Endocrinologia, Diabetes y Nutricion最新文献

英文中文

The overweight and obesity landscape in Spain: Data from the Spanish cohort of the multi-country IMPACT-O study 西班牙的超重和肥胖状况：来自多国IMPACT-O研究的西班牙队列数据

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501643

Irene Breton , Igotz Aranbarri , Anastasia Lampropoulou , Jennifer Redondo-Antón , Javier Ágreda , Atif Adam , Esther Artime

Introduction

The epIdeMiology landscape PAtient Care paThways of Obesity (IMPACT-O) study was a multi-country, retrospective cohort study that utilised healthcare databases to determine the landscape/impact of overweight and obesity. Here we describe the sociodemographic, clinical and treatment characteristics of adults with a first record of overweight/obesity or obesity in Spain between 2018 and 2022.

Materials and methods

The IQVIA longitudinal patient database in Spain was used to identify individuals with a first record of overweight/obesity, as determined by diagnosis codes and/or body mass index (BMI) measurements (overweight/obesity cohort: BMI ≥25 kg/m²; obesity cohort: BMI ≥30 kg/m²), in the years 2018–2022. Demographic and clinical parameters, including obesity-related complications (ORCs), as recorded by primary care providers and specialists contributing to the database, were described.

Results

The overweight/obesity cohort included 25,016 individuals, and the obesity cohort 13,441 individuals. Most individuals with overweight/obesity (60.1%) and obesity (63.6%) presented with ≥1 ORCs. The most frequent ORCs among people with obesity were hypertension (25.3%), dyslipidaemia (19.8%), anxiety (19.0%), osteoarthritis (14.3%), low-back pain (10.9%) and depression (10.9%). The proportion of individuals receiving pharmacological therapies with an effect on weight was <1%. There were no records of lifestyle interventions or bariatric surgery in the database for this population.

Conclusions

This study highlights the high ORC burden at first documented diagnosis of overweight/obesity. Very few individuals with obesity in Spain receive pharmacological treatment with an effect on weight. Patient management could be improved by systematically recording all interventions in this population.

肥胖症患者护理路径的流行病学景观（impact - o）研究是一项多国回顾性队列研究，利用医疗保健数据库确定超重和肥胖症的景观/影响。在这里，我们描述了2018年至2022年间西班牙首次有超重/肥胖或肥胖记录的成年人的社会人口学、临床和治疗特征。材料和方法采用西班牙IQVIA纵向患者数据库，通过诊断代码和/或体重指数（BMI）测量（超重/肥胖队列：BMI≥25 kg/m2；肥胖队列：BMI≥30 kg/m2）确定2018-2022年间首次有超重/肥胖记录的个体。描述了由初级保健提供者和提供数据库的专家记录的人口统计学和临床参数，包括肥胖相关并发症（ORCs）。结果超重/肥胖组包括25,016人，肥胖组包括13,441人。大多数超重/肥胖（60.1%）和肥胖（63.6%）患者的orc≥1。肥胖人群中最常见的orc是高血压（25.3%）、血脂异常（19.8%）、焦虑（19.0%）、骨关节炎（14.3%）、腰痛（10.9%）和抑郁症（10.9%）。接受药物治疗对体重有影响的个体比例为1%。数据库中没有针对这一人群的生活方式干预或减肥手术的记录。结论：本研究强调了超重/肥胖首次确诊时的高ORC负担。在西班牙，很少有肥胖者接受对体重有影响的药物治疗。通过系统地记录该人群的所有干预措施，可以改善患者管理。

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引用次数: 0

Pembrolizumab-induced dual endocrine disruption: A case report 派姆单抗诱导双内分泌干扰1例

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501630

María Carmen Dameto Pons, Elena González Arnáiz, María Antequera González, Xavier F. Pérez Candel, Diana Ariadel Cobo, Javier Castañón Alonso, María D. Ballesteros Pomar

Immunotherapy is an increasingly used treatment for different types of cancer. The most widely used are cytotoxic T-lymphocyte antigen 4 (CTLA-4) inhibitors, PD-1 ligand (PD-L1) inhibitors and PD-1 receptor inhibitors. All of them can produce endocrine autoimmune side effects in multiple organs. The most frequent are thyroid disorders and hypophysitis although, less frequently, they can also cause autoimmune adrenalitis and autoimmune diabetes. Thyroid involvement is usually transient but can become chronic in the form of hypothyroidism in more than 50% of cases. Diabetes is due to autoimmune destruction of pancreatic β-cells, in many cases abrupt and irreversible. The 2 entities occur more frequently with PD-1 or PD-L1 inhibitors. This is the case of a patient with cutaneous melanoma on pembrolizumab who simultaneously developed thyroiditis and fulminant autoimmune diabetes.

