This study aimed to assess serum Neuromedin U (NmU) levels in patients with Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM) vs healthy controls and evaluate the correlation between NmU and body mass index (BMI).
Research design and methods
We conducted a cross-sectional study with 134 participants: 45 with T1DM, 49 with T2DM, and 40 healthy controls. Serum NmU levels were measured using enzyme-linked immunosorbent assay (ELISA), and the correlation with BMI was assessed.
Results
NmU levels were not significantly different between diabetic patients and healthy controls. No significant correlation was observed between NmU and BMI in T1DM or T2DM groups. However, the healthy control group found a significant inverse correlation between NmU and BMI (rho = −0.373, p < 0.05).
Conclusions
NmU may not be a direct biomarker for diabetes, but its significant correlation with BMI in healthy individuals suggests a potential role in metabolic regulation. This is the first study ever conducted to compare NmU levels across diabetic subtypes, offering novel insights into the role of in metabolic homeostasis.
目的比较1型糖尿病（T1DM）和2型糖尿病（T2DM）患者与健康对照者血清神经medin U （NmU）水平，并评价NmU与体重指数（BMI）的相关性。研究设计和方法我们对134名参与者进行了横断面研究：45名1型糖尿病患者，49名2型糖尿病患者，40名健康对照。采用酶联免疫吸附试验（ELISA）测定血清NmU水平，并评估与BMI的相关性。结果糖尿病患者血清snmu水平与健康对照组无显著差异。T1DM组和T2DM组NmU与BMI无显著相关性。而健康对照组NmU与BMI呈显著负相关（rho = - 0.373, p < 0.05）。结论snmu可能不是糖尿病的直接生物标志物，但其与健康个体BMI的显著相关性提示其在代谢调节中可能发挥作用。这是有史以来第一个比较糖尿病亚型中NmU水平的研究，为其在代谢稳态中的作用提供了新的见解。
{"title":"Neuromedin U and BMI correlation in T1DM and T2DM vs healthy controls: A comparative study","authors":"Yasemin Çalışkan , Emre Sarandöl , Nizameddin Koca","doi":"10.1016/j.endinu.2025.501631","DOIUrl":"10.1016/j.endinu.2025.501631","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess serum Neuromedin U (NmU) levels in patients with Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM) vs healthy controls and evaluate the correlation between NmU and body mass index (BMI).</div></div><div><h3>Research design and methods</h3><div>We conducted a cross-sectional study with 134 participants: 45 with T1DM, 49 with T2DM, and 40 healthy controls. Serum NmU levels were measured using enzyme-linked immunosorbent assay (ELISA), and the correlation with BMI was assessed.</div></div><div><h3>Results</h3><div>NmU levels were not significantly different between diabetic patients and healthy controls. No significant correlation was observed between NmU and BMI in T1DM or T2DM groups. However, the healthy control group found a significant inverse correlation between NmU and BMI (rho<!--> <!-->=<!--> <!-->−0.373, <em>p</em> <!--><<!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>NmU may not be a direct biomarker for diabetes, but its significant correlation with BMI in healthy individuals suggests a potential role in metabolic regulation. This is the first study ever conducted to compare NmU levels across diabetic subtypes, offering novel insights into the role of in metabolic homeostasis.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 8","pages":"Article 501631"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134902","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 : 2025-06-17DOI: 10.1016/j.endinu.2025.501623
Lili Wang , Linjun Zheng , Jiayu Hu , Nongnong Zhao
<div><h3>Background</h3><div>Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM), and left ventricular diastolic dysfunction (LVDD) is considered one of the earliest markers of myocardial dysfunction. Fragmented QRS (fQRS) and microalbuminuria (MAU) are important biomarkers of cardiac electrophysiological changes and CVD, but their relationship with LVDD in T2DM remains unclear. This study aims to explore the impact of fQRS and MAU on LVDD in T2DM patients and to analyze whether the association between fQRS and LVDD differs across varying MAU statuses.