Pub Date : 2025-12-01Epub Date: 2025-08-28DOI: 10.1016/j.endinu.2025.501654
Marta Araujo-Castro , Rogelio García-Centeno , Javier Aller , Mónica Marazuela , Alfonso Soto , María Ángeles Gálvez , Rosa Cámara , Elena Valassi , Ignacio Bernabeu , Rocío Villar-Taibo , Felicia A. Hanzu
Severe Cushing's syndrome (SCS) is usually defined as a CS with urinary free cortisol (UFC) levels above five times the upper limit of normal or associated with severe complications of hypercortisolism. Combination therapy with ketoconazole and metyrapone is a useful option for these patients. Osilodrostat is the most potent and effective oral drug in monotherapy for the treatment of SCS. For cases with very severe hypercortisolism and/or oral intolerance, etomidate is the most effective and rapid drug for reducing cortisol levels. Bilateral adrenalectomy may be indicated in cases of life-threatening severe hypercortisolism, but UFC should be reduced before surgery to reduce the perioperative morbimortality. Prompt treatment of comorbidities and thrombo- and infection prophylaxis are recommended. In conclusion, a rapid control of hypercortisolism is vital in SCS, and for this purpose combination therapy or potent drugs with a rapid onset of action such as etomidate or osilodrostat are indicated.
{"title":"Executive summary of the consensus document for the management of severe Cushing's syndrome: Consensus document of the Neuroendocrinology Focus Group of the Spanish Society of Endocrinology and Nutrition (SEEN)","authors":"Marta Araujo-Castro , Rogelio García-Centeno , Javier Aller , Mónica Marazuela , Alfonso Soto , María Ángeles Gálvez , Rosa Cámara , Elena Valassi , Ignacio Bernabeu , Rocío Villar-Taibo , Felicia A. Hanzu","doi":"10.1016/j.endinu.2025.501654","DOIUrl":"10.1016/j.endinu.2025.501654","url":null,"abstract":"<div><div>Severe Cushing's syndrome (SCS) is usually defined as a CS with urinary free cortisol (UFC) levels above five times the upper limit of normal or associated with severe complications of hypercortisolism. Combination therapy with ketoconazole and metyrapone is a useful option for these patients. Osilodrostat is the most potent and effective oral drug in monotherapy for the treatment of SCS. For cases with very severe hypercortisolism and/or oral intolerance, etomidate is the most effective and rapid drug for reducing cortisol levels. Bilateral adrenalectomy may be indicated in cases of life-threatening severe hypercortisolism, but UFC should be reduced before surgery to reduce the perioperative morbimortality. Prompt treatment of comorbidities and thrombo- and infection prophylaxis are recommended. In conclusion, a rapid control of hypercortisolism is vital in SCS, and for this purpose combination therapy or potent drugs with a rapid onset of action such as etomidate or osilodrostat are indicated.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501654"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683634","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 : 2025-12-01Epub Date: 2025-08-14DOI: 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.
{"title":"The overweight and obesity landscape in Spain: Data from the Spanish cohort of the multi-country IMPACT-O study","authors":"Irene Breton , Igotz Aranbarri , Anastasia Lampropoulou , Jennifer Redondo-Antón , Javier Ágreda , Atif Adam , Esther Artime","doi":"10.1016/j.endinu.2025.501643","DOIUrl":"10.1016/j.endinu.2025.501643","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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/m<sup>2</sup>; obesity cohort: BMI ≥30<!--> <!-->kg/m<sup>2</sup>), 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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501643"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683636","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 : 2025-12-01Epub Date: 2025-12-05DOI: 10.1016/j.endinu.2025.501730
Ildefonso Hernández-Aguado , Elisa Chilet-Rosell
{"title":"La decisión ineludible de las sociedades médicas: deriva comercial o integridad","authors":"Ildefonso Hernández-Aguado , Elisa Chilet-Rosell","doi":"10.1016/j.endinu.2025.501730","DOIUrl":"10.1016/j.endinu.2025.501730","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501730"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683637","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 : 2025-12-01Epub Date: 2025-06-13DOI: 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.
