Endocrinologia, Diabetes y Nutricion最新文献

英文中文

Significación clínica de la consistencia del adenoma hipofisario en pacientes sometidos a cirugía transesfenoidal endoscópica 内窥镜经蝶手术患者垂体腺瘤一致性的临床意义

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-10-01 DOI: 10.1016/j.endinu.2024.04.005

Alberto Acitores Cancela , Víctor Rodríguez Berrocal

引用次数: 0

Executive summary of the Spanish consensus for the diagnosis, management, and follow-up of primary hyperaldosteronism 西班牙原发性醛固酮增多症诊断、管理和随访共识执行摘要

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Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-10-01 DOI: 10.1016/j.endinu.2024.05.007

Marta Araujo-Castro , Paola Parra Ramírez , Felicia A. Hanzu , On behalf the following medical Spanish societies: SEEN, SEC, SEN, SEMI, SERAM, SERVEI, SEQC(ML), AEC

Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension (HTN) and is associated with a higher cardiometabolic risk than essential HTN. Nevertheless, PH remains clearly underdiagnosed. An early diagnosis and adequate treatment of this disease are essential to reduce the cardiometabolic morbimortality associated with aldosterone excess. PH follow-up is equally essential; however, there is little consensus on how it should be performed, being a topic rarely mentioned by the different clinical practice guidelines. The aim of this executive summary is to summarize the recommendations made in the Spanish consensus of PH for the diagnosis, management, and follow-up of these patients. The Spanish consensus was reached from a multidisciplinary perspective through a nominal group consensus approach by experts from the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Society of Cardiology (SEC), the Spanish Society of Nephrology (SEN), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Radiology (SERAM), the Spanish Society of Vascular and Interventional Radiology (SERVEI), the Spanish Society of Laboratory Medicine (SEQC(ML)), the Spanish Society of Anatomic-Pathology (EAP), and the Spanish Association of Surgeons (AEC).

原发性高醛固酮血症（PH）是继发性高血压（HTN）最常见的病因，其心脏代谢风险高于原发性高血压。然而，PH 的诊断率明显偏低。要降低与醛固酮过多相关的心脏代谢死亡率，就必须对该疾病进行早期诊断和适当治疗。PH 的随访也同样重要；然而，对于如何进行随访却鲜有共识，不同的临床实践指南也很少提及这一主题。本摘要旨在总结西班牙 PH 共识中对这些患者的诊断、管理和随访提出的建议。西班牙内科医学会 (SEMI)、西班牙放射学会 (SERAM)、西班牙血管和介入放射学会 (SERVEI)、西班牙检验医学会 (SEQC(ML))、西班牙解剖病理学会 (EAP) 和西班牙外科医生协会 (AEC)。

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引用次数: 0

Increased incidence of pediatric type 1 diabetes during the pandemic in Biscay, Spain 西班牙比斯开大流行期间小儿 1 型糖尿病发病率增加

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-10-01 DOI: 10.1016/j.endinu.2024.05.006

Concepción Fernández-Ramos , Eunate Arana-Arri , Amaia Vela , Inés Urrutia , Borja Santos Zorrozua , Itxaso Rica

Objective

To update the incidence rate (IR) and trends of type 1 diabetes mellitus (T1DM) in children aged 0–14 years from 2003 to 2022, in Biscay, Spain.

Subjects and method

We used the capture–recapture method: primary cases were prospectively extracted from the hospital registry and a secondary independent data source was obtained from diabetes associations and a public health database. The IRs standardized by age and sex were calculated using the direct method, assuming an equal distribution in each age/sex group. The IR occurring during the various COVID-19 waves was compared with the pre-pandemic IR.

Results

A total of 378 new cases were identified. The mean age at diagnosis was 9.7 years (5.8–11.9). The completeness of ascertainment was 99.1%. The mean annual age-standardized IR was 12.92 (95%CI, 11.35–13.91). The mean IRs for the 0–4, 5–9, and 10–14 age groups were 7.67, 13.41 and 17.83 cases/100,000 children/year, respectively. The IR trend was statistically significant in the entire group and in the 5–9 year-old group with a mean annual increase of 1.9% (95%CI, 0.1–3.8) and 3.3% (95%CI, 1.002–1.065); p = 0.039.