</div></div><div><h3>Methods</h3><div>A total of 374 patients with T2DM were ultimately enrolled in this study. Twelve-lead electrocardiography (ECG) and echocardiography were performed, and the patients’ baseline characteristics, laboratory results, and echocardiographic parameters were collected. Univariate and multivariate logistic regression analyses were conducted to assess the association between fQRS, MAU, and LVDD in T2DM patients. A stratified analysis was performed to examine the relationship between fQRS and LVDD across different MAU statuses.</div></div><div><h3>Results</h3><div>The mean age of the T2DM patients was 57.19<!--> <!-->±<!--> <!-->12.47 years, and 62.57% were male. fQRS, MAU, and age were independent risk factors for LVDD in patients with T2DM. The risk of developing LVDD was 3.72 times higher in patients with fQRS compared to those without fQRS [95% CI<!--> <!-->=<!--> <!-->2.125–6.513, <em>P</em> <!--><<!--> <!-->0.0001]. The risk of LVDD was 4.05 times higher in patients with MAU compared to those without MAU [95% CI<!--> <!-->=<!--> <!-->2.252–7.282, <em>P</em> <!--><<!--> <!-->0.0001]. For each additional year of age, the risk of LVDD increased by 5.2% [95% CI<!--> <!-->=<!--> <!-->1.022–1.084, <em>P</em> <!-->=<!--> <!-->0.001]. Stratified analysis based on MAU status revealed that in patients without MAU, the association between fQRS and LVDD was stronger [OR<!--> <!-->=<!--> <!-->7.084, 95% CI<!--> <!-->=<!--> <!-->3.255–15.419, <em>P</em> <!--><<!--> <!-->0.0001]. However, in patients with MAU, the relationship between fQRS and LVDD was no longer significant [OR<!--> <!-->=<!--> <!-->1.499, 95% CI<!--> <!-->=<!--> <!-->0.603–3.722, <em>P</em> <!-->=<!--> <!-->0.383].</div></div><div><h3>Conclusions</h3><div>Our study found that both fQRS and MAU are independent risk factors for LVDD in patients with T2DM. The presence of fQRS increased the risk of LVDD by 3.72 times, while MAU increased the risk by 4.05 times. Stratified analysis further revealed that in patients without MAU, the association between fQRS and LVDD was significantly stronger (OR<!--> <!-->=<!--> <!-->7.084, <em>P</em> <!--><<!--> <!-->0.0001), while in patients with MAU, this association was no longer significant (<em>P</em> <!-->=<!--> <!-->0.383). These findings suggest that combining the detection of fQRS and MAU may provide valuab
背景：心血管疾病（CVD）是2型糖尿病（T2DM）患者死亡的主要原因，而左室舒张功能障碍（LVDD）被认为是心肌功能障碍的最早标志之一。碎片化QRS （fQRS）和微量白蛋白尿（MAU）是心脏电生理变化和CVD的重要生物标志物，但它们与T2DM患者LVDD的关系尚不清楚。本研究旨在探讨fQRS和MAU对T2DM患者LVDD的影响，并分析fQRS与LVDD的相关性是否因MAU状态的不同而不同。方法共纳入374例T2DM患者。行十二导联心电图（ECG）和超声心动图，收集患者的基线特征、实验室结果和超声心动图参数。进行单因素和多因素logistic回归分析，评估T2DM患者fQRS、MAU和LVDD之间的关系。对不同MAU状态下fQRS和LVDD之间的关系进行了分层分析。结果T2DM患者平均年龄57.19±12.47岁，男性占62.57%。fQRS、MAU和年龄是T2DM患者LVDD的独立危险因素。fQRS患者发生LVDD的风险是无fQRS患者的3.72倍[95% CI = 2.125-6.513, P < 0.0001]。MAU患者发生LVDD的风险是无MAU患者的4.05倍[95% CI = 2.252-7.282, P < 0.0001]。每增加一岁，LVDD的风险增加5.2% [95% CI = 1.022-1.084, P = 0.001]。基于MAU状态的分层分析显示，在无MAU患者中，fQRS与LVDD的相关性更强[OR = 7.084, 95% CI = 3.255-15.419, P < 0.0001]。而在MAU患者中，fQRS与LVDD的关系不再显著[OR = 1.499, 95% CI = 0.603-3.722, P = 0.383]。结论本研究发现fQRS和MAU均为T2DM患者LVDD的独立危险因素。fQRS的存在使LVDD的风险增加了3.72倍，MAU的存在使LVDD的风险增加了4.05倍。分层分析进一步发现，在无MAU患者中，fQRS与LVDD的相关性显著增强（OR = 7.084, P < 0.0001），而在有MAU患者中，这种相关性不再显著（P = 0.383）。这些研究结果表明，fQRS和MAU的联合检测可能为T2DM患者心血管风险评估提供有价值的信息，有助于制定个性化的干预策略，最终改善患者预后。
{"title":"The association between fragmented QRS and left ventricular diastolic dysfunction in type 2 diabetes patients with or without microalbuminuria","authors":"Lili Wang , Linjun Zheng , Jiayu Hu , Nongnong Zhao","doi":"10.1016/j.endinu.2025.501623","DOIUrl":"10.1016/j.endinu.2025.501623","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM), and left ventricular diastolic dysfunction (LVDD) is considered one of the earliest markers of myocardial dysfunction. Fragmented QRS (fQRS) and microalbuminuria (MAU) are important biomarkers of cardiac electrophysiological changes and CVD, but their relationship with LVDD in T2DM remains unclear. This study aims to explore the impact of fQRS and MAU on LVDD in T2DM patients and to analyze whether the association between fQRS and LVDD differs across varying MAU statuses.