Endocrinologia, Diabetes y Nutricion最新文献

{"title":"Beyond the transtubular potassium gradient: Alternative urinary markers for diagnosing hypoaldosteronism","authors":"Jorge Gabriel Ruiz-Sánchez ,&nbsp;Alfonso Luis Calle-Pascual ,&nbsp;Miguel Ángel Rubio-Herrera ,&nbsp;María Paz De Miguel Novoa ,&nbsp;Emilia Gómez-Hoyos ,&nbsp;Isabelle Runkle","doi":"10.1016/j.endinu.2025.501686","DOIUrl":"10.1016/j.endinu.2025.501686","url":null,"abstract":"<div><h3>Background</h3><div>The transtubular potassium gradient (TTKG) is a widely accepted tool for assessing mineralocorticoid activity in hyperkalemia. However, its clinical utility is often limited due to the unavailability of urine osmolality. Identifying alternative, more accessible urinary indices could improve diagnostic performance in suspected hypoaldosteronism.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study including 106 hyperkalemic patients with hypoaldosteronism referred to Endocrinology Department. Through correlation analyses using Spearman's <em>ρ</em> and Pearson's <em>r</em>, we assessed the relationship between TTKG values and the urinary potassium-to-serum potassium ratio (UK⁺/SK⁺), the urinary potassium-to-creatinine ratio (UK⁺/creatinine), the fractional excretion of potassium (FEK), and the urinary sodium-to-potassium ratio (UNa⁺/UK).</div></div><div><h3>Results</h3><div>Mean age, 74<!--> <!-->±<!--> <!-->12 years; mean TTKG, 3.8<!--> <!-->±<!--> <!-->1.2, and UK⁺/creatinine, 62<!--> <!-->±<!--> <!-->28<!--> <!-->mmol/g. Median UNa⁺/UK⁺, 2.78 [1.81–3.72]; UK⁺/SK⁺, 5.1 [4–6.8]; FEK, 12.9% [7–18.9]. TTKG showed a strong positive correlation with UK⁺/SK⁺ (<em>ρ</em> <!-->=<!--> <!-->0.706; <em>p</em> <!-->&lt;<!--> <!-->0.001) and FEK (<em>ρ</em> <!-->=<!--> <!-->0.585; <em>p</em> <!-->&lt;<!--> <!-->0.001), and a moderate correlation with UK⁺/creatinine (<em>r</em> <!-->=<!--> <!-->0.352; <em>p</em> <!-->=<!--> <!-->0.011). An inverse strong correlation was observed with UNa⁺/UK⁺ (<em>ρ</em> <!-->=<!--> <!-->−0.655; <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>UK⁺/SK, UK⁺/creatinine, FEK, and UNa⁺/UK⁺ seem to be practical alternatives for assessing renal potassium excretion in hyperkalemia associated with hypoaldosteronism. Further studies are warranted to validate these findings in larger and diverse cohorts.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 3","pages":"Article 501686"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412155","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}

