Pub Date : 2025-06-01Epub Date: 2025-03-25DOI: 10.1016/j.endinu.2025.501577
Tomás González-Vidal , Diego Rivas-Otero , Carmen Lambert , Jessica Ares Blanco , Elías Delgado-Álvarez , Edelmiro Menéndez Torre
Objective
To predict the length of hospital stay in hyperosmolar hyperglycemic crises (HHC) using variables available on admission.
Methods
We conducted a retrospective cohort study with 132 patients (65 [49.2%] men; median age 72 years; range 19–98 years) hospitalized for HHC (including hyperosmolar hyperglycemic state and diabetic ketoacidosis with elevated osmolality) in a Spanish teaching hospital. Baseline variables and those upon arrival to the emergency department were collected (both variables related to physical examination and biochemical tests), as well as the in-hospital mortality rate and overall length of hospital stay in survivors.
Results
Patients who died (n = 13) had higher total serum osmolality and higher C-reactive protein concentrations on admission vs survivors. Among survivors, the length of stay correlated positively with total serum osmolality (Rho = 0.398; p < 0.001) and C-reactive protein (Rho = 0.342; p < 0.001) on admission. Older age, female sex, lack of pre-admission diagnosis of insulin-requiring diabetes, impaired mental status on arrival, non-ketotic metabolic acidosis, and low serum potassium concentrations were also associated with long lengths of stay. In multivariate analysis, only serum glucose (one of the three components of total osmolality) and C-reactive protein concentrations on admission kept a positive association with the length of stay.
Conclusions
Hyperglycemia and elevated C-reactive protein on admission are independent predictors of long lengths of stay in survivors with HHC.
{"title":"Predictors of length of hospital stay in patients presenting to the emergency department with hyperosmolar hyperglycemic crises","authors":"Tomás González-Vidal , Diego Rivas-Otero , Carmen Lambert , Jessica Ares Blanco , Elías Delgado-Álvarez , Edelmiro Menéndez Torre","doi":"10.1016/j.endinu.2025.501577","DOIUrl":"10.1016/j.endinu.2025.501577","url":null,"abstract":"<div><h3>Objective</h3><div>To predict the length of hospital stay in hyperosmolar hyperglycemic crises (HHC) using variables available on admission.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study with 132 patients (65 [49.2%] men; median age 72 years; range 19–98 years) hospitalized for HHC (including hyperosmolar hyperglycemic state and diabetic ketoacidosis with elevated osmolality) in a Spanish teaching hospital. Baseline variables and those upon arrival to the emergency department were collected (both variables related to physical examination and biochemical tests), as well as the in-hospital mortality rate and overall length of hospital stay in survivors.</div></div><div><h3>Results</h3><div>Patients who died (<em>n</em> <!-->=<!--> <!-->13) had higher total serum osmolality and higher C-reactive protein concentrations on admission vs survivors. Among survivors, the length of stay correlated positively with total serum osmolality (Rho<!--> <!-->=<!--> <!-->0.398; <em>p</em> <!--><<!--> <!-->0.001) and C-reactive protein (Rho<!--> <!-->=<!--> <!-->0.342; <em>p</em> <!--><<!--> <!-->0.001) on admission. Older age, female sex, lack of pre-admission diagnosis of insulin-requiring diabetes, impaired mental status on arrival, non-ketotic metabolic acidosis, and low serum potassium concentrations were also associated with long lengths of stay. In multivariate analysis, only serum glucose (one of the three components of total osmolality) and C-reactive protein concentrations on admission kept a positive association with the length of stay.</div></div><div><h3>Conclusions</h3><div>Hyperglycemia and elevated C-reactive protein on admission are independent predictors of long lengths of stay in survivors with HHC.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501577"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-05-23DOI: 10.1016/j.endinu.2025.501600
Núria Alonso , María Teresa Julián
{"title":"Adipopatía y disglucemia en la enfermedad metabólica sistémica: hacia un abordaje integral multidisciplinar liderado por el endocrinólogo","authors":"Núria Alonso , María Teresa Julián","doi":"10.1016/j.endinu.2025.501600","DOIUrl":"10.1016/j.endinu.2025.501600","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501600"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-03-28DOI: 10.1016/j.endinu.2025.501580
Sandra Herranz-Antolín , Rosa Quílez-Toboso , Jesús Moreno-Fernández , Javier González-López , María López-Iglesias , Julia Sastre
Objective
To analyze the clinical presentation, diagnosis, management and survival of Anaplastic Thyroid Carcinomas (ATC) in the Hospitals of Castilla-La Mancha (Spain).
Material and methods
Retrospective multicenter descriptive study. Adult patients with ATC diagnosed from 2002 to 2022 were included.