</div></div><div><h3>Methods</h3><div>A total of 374 patients with T2DM were ultimately enrolled in this study. Twelve-lead electrocardiography (ECG) and echocardiography were performed, and the patients’ baseline characteristics, laboratory results, and echocardiographic parameters were collected. Univariate and multivariate logistic regression analyses were conducted to assess the association between fQRS, MAU, and LVDD in T2DM patients. A stratified analysis was performed to examine the relationship between fQRS and LVDD across different MAU statuses.</div></div><div><h3>Results</h3><div>The mean age of the T2DM patients was 57.19<!--> <!-->±<!--> <!-->12.47 years, and 62.57% were male. fQRS, MAU, and age were independent risk factors for LVDD in patients with T2DM. The risk of developing LVDD was 3.72 times higher in patients with fQRS compared to those without fQRS [95% CI<!--> <!-->=<!--> <!-->2.125–6.513, <em>P</em> <!--><<!--> <!-->0.0001]. The risk of LVDD was 4.05 times higher in patients with MAU compared to those without MAU [95% CI<!--> <!-->=<!--> <!-->2.252–7.282, <em>P</em> <!--><<!--> <!-->0.0001]. For each additional year of age, the risk of LVDD increased by 5.2% [95% CI<!--> <!-->=<!--> <!-->1.022–1.084, <em>P</em> <!-->=<!--> <!-->0.001]. Stratified analysis based on MAU status revealed that in patients without MAU, the association between fQRS and LVDD was stronger [OR<!--> <!-->=<!--> <!-->7.084, 95% CI<!--> <!-->=<!--> <!-->3.255–15.419, <em>P</em> <!--><<!--> <!-->0.0001]. However, in patients with MAU, the relationship between fQRS and LVDD was no longer significant [OR<!--> <!-->=<!--> <!-->1.499, 95% CI<!--> <!-->=<!--> <!-->0.603–3.722, <em>P</em> <!-->=<!--> <!-->0.383].</div></div><div><h3>Conclusions</h3><div>Our study found that both fQRS and MAU are independent risk factors for LVDD in patients with T2DM. The presence of fQRS increased the risk of LVDD by 3.72 times, while MAU increased the risk by 4.05 times. Stratified analysis further revealed that in patients without MAU, the association between fQRS and LVDD was significantly stronger (OR<!--> <!-->=<!--> <!-->7.084, <em>P</em> <!--><<!--> <!-->0.0001), while in patients with MAU, this association was no longer significant (<em>P</em> <!-->=<!--> <!-->0.383). These findings suggest that combining the detection of fQRS and MAU may provide valuab","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 9","pages":"Article 501623"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374665","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 : 2025-06-01DOI: 10.1016/j.endinu.2025.501563
Karina Mercedes Becerra Añez , Carlos Sánchez Juan , Ana Artero Fullana , Ana Jiménez Portilla , Juan Carlos Ferrer García
Introduction
Hyponatremia is the most common electrolyte disorder in hospitals. This study analyzes the evolution of serum sodium levels during hospitalization.
Materials and methods
This is an observational, retrospective, and analytical study. Patients hospitalized for hyponatremia in a tertiary care hospital were included. Demographic and laboratory variables were collected, and hyponatremia was classified according to severity and etiology. Criteria and risk factors for serum sodium overcorrection were defined, and the effectiveness of treatments used for hyponatremia was described. The Chi-square test was used for qualitative variables, while Student's t-test and Mann-Whitney U test were applied for quantitative variables. Predictive models were also used to determine the risk of an event.
Results
A total of 216 patients hospitalized for hyponatremia were included, with a higher prevalence in patients over 75 years of age and females. Longer hospital stays were associated with older age and male gender. Severe hyponatremia and hypokalemia were linked to a higher risk of overcorrection. The therapies for hyponatremia correction across the three groups were effective either alone or in combination. Additionally, severe hyponatremia was associated with increased 5-year mortality.
