Endocrinology, Diabetes and Metabolism最新文献_第7页

Assessment of the Relationship Between Liver Enzymes and Cardiovascular Disease: A Study in Bangladeshi Adults 评估肝脏酶与心血管疾病之间的关系：孟加拉国成年人研究

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-03-17 DOI: 10.1002/edm2.481

Akibul Hasan, Ali Newaj, Aporajita Das Trisha, Jaasia Momtahena Hafsa, Nayan Chandra Mohanto, Nurshad Ali

Objectives

Elevated liver enzyme levels are suggested to be associated with an increased risk of cardiovascular disease (CVD). However, few studies have explored the relationship between liver enzymes and myocardial infarction (MI). This study aimed to evaluate the potential association of elevated liver enzymes with MI within a population group in Bangladesh.

Methods

In this cross-sectional study, 348 participants were enrolled, 189 with MI in the CVD group and 159 in the control group. Serum levels of liver enzymes (AST, ALT and GGT) and other biochemical parameters were measured using standard methods. Multivariate logistic regression models were applied to determine the associations between elevated liver enzymes and CVD.

Result

In the CVD group, 51.6%, 30.9% and 67.7% of individuals had elevated serum AST, ALT and GGT levels, respectively. On the contrary, the control group had 17.0%, 15.1% and 35.2% of individuals with high serum AST, ALT and GGT levels, respectively. Overall, 71.8% of the subjects in the CVD group and 44.7% of the subjects in the control group had at least one or more elevated liver enzymes (p < 0.001). The mean level of all three liver enzymes was significantly higher in the CVD group than in the control group (p < 0.001). In both the CVD and control groups, males had higher levels of liver enzymes than females. In the regression models, the serum levels of AST, ALT and GGT showed a positive and independent association with the prevalence of CVD (p < 0.001). However, GGT showed the strongest association among the three enzymes.

Conclusions

This study shows a high prevalence of liver enzyme abnormalities in individuals with CVD. Serum levels of AST, ALT and GGT were independently associated with the prevalence of CVD. This suggests that measuring liver enzyme levels could be a useful marker in predicting CVD at an early stage.

目的：肝酶水平升高被认为与心血管疾病（CVD）风险增加有关。然而，很少有研究探讨肝酶与心肌梗死（MI）之间的关系。本研究旨在评估孟加拉国人群中肝酶升高与心肌梗死之间的潜在关系：在这项横断面研究中，共招募了 348 名参与者，其中心血管疾病组中有 189 人患有心肌梗死，对照组中有 159 人。采用标准方法测量了血清肝酶（谷草转氨酶、谷丙转氨酶和谷草转氨酶）水平及其他生化参数。采用多变量逻辑回归模型确定肝酶升高与心血管疾病之间的关系：结果：在心血管疾病组中，分别有 51.6%、30.9% 和 67.7% 的人血清 AST、ALT 和 GGT 水平升高。相反，对照组中分别有 17.0%、15.1% 和 35.2% 的人血清中谷草转氨酶、谷丙转氨酶和谷草转氨酶水平偏高。总体而言，心血管疾病组 71.8% 的受试者和对照组 44.7% 的受试者至少有一种或多种肝酶升高（P 结论：心血管疾病组和对照组肝酶升高的比例分别为 71.8% 和 44.7%：这项研究表明，心血管疾病患者肝酶异常的发生率很高。血清中谷草转氨酶（AST）、谷丙转氨酶（ALT）和谷草转氨酶（GGT）的水平与心血管疾病的患病率呈独立相关。这表明，测量肝酶水平可以作为早期预测心血管疾病的有用指标。

{"title":"Assessment of the Relationship Between Liver Enzymes and Cardiovascular Disease: A Study in Bangladeshi Adults","authors":"Akibul Hasan, Ali Newaj, Aporajita Das Trisha, Jaasia Momtahena Hafsa, Nayan Chandra Mohanto, Nurshad Ali","doi":"10.1002/edm2.481","DOIUrl":"10.1002/edm2.481","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Elevated liver enzyme levels are suggested to be associated with an increased risk of cardiovascular disease (CVD). However, few studies have explored the relationship between liver enzymes and myocardial infarction (MI). This study aimed to evaluate the potential association of elevated liver enzymes with MI within a population group in Bangladesh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 348 participants were enrolled, 189 with MI in the CVD group and 159 in the control group. Serum levels of liver enzymes (AST, ALT and GGT) and other biochemical parameters were measured using standard methods. Multivariate logistic regression models were applied to determine the associations between elevated liver enzymes and CVD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>In the CVD group, 51.6%, 30.9% and 67.7% of individuals had elevated serum AST, ALT and GGT levels, respectively. On the contrary, the control group had 17.0%, 15.1% and 35.2% of individuals with high serum AST, ALT and GGT levels, respectively. Overall, 71.8% of the subjects in the CVD group and 44.7% of the subjects in the control group had at least one or more elevated liver enzymes (<i>p</i> < 0.001). The mean level of all three liver enzymes was significantly higher in the CVD group than in the control group (<i>p</i> < 0.001). In both the CVD and control groups, males had higher levels of liver enzymes than females. In the regression models, the serum levels of AST, ALT and GGT showed a positive and independent association with the prevalence of CVD (<i>p</i> < 0.001). However, GGT showed the strongest association among the three enzymes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows a high prevalence of liver enzyme abnormalities in individuals with CVD. Serum levels of AST, ALT and GGT were independently associated with the prevalence of CVD. This suggests that measuring liver enzyme levels could be a useful marker in predicting CVD at an early stage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144181","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

Polycystic Ovary Syndrome and Irritable Bowel Syndrome: Is There a Common Pathway? 多囊卵巢综合征和肠易激综合征：有共同的发病途径吗？

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-03-17 DOI: 10.1002/edm2.477

Marzieh Saei Ghare Naz, Vida Ghasemi, Shabahang Amirshekari, Fahimeh Ramezani Tehrani

Objective

Little is known about how polycystic ovary syndrome (PCOS) is linked to irritable bowel syndrome (IBS). This study aimed to review the existing literature regarding the association between PCOS or its symptoms and complications with IBS.

Methods

In this review, studies that investigated the proposed cross-link between features of PCOS and IBS were included. This review collectively focused on recent findings on the mechanism and novel insight regarding the association between IBS and PCOS in future clinical practice. An electronic search of PubMed, Scopus, Epistemonikos, Cochrane Library and Google Scholar was performed. We did not restrict the study setting and publication date.