免疫疗法越来越多地用于治疗不同类型的癌症。应用最广泛的是细胞毒性t淋巴细胞抗原4 （CTLA-4）抑制剂、PD-1配体（PD-L1）抑制剂和PD-1受体抑制剂。它们都能在多个器官产生内分泌自身免疫性副作用。最常见的是甲状腺疾病和垂体炎，尽管不太常见，它们也可以引起自身免疫性肾上腺炎和自身免疫性糖尿病。甲状腺受累通常是短暂的，但在50%以上的病例中可发展为慢性甲状腺功能减退。糖尿病是由于自身免疫性胰腺β细胞的破坏，在许多情况下是突然的和不可逆的。这两种情况在PD-1或PD-L1抑制剂中更常见。这是一位接受派姆单抗治疗的皮肤黑色素瘤患者同时发展为甲状腺炎和暴发性自身免疫性糖尿病。

引用次数: 0

Reversión de bypass gastroileal como tratamiento de hiperparatiroidismo yatrogénico e hipocalcemia refractaria 逆转胃分流术，用于治疗肌源性甲状旁腺增生和难治性低钙血症

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501632

Bryan-Josué Flores-Robles , Juan Antonio López Martín , María Jesús Chinchetru Ranedo , José Miguel Lázaro Guevara , José Fernando Marín Díez , Núria Guañabens

引用次数: 0

La decisión ineludible de las sociedades médicas: deriva comercial o integridad 医学界不可避免的选择：商业漂移还是诚信

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501730

Ildefonso Hernández-Aguado , Elisa Chilet-Rosell

引用次数: 0

Enfermedad del ojo de pez. Alteración del metabolismo HDL colesterol y afectación corneal: a propósito de un caso 鱼眼疾病。高密度脂蛋白胆固醇代谢紊乱和角膜病变：以案例为例

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501638

Ana Álvarez ODogherty , Carmen Rodríguez Jiménez , Amaya Belanger-Quintana , Sonia Rodríguez Novoa , Francisco Arrieta Blanco

引用次数: 0

Consenso Delphi del Área de Nutrición de la SEEN (NutriSEEN) sobre el empleo de la nutrición enteral por sonda en las personas con demencia avanzada SEEN营养领域的Delphi共识（NutriSEEN）关于在晚期痴呆患者中使用探索性肠内营养

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501640

Francisco Pita Gutiérrez , Irene Breton Lesmes , Julia Álvarez Hernández , María D. Ballesteros-Pomar , Rocío Campos del Portillo , Ana Hernández Moreno , Francisco Botella Romero

Introduction

Despite the available scientific evidence, the use of enteral tube feeding in people with advanced dementia is currently controversial. Given this situation, and following the position paper promoted by the SEEN (Spanish Society of Endocrinology and Nutrition), a consensus is sought to contribute to improving the management of this condition.

Material and methods

A Delphi consultation was conducted, a formal and systematic method for obtaining consensus. The project was developed in the following stages: 1) questionnaire development by the Scientific Committee; 2) first round of Delphi consultation; 3) second round of Delphi consultation, and 4) a meeting to present the results.

Results

A total of 340 expert members of the SEEN Nutrition Department were invited to participate through the society itself. Of these, 128 panellists completed the questionnaire in the first round (response rate of 38%) and 53 in the second round (response rate of 41%, compared to the first round). Of the 24 statements initially proposed, 14 (58%) reached consensus. Of these, 13 achieved this goal in the first round and one in the second.

Conclusions

Advanced dementia represents a significant challenge for both healthcare professionals and patients’ families, raising ethical and practical dilemmas regarding appropriate treatment and management to improve the quality of life of those affected. This paper draws several key conclusions that can guide the care and attention of these patients.