{"title":"Pembrolizumab-induced dual endocrine disruption: A case report","authors":"María Carmen Dameto Pons, Elena González Arnáiz, María Antequera González, Xavier F. Pérez Candel, Diana Ariadel Cobo, Javier Castañón Alonso, María D. Ballesteros Pomar","doi":"10.1016/j.endinu.2025.501630","DOIUrl":"10.1016/j.endinu.2025.501630","url":null,"abstract":"<div><div><span>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 </span>pembrolizumab who simultaneously developed thyroiditis and fulminant autoimmune diabetes.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501630"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683682","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 : 2025-12-01Epub Date: 2025-07-07DOI: 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
{"title":"Reversión de bypass gastroileal como tratamiento de hiperparatiroidismo yatrogénico e hipocalcemia refractaria","authors":"Bryan-Josué Flores-Robles , Juan Antonio López Martín , María Jesús Chinchetru Ranedo , José Miguel Lázaro Guevara , José Fernando Marín Díez , Núria Guañabens","doi":"10.1016/j.endinu.2025.501632","DOIUrl":"10.1016/j.endinu.2025.501632","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501632"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683683","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 : 2025-12-01Epub Date: 2025-07-16DOI: 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.
{"title":"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","authors":"Francisco Pita Gutiérrez , Irene Breton Lesmes , Julia Álvarez Hernández , María D. Ballesteros-Pomar , Rocío Campos del Portillo , Ana Hernández Moreno , Francisco Botella Romero","doi":"10.1016/j.endinu.2025.501640","DOIUrl":"10.1016/j.endinu.2025.501640","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501640"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683635","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 : 2025-12-01Epub Date: 2025-08-12DOI: 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.
{"title":"Estado actual de la yodación en gestantes asturianas","authors":"Carmen Sánchez Blanco , Marina García Cancelo , Cristina González Martínez , Leire Cardo González , Marta Diéguez Felechosa","doi":"10.1016/j.endinu.2025.501646","DOIUrl":"10.1016/j.endinu.2025.501646","url":null,"abstract":"<div><h3>Introduction</h3><div>Although former studies indicated that Asturias (Spain) is an iodine-sufficient region, preliminary data suggest this trend may be changing.</div></div><div><h3>Objective</h3><div>To determine the prevalence of iodine deficiency in pregnant women in Asturias.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501646"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683639","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 : 2025-12-01Epub Date: 2025-07-14DOI: 10.1016/j.endinu.2025.501638
Ana Álvarez ODogherty , Carmen Rodríguez Jiménez , Amaya Belanger-Quintana , Sonia Rodríguez Novoa , Francisco Arrieta Blanco
{"title":"Enfermedad del ojo de pez. Alteración del metabolismo HDL colesterol y afectación corneal: a propósito de un caso","authors":"Ana Álvarez ODogherty , Carmen Rodríguez Jiménez , Amaya Belanger-Quintana , Sonia Rodríguez Novoa , Francisco Arrieta Blanco","doi":"10.1016/j.endinu.2025.501638","DOIUrl":"10.1016/j.endinu.2025.501638","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501638"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683686","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}
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。
{"title":"The impact of microscopic extrathyroidal extension on the prognosis of medullary thyroid carcinoma: A multicenter cohort study","authors":"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","doi":"10.1016/j.endinu.2025.501633","DOIUrl":"10.1016/j.endinu.2025.501633","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Among the 208 patients, 16.3% (<em>n</em> <!-->=<!--> <!-->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 <em>p</em> <!--><<!--> <!-->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, <em>p</em> <!-->=<!--> <!-->0.76 and HR: 9.6; 95% CI 1.21–76.9, <em>p</em> <!-->=<!--> <!-->0.03, respectively).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 10","pages":"Article 501633"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683638","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 : 2025-11-01Epub Date: 2025-06-18DOI: 10.1016/j.endinu.2025.501629
Julieta Cigarroa-Durán , Gabriel López-Ramírez , Mirian Carolina Martínez-López , Itandehui Castro-Quezada , Arturo Ortega Soto , Orquidia G. Méndez-Flores
Introduction
Bitterness perception requires activation of the taste-receptor cells (TRCs) in the lingual papillae. The TAS2R38 specialist receptor (T2R family) is activated by thiol-urea chemicals, where 3 haplotype combinations are highly related to bitterness perception. Tasters (PAV/PAV) and non-tasters (AVI/AVI) represent the homozygous phenotypes, while the heterozygous combinations form the moderate tasters, who comprise approximately half of the population.
Material and methods
We determined the bitterness perception phenotype of 153 young adults, as they reacted to a phenylthiocarbamide (PTC) impregnated paper strip placed on their tongues. We measured their weight, height, waist and hip circumferences, total body fat and lean body mass. Mean and standard deviation is shown to express quantitative variables, Kruskal–Wallis test and Dunn's multiple comparison test was used, with 95% confidence intervals.