Results
Of the 43 patients included, 53.5% were women, with a mean age of 72 years (SD 10) at the time of diagnosis. Symptoms were present in 100% of the patients and the most frequent symptom was a rapidly growing mass (79.1% of the cases). Infiltration of neighboring structures (76.7%), lymph node involvement (78.1%) and distant metastasis (51.2%). The AJCC-TNM category was IVa in 9.3%, IVb in 39.5% and IVc in 51.2%. BRAFV600E determination was not performed in 74.4% and 5 of the 11 cases in which it was evaluated (45.4%) had the mutation. Active treatment was received in 76.7% of patients in the first 3 months. Surgical approach was performed in 63.6% of the cases, with complete resection in 23.8%, and 51.5% received multimodality treatment in this period. 42.3% received active treatment during follow-up (≥ 3 months), primarily systemic chemotherapy (72.7%), and 54.4% received multimodality treatment during this period. The median specific survival was 3.5 months (95% CI 1.7-5.2). Factors associated with longer specific survival were initial multimodality treatment (p < 0.01) or during follow-up (p = 0.01) and initial BRAF/MEK inhibitor treatment (p = 0.04).
Conclusion
CAT is an infrequent and aggressive tumor that requires early, multidisciplinary, personalized and multimodal treatment.
目的分析西班牙卡斯蒂利亚-拉曼查医院甲状腺间变性癌（ATC）的临床表现、诊断、治疗及生存情况。材料与方法回顾性多中心描述性研究。纳入了2002年至2022年诊断为ATC的成年患者。结果纳入的43例患者中，53.5%为女性，诊断时平均年龄为72岁（SD 10）。100%的患者出现症状，最常见的症状是快速增长的肿块（79.1%的病例）。邻近组织浸润（76.7%）、淋巴结受累（78.1%）和远处转移（51.2%）。AJCC-TNM分类中IVa占9.3%，IVb占39.5%，IVc占51.2%。74.4%的患者未进行BRAFV600E检测，11例患者中有5例（45.4%）存在突变。76.7%的患者在前3个月接受了积极治疗。63.6%的病例行手术入路，23.8%的病例行完全切除，51.5%的病例在此期间接受了多模式治疗。42.3%的人在随访期间（≥3个月）接受了积极治疗，主要是全身化疗（72.7%），54.4%的人在此期间接受了多模式治疗。中位特异性生存期为3.5个月（95% CI 1.7-5.2）。与更长的特异性生存期相关的因素是初始多模式治疗(p <；0.01)或随访期间（p = 0.01）和初始BRAF/MEK抑制剂治疗期间（p = 0.04）。结论cat是一种罕见的侵袭性肿瘤，需要早期、多学科、个性化、多模式治疗。
{"title":"Proyecto CANTCAM (Carcinoma ANaplásico de Tiroides en CAstilla-La Mancha). Estudio retrospectivo multicéntrico","authors":"Sandra Herranz-Antolín , Rosa Quílez-Toboso , Jesús Moreno-Fernández , Javier González-López , María López-Iglesias , Julia Sastre","doi":"10.1016/j.endinu.2025.501580","DOIUrl":"10.1016/j.endinu.2025.501580","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the clinical presentation, diagnosis, management and survival of Anaplastic Thyroid Carcinomas (ATC) in the Hospitals of Castilla-La Mancha (Spain).</div></div><div><h3>Material and methods</h3><div>Retrospective multicenter descriptive study. Adult patients with ATC diagnosed from 2002 to 2022 were included.</div></div><div><h3>Results</h3><div>Of the 43 patients included, 53.5% were women, with a mean age of 72 years (SD 10) at the time of diagnosis. Symptoms were present in 100% of the patients and the most frequent symptom was a rapidly growing mass (79.1% of the cases). Infiltration of neighboring structures (76.7%), lymph node involvement (78.1%) and distant metastasis (51.2%). The AJCC-TNM category was IVa in 9.3%, IVb in 39.5% and IVc in 51.2%. <em>BRAF</em><sup><em>V600E</em></sup> determination was not performed in 74.4% and 5 of the 11 cases in which it was evaluated (45.4%) had the mutation. Active treatment was received in 76.7% of patients in the first 3 months. Surgical approach was performed in 63.6% of the cases, with complete resection in 23.8%, and 51.5% received multimodality treatment in this period. 42.3% received active treatment during follow-up (≥<!--> <!-->3 months), primarily systemic chemotherapy (72.7%), and 54.4% received multimodality treatment during this period. The median specific survival was 3.5 months (95% CI 1.7-5.2). Factors associated with longer specific survival were initial multimodality treatment (p<!--> <!--><<!--> <!-->0.01) or during follow-up (p<!--> <!-->=<!--> <!-->0.01) and initial BRAF/MEK inhibitor treatment (p<!--> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusion</h3><div>CAT is an infrequent and aggressive tumor that requires early, multidisciplinary, personalized and multimodal treatment.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501580"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-03-22DOI: 10.1016/j.endinu.2025.501574
Felipe Pardo Lozano , Arantxa Rubio Marcos , Rosa Casañ Fernández , Amparo Bartual Rodrigo , Sergio Martínez-Hervás , Francisco Javier Ampudia-Blasco
Introduction
Dulaglutide and semaglutide are once-weekly administered GLP-1 receptor agonists (GLP-1 RAs) indicated for the treatment of hyperglycemia in individuals with type 2 diabetes mellitus (T2DM) and obesity (BMI ≥ 30 kg/m2).