尽管已有科学证据，但在晚期痴呆患者中使用肠内管喂养目前仍存在争议。鉴于这种情况，并遵循西班牙内分泌与营养学会（西班牙内分泌与营养学会）的立场文件，寻求共识，以促进改善这种情况的管理。材料与方法进行德尔菲咨询，这是一种获得共识的正式、系统的方法。该项目分为以下几个阶段：1)科学委员会编制问卷；2)第一轮德尔菲咨询；3)第二轮德尔菲咨询，4)会议介绍结果。结果通过协会邀请我院营养科专家共340人参加。其中，128名小组成员在第一轮完成问卷（回复率为38%），53名小组成员在第二轮完成问卷（回复率为41%，与第一轮相比）。在最初提出的24项声明中，14项（58%）达成了共识。其中，13人在第一轮达到了这一目标，1人在第二轮达到了这一目标。结论：晚期痴呆对医疗专业人员和患者家属来说都是一个重大挑战，在适当的治疗和管理方面提出了伦理和实践难题，以提高患者的生活质量。本文得出了几个关键结论，可以指导这些患者的护理和注意。

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引用次数: 0

Estado actual de la yodación en gestantes asturianas 阿斯图里亚孕妇的碘化状况

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501646

Carmen Sánchez Blanco , Marina García Cancelo , Cristina González Martínez , Leire Cardo González , Marta Diéguez Felechosa

Introduction

Although former studies indicated that Asturias (Spain) is an iodine-sufficient region, preliminary data suggest this trend may be changing.

Objective

To determine the prevalence of iodine deficiency in pregnant women in Asturias.

Material and methods

We designed an observational, prospective, multicenter study. The urinary iodine concentration of 371 pregnant women was analyzed between November 2021 and March 2023. Participants were recruited from the 3 central areas of the Principality of Asturias (Areas III, IV and V). The project received approval from the Research Ethics Committee of the Principality of Asturias.

Results

A total of 52% of pregnant women had urinary iodine levels indicative of iodine deficiency (<150 μg/L). The average urinary iodine concentration in our cohort was 146 μg/L. We compared thyroid-stimulating hormone levels between pregnant women with iodine deficiency and those with sufficient iodine, but found no statistically significant differences in thyroid-stimulating hormone levels between the 2 groups. We also couldn’t establish statistically significant links between iodine deficiency status and body mass index, number of previous births, nationality, or age. Furthermore, iodine deficiency did not show a significant link to obstetric complications such such as hypertension during pregnancy or premature birth.

Conclusions

These findings support the hypothesis of an increase in iodine deficiency during the first trimester of pregnancy in our population. This highlights the urgent need to review our supplementation strategies and nutritional education programs.

虽然以前的研究表明阿斯图里亚斯（西班牙）是一个碘充足的地区，但初步数据表明这一趋势可能正在改变。目的了解阿斯图里亚斯地区孕妇碘缺乏症的患病率。材料和方法我们设计了一项观察性、前瞻性、多中心研究。分析了2021年11月至2023年3月期间371名孕妇的尿碘浓度。参与者从阿斯图里亚斯公国的3个中心地区（区III、区IV和区V）招募。该项目获得了阿斯图里亚斯公国研究伦理委员会的批准。结果52%的孕妇尿碘水平提示缺碘（150 μg/L）。我们的队列平均尿碘浓度为146 μg/L。我们比较了碘缺乏孕妇和碘充足孕妇的促甲状腺激素水平，但发现两组之间促甲状腺激素水平无统计学差异。我们也不能在统计上确定碘缺乏状况与体重指数、以前出生的数量、国籍或年龄之间的显著联系。此外，缺碘没有显示出与妊娠期高血压或早产等产科并发症有显著联系。结论：这些发现支持了在我们的人群中，在怀孕的前三个月碘缺乏症增加的假设。这凸显了我们迫切需要审查我们的补充策略和营养教育计划。

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引用次数: 0

The impact of microscopic extrathyroidal extension on the prognosis of medullary thyroid carcinoma: A multicenter cohort study 镜下甲状腺外展对甲状腺髓样癌预后的影响：一项多中心队列研究