The 5-year period analysis confirmed that the increase was significant only in the last 5 years (20%). When 2020–2022 (pandemic) and 2017–2019 (pre-pandemic) periods were compared this difference goes up to 44.5%; p = 0.029.

Conclusions

After a long period of stability in the IR of T1DM in children younger than 15 years of age in Biscay, Spain, an increase in recent years has been reported, which is consistent with the SARS-CoV2 pandemic, with the largest increase being reported in the 5-to 9-year-old age group.

目的更新西班牙比斯开省 0-14 岁儿童中 1 型糖尿病（T1DM）的发病率（IR）和趋势（2003-2022 年）。根据年龄和性别标准化的IR采用直接法计算，假设每个年龄/性别组的IR分布相同。结果共发现 378 例新病例。确诊时的平均年龄为 9.7 岁（5.8-11.9 岁）。确诊率为 99.1%。年均年龄标准化 IR 为 12.92（95%CI，11.35-13.91）。0-4岁、5-9岁和10-14岁年龄组的平均IR分别为7.67、13.41和17.83例/100,000名儿童/年。整个年龄组和 5-9 岁年龄组的 IR 趋势具有显著的统计学意义，年平均增长率分别为 1.9% (95%CI, 0.1-3.8) 和 3.3% (95%CI, 1.002-1.065); p = 0.039。结论西班牙比斯开省 15 岁以下儿童中 T1DM 的 IR 值长期稳定后，近年来有所上升，这与 SARS-CoV2 大流行是一致的，其中 5-9 岁年龄组的上升幅度最大。

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引用次数: 0

Sistemas de infusión automatizada de insulina en el tratamiento de la diabetes: beneficios, retos y consideraciones prácticas en la edad pediátrica 治疗糖尿病的自动胰岛素输注系统：儿科的优势、挑战和实际考虑因素。

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-09-13 DOI: 10.1016/j.endinu.2024.07.002

Patricia Enes Romero , María Güemes , Blanca Guijo , Gabriel Á. Martos-Moreno , Jesús Pozo Román , Jesús Argente

At present, the majority of patients with type 1 diabetes mellitus do not achieve the recommended glycemic control goals to reduce the risk of acute and chronic complications. Hybrid closed-loop systems or automated insulin infusion systems emerged as an opportunity to improve metabolic control, quality of life and reduce the psychosocial impact of type 1 diabetes. This article analyzes the evidence regarding their effectiveness and safety, the challenges they pose and best practices to optimize results when implemented in clinical practice.

目前，大多数 1 型糖尿病患者无法达到建议的血糖控制目标，从而降低急性和慢性并发症的风险。混合闭环系统或自动胰岛素输注系统的出现，为改善代谢控制、生活质量和减轻1型糖尿病的社会心理影响提供了机会。本文分析了有关其有效性和安全性的证据、它们带来的挑战以及在临床实践中优化效果的最佳做法。

引用次数: 0

Carcinoma de tiroides precoz en un síndrome PTEN. Importancia del cribado ecográfico inmediato PTEN综合征中的早期甲状腺癌。即时超声筛查的重要性

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-09-04 DOI: 10.1016/j.endinu.2024.08.002

Emilio García García , Mercedes L. Llempén López , María Molina Mata , Rosa Cabello Laureano , Suset Dueñas Disotuar

引用次数: 0

Distortion of body image perception in the Prader-Willi syndrome: Relationship with the perceptual reasoning index 普拉德-威利综合征患者对身体形象认知的扭曲：与知觉推理指数的关系

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-09-04 DOI: 10.1016/j.endinu.2024.06.002

Natalia R. Iglesias , Romina Ceccomancini , María del Pilar Jaime , Ayla Gerk , Delfina Mendiola , Jorgelina Stegmann

Introduction

Self-perception of body image has been scarcely evaluated in people with Prader-Willi syndrome (PWS), who, in addition to intellectual disability, are often obese. Therefore, we explored whether people with PWS can accurately identify their true image and how this self-perception is impacted by their neuropsychological profile.