Objective
To evaluate the efficacy and safety of switching from subcutaneous (SC) dulaglutide to SC semaglutide, in real-world conditions.
Materials and methods
A total of 123 individuals with T2DM on SC dulaglutide, either as monotherapy or with other antihyperglycemic drugs, who switched to SC semaglutide were included. This switch was motivated by insufficient reduction in glycated hemoglobin (HbA1c), the need for greater weight loss, or gastrointestinal intolerance associated with dulaglutide. Changes with semaglutide in HbA1c and weight at 6, 12, 18, and 24 months, as well as any changes in associated adverse effects. Data are expressed as mean ± standard deviation.
Results
Previous treatment with dulaglutide (duration 16.9 ± 13.8 months) reduced HbA1c by 0.38% (P = .003 vs. baseline) and weight by −1.3 kg (P = .003 vs. baseline). After switching to semaglutide, an additional reduction in HbA1c levels was observed at 6, 12, 18, and 24 months (−0.43%, P = .000; −0.54%, P = .000; −0.38%, P = .021; −0.12%, P = .622, respectively) and in weight at 6, 12, 18, and 24 months (−2.7 kg, P = .000; −3.7 kg, P = .000; −5.4 kg, P = .001; −4.2 kg, P = .000, respectively) With no significant differences in the frequency of adverse effects after switching to semaglutide.
Conclusions
In real-world conditions, switching dulaglutide to semaglutide in obese patients with T2DM is associated with an additional reduction in HbA1c and weight, without notable changes in the frequency of adverse effects.
dulaglutide和semaglutide是每周一次的GLP-1受体激动剂（GLP-1 RAs），用于治疗2型糖尿病（T2DM）和肥胖（BMI≥30 kg/m2）患者的高血糖。目的评价在现实条件下，从皮下（SC）杜拉鲁肽转换为皮下（SC）西马鲁肽的有效性和安全性。材料和方法共纳入123例T2DM患者，无论是单药治疗还是与其他降糖药物联合使用，均改用SC semaglutide。这种转变的动机是糖化血红蛋白（HbA1c）降低不足，需要更大程度的减肥，或杜拉鲁肽相关的胃肠道不耐受。在6个月、12个月、18个月和24个月时，西马鲁肽对HbA1c和体重的变化，以及相关不良反应的任何变化。数据以平均值±标准差表示。结果既往杜拉鲁肽治疗（持续时间16.9±13.8个月）使HbA1c降低0.38% (P = 0.003)，体重降低- 1.3 kg （P = 0.003）。改用西马鲁肽后，在6、12、18和24个月观察到HbA1c水平的进一步降低(- 0.43%,P = 0.000；−0.54%,p = 0.000；−0.38%,p = 0.021；- 0.12%, P = .622)， 6、12、18和24个月时体重下降(- 2.7 kg, P = .000；−3.7 kg, P = .000；−5.4 kg, P = .001；−4.2 kg, P = .000)改用西马鲁肽后不良反应发生频率无显著差异。结论：在现实情况下，肥胖T2DM患者将杜拉鲁肽转换为西马鲁肽与HbA1c和体重的额外降低相关，而不良反应的频率没有显著变化。
{"title":"Valoración en vida real de la eficacia y de la seguridad del cambio de dulaglutida semanal a semaglutida semanal: estudio SEMA-SWITCH","authors":"Felipe Pardo Lozano , Arantxa Rubio Marcos , Rosa Casañ Fernández , Amparo Bartual Rodrigo , Sergio Martínez-Hervás , Francisco Javier Ampudia-Blasco","doi":"10.1016/j.endinu.2025.501574","DOIUrl":"10.1016/j.endinu.2025.501574","url":null,"abstract":"<div><h3>Introduction</h3><div>Dulaglutide and semaglutide are once-weekly administered GLP-1 receptor agonists (GLP-1 RAs) indicated for the treatment of hyperglycemia in individuals with type<!--> <!-->2 diabetes mellitus (T2DM) and obesity (BMI ≥<!--> <!-->30<!--> <!-->kg/m<sup>2</sup>).</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of switching from subcutaneous (SC) dulaglutide to SC semaglutide, in real-world conditions.</div></div><div><h3>Materials and methods</h3><div>A total of 123 individuals with T2DM on SC dulaglutide, either as monotherapy or with other antihyperglycemic drugs, who switched to SC semaglutide were included. This switch was motivated by insufficient reduction in glycated hemoglobin (HbA1c), the need for greater weight loss, or gastrointestinal intolerance associated with dulaglutide. Changes with semaglutide in HbA1c and weight at 6, 12, 18, and 24<!--> <!-->months, as well as any changes in associated adverse effects. Data are expressed as mean ±<!--> <!-->standard deviation.</div></div><div><h3>Results</h3><div>Previous treatment with dulaglutide (duration 16.9<!--> <!-->±<!--> <!-->13.8 months) reduced HbA1c by 0.38% (<em>P</em> <!-->=<!--> <!-->.003 vs. baseline) and weight by −1.3<!--> <!-->kg (<em>P</em> <!-->=<!--> <!-->.003 vs. baseline). After switching to semaglutide, an additional reduction in HbA1c levels was observed at 6, 12, 18, and 24<!--> <!-->months (−0.43%, <em>P</em> <!-->=<!--> <!-->.000; −0.54%, <em>P</em> <!-->=<!--> <!-->.000; −0.38%, <em>P</em> <!-->=<!--> <!-->.021; −0.12%, <em>P</em> <!-->=<!--> <!-->.622, respectively) and in weight at 6, 12, 18, and 24<!