{"title":"Outcomes of a population-based flash glucose monitoring program in adults with type 2 diabetes mellitus on intensive insulin therapy in Andalusia","authors":"Mercedes Peinado Ruíz ,&nbsp;Beatriz Rodríguez Jiménez ,&nbsp;Pablo Rodríguez de Vera Gómez ,&nbsp;Nieves Lafuente Robles ,&nbsp;Rafael Palomares Ortega ,&nbsp;Francisco José Sánchez-Laguna ,&nbsp;Inmaculada Vázquez Cruz ,&nbsp;Eduardo Mayoral Sánchez ,&nbsp;María Jesús Sanchez-Alvarez ,&nbsp;Celia Fernandez-Delgado ,&nbsp;Ismael Muñoz Martínez ,&nbsp;María Asunción Martínez-Brocca","doi":"10.1016/j.endinu.2025.501661","DOIUrl":"10.1016/j.endinu.2025.501661","url":null,"abstract":"<div><div>The implementation of flash glucose monitoring (FGM) in people with type 2 diabetes mellitus (T2DM) undergoing intensive insulin therapy represents an organizational challenge for health care systems.</div></div><div><h3>Objective</h3><div>To evaluate the outcomes of the FGM system rollout in adults with T2DM within the Andalusian Public Health System.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional, population-based descriptive study in Andalusia (Spain), analyzing the shared care model between Primary Care (PC) and Hospital Care (HC) for the implementation of FGM systems in adult patients with T2DM on intensive basal-bolus insulin therapy, 34 months after starting the program (program duration: from April 2022 to February 2025).</div></div><div><h3>Results</h3><div>A total of 25,052 active FGM users were identified (48.6% women; mean age, 69.0<!--> <!-->±<!--> <!-->12.8 years) out of an estimated target population of 29,979 patients. The main indications for FGM use were functional disability or dependency (<em>n</em> <!-->=<!--> <!-->4283; 17%), severe hypoglycemia (<em>n</em> <!-->=<!--> <!-->1899; 7.4%), pregestational T2DM (<em>n</em> <!-->=<!--> <!-->266; 1%), and frequent non-severe hypoglycemia (<em>n</em> <!-->=<!--> <!-->9104; 36.2%). The remaining cohort (<em>n</em> <!-->=<!--> <!-->9683; 38.4%) included individuals without prioritization criteria. The main indication setting was PC, where 23,669 devices (80.2%) were initiated. The permanent discontinuation rate was 15%, with no serious adverse events being reported. A total of 9185 active users (36.4%) had their glucose monitoring data integrated into the electronic health record (EHR) of the Andalusian Public Health System.</div></div><div><h3>Conclusions</h3><div>Coordinated action across health care levels is an effective strategy for equitable access to technologies such as FGM among Andalusian patients with T2DM on intensive insulin therapy. Integration of glucose data into the EHR is a key tool for ensuring continuity of care.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501661"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102440","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}

{"title":"Metástasis ovárica en mujer joven con carcinoma folicular de tiroides: diagnóstico diferencial con struma ovarii","authors":"Dolores Tejedo-Flors ,&nbsp;Thalía Argüello-Gordillo ,&nbsp;Elena Argente-Martínez ,&nbsp;Beatriz López-Muñoz ,&nbsp;Pedro López-Mondéjar","doi":"10.1016/j.endinu.2025.501676","DOIUrl":"10.1016/j.endinu.2025.501676","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501676"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102447","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}

{"title":"Segunda edición de las recomendaciones para «no hacer» de la Sociedad Española de Endocrinología y Nutrición (SEEN)","authors":"Juan José Díez ,&nbsp;Manuel Gargallo Fernández ,&nbsp;José Antonio Gimeno Orna ,&nbsp;Elena González Arnaiz ,&nbsp;Isabel Huguet Moreno ,&nbsp;Sílvia Martínez Couselo ,&nbsp;María Miguélez González ,&nbsp;María Julia Ocón ,&nbsp;Gilberto Pérez López ,&nbsp;Francisco Pita Gutiérrez ,&nbsp;Jordi Luis Reverter Calatayud ,&nbsp;Cristina Tejera Pérez ,&nbsp;Eulàlia Urgell Rull ,&nbsp;Alberto Fernández","doi":"10.1016/j.endinu.2025.501687","DOIUrl":"10.1016/j.endinu.2025.501687","url":null,"abstract":"<div><div>Low-value clinical practices —defined as diagnostic or therapeutic interventions that provide limited clinical benefit and may be associated with unnecessary risks or costs— remain common in endocrinology and nutrition. The Spanish Society of Endocrinology and Nutrition (SEEN) presents this second edition as an updated set of recommendations on “what not to do” in clinical practice, developed by its sections and working groups. The methodological process included the selection of relevant topics, systematic literature review, and multidisciplinary consensus. Key areas addressed include diabetes, obesity, nutrition, gonads, lipids, laboratory, mineral metabolism, and imaging, identifying low-value interventions and offering alternatives based on the best available evidence. The implementation of these recommendations aims to optimize care quality, reduce risks, and contribute to the sustainability of the healthcare system.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501687"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102445","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}