Results
PTC tasters comprised 27% of the study group, with non-tasters making up 18%. When analyzed by sex, 32% of women were PTC tasters vs 18% of men. Notably, for men, PTC tasters exhibited higher mean values across several body composition measures than non-tasters, including a BMI of 28 kg/m2 vs 24 kg/m2, a waist circumference of 94 cm vs 79 cm, a waist-to-height ratio of 0.54 vs 0.49, and a body fat percentage of 28% vs 15%. In contrast, women showed no significant differences in these measures based on their bitterness perception.
Conclusions
The distribution of perception groups and preponderance of female PTC tasters corresponds to previously reported data. Taster men had a body composition distant from healthy parameters and above the non-tasters values, yet not significant differences were found for female participants.
苦味感知需要激活舌乳头中的味觉受体细胞（TRCs）。TAS2R38特殊受体（T2R家族）被硫醇-尿素化学物质激活，其中3个单倍型组合与苦味感知高度相关。品尝者（PAV/PAV）和非品尝者（AVI/AVI）代表纯合表型，而杂合组合形成中等品尝者，约占人口的一半。材料和方法我们测定了153名年轻人的苦味感知表型，当他们对放在舌头上的浸渍了苯硫脲（PTC）的纸条做出反应时。我们测量了他们的体重、身高、腰围和臀围、全身脂肪和瘦体重。以均数和标准差表示定量变量，采用Kruskal-Wallis检验和Dunn’s多重比较检验，置信区间为95%。结果sptc品酒者占研究组的27%，非品酒者占18%。当按性别分析时，32%的女性是PTC品酒师，而男性是18%。值得注意的是，对于男性来说，PTC品酒师在几项身体成分测量中表现出比非品酒师更高的平均值，包括BMI为28 kg/m2 vs 24 kg/m2，腰围为94 cm vs 79 cm，腰高比为0.54 vs 0.49，体脂率为28% vs 15%。相比之下，女性在这些基于苦味感知的测量中没有显着差异。结论感知组的分布和女性味觉者的优势与先前报道的数据一致。品酒师男性的身体组成远离健康参数，高于非品酒师的值，但女性参与者没有发现显著差异。
{"title":"In young adult males, bitterness perception is associated with excess body mass and metabolic dysregulation","authors":"Julieta Cigarroa-Durán , Gabriel López-Ramírez , Mirian Carolina Martínez-López , Itandehui Castro-Quezada , Arturo Ortega Soto , Orquidia G. Méndez-Flores","doi":"10.1016/j.endinu.2025.501629","DOIUrl":"10.1016/j.endinu.2025.501629","url":null,"abstract":"<div><h3>Introduction</h3><div>Bitterness perception requires activation of the taste-receptor cells (TRCs) in the lingual papillae. The TAS2R38 specialist receptor (T2R family) is activated by thiol-urea chemicals, where 3 haplotype combinations are highly related to bitterness perception. Tasters (PAV/PAV) and non-tasters (AVI/AVI) represent the homozygous phenotypes, while the heterozygous combinations form the moderate tasters, who comprise approximately half of the population.</div></div><div><h3>Material and methods</h3><div>We determined the bitterness perception phenotype of 153 young adults, as they reacted to a phenylthiocarbamide (PTC) impregnated paper strip placed on their tongues. We measured their weight, height, waist and hip circumferences, total body fat and lean body mass. Mean and standard deviation is shown to express quantitative variables, Kruskal–Wallis test and Dunn's multiple comparison test was used, with 95% confidence intervals.</div></div><div><h3>Results</h3><div>PTC tasters comprised 27% of the study group, with non-tasters making up 18%. When analyzed by sex, 32% of women were PTC tasters vs 18% of men. Notably, for men, PTC tasters exhibited higher mean values across several body composition measures than non-tasters, including a BMI of 28<!--> <!-->kg/m<sup>2</sup> vs 24<!--> <!-->kg/m<sup>2</sup>, a waist circumference of 94<!--> <!-->cm vs 79<!--> <!-->cm, a waist-to-height ratio of 0.54 vs 0.49, and a body fat percentage of 28% vs 15%. In contrast, women showed no significant differences in these measures based on their bitterness perception.</div></div><div><h3>Conclusions</h3><div>The distribution of perception groups and preponderance of female PTC tasters corresponds to previously reported data. Taster men had a body composition distant from healthy parameters and above the non-tasters values, yet not significant differences were found for female participants.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 9","pages":"Article 501629"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374673","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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