Results

The existing evidence has not completely answered the question of whether there is an association between PCOS and IBS and vice versa. Six case–control studies (793 women with PCOS and 547 women in the control group) directly assessed the association between PCOS and IBS. The prevalence of IBS among women with PCOS in these studies has ranged from 10% to 52% compared with 5%–50% in control groups. Evidence suggested the common pathways may have contributed to the interaction between IBS and PCOS, including metabolic syndrome, sex hormone fluctuation, dysregulation of neurotransmitters, psychological problems and environmental and lifestyle factors. To date, it is still ambiguous which of the mentioned components largely contributes to the pathogenesis of both.

Conclusion

Although limited evidence has shown a higher prevalence of IBS in women with PCOS, there are several potential, direct and common indirect pathways contributing to the development of both IBS and PCOS.

目的：人们对多囊卵巢综合征（PCOS）与肠易激综合征（IBS）之间的关系知之甚少。本研究旨在回顾有关多囊卵巢综合征或其症状和并发症与肠易激综合征之间关系的现有文献：方法：本综述纳入了调查多囊卵巢综合征特征与肠易激综合征之间交叉联系的研究。方法：本综述纳入了调查多囊卵巢综合征与肠易激综合征之间交叉联系的研究，重点关注有关肠易激综合征与多囊卵巢综合征之间关联机制的最新研究结果以及在未来临床实践中的新见解。我们对 PubMed、Scopus、Epistemonikos、Cochrane Library 和 Google Scholar 进行了电子检索。我们没有限制研究环境和发表日期：现有证据尚未完全回答多囊卵巢综合征与肠易激综合征之间是否存在关联，反之亦然。六项病例对照研究（793 名患有多囊卵巢综合症的妇女和 547 名对照组妇女）直接评估了多囊卵巢综合症与肠易激综合征之间的关联。在这些研究中，患有多囊卵巢综合症的妇女中肠易激综合征的发病率为 10%-52%，而对照组的发病率为 5%-50%。有证据表明，导致肠易激综合征与多囊卵巢综合征相互作用的共同途径包括代谢综合征、性激素波动、神经递质失调、心理问题以及环境和生活方式因素。迄今为止，上述因素中哪一个在很大程度上导致了这两种疾病的发病机制仍不明确：结论：尽管有限的证据表明，患有多囊卵巢综合征的女性中肠道易激综合征的发病率较高，但有几种潜在的、直接的和常见的间接途径可导致肠道易激综合征和多囊卵巢综合征的发生。

{"title":"Polycystic Ovary Syndrome and Irritable Bowel Syndrome: Is There a Common Pathway?","authors":"Marzieh Saei Ghare Naz, Vida Ghasemi, Shabahang Amirshekari, Fahimeh Ramezani Tehrani","doi":"10.1002/edm2.477","DOIUrl":"10.1002/edm2.477","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Little is known about how polycystic ovary syndrome (PCOS) is linked to irritable bowel syndrome (IBS). This study aimed to review the existing literature regarding the association between PCOS or its symptoms and complications with IBS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this review, studies that investigated the proposed cross-link between features of PCOS and IBS were included. This review collectively focused on recent findings on the mechanism and novel insight regarding the association between IBS and PCOS in future clinical practice. An electronic search of PubMed, Scopus, Epistemonikos, Cochrane Library and Google Scholar was performed. We did not restrict the study setting and publication date.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The existing evidence has not completely answered the question of whether there is an association between PCOS and IBS and vice versa. Six case–control studies (793 women with PCOS and 547 women in the control group) directly assessed the association between PCOS and IBS. The prevalence of IBS among women with PCOS in these studies has ranged from 10% to 52% compared with 5%–50% in control groups. Evidence suggested the common pathways may have contributed to the interaction between IBS and PCOS, including metabolic syndrome, sex hormone fluctuation, dysregulation of neurotransmitters, psychological problems and environmental and lifestyle factors. To date, it is still ambiguous which of the mentioned components largely contributes to the pathogenesis of both.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although limited evidence has shown a higher prevalence of IBS in women with PCOS, there are several potential, direct and common indirect pathways contributing to the development of both IBS and PCOS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144182","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

Effects of Empagliflozin-Induced Glycosuria on Weight Gain, Food Intake and Metabolic Indicators in Mice Fed a High-Fat Diet Empagliflozin 诱导的糖尿对高脂饮食小鼠体重增加、食物摄入量和代谢指标的影响

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-03-12 DOI: 10.1002/edm2.475

Anh T. Nguyen, Zachary Amigo, Kathleen McDuffie, Victoria C. MacQueen, Lane D. Bell, Lan K. Truong, Gloria Batchi, Sara M. McMillin

Background

Sodium glucose-linked transporter 2 (SGLT2) inhibitors promote glucose, and therefore calorie, excretion in the urine. Patients taking SGLT2 inhibitors typically experience mild weight loss, but the amount of weight loss falls short of what is expected based on caloric loss. Understanding the mechanisms responsible for this weight loss discrepancy is imperative, as strategies to improve weight loss could markedly improve type 2 diabetes management and overall metabolic health.

Methods

Two mouse models of diet-induced obesity were administered the SGLT2 inhibitor empagliflozin in the food for 3 months. Urine glucose excretion, body weight, food intake and activity levels were monitored. In addition, serum hormone measurements were taken, and gene expression analyses were conducted.

Results

In both mouse models, mice receiving empagliflozin gained the same amount of body weight as their diet-matched controls despite marked glucose loss in the urine. No changes in food intake, serum ghrelin concentrations or activity levels were observed, but serum levels of fibroblast growth factor 21 (FGF21) decreased after treatment. A decrease in the levels of deiodinase 2 (Dio2) was also observed in the white adipose tissue, a primary target tissue of FGF21.

Conclusion

These findings suggest that compensatory metabolic adaptations, other than increased food intake or decreased physical activity, occur in response to SGLT2 inhibitor-induced glycosuria that combats weight loss, and that reductions in FGF21, along with subsequent reductions in peripheral Dio2, may play a role.

背景：钠葡萄糖连接转运体 2 (SGLT2) 抑制剂可促进葡萄糖，从而促进热量随尿液排出。服用 SGLT2 抑制剂的患者通常会出现轻微的体重减轻，但体重减轻的幅度却低于预期的热量损失。当务之急是了解造成这种体重减轻差异的机制，因为改善体重减轻的策略可以显著改善 2 型糖尿病的管理和整体代谢健康：方法：给两种饮食诱导肥胖的小鼠模型喂食 SGLT2 抑制剂 Empagliflozin，为期 3 个月。监测尿糖排泄、体重、食物摄入和活动水平。此外，还进行了血清激素测定和基因表达分析：结果：在两种小鼠模型中，接受empagliflozin治疗的小鼠尽管尿液中葡萄糖明显减少，但体重增加量与饮食匹配对照组相同。食物摄入量、血清胃泌素浓度或活动水平未见变化，但治疗后血清成纤维细胞生长因子21（FGF21）水平下降。在白色脂肪组织中也观察到脱碘酶 2（Dio2）水平的下降，而白色脂肪组织是 FGF21 的主要靶组织：这些研究结果表明，除了增加食物摄入量或减少体力活动外，SGLT2 抑制剂诱导的糖尿也会导致代偿性代谢适应，从而减轻体重，而 FGF21 的减少以及随之而来的外周 Dio2 的减少可能在其中发挥了作用。

