir, Shafique Ahmed, Muhammad Safiullah, Muhammad Imaz Bhatti, Sana Iftikhar, Muhammad Nabeel Saddique, Widyan Alfalh, Rihab Mohammed bin Omar, Husam Abu Dawood","doi":"10.1002/edm2.70134","DOIUrl":"https://doi.org/10.1002/edm2.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obesity represents a major global health challenge, contributing substantially to cardiovascular disease and metabolic complications. Orforglipron, a novel oral non-peptide GLP-1 receptor agonist, has emerged as a promising therapeutic option for weight management and glycemic control. This meta-analysis evaluated the efficacy and safety of orforglipron in obese patients with or without type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library and ClinicalTrials.gov from inception to October 2025 to identify randomised controlled trials (RCTs) evaluating orforglipron in obese patients. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five RCTs comprising 4410 participants were included. Orforglipron demonstrated dose-dependent reductions in body weight from 2.48% at 3 mg to 9.8% at 45 mg, BMI from 0.89 to 3.62 kg/m<sup>2</sup>, waist circumference from 1.57 to 6.9 cm, and HbA1c from 0.76% to 1.04% compared with placebo. Favourable lipid changes included reductions in total cholesterol (MD: −4.51% [95% CI: −6.91 to −2.11]), LDL-C (MD: −5.34% [95% CI: −7.10 to −3.58]), and triglycerides (MD: −10.07% [95% CI: −12.33 to −7.80]), with increased HDL-C (MD: 2.94% [95% CI: 1.38 to 4.49]). However, gastrointestinal adverse events were significantly more frequent at doses of 12 mg or higher and treatment discontinuation rates were highest at 24 mg (RR:4.61 [95% CI:1.6 to 13.33]) and 36 mg (RR:3.68 [95% CI:2.48 to 5.44]) doses. Serious adverse events and mortality rates were comparable to those with placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Orforglipron significantly improved glycemic and lipid parameters in patients with obesity, demonstrating dose-dependent efficacy with maximal benefits at higher doses. While gastrointestinal tolerability remains a clinically important limitation requiring mitigation strategies, orforglipron represents a promising oral therapeutic option for comprehensive obesity and metabolic management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625912","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}

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