{"title":"Prevalencia, incidencia y marcadores de riesgo ocupacionales de dislipidemias en trabajadores peruanos","authors":"Jhosmer Ballena-Caicedo ,&nbsp;Fiorella E. Zuzunaga-Montoya ,&nbsp;Juan Carlos Bustamante-Rodríguez ,&nbsp;Nataly Mayely Sanchez-Tamay ,&nbsp;Luisa Erika Milagros Vásquez-Romero ,&nbsp;Joan A. Loayza-Castro ,&nbsp;Carmen Inés Gutierrez De Carrillo ,&nbsp;Víctor Juan Vera-Ponce","doi":"10.1016/j.endinu.2025.501672","DOIUrl":"10.1016/j.endinu.2025.501672","url":null,"abstract":"<div><h3>Introduction</h3><div>Dyslipidemias are a significant risk factor for cardiovascular diseases. In Peru, nutritional transition and lifestyle changes may be contributing to an increase in the incidence of these metabolic disorders, particularly among the working population.</div></div><div><h3>Objective</h3><div>To determine the incidence of dyslipidemias and evaluate associated occupational factors in Peruvian workers.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using electronic medical records from 4,200 workers attending an occupational health clinic between 2013 and 2022. Incidence rates of hypertriglyceridemia, hypercholesterolemia, and combined dyslipidemia were calculated. Specific occupational factors (type of work, sitting time, and night shift work) were analyzed using Cox regression models adjusted for age (with splines) and sex.</div></div><div><h3>Results</h3><div>The incidence of hypercholesterolemia (87.22 cases per 1,000 person-years; 95% CI: 79.99–94.45) was significantly higher than that of hypertriglyceridemia (65.71 cases per 1,000 person-years; 95% CI: 59.71–71.72). Combined dyslipidemia showed an incidence of 48.28 cases per 1,000 person-years (95% CI: 43.60–52.97). Workers in social services had a higher risk of developing dyslipidemias (aHR: 1.78; 95% CI: 1.27–2.49) compared to office workers. Prolonged sitting time (&gt;4<!--> <!-->hours) was significantly associated with an increased risk of hypertriglyceridemia (aHR: 1.28; 95% CI: 1.05–1.56) and combined dyslipidemia (aHR: 1.42; 95% CI: 1.15–1.76).</div></div><div><h3>Conclusions</h3><div>The high incidence of dyslipidemias—particularly hypercholesterolemia—may reflect the increasing consumption of ultra-processed foods and the ongoing nutritional transition in the Peruvian population. Occupational factors play a crucial role in the development of these metabolic disorders, highlighting the need for specific preventive strategies in the workplace.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501672"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102441","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}

{"title":"Hipogonadismo hipogonadotropo familiar: cuando dos mutaciones se encuentran","authors":"Luis Muñoz Arenas,&nbsp;Mercedes Senent Capote,&nbsp;Javier Olmedo Pérez-Montaut,&nbsp;Antonio Ballesteros Martín-Portugués,&nbsp;Esteban Sánchez-Toscano,&nbsp;Maria Gloria Baena-Nieto","doi":"10.1016/j.endinu.2025.501675","DOIUrl":"10.1016/j.endinu.2025.501675","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501675"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102446","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}