--> <!-->months (−2.7<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.000; −3.7<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.000; −5.4<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.001; −4.2<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.000, respectively) With no significant differences in the frequency of adverse effects after switching to semaglutide.</div></div><div><h3>Conclusions</h3><div>In real-world conditions, switching dulaglutide to semaglutide in obese patients with T2DM is associated with an additional reduction in HbA1c and weight, without notable changes in the frequency of adverse effects.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501574"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-03-22DOI: 10.1016/j.endinu.2025.501576
Mónica Baptista Lopes , Ricardo Fonseca , João Fernandes Serôdio , Ricardo Paquete Oliveira , José Delgado Alves
Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is a cause of Cushing's syndrome usually associated with neuroendocrine tumors. Olfactory neuroblastoma (ONB) is a rare malignant neoplasm of the olfactory epithelium. This is the case of a 56-year-old woman with an ONB presenting with EAS. After initiating metyrapone, she developed a Pneumocystis jirovecii pneumonia. Following successful treatment of the infection, she underwent surgical tumor excision and radiotherapy, which has been in remission for the past 3 years. The authors provide a literature review of the 30 previously published cases of ONB presenting with EAS. Most were reported in middle-aged men, with a recurrence rate of 15.6% (3 patients eventually died). A total of 9.5% of all reported had an infection after starting corticosteroid-blocking therapy. ONB is a very rare cause of EAS with poor prognosis and a relapsing course. In the presence of severe hypercortisolism, chemoprophylaxis for common opportunistic agents must be considered.
{"title":"Ectopic adrenocorticotropic hormone syndrome due to olfactory neuroblastoma: A case report and literature review","authors":"Mónica Baptista Lopes , Ricardo Fonseca , João Fernandes Serôdio , Ricardo Paquete Oliveira , José Delgado Alves","doi":"10.1016/j.endinu.2025.501576","DOIUrl":"10.1016/j.endinu.2025.501576","url":null,"abstract":"<div><div>Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is a cause of Cushing's syndrome usually associated with neuroendocrine tumors. Olfactory neuroblastoma (ONB) is a rare malignant neoplasm of the olfactory epithelium. This is the case of a 56-year-old woman with an ONB presenting with EAS. After initiating metyrapone, she developed a <em>Pneumocystis jirovecii</em> pneumonia. Following successful treatment of the infection, she underwent surgical tumor excision and radiotherapy, which has been in remission for the past 3 years. The authors provide a literature review of the 30 previously published cases of ONB presenting with EAS. Most were reported in middle-aged men, with a recurrence rate of 15.6% (3 patients eventually died). A total of 9.5% of all reported had an infection after starting corticosteroid-blocking therapy. ONB is a very rare cause of EAS with poor prognosis and a relapsing course. In the presence of severe hypercortisolism, chemoprophylaxis for common opportunistic agents must be considered.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501576"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-03-12DOI: 10.1016/j.endinu.2025.501560
Elena González Arnáiz , Juan José López Gómez , Diana Ariadel Cobo , Brisamar Estébanez , María García Duque , Carmen Dameto Pons , David Barajas Galindo , Diana García Sastre , Ana Urioste Fondo , María J. Cuevas , María D. Ballesteros Pomar