{"title":"Effects of Empagliflozin-Induced Glycosuria on Weight Gain, Food Intake and Metabolic Indicators in Mice Fed a High-Fat Diet","authors":"Anh T. Nguyen, Zachary Amigo, Kathleen McDuffie, Victoria C. MacQueen, Lane D. Bell, Lan K. Truong, Gloria Batchi, Sara M. McMillin","doi":"10.1002/edm2.475","DOIUrl":"10.1002/edm2.475","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sodium glucose-linked transporter 2 (SGLT2) inhibitors promote glucose, and therefore calorie, excretion in the urine. Patients taking SGLT2 inhibitors typically experience mild weight loss, but the amount of weight loss falls short of what is expected based on caloric loss. Understanding the mechanisms responsible for this weight loss discrepancy is imperative, as strategies to improve weight loss could markedly improve type 2 diabetes management and overall metabolic health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two mouse models of diet-induced obesity were administered the SGLT2 inhibitor empagliflozin in the food for 3 months. Urine glucose excretion, body weight, food intake and activity levels were monitored. In addition, serum hormone measurements were taken, and gene expression analyses were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In both mouse models, mice receiving empagliflozin gained the same amount of body weight as their diet-matched controls despite marked glucose loss in the urine. No changes in food intake, serum ghrelin concentrations or activity levels were observed, but serum levels of fibroblast growth factor 21 (FGF21) decreased after treatment. A decrease in the levels of deiodinase 2 (Dio2) was also observed in the white adipose tissue, a primary target tissue of FGF21.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that compensatory metabolic adaptations, other than increased food intake or decreased physical activity, occur in response to SGLT2 inhibitor-induced glycosuria that combats weight loss, and that reductions in FGF21, along with subsequent reductions in peripheral Dio2, may play a role.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111691","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

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review 继发于肾上腺皮质腺瘤的妊娠期库欣综合征：病例系列和综述。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-03-12 DOI: 10.1002/edm2.474

Yan Wang, Yufen An, Xiaomei Hou, Yanan Xu, Zhen Li, Xin Liu, Fumin Zheng, Mingze Sun, Rendong Han, Caixia Lu, Jing Li, Jun Zhou

Purpose

To present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes.

Methods

We describe five pregnant women with CS, detailing clinical presentations and laboratory findings.

Results

Common clinical features included a full moon face, buffalo back and severe hypertension. Elevated blood cortisol levels with circadian rhythm disruption and suppressed adrenocorticotrophic hormone (ACTH) levels were observed. Imaging revealed unilateral adrenal tumours. Two cases underwent laparoscopic adrenalectomies during the second trimester, while three had postpartum surgery. All required hormone replacement therapy, with postoperative pathological confirmation of adrenocortical adenomas.

Conclusion

Diagnosis of CS during pregnancy is challenging due to overlapping features with normal pregnancy: elevated blood cortisol levels and abnormal diurnal rhythm of blood cortisol, suppressed aid diagnosis. Treatment should be individualised due to a lack of explicit optimum therapeutic approaches. Laparoscopic adrenalectomy may be an optimal choice, along with multidisciplinary management including hormone replacement therapy.

目的：介绍肾上腺皮质腺瘤引起的妊娠期库欣综合征（CS）的一系列病例，重点介绍临床特征、激素评估和结果：我们描述了五名患有库欣综合征的孕妇，详细介绍了她们的临床表现和实验室检查结果：常见的临床特征包括满月脸、水牛背和严重高血压。血液皮质醇水平升高，昼夜节律紊乱，肾上腺皮质激素（ACTH）水平受抑制。影像学检查发现单侧肾上腺肿瘤。两个病例在妊娠后三个月接受了腹腔镜肾上腺切除术，三个病例在产后接受了手术。所有病例都需要激素替代治疗，术后病理证实为肾上腺皮质腺瘤：结论：妊娠期 CS 的诊断具有挑战性，因为其特征与正常妊娠重叠：血液皮质醇水平升高，血液皮质醇的昼夜节律异常，这有助于诊断。由于缺乏明确的最佳治疗方法，治疗应因人而异。腹腔镜肾上腺切除术可能是最佳选择，同时进行多学科治疗，包括激素替代疗法。

{"title":"Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review","authors":"Yan Wang, Yufen An, Xiaomei Hou, Yanan Xu, Zhen Li, Xin Liu, Fumin Zheng, Mingze Sun, Rendong Han, Caixia Lu, Jing Li, Jun Zhou","doi":"10.1002/edm2.474","DOIUrl":"10.1002/edm2.474","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We describe five pregnant women with CS, detailing clinical presentations and laboratory findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Common clinical features included a full moon face, buffalo back and severe hypertension. Elevated blood cortisol levels with circadian rhythm disruption and suppressed adrenocorticotrophic hormone (ACTH) levels were observed. Imaging revealed unilateral adrenal tumours. Two cases underwent laparoscopic adrenalectomies during the second trimester, while three had postpartum surgery. All required hormone replacement therapy, with postoperative pathological confirmation of adrenocortical adenomas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Diagnosis of CS during pregnancy is challenging due to overlapping features with normal pregnancy: elevated blood cortisol levels and abnormal diurnal rhythm of blood cortisol, suppressed aid diagnosis. Treatment should be individualised due to a lack of explicit optimum therapeutic approaches. Laparoscopic adrenalectomy may be an optimal choice, along with multidisciplinary management including hormone replacement therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111690","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

A systematic review of literature on Insulin-like growth factor-2-mediated hypoglycaemia in non-islet cell tumours 关于非胰岛细胞肿瘤中胰岛素样生长因子-2介导的低血糖症的系统性文献综述。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-02-27 DOI: 10.1002/edm2.471

Fateen Ata, Hassan Choudry, Adeel Ahmad Khan, Anum, Ibrahim Khamees, Anas Al-sadi, Abdelaziz Mohamed, Lujain Malkawi, Esra'a Aljaloudi

Introduction

Insulin-like growth factor-2 (IGF-2)-mediated hypoglycemia is a rare yet clinically significant entity with considerable morbidity and mortality. Existing literature is limited and fails to offer a comprehensive understanding of its clinical trajectory, management and prognostication.

Methods

Systematic review of English-language articles reporting primary patient data on IMH was searched using electronic databases (PubMed, Scopus and Embase) from any date up to 21 December 2022. Data were analysed in STATA-16.