{"title":"Influence of oncostatin M and leukemia inhibitor factor on sarcopenia in individuals with cancer and malnutrition","authors":"Daniel de Luis,&nbsp;David Primo,&nbsp;Olatz Izaola,&nbsp;Juan José López Gómez","doi":"10.1016/j.endinu.2025.501677","DOIUrl":"10.1016/j.endinu.2025.501677","url":null,"abstract":"<div><h3>Objectives</h3><div>Oncostatin-M (OSM) and leukemia inhibitor factor (LIF) have shown relationship with muscle catabolism in Disease Related Malnutrition (DRM). We aimed to investigate the role of OSM and LIF in sarcopenia among patients with cancer and DRM.</div></div><div><h3>Design and methods</h3><div>33 cancer patients with DRM were included. Muscle mass assessment via ultrasound at the rectus femoris (RF) level, bioimpedance (skeletal muscle mass (SMM), appendicular SMM (aSMM), and the aSMM index (aSMMI)), and circulating OSM and LIF levels were evaluated. Confirmed sarcopenia was diagnosed based on the criteria of low muscle strength combined with an abnormal aSMMI.</div></div><div><h3>Results</h3><div>The average age was 66.5<!--> <!-->±<!--> <!-->15.5 years. The gender distribution was 16 females (48.5%) and 17 males (51.5%). Sixteen patients (48.5%) were diagnosed with sarcopenia. Patients with sarcopenia showed worse values: phase angle (−0.4<!--> <!-->±<!--> <!-->0.1°; <em>p</em> <!-->=<!--> <!-->0.01), reactance (−4.9<!--> <!-->±<!--> <!-->1.8<!--> <!-->Ω; <em>p</em> <!-->=<!--> <!-->0.03), SMM (−2.0<!--> <!-->±<!--> <!-->0.3<!--> <!-->kg; <em>p</em> <!-->=<!--> <!-->0.03), aSMM (−1.6<!--> <!-->±<!--> <!-->0.2<!--> <!-->kg; <em>p</em> <!-->=<!--> <!-->0.03), aSMMI (−0.6<!--> <!-->±<!--> <!-->0.2<!--> <!-->kg/m²; <em>p</em> <!-->=<!--> <!-->0.02), muscle area RF (−0.7<!--> <!-->±<!--> <!-->0.2<!--> <!-->cm²; <em>p</em> <!-->=<!--> <!-->0.04), <em>Y</em>-axis RF (−0.4<!--> <!-->±<!--> <!-->0.1<!--> <!-->cm; <em>p</em> <!-->=<!--> <!-->0.03), muscle strength (−8.1<!--> <!-->±<!--> <!-->1.5<!--> <!-->kg; <em>p</em> <!-->=<!--> <!-->0.01) and albumin levels (−0.3<!--> <!-->±<!--> <!-->0.1<!--> <!-->g/dl; <em>p</em> <!-->=<!--> <!-->0.03). Circulating levels of OSM and LIF were elevated in patients with sarcopenia, with values of 10.6<!--> <!-->±<!--> <!-->1.3<!--> <!-->pg/ml (<em>p</em> <!-->=<!--> <!-->0.01) and 6.4<!--> <!-->±<!--> <!-->2.3<!--> <!-->pg/ml (<em>p</em> <!-->=<!--> <!-->0.02), respectively. Logistic regression analysis indicated a significant OR (odds ratio) of sarcopenia associated with elevated median levels of OSM (OR<!--> <!-->=<!--> <!-->3.6, 95% CI<!--> <!-->=<!--> <!-->1.4–9.9; <em>p</em> <!-->=<!--> <!-->0.01) and LIF-1 (OR<!--> <!-->=<!--> <!-->3.3, 95% CI<!--> <!-->=<!--> <!-->1.3–10.1; <em>p</em> <!-->=<!--> <!-->0.01)</div></div><div><h3>Conclusion</h3><div>High levels of serum OSM and LIF-1 were closely associated with sarcopenia in patients with cancer and DRM.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501677"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102443","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}

{"title":"ATA 2025: Menos es más—Implicaciones prácticas para el manejo del cáncer diferenciado de tiroides","authors":"Garcilaso Riesco Eizaguirre ,&nbsp;Emma Anda Apiñániz ,&nbsp;Cecilia Sánchez Ragnarsson ,&nbsp;Jordi Lluis Reverter Calatayud ,&nbsp;Carles Zafon","doi":"10.1016/j.endinu.2026.501760","DOIUrl":"10.1016/j.endinu.2026.501760","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501760"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102448","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}

{"title":"New cortisol assay-specific thresholds for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation","authors":"Pablo Fernández Velasco ,&nbsp;Lucia Estévez Asensio ,&nbsp;Beatriz Torres Torres ,&nbsp;Ana Ortolá Buigues ,&nbsp;Emilia Gómez Hoyos ,&nbsp;Esther Delgado García ,&nbsp;Daniel de Luis Román ,&nbsp;Gonzalo Díaz Soto","doi":"10.1016/j.endinu.2025.501685","DOIUrl":"10.1016/j.endinu.2025.501685","url":null,"abstract":"<div><h3>Purpose</h3><div>Adrenal insufficiency (AI) is traditionally diagnosed using the corticotropin stimulation test (CST) with a cortisol threshold of 18.0<!--> <!-->μg/dL. However, newer immunoassays suggest revising this threshold to enhance diagnostic accuracy. This study aimed to evaluate the diagnostic performance of baseline cortisol (CB) and stimulated cortisol levels at 30<!--> <!-->min (C30<!--> <!-->min) and 60<!--> <!-->min (C60<!--> <!-->min) post-CST, using a revised threshold of 15.6<!--> <!-->μg/dL.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed a total of 140 patients with suspected AI who underwent CST from 2016 to 2022. Demographic, clinical, and biochemical data were collected. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis to compare the performance of the traditional 18.0<!--> <!-->μg/dL threshold with the proposed 15.6<!--> <!-->μg/dL cutoff.</div></div><div><h3>Results</h3><div>The study population had a mean age of 45.6<!--> <!-->±<!--> <!-->19.3 years (68.6%, women). Mean cortisol levels were CB 12.3<!--> <!-->±<!--> <!-->5.7<!--> <!-->μg/dL, C30<!--> <!-->min 20.2<!--> <!-->±<!--> <!-->6.7<!--> <!-->μg/dL, and C60<!--> <!-->min 22.9<!--> <!-->±<!--> <!-->7.8<!--> <!-->μg/dL. A strong correlation was observed between CB and maximum stimulated cortisol (<em>R</em> <!-->=<!--> <!-->0.610, <em>p</em> <!-->=<!--> <!-->0.0003.) The revised 15.6<!--> <!-->μg/dL threshold reduced false-positive diagnoses by 17.9% (<em>p</em> <!-->=<!--> <!-->0.029). ROC analysis demonstrated high diagnostic accuracy for CB (AUC, 0.901), with CB<!--> <!-->&gt;<!--> <!-->13.1<!--> <!-->μg/dL predicted a normal response, and CB<!--> <!-->&lt;<!--> <!-->1.5<!--> <!-->μg/dL was always suggestive of pathology.</div></div><div><h3>Conclusion</h3><div>The revised 15.6<!--> <!-->μg/dL cortisol threshold enhances CST diagnostic accuracy by reducing false positives and avoiding unnecessary glucocorticoid therapy. Additionally, CB alone showed strong predictive value, and a single C30<!--> <!-->min measurement may be sufficient for diagnosis in most cases. Further validation studies across different immunoassay platforms are necessary.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501685"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102444","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}