Methodology

This observational study included patients with PWS with regular attendance to transdisciplinary treatment at a center specialized in the management of rare diseases. All patients were evaluated with the Stunkard scale (including silhouettes ranging from extremely skinny to extremely obese) and the WISC-IV and WAIS-III questionnaires, specifically the perceptual reasoning index (PRI).

Results

Among the 21 participants, 62% misperceived their body image, most underestimating their body dimensions (actual BMI 28.0 ± 8.3 kg/m² vs self-perceived BMI 23.2 ± 4.7 kg/m², p = 0.03). While BMI differences between accurate and inaccurate body image perception were nonsignificant (accurate 26.6 ± 8.8 kg/m² vs inaccurate 28.9 ± 8.1 kg/m², p = 0.56), individuals with accurate perception showed both higher PRI scores (accurate 67.6 ± 8.2 vs inaccurate 60.2 ± 7.2, p = 0.043) and, to a lesser extent, intelligence quotients (IQ) (accurate 60.0 ± 4.9 vs inaccurate 55.0 ± 7.5, p = 0.079).

Conclusion

In this study, we identified distortion of body image perception as a very common finding among PWS patients, in most cases as underestimation, and influenced by the neuropsychological profile.

简介：普拉德-威利综合征（PWS）患者除了智力障碍外，通常还很肥胖，他们对身体形象的自我感知很少得到评估。因此，我们探讨了普氏综合征患者能否准确识别自己的真实形象，以及这种自我认知如何受到神经心理学特征的影响。方法这项观察性研究纳入了在一家专门治疗罕见病的中心定期接受跨学科治疗的普氏综合征患者。结果在21名参与者中，62%的人对自己的身体形象有误解，其中大多数人低估了自己的身体尺寸（实际体重指数为28.0 ± 8.3 kg/m2，自我感觉体重指数为23.2 ± 4.7 kg/m2，P = 0.03）。虽然准确和不准确身体形象认知之间的体重指数差异不显著（准确 26.6 ± 8.8 kg/m2 vs 不准确 28.9 ± 8.1 kg/m2，p = 0.56），但准确认知的个体显示出更高的 PRI 分数（准确 67.6 ± 8.2 vs 不准确 60.2 ± 7.2，p = 0.结论在这项研究中，我们发现身体形象感知失真是 PWS 患者中一个非常常见的发现，在大多数情况下是低估，并受到神经心理学特征的影响。

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引用次数: 0

¿Estamos infradiagnosticando el deterioro cognitivo en pacientes con diabetes mellitus tipo 2? 我们是否对 2 型糖尿病患者的认知障碍诊断不足？

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-09-03 DOI: 10.1016/j.endinu.2024.07.001

Antelm Pujol , Pilar Sanchis , María I. Tamayo , Lluís Masmiquel

引用次数: 0

Super response to liraglutide in people with obesity: A case report and literature review 肥胖症患者对利拉鲁肽的超级反应：病例报告和文献综述

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-08-23 DOI: 10.1016/j.endinu.2024.05.014

Sonsoles Gutiérrez Medina , Elena Sánchez Campayo , Sonsoles Guadalix , Javier Escalada

GLP1 receptor agonists (GLP1-RAs) are currently the most widely used pharmacological option to treat obesity. However, considerable heterogeneity in weight loss response has been observed with different anti-obesity drugs and response predictors to these drugs still remain ambiguous. Furthermore, very few published data have been available on cases of high-responders to treatment with GLP1-RAs. In this article, we present the case of a patient with grade 4 obesity (initial body mass index, 50.2 kg/m²) with associated mechanical and metabolic complications who achieved an initial weight loss of 40% at 1 year with hygienic-dietary measures and drug treatment with liraglutide. We also review the available literature on factors potentially contributing to variations in weight loss with GLP1-RAs in general and liraglutide, in particular.