Results

The systematic review contains 172 studies, including 1 Randomised controlled trial, 1 prospective observational study, 5 retrospective observational studies, 150 case reports, 11 case series and 4 conference abstracts. A total of 233 patients were analysed, averaging 60.6 ± 17.1 years in age, with comparable proportions of males and females. The commonest tumours associated with Insulin-like Growth Factor-2-mediated hypoglycaemia were fibrous tumours (N = 124, 53.2%), followed by non-fibrous tumours originating from the liver (N = 21, 9%), hemangiopericytomas (N = 20, 8.5%) and mesotheliomas (N = 11, 4.7%). Hypoglycaemia was the presenting feature of NICT in 42% of cases. Predominant clinical features included loss of consciousness (26.7%) and confusion (21%). The mean IGF-2 and IGF-1 levels were 882.3 ± 630.6 ng/dL and 41.8 ± 47.8, respectively, with no significant correlation between these levels and patient outcomes. Surgical removal was the most employed treatment modality (47.2%), followed by medication therapy. The recovery rate was 77%, with chronic liver disease (CLD) significantly associated with a poor outcome (OR: 7.23, P: 0.03). Tumours originating from fibrous tissues were significantly associated with recovery (p < .001). In the logistic regression model, CLD remained a significant predictor of poor outcomes.

Conclusion

This systematic review highlights that most non-islet-cell tumour-hypoglycaemia (NICTH) is due to fibrous tumours. NICTs demonstrate a variable prognosis, which is fair if originating from fibrous tissue. Management such as octreotide, corticosteroids, diazoxide, embolization, radiotherapy and surgical resection have disparate success rates.

导言：胰岛素样生长因子-2（IGF-2）介导的低血糖症是一种罕见但临床意义重大的疾病，具有相当高的发病率和死亡率。现有文献有限，无法全面了解其临床轨迹、管理和预后：方法：使用电子数据库（PubMed、Scopus 和 Embase）对截至 2022 年 12 月 21 日报告 IMH 主要患者数据的英文文章进行系统性检索。数据用 STATA-16 进行分析：系统综述包含 172 项研究，其中包括 1 项随机对照试验、1 项前瞻性观察研究、5 项回顾性观察研究、150 篇病例报告、11 篇系列病例和 4 篇会议摘要。共分析了 233 名患者，平均年龄（60.6 ± 17.1）岁，男女比例相当。与胰岛素样生长因子-2介导的低血糖相关的最常见肿瘤是纤维性肿瘤（124例，53.2%），其次是源自肝脏的非纤维性肿瘤（21例，9%）、血管瘤（20例，8.5%）和间皮瘤（11例，4.7%）。42%的病例以低血糖为主要特征。主要临床特征包括意识丧失（26.7%）和意识模糊（21%）。IGF-2和IGF-1的平均水平分别为882.3 ± 630.6 ng/dL和41.8 ± 47.8，这些水平与患者的预后无显著相关性。手术切除是最常用的治疗方式（47.2%），其次是药物治疗。痊愈率为 77%，慢性肝病（CLD）与不良预后有显著相关性（OR：7.23，P：0.03）。来源于纤维组织的肿瘤与痊愈显著相关（P 结论：本系统综述强调，大多数非胰岛细胞肿瘤性低血糖症（NICTH）是由纤维性肿瘤引起的。非胰岛细胞瘤的预后不一，如果来自纤维组织，预后尚可。奥曲肽、皮质类固醇、双氮卓、栓塞、放疗和手术切除等治疗方法的成功率各不相同。

{"title":"A systematic review of literature on Insulin-like growth factor-2-mediated hypoglycaemia in non-islet cell tumours","authors":"Fateen Ata, Hassan Choudry, Adeel Ahmad Khan,  Anum, Ibrahim Khamees, Anas Al-sadi, Abdelaziz Mohamed, Lujain Malkawi, Esra'a Aljaloudi","doi":"10.1002/edm2.471","DOIUrl":"10.1002/edm2.471","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Insulin-like growth factor-2 (IGF-2)-mediated hypoglycemia is a rare yet clinically significant entity with considerable morbidity and mortality. Existing literature is limited and fails to offer a comprehensive understanding of its clinical trajectory, management and prognostication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic review of English-language articles reporting primary patient data on IMH was searched using electronic databases (PubMed, Scopus and Embase) from any date up to 21 December 2022. Data were analysed in STATA-16.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The systematic review contains 172 studies, including 1 Randomised controlled trial, 1 prospective observational study, 5 retrospective observational studies, 150 case reports, 11 case series and 4 conference abstracts. A total of 233 patients were analysed, averaging 60.6 ± 17.1 years in age, with comparable proportions of males and females. The commonest tumours associated with Insulin-like Growth Factor-2-mediated hypoglycaemia were fibrous tumours (<i>N</i> = 124, 53.2%), followed by non-fibrous tumours originating from the liver (<i>N</i> = 21, 9%), hemangiopericytomas (<i>N</i> = 20, 8.5%) and mesotheliomas (<i>N</i> = 11, 4.7%). Hypoglycaemia was the presenting feature of NICT in 42% of cases. Predominant clinical features included loss of consciousness (26.7%) and confusion (21%). The mean IGF-2 and IGF-1 levels were 882.3 ± 630.6 ng/dL and 41.8 ± 47.8, respectively, with no significant correlation between these levels and patient outcomes. Surgical removal was the most employed treatment modality (47.2%), followed by medication therapy. The recovery rate was 77%, with chronic liver disease (CLD) significantly associated with a poor outcome (OR: 7.23, P: 0.03). Tumours originating from fibrous tissues were significantly associated with recovery (<i>p</i> < .001). In the logistic regression model, CLD remained a significant predictor of poor outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This systematic review highlights that most non-islet-cell tumour-hypoglycaemia (NICTH) is due to fibrous tumours. NICTs demonstrate a variable prognosis, which is fair if originating from fibrous tissue. Management such as octreotide, corticosteroids, diazoxide, embolization, radiotherapy and surgical resection have disparate success rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973789","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

What are the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population? A systematic review 对体弱人群中的 2 型糖尿病过度治疗和治疗不足会产生什么后果？系统综述。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-02-27 DOI: 10.1002/edm2.470

Helen O'Neil, Adam Todd, Mark Pearce, Andrew Husband

Aims

This review aims to identify the evidence base for the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population.

Method

In this systematic review, we searched MEDLINE, Embase, PubMed, CINAHL and the Cochrane Library for studies from January 2001 to 15th August 2022. We included a variety of study types that assessed and reported frailty including patients ≥18 years old. Studies included those that reported the prevalence of over or undertreatment of diabetes mellitus in a frail population and those examining outcomes related to glucose control in frail older people living with diabetes. Data were extracted using a bespoke extraction table using a narrative synthesis approach.