<div><h3>Background</h3><div>Hand grip strength — measured by dynamometry — is an essential tool in nutritional assessment, particularly for detecting sarcopenia, even before weight or muscle mass loss is evident. In individuals with obesity, hand grip strength can help identify muscle weakness that may not be apparent due to high body mass. The purpose of this study is to describe the absolute and adjusted hand grip strength values for weight, height, body mass index (BMI), and appendicular skeletal muscle mass (ASMM) in obese patients. It also aims to determine the prevalence of low muscle strength in this group of patients and to compare these results with those obtained in a healthy population.</div></div><div><h3>Material and Methods</h3><div>Prospective observational study including patients with obesity and healthy volunteers. Absolute and adjusted hand grip strength values for weight, height, BMI and appendicular muscle mass were determined in patients with obesity and compared with the results of healthy volunteers. Muscle strength was measured by hand grip strength according to Sánchez-Torralvo, Dodds, and <<!--> <!-->−2<!--> <!-->SD cut-off points of healthy reference population.</div></div><div><h3>Results</h3><div>The results obtained show that the absolute hand grip strength values are higher in healthy volunteers (30.7<!--> <!-->±<!--> <!-->10.5<!--> <!-->kg) vs patients with obesity (26.6<!--> <!-->±<!--> <!-->9.7<!--> <!-->kg); <em>P</em> <!--><<!--> <!-->.008. As for hand grip strength values adjusted for height, weight, BMI and ASMM, they are also statistically significantly higher in healthy volunteers (18.0<!--> <!-->±<!--> <!-->5.5 vs. 15.9<!--> <!-->±<!--> <!-->5.4, <em>P</em> <!--><<!--> <!-->.014; 05<!--> <!-->±<!--> <!-->0.10 vs. 0.2<!--> <!-->±<!--> <!-->0.06, <em>P</em> <!--><<!--> <!-->.001; 1.4<!--> <!-->±<!--> <!-->0.4 vs. 0.6<!--> <!-->±<!--> <!-->0.2, <em>P</em> <!--><<!--> <!-->.001; 1.5<!--> <!-->±<!--> <!-->0.2 vs. 0.9<!--> <!-->±<!--> <!-->0.3, <em>P</em> <!--><<!--> <!-->.001). According to sex, men had significantly higher absolute and adjusted hand grip strength values in both obese patients and healthy volunteers. The prevalence of low muscle strength in patients with obesity goes from 14.5% up and 23.4% depending on the cut-off points used, being higher with those of Sánchez-Torralvo's cut-off points. Based on sex distribution, obese men had a higher prevalence of low muscle strength with absolute hand grip strength values vs women, being these differences statistically significant only with the Sánchez-Torralvo's cut-off points. In terms of the prevalence of low muscle strength with adjusted hand grip strength values, more variable percentages (3.2%-96.8%) were observed without clear differences across sexes.</div></div><div><h3>Conclusions</h3><div>Hand grip strength values in obese patients vary according to absolute or adjusted measurements. Obese patients have lower absolute and adj
手握力是营养评估的重要工具，特别是在体重或肌肉质量明显下降之前检测肌肉减少症。对于肥胖的人来说，握力可以帮助识别由于高体重而不明显的肌肉无力。本研究的目的是描述肥胖患者的体重、身高、体重指数（BMI）和阑尾骨骼肌质量（ASMM）的绝对握力值和调整后的握力值。它还旨在确定这组患者中肌肉力量低下的患病率，并将这些结果与健康人群中获得的结果进行比较。材料与方法前瞻性观察性研究，包括肥胖患者和健康志愿者。测量肥胖患者的体重、身高、BMI和阑尾肌质量的绝对握力值和调整后的握力值，并与健康志愿者的结果进行比较。肌肉力量根据Sánchez-Torralvo， Dodds和<；−2个健康参考人群的SD分界点。结果健康志愿者的绝对握力值（30.7±10.5 kg）高于肥胖患者（26.6±9.7 kg）；P & lt;.008。经身高、体重、BMI和ASMM调整后的握力值，健康志愿者的握力值(18.0±5.5比15.9±5.4,P <；.014;0.05±0.10 vs. 0.2±0.06,P <；措施;1.4±0.4比0.6±0.2,P <；措施;1.5±0.2 vs. 0.9±0.3,P <；措施)。从性别上看，男性的绝对握力值和调整后的握力值在肥胖患者和健康志愿者中都明显更高。根据使用的分界点，肥胖患者中肌肉力量不足的患病率从14.5%上升到23.4%，与Sánchez-Torralvo的分界点相比更高。根据性别分布，肥胖男性的绝对握力值和肌肉力量较低的患病率高于女性，这些差异仅在Sánchez-Torralvo的分界点上具有统计学意义。在调整过的握力值后的低肌力患病率方面，变化的百分比较多（3.2% ~ 96.8%），性别差异不明显。结论肥胖患者的握力和握力值根据绝对测量值或调整测量值而变化。与健康人群相比，肥胖患者的绝对握力值和调整后的握力值较低。然而，需要更多的研究来确定肥胖患者握力的具体分界点。
{"title":"Valores de dinamometría absolutos y ajustados en pacientes con obesidad","authors":"Elena González Arnáiz , Juan José López Gómez , Diana Ariadel Cobo , Brisamar Estébanez , María García Duque , Carmen Dameto Pons , David Barajas Galindo , Diana García Sastre , Ana Urioste Fondo , María J. Cuevas , María D. Ballesteros Pomar","doi":"10.1016/j.endinu.2025.501560","DOIUrl":"10.1016/j.endinu.2025.501560","url":null,"abstract":"<div><h3>Background</h3><div>Hand grip strength — measured by dynamometry — is an essential tool in nutritional assessment, particularly for detecting sarcopenia, even before weight or muscle mass loss is evident. In individuals with obesity, hand grip strength can help identify muscle weakness that may not be apparent due to high body mass. The purpose of this study is to describe the absolute and adjusted hand grip strength values for weight, height, body mass index (BMI), and appendicular skeletal muscle mass (ASMM) in obese patients. It also aims to determine the prevalence of low muscle strength in this group of patients and to compare these results with those obtained in a healthy population.