GLP1 受体激动剂（GLP1-RAs）是目前治疗肥胖症最广泛使用的药物。然而，不同的抗肥胖药物在减轻体重反应方面存在很大的异质性，而且这些药物的反应预测指标仍不明确。此外，关于 GLP1-RAs 治疗高反应者病例的公开数据也非常少。在这篇文章中，我们介绍了一位患有四级肥胖症（初始体重指数为 50.2 kg/m2）并伴有机械性和代谢性并发症的患者的病例，该患者在接受卫生饮食措施和利拉鲁肽药物治疗 1 年后，初始体重下降了 40%。我们还回顾了现有文献中可能导致 GLP1-RA（尤其是利拉鲁肽）减重变化的因素。

引用次数: 0

Hiperfosfatasemia familiar benigna. Una entidad poco conocida 良性家族性高磷血症。一个鲜为人知的实体

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-08-22 DOI: 10.1016/j.endinu.2024.07.005

Antonio Bustos-Merlo, Antonio Rosales-Castillo

引用次数: 0

Ángulo de fase: diferencias entre desnutrición relacionada con la enfermedad, obesidad y población sana 相角：与疾病相关的营养不良、肥胖和健康人群之间的差异

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion

Pub Date : 2024-08-22 DOI: 10.1016/j.endinu.2024.07.004

Mario A. Saavedra Vásquez , Javier Castañón Alonso , Begoña Pintor de la Maza , Elena González Arnáiz , Diana García Sastre , Diana G. Ariadel Cobo , Ana M. Urioste Fondo , María Antequera González , María del Carmen Dameto Pons , María D. Ballesteros Pomar

Introduction

Bioelectrical Impedance Analysis (BIA) is a tool used in clinical nutrition and pure electrical data such as phase angle (PA) has shown prognostic value. It relates resistance and reactance indicating cellular health.

Objective

To determine differences in PA between patients with obesity and disease-related malnutrition (DRM) compared to the healthy population, and to establish associations between PA and other body composition (BC) parameters.

Materials and methods

Retrospective observational study with 1079 patients from the Obesity and Nutrition Department of the Complejo Asistencial Universitario de León between April/2014 and August/2022 as well as 86 healthy controls. Demographic and anthropometric variables were collected and BC was performed with BIA Tanita MC780®. Diagnosis of malnutrition according to GLIM criteria and obesity with body mass index (BMI).

Results

PA50KHz in obesity group is 5.98°, DRM 4.79° and control group 6.08°. Statistically significant differences in PA between DRM and control groups, as well as DRM and obesity (p < 0.001). Weak positive correlation in total population (r = 0.452, p < 0.001) as well as control group (r = 0.463, p < 0.001) between BMI and PA. Weak negative correlation in the total population (r = -0.408, p < 0.001), DRM (r = -0.268, p < 0.001) and obesity (r = -0.342, p < 0.001) between age and PA.

Conclusions

In this study, significantly lower PA was observed in the DRM group than in the control and obesity groups. No statistically significant differences between PA in the obesity and control groups and no correlation between BMI and PA in the obesity group. More studies are needed to standardise cut-off points in different contexts and populations.

导言生物电阻抗分析（BIA）是临床营养学中使用的一种工具，相位角（PA）等纯电数据具有预后价值。材料和方法对 2014 年 4 月至 2022 年 8 月期间莱昂大学综合医院肥胖和营养科的 1079 名患者以及 86 名健康对照者进行了回顾性观察研究。研究人员收集了人口统计学和人体测量变量，并使用 BIA Tanita MC780® 进行了 BC 分析。结果肥胖组的 PA50KHz 为 5.98°，DRM 为 4.79°，对照组为 6.08°。DRM 组和对照组之间以及 DRM 组和肥胖组之间的 PA 差异具有统计学意义（p < 0.001）。体重指数（BMI）和运动量（PA）之间在总人口（r = 0.452，p < 0.001）和对照组（r = 0.463，p < 0.001）中存在微弱的正相关关系。在总人口（r = -0.408，p < 0.001）、DRM（r = -0.268，p < 0.001）和肥胖（r = -0.342，p < 0.001）中，年龄与 PA 之间呈弱负相关。肥胖组和对照组的 PA 没有明显的统计学差异，肥胖组的 BMI 和 PA 之间也没有相关性。需要进行更多的研究，以便在不同的环境和人群中统一截断点。

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