Results

A total of 4114 articles were identified with 112 meeting inclusion criteria. These included 15,130 participants across the 11 studies with sample sizes ranging from 101 to 11,140. Several areas were identified in the included studies where under or overtreatment of diabetes impacted outcomes for patients. These included hospital admissions, readmissions, length of stay, falls, mortality, cognitive impairment and cardiovascular disease outcomes.

Conclusion

The results showed that there was a high heterogeneity of outcomes between the studies and that many examined small numbers of participants. In this review, both over and undertreatment were shown to increase adverse outcomes in frail older people. Further research around optimal glycaemic control for frail older people living with diabetes is required with the aim to identify ideal target ranges and produce practical clinical guidelines to promote attainment of these.

目的：本综述旨在确定体弱人群 2 型糖尿病过度治疗和治疗不足的后果的证据基础：在本系统性综述中，我们检索了 MEDLINE、Embase、PubMed、CINAHL 和 Cochrane 图书馆 2001 年 1 月至 2022 年 8 月 15 日期间的研究。我们纳入了评估和报告虚弱情况的各种类型的研究，包括年龄≥18 岁的患者。研究包括那些报告虚弱人群中糖尿病过度治疗或治疗不足发生率的研究，以及那些研究虚弱老年糖尿病患者血糖控制结果的研究。数据提取采用了专用的提取表，并采用了叙述性综合方法：共发现 4114 篇文章，其中 112 篇符合纳入标准。这 11 项研究共纳入 15130 名参与者，样本量从 101 到 11140 不等。在纳入的研究中发现，糖尿病治疗不足或治疗过度会影响患者的治疗效果。这些方面包括入院率、再入院率、住院时间、跌倒、死亡率、认知障碍和心血管疾病结果：结论：研究结果表明，不同研究的结果存在很大的异质性，而且许多研究的参与者人数较少。本综述显示，过度治疗和治疗不足都会增加体弱老年人的不良后果。需要围绕糖尿病老年患者的最佳血糖控制开展进一步研究，以确定理想的目标范围，并制定切实可行的临床指南，促进实现这些目标。

{"title":"What are the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population? A systematic review","authors":"Helen O'Neil, Adam Todd, Mark Pearce, Andrew Husband","doi":"10.1002/edm2.470","DOIUrl":"10.1002/edm2.470","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This review aims to identify the evidence base for the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In this systematic review, we searched MEDLINE, Embase, PubMed, CINAHL and the Cochrane Library for studies from January 2001 to 15th August 2022. We included a variety of study types that assessed and reported frailty including patients ≥18 years old. Studies included those that reported the prevalence of over or undertreatment of diabetes mellitus in a frail population and those examining outcomes related to glucose control in frail older people living with diabetes. Data were extracted using a bespoke extraction table using a narrative synthesis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4114 articles were identified with 112 meeting inclusion criteria. These included 15,130 participants across the 11 studies with sample sizes ranging from 101 to 11,140. Several areas were identified in the included studies where under or overtreatment of diabetes impacted outcomes for patients. These included hospital admissions, readmissions, length of stay, falls, mortality, cognitive impairment and cardiovascular disease outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results showed that there was a high heterogeneity of outcomes between the studies and that many examined small numbers of participants. In this review, both over and undertreatment were shown to increase adverse outcomes in frail older people. Further research around optimal glycaemic control for frail older people living with diabetes is required with the aim to identify ideal target ranges and produce practical clinical guidelines to promote attainment of these.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973837","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

Machine-learning algorithms in screening for type 2 diabetes mellitus: Data from Fasa Adults Cohort Study 筛查 2 型糖尿病的机器学习算法：来自 Fasa 成人队列研究的数据。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-02-27 DOI: 10.1002/edm2.472

Hanieh Karmand, Aref Andishgar, Reza Tabrizi, Alireza Sadeghi, Babak Pezeshki, Mahdi Ravankhah, Erfan Taherifard, Fariba Ahmadizar

Introduction

The application of machine learning (ML) is increasingly growing in biomedical sciences. This study aimed to evaluate factors associated with type 2 diabetes mellitus (T2DM) and compare the performance of ML methods in identifying individuals with the disease in an Iranian setting.

Methods

Using the baseline data from Fasa Adult Cohort Study (FACS) and in a sex-stratified manner, we studied factors associated with T2DM by applying seven different ML methods including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbours (KNN), Gradient Boosting Machine (GBM), Extreme Gradient Boosting (XGB) and Bagging classifier (BAG). We further compared the performance of these methods; for each algorithm, accuracy, precision, sensitivity, specificity, F1 score, and Area Under Curve (AUC) were calculated.

Results

10,112 participants were recruited between 2014 and 2016, of whom 1246 had T2DM at baseline. 4566 (45%) participants were males, aged between 35 and 70 years. For males, age, sugar consumption, and history of hospitalization were the most weighted variables regarding their importance in screening for T2DM using the GBM model, respectively; these variables were sugar consumption, urine blood, and age for females. GBM outperformed other models for both males and females with AUC of 0.75 (0.69–0.82) and 0.76 (0.71–0.80), and F1 score of 0.33 (0.27–0.39) and 0.42 (0.38–0.46), respectively. GBM also showed a sensitivity of 0.24 (0.19–0.29) and a specificity of 0.98 (0.96–1.0) in males and a sensitivity of 0.38 (0.34–0.42) and specificity of 0.92 (0.89–0.95) in females. Notably, close performance characteristics were detected among other ML models.

Conclusions

GBM model might achieve better performance in screening for T2DM in a south Iranian population.

介绍：机器学习（ML）在生物医学领域的应用日益广泛。本研究旨在评估与 2 型糖尿病（T2DM）相关的因素，并比较 ML 方法在伊朗环境下识别糖尿病患者的性能：我们利用法萨成人队列研究（FACS）的基线数据，以性别分层的方式，通过应用七种不同的 ML 方法，包括逻辑回归（LR）、支持向量机（SVM）、随机森林（RF）、K-近邻（KNN）、梯度提升机（GBM）、极端梯度提升（XGB）和袋式分类器（BAG），研究了与 T2DM 相关的因素。我们进一步比较了这些方法的性能；计算了每种算法的准确度、精确度、灵敏度、特异性、F1 分数和曲线下面积（AUC）：2014 年至 2016 年间共招募了 10112 名参与者，其中 1246 人基线时患有 T2DM。4566人（45%）为男性，年龄在35至70岁之间。在使用GBM模型筛查T2DM的重要性方面，男性的年龄、食糖摄入量和住院史分别是权重最高的变量；女性的这些变量分别是食糖摄入量、尿血和年龄。对男性和女性而言，GBM 的 AUC 分别为 0.75（0.69-0.82）和 0.76（0.71-0.80），F1 分别为 0.33（0.27-0.39）和 0.42（0.38-0.46），优于其他模型。GBM 对男性的灵敏度为 0.24（0.19-0.29），特异性为 0.98（0.96-1.0）；对女性的灵敏度为 0.38（0.34-0.42），特异性为 0.92（0.89-0.95）。值得注意的是，其他 ML 模型的性能特征也很接近：结论：GBM 模型在伊朗南部人群中筛查 T2DM 的效果可能更好。