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-12-01 DOI: 10.1016/j.endinu.2025.501633

Beyza Olcay Ozturk , Umran Keskin , Serhat Uysal , Aysa Hacioglu , Seda Karsli , Burak Andac , Umit Nur Ozbay , Hulyanur Sodan , Sebnem Burhan , Coskun Ates , Ugur Avci , Faruk Kilinc , Selvinaz Erol , Merve Catak , Zafer Pekkolay , Gulhan Akbaba , Goknur Yorulmaz , Sakin Tekin , Birol Topcu , Mazhar Muslum Tuna , Sayid Shafi Zuhur

Purpose

Despite several factors are associated with worse disease-free survival (DFS) and prognosis in medullary thyroid carcinoma (MTC) patients, the effect of microscopic extrathyroidal extension (mETE) on the prognosis and DFS is not well understood. This study aims to evaluate the impact of mETE on DFS and prognosis in patients with MTC.

Methods

This multicenter study included 208 patients with MTC (17.8% with hereditary disease). Patients with mETE were compared to those without mETE in terms of clinical and histopathological variables.

Results

Among the 208 patients, 16.3% (n = 34) had mETE on histopathological analysis. Patients with mETE were more likely to have larger tumors, higher serum calcitonin (CTN) levels before and after surgery, increased rates of neck lymph node (LN) and distant metastasis, multifocal disease, and advanced disease stage. Kaplan–Meier analysis showed a significantly lower DFS in patients with mETE than those without mETE (14.7% vs. 71.3%, log-rank p < 0.001). However, mETE was not an independent contributing factor for persistent/recurrent disease, whereas neck LN involvement was the strongest independent contributing factor for persistent/recurrent disease (HR: 1.1; 95% CI 0.4–1.8, p = 0.76 and HR: 9.6; 95% CI 1.21–76.9, p = 0.03, respectively).

Conclusion

mETE in patients with MTC is associated with a lower DFS, larger tumor sizes, a higher likelihood of neck LN and distant metastasis, advanced stage, higher serum CTN levels, multifocality, and persistent/recurrent disease. However, mETE was not an independent predictor of persistent/recurrent disease. Further studies with a larger number of patients with mETE could further clarify the impact of mETE on the prognosis of MTC.

目的：尽管多种因素与甲状腺髓样癌（MTC）患者较差的无病生存（DFS）和预后有关，但显微甲状腺外展（mETE）对预后和DFS的影响尚不清楚。本研究旨在评价mETE对MTC患者DFS及预后的影响。方法本研究纳入208例MTC患者（17.8%为遗传性疾病）。将mETE患者与未mETE患者在临床和组织病理学变量方面进行比较。结果208例患者中，16.3% （n = 34）的组织病理学分析为mETE。mETE患者更可能有较大的肿瘤，术前和术后血清降钙素（CTN）水平较高，颈部淋巴结（LN）和远处转移、多灶性疾病和晚期疾病的发生率增加。Kaplan-Meier分析显示，mETE患者的DFS显著低于非mETE患者（14.7% vs. 71.3%, log-rank p < 0.001）。然而，mETE不是持续/复发性疾病的独立影响因素，而颈部LN受累是持续/复发性疾病的最强独立影响因素（HR: 1.1; 95% CI 0.4-1.8, p = 0.76; HR: 9.6; 95% CI 1.21-76.9, p = 0.03）。结论MTC患者的mete与较低的DFS、较大的肿瘤大小、较高的颈部LN和远处转移可能性、晚期、较高的血清CTN水平、多灶性和持续/复发性疾病相关。然而，mETE并不是疾病持续/复发的独立预测因子。更多mETE患者的进一步研究可以进一步阐明mETE对MTC预后的影响。

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NEUROENDOCRINOLOGÍA (PÓSTERES) NEUROENDOCRINOLOGÍA(海报)

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-10-01 DOI: 10.1016/S2530-0164(25)00455-0

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EJERCICIO Y MISCELÁNEA (PÓSTERES) 排泄物和杂质（海报）

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2025-10-01 DOI: 10.1016/S2530-0164(25)00465-3

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