{"title":"Incidentally vs nonincidentally diagnosed paragangliomas: Experience of a tertiary referral center","authors":"Patrícia Ferreira ,&nbsp;Sara Ribeiro ,&nbsp;Inês Meira ,&nbsp;Marta Canha ,&nbsp;Diana Festas Silva ,&nbsp;Joana Queirós","doi":"10.1016/j.endinu.2025.501673","DOIUrl":"10.1016/j.endinu.2025.501673","url":null,"abstract":"<div><h3>Purpose</h3><div>Incidental detection of paragangliomas (PGLs) is increasing due to the increased use and advancements in imaging modalities. Therefore, its clinical presentation is changing. We aimed to compare the clinical characteristics of incidentally discovered PGLs with the clinically suspected.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study with patients diagnosed with PGLs between 2004 and 2023 at a tertiary referral center. Our cohort was divided into 2 groups: clinically suspected PGLs and incidentally discovered PGLs. Data on age, tumor location, size, symptoms, metastasis, and genetic testing were collected and compared between the groups. A subgroup analysis was conducted to evaluate adrenal and extra-adrenal PGLs separately.</div></div><div><h3>Results</h3><div>Of the 140 included patients, 64.3% were diagnosed incidentally and 35.7% through clinical suspicion. Incidentalomas were older at diagnosis (54.6<!--> <!-->±<!--> <!-->16.3 vs 46.2<!--> <!-->±<!--> <!-->16.5 years; <em>p</em> <!-->=<!--> <!-->0.002) and had smaller tumors (4.5<!--> <!-->±<!--> <!-->2.5<!--> <!-->cm vs 5.4<!--> <!-->±<!--> <!-->2.4<!--> <!-->cm; <em>p</em> <!-->=<!--> <!-->0.030). Clinically suspected cases were more likely to have metastatic disease (16.3% vs 3.5%; <em>p</em> <!-->=<!--> <!-->0.009) and exhibit classic symptoms, including palpitations (44.7% vs 8.4%; <em>p</em> <!-->&lt;<!--> <!-->0.001), sweating (29.8% vs 7.2%; <em>p</em> <!-->&lt;<!--> <!-->0.001), and headaches (29.8% vs 9.6%; <em>p</em> <!-->=<!--> <!-->0.003). In addition, sustained hypertension was more common in the clinically suspected group (68.8% vs 47.1%; <em>p</em> <!-->=<!--> <!-->0.016). In extra-adrenal PGLs, differences in tumor size and metastatic rates were more pronounced. Genetic testing showed a higher prevalence of mutations in the clinically suspected group (75% vs 47.6%; <em>p</em> <!-->=<!--> <!-->0.003).</div></div><div><h3>Conclusions</h3><div>This study supports the shift in the predominant mode of paraganglioma presentation toward incidental findings. Enhanced recognition and proper follow up will refine the management of paragangliomas and ultimately improve patient outcomes.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 2","pages":"Article 501673"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102442","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}