{"title":"Machine-learning algorithms in screening for type 2 diabetes mellitus: Data from Fasa Adults Cohort Study","authors":"Hanieh Karmand, Aref Andishgar, Reza Tabrizi, Alireza Sadeghi, Babak Pezeshki, Mahdi Ravankhah, Erfan Taherifard, Fariba Ahmadizar","doi":"10.1002/edm2.472","DOIUrl":"10.1002/edm2.472","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The application of machine learning (ML) is increasingly growing in biomedical sciences. This study aimed to evaluate factors associated with type 2 diabetes mellitus (T2DM) and compare the performance of ML methods in identifying individuals with the disease in an Iranian setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the baseline data from Fasa Adult Cohort Study (FACS) and in a sex-stratified manner, we studied factors associated with T2DM by applying seven different ML methods including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbours (KNN), Gradient Boosting Machine (GBM), Extreme Gradient Boosting (XGB) and Bagging classifier (BAG). We further compared the performance of these methods; for each algorithm, accuracy, precision, sensitivity, specificity, F1 score, and Area Under Curve (AUC) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>10,112 participants were recruited between 2014 and 2016, of whom 1246 had T2DM at baseline. 4566 (45%) participants were males, aged between 35 and 70 years. For males, age, sugar consumption, and history of hospitalization were the most weighted variables regarding their importance in screening for T2DM using the GBM model, respectively; these variables were sugar consumption, urine blood, and age for females. GBM outperformed other models for both males and females with AUC of 0.75 (0.69–0.82) and 0.76 (0.71–0.80), and F1 score of 0.33 (0.27–0.39) and 0.42 (0.38–0.46), respectively. GBM also showed a sensitivity of 0.24 (0.19–0.29) and a specificity of 0.98 (0.96–1.0) in males and a sensitivity of 0.38 (0.34–0.42) and specificity of 0.92 (0.89–0.95) in females. Notably, close performance characteristics were detected among other ML models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GBM model might achieve better performance in screening for T2DM in a south Iranian population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973836","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

Copeptin and the syndrome of inappropriate antidiuresis (SIAD) after pituitary transsphenoidal surgery 垂体经蝶手术后的谷丙转氨酶和不适当抗利尿综合征（SIAD）

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-01-17 DOI: 10.1002/edm2.467

Agathoklis Efthymiadis, Riccardo Pofi, Hussam Rostom, Tim James, Brian Shine, Nish Guha, Simon Cudlip, Mirjam Christ-Crain, Aparna Pal

Objective

This study evaluates the predictive value of copeptin for syndrome of inappropriate antidiuresis (SIAD) postpituitary transsphenoidal surgery (TSS).

Design

Data from 133 consecutive patients undergoing TSS (November 2017–October 2022) at Oxford University Hospitals NHS trust are presented in this retrospective study.

Methods

Logistic regression (LR) and receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic utility of copeptin. The Mann–Whitney U test was used to compare copeptin levels between the SIAD and no SIAD groups.

Results

Fourteen patients (10.8%) developed SIAD. Copeptin was available in 121, 53 and 87 patients for Days 1, 241 and 8 post-TSS, respectively. LR for Day 1 copeptin to predict SIAD gave an odds ratio (OR) of 1.0 (95%CI 42 0.84–1.20, p = .99), area under-ROC curve (AUC) was 0.49; Day 2 copeptin OR was 0.65 (95%CI 0.39–1.19, 43 p = .77), AUC was 0.57 LR for Day 1 sodium to predict SIAD gave an odds ratio (OR) of 1.0 (95%CI 0.85–1.21, p = .99), AUC was 0.50.

Conclusions

In conclusion, our data provide no evidence for copeptin as a predictive marker for post-TSS SIAD.

目的本研究评估了 copeptin 对垂体经蝶手术（TSS）后不适当抗利尿综合征（SIAD）的预测价值。设计本回顾性研究提供了牛津大学医院 NHS 信托基金会接受 TSS 手术的 133 名连续患者（2017 年 11 月至 2022 年 10 月）的数据。方法采用逻辑回归（LR）和接收器操作特征曲线（ROC）评估 copeptin 的诊断效用。采用 Mann-Whitney U 检验比较 SIAD 组和非 SIAD 组的 copeptin 水平。结果 14 名患者（10.8%）出现了 SIAD。TSS后第1天、第241天和第8天分别有121名、53名和87名患者检测到铜肽。预测 SIAD 的第 1 天 copeptin LR 的几率比 (OR) 为 1.0 (95%CI 42 0.84-1.20, p = .99)，ROC 曲线下面积 (AUC) 为 0.49；第 2 天 copeptin OR 为 0.65（95%CI 0.39-1.19，43 p = .77），AUC 为 0.57；第 1 天钠预测 SIAD 的比值比 (OR) 为 1.0（95%CI 0.85-1.21，p = .99），AUC 为 0.50。结论总之，我们的数据没有提供证据表明 copeptin 可作为 TSS 后 SIAD 的预测标志物。

{"title":"Copeptin and the syndrome of inappropriate antidiuresis (SIAD) after pituitary transsphenoidal surgery","authors":"Agathoklis Efthymiadis, Riccardo Pofi, Hussam Rostom, Tim James, Brian Shine, Nish Guha, Simon Cudlip, Mirjam Christ-Crain, Aparna Pal","doi":"10.1002/edm2.467","DOIUrl":"https://doi.org/10.1002/edm2.467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluates the predictive value of copeptin for syndrome of inappropriate antidiuresis (SIAD) postpituitary transsphenoidal surgery (TSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Data from 133 consecutive patients undergoing TSS (November 2017–October 2022) at Oxford University Hospitals NHS trust are presented in this retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Logistic regression (LR) and receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic utility of copeptin. The Mann–Whitney U test was used to compare copeptin levels between the SIAD and no SIAD groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen patients (10.8%) developed SIAD. Copeptin was available in 121, 53 and 87 patients for Days 1, 241 and 8 post-TSS, respectively. LR for Day 1 copeptin to predict SIAD gave an odds ratio (OR) of 1.0 (95%CI 42 0.84–1.20, <i>p</i> = .99), area under-ROC curve (AUC) was 0.49; Day 2 copeptin OR was 0.65 (95%CI 0.39–1.19, 43 <i>p</i> = .77), AUC was 0.57 LR for Day 1 sodium to predict SIAD gave an odds ratio (OR) of 1.0 (95%CI 0.85–1.21, <i>p</i> = .99), AUC was 0.50.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, our data provide no evidence for copeptin as a predictive marker for post-TSS SIAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139488558","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