</div></div><div><h3>Material and Methods</h3><div>Prospective observational study including patients with obesity and healthy volunteers. Absolute and adjusted hand grip strength values for weight, height, BMI and appendicular muscle mass were determined in patients with obesity and compared with the results of healthy volunteers. Muscle strength was measured by hand grip strength according to Sánchez-Torralvo, Dodds, and <<!--> <!-->−2<!--> <!-->SD cut-off points of healthy reference population.</div></div><div><h3>Results</h3><div>The results obtained show that the absolute hand grip strength values are higher in healthy volunteers (30.7<!--> <!-->±<!--> <!-->10.5<!--> <!-->kg) vs patients with obesity (26.6<!--> <!-->±<!--> <!-->9.7<!--> <!-->kg); <em>P</em> <!--><<!--> <!-->.008. As for hand grip strength values adjusted for height, weight, BMI and ASMM, they are also statistically significantly higher in healthy volunteers (18.0<!--> <!-->±<!--> <!-->5.5 vs. 15.9<!--> <!-->±<!--> <!-->5.4, <em>P</em> <!--><<!--> <!-->.014; 05<!--> <!-->±<!--> <!-->0.10 vs. 0.2<!--> <!-->±<!--> <!-->0.06, <em>P</em> <!--><<!--> <!-->.001; 1.4<!--> <!-->±<!--> <!-->0.4 vs. 0.6<!--> <!-->±<!--> <!-->0.2, <em>P</em> <!--><<!--> <!-->.001; 1.5<!--> <!-->±<!--> <!-->0.2 vs. 0.9<!--> <!-->±<!--> <!-->0.3, <em>P</em> <!--><<!--> <!-->.001). According to sex, men had significantly higher absolute and adjusted hand grip strength values in both obese patients and healthy volunteers. The prevalence of low muscle strength in patients with obesity goes from 14.5% up and 23.4% depending on the cut-off points used, being higher with those of Sánchez-Torralvo's cut-off points. Based on sex distribution, obese men had a higher prevalence of low muscle strength with absolute hand grip strength values vs women, being these differences statistically significant only with the Sánchez-Torralvo's cut-off points. In terms of the prevalence of low muscle strength with adjusted hand grip strength values, more variable percentages (3.2%-96.8%) were observed without clear differences across sexes.</div></div><div><h3>Conclusions</h3><div>Hand grip strength values in obese patients vary according to absolute or adjusted measurements. Obese patients have lower absolute and adj","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 5","pages":"Article 501560"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2024-12-16DOI: 10.1016/j.endinu.2024.11.002
Juan J. Díez
{"title":"Nuevas opciones terapéuticas en el manejo del hipoparatiroidismo crónico","authors":"Juan J. Díez","doi":"10.1016/j.endinu.2024.11.002","DOIUrl":"10.1016/j.endinu.2024.11.002","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 5","pages":"Article 101532"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-03-10DOI: 10.1016/j.endinu.2025.501562
Fernando Garagoli , Walter Masson , Leandro Barbagelata , Martín Lobo
Objective
To evaluate the effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on the risk of major adverse limb events (MALE).
Methods
We conducted a systematic review and meta-analysis of randomized clinical trials assessing the effects of GLP-1RAs therapy on peripheral arterial disease (PAD)-related outcomes in patients with type 2 diabetes mellitus (T2DM). This meta-analysis was performed according to PRISMA guidelines. The random-effects model was performed.
Results
A total of 6 randomized clinical trials were considered eligible for this systematic review. On the other hand, 4 clinical trials were included for the meta-analysis. A total of 15,427 subjects were allocated to the GLP-1RAs group, and 15,476 to the placebo group. Overall, this meta-analysis showed that the use of GLP-1RAs is associated with a lower risk of PAD-related events (OR, 0.78; 95%CI, 0.62–0.98, I2 = 39%) vs the placebo group. The analytical evaluation did not suggest publication bias, and the sensitivity analysis demonstrated that the result was robust.
Conclusion
This meta-analysis demonstrated that the use of GLP-1RAs is associated with fewer PAD-related clinical events. Of note, despite the clinical significance of PAD, most analyzed studies did not specifically report on these events. Future studies should include PAD as a key endpoint. PROSPERO Registration: CRD42024565567.
{"title":"Effect of glucagon-like peptide-1 receptor agonists on the risk of major adverse limb events in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized clinical trials","authors":"Fernando Garagoli , Walter Masson , Leandro Barbagelata , Martín Lobo","doi":"10.1016/j.endinu.2025.501562","DOIUrl":"10.1016/j.endinu.2025.501562","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on the risk of major adverse limb events (MALE).</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized clinical trials assessing the effects of GLP-1RAs therapy on peripheral arterial disease (PAD)-related outcomes in patients with type 2 diabetes mellitus (T2DM). This meta-analysis was performed according to PRISMA guidelines. The random-effects model was performed.</div></div><div><h3>Results</h3><div>A total of 6 randomized clinical trials were considered eligible for this systematic review. On the other hand, 4 clinical trials were included for the meta-analysis. A total of 15,427 subjects were allocated to the GLP-1RAs group, and 15,476 to the placebo group. Overall, this meta-analysis showed that the use of GLP-1RAs is associated with a lower risk of PAD-related events (OR, 0.78; 95%CI, 0.62–0.98, <em>I</em><sup>2</sup> <!-->=<!--> <!-->39%) vs the placebo group. The analytical evaluation did not suggest publication bias, and the sensitivity analysis demonstrated that the result was robust.</div></div><div><h3>Conclusion</h3><div>This meta-analysis demonstrated that the use of GLP-1RAs is associated with fewer PAD-related clinical events. Of note, despite the clinical significance of PAD, most analyzed studies did not specifically report on these events. Future studies should include PAD as a key endpoint. PROSPERO Registration: CRD42024565567.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 5","pages":"Article 501562"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-03-12DOI: 10.1016/j.endinu.2025.501544
María Fernanda Reinoso Gomezcoello , Isabel Pavón de Paz , Cristina Navea Aguilera , Belén Gil Fournier , Ana María Bueno Sanchez , Guadalupe Guijarro de Armas , María Merino Viveros , Jose Antonio Rosado Sierra , Paloma Iglesias Bolaños , María Durán Martínez
Osteogenesis imperfecta (OI) is a rare inherited connective tissue disorder. It is characterized by short stature, fragility and decreased bone mass, which leads to multiple and recurrent fractures after low-energy trauma, which generates susceptibility to long bone deformity and vertebral compression. There are several types of OI, with types I to IV, in which the COL1A1 and COL1A2 genes are affected, being the most frequent. In recent years, the discovery of new forms of OI has led to research into the pathways critical aspects of bone metabolism, with new genes involved being identified. The mutation in IFITM5 has been identified as the cause of OI type V, of autosomal dominant inheritance. OI type V has distinctive clinical features including the developmentt of hypertrophic callus after fracture, early calcification of the interosseous membrane in the forearm, and the presence of hyperdense metaphyseal bands.
The case of a patient with a novo mutation in IFITM5 is presented.
{"title":"Osteogénesis imperfecta tipo V: a propósito de un caso clínico","authors":"María Fernanda Reinoso Gomezcoello , Isabel Pavón de Paz , Cristina Navea Aguilera , Belén Gil Fournier , Ana María Bueno Sanchez , Guadalupe Guijarro de Armas , María Merino Viveros , Jose Antonio Rosado Sierra , Paloma Iglesias Bolaños , María Durán Martínez","doi":"10.1016/j.endinu.2025.501544","DOIUrl":"10.1016/j.endinu.2025.501544","url":null,"abstract":"<div><div>Osteogenesis imperfecta (OI) is a rare inherited connective tissue disorder. It is characterized by short stature, fragility and decreased bone mass, which leads to multiple and recurrent fractures after low-energy trauma, which generates susceptibility to long bone deformity and vertebral compression. There are several types of OI, with types<!--> <!-->I to<!--> <!-->IV, in which the <em>COL1A1</em> and <em>COL1A2</em> genes are affected, being the most frequent. In recent years, the discovery of new forms of OI has led to research into the pathways critical aspects of bone metabolism, with new genes involved being identified. The mutation in <em>IFITM5</em> has been identified as the cause of OI type<!--> <!-->V, of autosomal dominant inheritance. OI type<!--> <!-->V has distinctive clinical features including the developmentt of hypertrophic callus after fracture, early calcification of the interosseous membrane in the forearm, and the presence of hyperdense metaphyseal bands.</div><div>The case of a patient with a novo mutation in <em>IFITM5</em> is presented.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 5","pages":"Article 501544"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-03-10DOI: 10.1016/j.endinu.2025.501564
Berta Bella Burgos , Ruben Carrera Salas , Ricard Onieva Carbajo , Catalina Padilla Navas , María del Carmen Ramos Guijo , Laura Escudero Larrá , Rosa María Rodríguez Millán , José Antonio Vázquez Luque , Silvia Hurtado Mas , Adrià Asensi Puig , Carmen María Blázquez Mañá , Santi Barcons Vilaplana , Ismail Capel Flores , Xavier Guirao Garriga , Víctor Pérez-Riverola , Mario Prenafeta Moreno , Neus Combalia Soriano , Ruth Orellana Fernández , Joan Carles Ferreres Piñas , María Rosa Bella-Cueto
Introduction
Since the C228T mutation in the TERT promoter (TERTp) has been identified almost exclusively in thyroid malignancies, our objective was to study the usefulness of its determination in thyroid fine needle aspirations (FNA) of the IV category of the Bethesda classification (B.IV).