Comparing the association of two metabolic syndrome definitions, NCEP ATP III and IDF, with the risk of developing atherosclerotic cardiovascular disease: An analytical cross-sectional study 比较两种代谢综合征定义（NCEP ATP III 和 IDF）与动脉粥样硬化性心血管疾病发病风险的关系：横断面分析研究

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-01-17 DOI: 10.1002/edm2.468

Gholamreza Yousefzadeh, Amin Sayyadi, Hamid Najafipour, Vida Sabaghnejad, Sara Pezeshki

Introduction

Atherosclerotic cardiovascular diseases (ASCVD) are significant sources of mortality and morbidity with substantial economic implications and preventive measures play key roles in this regard. Metabolic syndrome (MetS) is a common condition, and its association with ASCVD and mortality has made it clinically important. However, controversies persist regarding the best definition for MetS. Here in, we investigated the ability of the International Diabetes Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) in the prediction of ASCVD incidence.

Methods

We conducted an investigation on individuals diagnosed with MetS as part of the “Kerman Coronary Artery Diseases Risk Factor Study” (KERCADRS). This study was a cohort study conducted on a population aged 15–75 years residing in Kerman, Iran to assess the risk of ASCVD. We employed ACC/AHA ASCVD Risk Estimator for predicting ASCVD occurrence in the future and then compared the results with different definitions of MetS including IDF and NCEP ATP III.

Results

Patients with MetS consistent with NCEP ATP III had higher ASCVD risk scores than those with IDF (10.63 ± 10.989 vs. 9.50 ± 9.357). NCEP ATP III had better overall performance in terms of specificity, accuracy, sensitivity and positive and negative predictive values especially in higher ASCVD risk score categories. The agreement between IDF and NCEP ATP III was none to slight (Cohen's Kappa <0.2) except for IDF in the group of ASCVD >30%, which revealed no agreement (Cohen's Kappa = 0).

Conclusion

NCEP ATP III has better overall performance compared to IDF. The ability of NCEP ATP III increases as the ASCVD risk score goes higher. IDF may be useful in primary screening and patients with lower ASCVD risk scores.

导言动脉粥样硬化性心血管疾病（ASCVD）是死亡率和发病率的重要来源，具有重大的经济影响，而预防措施在这方面发挥着关键作用。代谢综合征（MetS）是一种常见病，它与 ASCVD 和死亡率的关系使其在临床上具有重要意义。然而，关于 MetS 的最佳定义仍存在争议。在此，我们研究了国际糖尿病联盟（IDF）和美国国家胆固醇教育计划成人治疗小组 III（NCEP ATP III）在预测 ASCVD 发病率方面的能力。方法我们对 "克尔曼冠状动脉疾病危险因素研究"（KERCADRS）中被诊断出患有 MetS 的人进行了调查。这项研究是一项队列研究，对象是居住在伊朗克尔曼的 15-75 岁人群，目的是评估 ASCVD 风险。我们采用 ACC/AHA ASCVD 风险估算器预测未来发生 ASCVD 的风险，然后将结果与 MetS 的不同定义（包括 IDF 和 NCEP ATP III）进行比较。结果符合 NCEP ATP III 的 MetS 患者的 ASCVD 风险评分高于 IDF 患者（10.63 ± 10.989 vs. 9.50 ± 9.357）。NCEP ATP III 在特异性、准确性、灵敏度以及阳性和阴性预测值方面的总体表现更好，尤其是在较高的 ASCVD 风险评分类别中。IDF 和 NCEP ATP III 之间的一致性仅为微弱（Cohen's Kappa <0.2），只有 ASCVD >30% 组的 IDF 显示不一致（Cohen's Kappa = 0）。结论 NCEP ATP III 的整体性能优于 IDF。当 ASCVD 风险评分越高时，NCEP ATP III 的能力越强。IDF 可用于初筛和 ASCVD 风险评分较低的患者。

{"title":"Comparing the association of two metabolic syndrome definitions, NCEP ATP III and IDF, with the risk of developing atherosclerotic cardiovascular disease: An analytical cross-sectional study","authors":"Gholamreza Yousefzadeh, Amin Sayyadi, Hamid Najafipour, Vida Sabaghnejad, Sara Pezeshki","doi":"10.1002/edm2.468","DOIUrl":"https://doi.org/10.1002/edm2.468","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Atherosclerotic cardiovascular diseases (ASCVD) are significant sources of mortality and morbidity with substantial economic implications and preventive measures play key roles in this regard. Metabolic syndrome (MetS) is a common condition, and its association with ASCVD and mortality has made it clinically important. However, controversies persist regarding the best definition for MetS. Here in, we investigated the ability of the International Diabetes Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) in the prediction of ASCVD incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an investigation on individuals diagnosed with MetS as part of the “Kerman Coronary Artery Diseases Risk Factor Study” (KERCADRS). This study was a cohort study conducted on a population aged 15–75 years residing in Kerman, Iran to assess the risk of ASCVD. We employed ACC/AHA ASCVD Risk Estimator for predicting ASCVD occurrence in the future and then compared the results with different definitions of MetS including IDF and NCEP ATP III.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with MetS consistent with NCEP ATP III had higher ASCVD risk scores than those with IDF (10.63 ± 10.989 vs. 9.50 ± 9.357). NCEP ATP III had better overall performance in terms of specificity, accuracy, sensitivity and positive and negative predictive values especially in higher ASCVD risk score categories. The agreement between IDF and NCEP ATP III was none to slight (Cohen's Kappa <0.2) except for IDF in the group of ASCVD >30%, which revealed no agreement (Cohen's Kappa = 0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>NCEP ATP III has better overall performance compared to IDF. The ability of NCEP ATP III increases as the ASCVD risk score goes higher. IDF may be useful in primary screening and patients with lower ASCVD risk scores.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139488559","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

Real-world glycaemic outcomes in patients with type 1 diabetes using glucose sensors—Experience from a single centre in Dublin 使用葡萄糖传感器的 1 型糖尿病患者的实际血糖结果-都柏林单一中心的经验

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-01-17 DOI: 10.1002/edm2.469

Robert E. Lyons, Roshaida Abdul Wahab, Sue Yee Goh, Cathy Breen, Amanda Rhynehart, Mary O'Scannail, Hannah Jade Kelly, Karl Neff, Donal O'Shea, Ronan Canavan, Wan Aizad Wan Mahmood

Aims

To evaluate changes in glycated haemoglobin (HbA₁c) and sensor-based glycaemic metrics after glucose sensor commencement in adults with T1D.