Methodology
From the FNAs performed between 1993 and 2015, we selected those with a diagnosis of B.IV or equivalent and subsequent thyroidectomy. A retrospective study of the C228T mutation in TERTp was performed by pyrosequencing in neoplastic cases (adenomas, low risk neoplasms and carcinomas), both from the surgical specimen and from the FNA material if feasible.
Results
79 cases with a diagnosis of B.IV were identified, and mutational study was performed in the 61 cases corresponding to neoplasms, identifying 10 cases with the mutation (12.6% of the series), with a higher presence in Poorly Differentiated Carcinomas (PDC) or with a minor PDC component (45%), in cases with death attributable to thyroid carcinoma (50%) and in patients alive but with persistence of thyroid carcinoma (50%). The mutation was confirmed in 7 of 8 cases with the mutation and satisfactory cytological material. In 4 cases, preoperative knowledge of the mutation could have avoided a two-stage thyroidectomy.
Conclusion
The study of the C228T mutation of TERTp can be useful to detect malignancy and establish the best surgical approach in patients with thyroid FNA with a diagnosis of B.IV.
{"title":"Estudio de la mutación C228T del promotor de TERT en punciones aspirativas tiroideas de la categoría IV de la clasificación de Bethesda","authors":"Berta Bella Burgos , Ruben Carrera Salas , Ricard Onieva Carbajo , Catalina Padilla Navas , María del Carmen Ramos Guijo , Laura Escudero Larrá , Rosa María Rodríguez Millán , José Antonio Vázquez Luque , Silvia Hurtado Mas , Adrià Asensi Puig , Carmen María Blázquez Mañá , Santi Barcons Vilaplana , Ismail Capel Flores , Xavier Guirao Garriga , Víctor Pérez-Riverola , Mario Prenafeta Moreno , Neus Combalia Soriano , Ruth Orellana Fernández , Joan Carles Ferreres Piñas , María Rosa Bella-Cueto","doi":"10.1016/j.endinu.2025.501564","DOIUrl":"10.1016/j.endinu.2025.501564","url":null,"abstract":"<div><h3>Introduction</h3><div>Since the C228T mutation in the <em>TERT</em> promoter (<em>TERTp</em>) has been identified almost exclusively in thyroid malignancies, our objective was to study the usefulness of its determination in thyroid fine needle aspirations (FNA) of the IV category of the Bethesda classification (B.IV).</div></div><div><h3>Methodology</h3><div>From the FNAs performed between 1993 and 2015, we selected those with a diagnosis of B.IV or equivalent and subsequent thyroidectomy. A retrospective study of the C228T mutation in <em>TERTp</em> was performed by pyrosequencing in neoplastic cases (adenomas, low risk neoplasms and carcinomas), both from the surgical specimen and from the FNA material if feasible.</div></div><div><h3>Results</h3><div>79 cases with a diagnosis of B.IV were identified, and mutational study was performed in the 61 cases corresponding to neoplasms, identifying 10 cases with the mutation (12.6% of the series), with a higher presence in Poorly Differentiated Carcinomas (PDC) or with a minor PDC component (45%), in cases with death attributable to thyroid carcinoma (50%) and in patients alive but with persistence of thyroid carcinoma (50%). The mutation was confirmed in 7 of 8 cases with the mutation and satisfactory cytological material. In 4 cases, preoperative knowledge of the mutation could have avoided a two-stage thyroidectomy.</div></div><div><h3>Conclusion</h3><div>The study of the C228T mutation of <em>TERTp</em> can be useful to detect malignancy and establish the best surgical approach in patients with thyroid FNA with a diagnosis of B.IV.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 5","pages":"Article 501564"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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