Methods

We performed a retrospective observational single-centre study on HbA₁c, and sensor-based glycaemic data following the initiation of continuous glucose monitoring (CGM) in adults with T1D (n = 209).

Results

We observed an overall improvement in HbA₁c from 66 (59–78) mmol/mol [8.2 (7.5–9.3)%] pre-sensor to 60 (53–71) mmol/mol [7.6 (7.0–8.6)%] on-sensor (p < .001). The pre-sensor HbA₁c improved from 66 (57–74) mmol/mol [8.2 (7.4–8.9)%] to 62 (54–71) mmol/mol [7.8 (7.1–8.7)%] within the first year of usage to 60 (53–69) mmol/mol [7.6 (7.0–8.4)%] in the following year (n = 121, p < .001). RT-CGM-user had a significant improvement in HbA₁c (Dexcom G6; p < .001, r = 0.33 and Guardian 3; p < .001, r = 0.59) while a non-significant reduction was seen in FGM-user (Libre 1; p = .279). Both MDI (p < .001, r = 0.33) and CSII group (p < .001, r = 0.41) also demonstrated significant HbA₁c improvement. Patients with pre-sensor HbA₁c of ≥64 mmol/mol [8.0%] (n = 125), had attenuation of pre-sensor HbA₁c from 75 (68–83) mmol/mol [9.0 (8.4–9.7)%] to 67 (59–75) mmol/mol [8.2 (7.6–9.0)%] (p < .001, r = 0.44). Altogether, 25.8% of patients achieved the recommended HbA₁c goal of ≤53 mmol/mol and 16.7% attained the recommended ≥70% time in range (3.9–10.0 mmol/L).

Conclusions

Our study demonstrated that minimally invasive glucose sensor technology in adults with T1D is associated with improvement in glycaemic outcomes. However, despite significant improvements in HbA₁c, achieving the recommended goals for all glycaemic metrics remained challenging.

目的评估 T1D 成人患者使用葡萄糖传感器后糖化血红蛋白 (HbA1c) 和基于传感器的血糖指标的变化。方法我们对患有 T1D 的成人（n = 209）开始使用连续葡萄糖监测 (CGM) 后的 HbA1c 和基于传感器的血糖数据进行了一项回顾性单中心观察研究。结果我们观察到 HbA1c 整体有所改善，从传感器前的 66 (59-78) mmol/mol [8.2 (7.5-9.3)%] 降至传感器上的 60 (53-71) mmol/mol [7.6 (7.0-8.6)%] (p <.001)。使用 RT-CGM 的第一年，HbA1c 从使用前的 66 (57-74) mmol/mol [8.2 (7.4-8.9)%] 降至 62 (54-71) mmol/mol [7.8 (7.1-8.7)%] ，第二年降至 60 (53-69) mmol/mol [7.6 (7.0-8.4)%] （n = 121，p < .001）。RT-CGM 用户的 HbA1c 有显著改善（Dexcom G6；p <；.001，r = 0.33 和 Guardian 3；p <；.001，r = 0.59），而 FGM 用户的 HbA1c 降幅不大（Libre 1；p = .279）。MDI 组（p < .001，r = 0.33）和 CSII 组（p < .001，r = 0.41）的 HbA1c 也有显著改善。传感器前 HbA1c≥64 mmol/mol [8.0%] 的患者（n = 125），传感器前 HbA1c 从 75 (68-83) mmol/mol [9.0 (8.4-9.7)%] 下降到 67 (59-75) mmol/mol [8.2 (7.6-9.0)%] (p < .001, r = 0.44)。总共有 25.8% 的患者达到了推荐的 HbA1c ≤53 mmol/mol 的目标，16.7% 的患者达到了推荐的≥70% 时间范围（3.9-10.0 mmol/L）。结论我们的研究表明，微创血糖传感器技术可改善成人 T1D 患者的血糖结果。然而，尽管 HbA1c 有了明显改善，但要达到所有血糖指标的建议目标仍具有挑战性。

{"title":"Real-world glycaemic outcomes in patients with type 1 diabetes using glucose sensors—Experience from a single centre in Dublin","authors":"Robert E. Lyons, Roshaida Abdul Wahab, Sue Yee Goh, Cathy Breen, Amanda Rhynehart, Mary O'Scannail, Hannah Jade Kelly, Karl Neff, Donal O'Shea, Ronan Canavan, Wan Aizad Wan Mahmood","doi":"10.1002/edm2.469","DOIUrl":"https://doi.org/10.1002/edm2.469","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate changes in glycated haemoglobin (HbA<sub>1</sub>c) and sensor-based glycaemic metrics after glucose sensor commencement in adults with T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective observational single-centre study on HbA<sub>1</sub>c, and sensor-based glycaemic data following the initiation of continuous glucose monitoring (CGM) in adults with T1D (<i>n</i> = 209).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed an overall improvement in HbA<sub>1</sub>c from 66 (59–78) mmol/mol [8.2 (7.5–9.3)%] pre-sensor to 60 (53–71) mmol/mol [7.6 (7.0–8.6)%] on-sensor (<i>p</i> < .001). The pre-sensor HbA<sub>1</sub>c improved from 66 (57–74) mmol/mol [8.2 (7.4–8.9)%] to 62 (54–71) mmol/mol [7.8 (7.1–8.7)%] within the first year of usage to 60 (53–69) mmol/mol [7.6 (7.0–8.4)%] in the following year (<i>n</i> = 121, <i>p</i> < .001). RT-CGM-user had a significant improvement in HbA<sub>1</sub>c (Dexcom G6; <i>p</i> < .001, <i>r</i> = 0.33 and Guardian 3; <i>p</i> < .001, <i>r</i> = 0.59) while a non-significant reduction was seen in FGM-user (Libre 1; <i>p</i> = .279). Both MDI (<i>p</i> < .001, <i>r</i> = 0.33) and CSII group (<i>p</i> < .001, <i>r</i> = 0.41) also demonstrated significant HbA<sub>1</sub>c improvement. Patients with pre-sensor HbA<sub>1</sub>c of ≥64 mmol/mol [8.0%] (<i>n</i> = 125), had attenuation of pre-sensor HbA<sub>1</sub>c from 75 (68–83) mmol/mol [9.0 (8.4–9.7)%] to 67 (59–75) mmol/mol [8.2 (7.6–9.0)%] (<i>p</i> < .001, <i>r</i> = 0.44). Altogether, 25.8% of patients achieved the recommended HbA<sub>1</sub>c goal of ≤53 mmol/mol and 16.7% attained the recommended ≥70% time in range (3.9–10.0 mmol/L).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrated that minimally invasive glucose sensor technology in adults with T1D is associated with improvement in glycaemic outcomes. However, despite significant improvements in HbA<sub>1</sub>c, achieving the recommended goals for all glycaemic metrics remained challenging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139488560","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