Conclusions
Hyponatremia in hospitalized patients is more prevalent in those over 75 years old and in females. Severe hyponatremia increases 5-year mortality. There are factors that increase the risk of overcorrection, so treatment should be carefully managed to avoid osmotic demyelination syndrome (ODS).
{"title":"Evolución del sodio en la hiponatremia: análisis retrospectivo en un centro de tercer nivel","authors":"Karina Mercedes Becerra Añez , Carlos Sánchez Juan , Ana Artero Fullana , Ana Jiménez Portilla , Juan Carlos Ferrer García","doi":"10.1016/j.endinu.2025.501563","DOIUrl":"10.1016/j.endinu.2025.501563","url":null,"abstract":"<div><h3>Introduction</h3><div>Hyponatremia is the most common electrolyte disorder in hospitals. This study analyzes the evolution of serum sodium levels during hospitalization.</div></div><div><h3>Materials and methods</h3><div>This is an observational, retrospective, and analytical study. Patients hospitalized for hyponatremia in a tertiary care hospital were included. Demographic and laboratory variables were collected, and hyponatremia was classified according to severity and etiology. Criteria and risk factors for serum sodium overcorrection were defined, and the effectiveness of treatments used for hyponatremia was described. The Chi-square test was used for qualitative variables, while Student's t-test and Mann-Whitney U test were applied for quantitative variables. Predictive models were also used to determine the risk of an event.</div></div><div><h3>Results</h3><div>A total of 216 patients hospitalized for hyponatremia were included, with a higher prevalence in patients over 75 years of age and females. Longer hospital stays were associated with older age and male gender. Severe hyponatremia and hypokalemia were linked to a higher risk of overcorrection. The therapies for hyponatremia correction across the three groups were effective either alone or in combination. Additionally, severe hyponatremia was associated with increased 5-year mortality.</div></div><div><h3>Conclusions</h3><div>Hyponatremia in hospitalized patients is more prevalent in those over 75 years old and in females. Severe hyponatremia increases 5-year mortality. There are factors that increase the risk of overcorrection, so treatment should be carefully managed to avoid osmotic demyelination syndrome (ODS).</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501563"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184468","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 : 2025-06-01DOI: 10.1016/j.endinu.2025.501561
Faezeh Ebrahimi , Hadi Maleki , Mansour Ebrahimi , Amir Hossein Beiki
Background/Purpose of the study
Type 2 diabetes mellitus (T2DM)—one of the fastest globally spreading diseases—is a chronic metabolic disorder characterized by elevated blood glucose levels. It has been suggested that the composition of gut microbiota plays key roles in the prevalence of T2DM. In this study, a novel approach of large-scale data mining and multivariate analysis of the gut microbiome of T2DM patients and healthy controls was conducted to find the key compositional differences in their microbiota and potential biomarkers of the disease.
Methods
First, suitable datasets were identified (9 in total with 946 samples), analyzed, and their operational taxonomic units (OTUs) were computed by identical parameters to increase accuracy. The following OTUs were merged and compared based on their health status, and compositional differences detected. For biomarker identification, the OTUs were subjected to 9 different attribute weighting models. Additionally, OTUs were independently analyzed by multivariate algorithms (LEfSe test) to verify the realized biomarkers.
Results
Overall, 23 genera and 4 phyla were identified as possible biomarkers. At genus level, the decrease of Bacteroides, Methanobrevibacter, Paraprevotella, and [Eubacterium] hallii group in T2DM and the increase of Prevotella, Megamonas, Megasphaera, Ligilactobacillus, and Lachnoclostridium were selected as biomarkers; and at phylum level, the increase of Synergistota and the decrease of Euryarchaeota, Desulfobacterota (Thermodesulfobacteriota), and Ptescibacteria.
Conclusion
This is the first study ever conducted to find the microbial compositional differences and biomarkers in T2DM using data mining models applied on a widespread metagenome dataset and verified by multivariate analysis.
{"title":"A novel approach to finding the compositional differences and biomarkers in gut microbiota in type 2 diabetic patients via meta-analysis, data-mining, and multivariate analysis","authors":"Faezeh Ebrahimi , Hadi Maleki , Mansour Ebrahimi , Amir Hossein Beiki","doi":"10.1016/j.endinu.2025.501561","DOIUrl":"10.1016/j.endinu.2025.501561","url":null,"abstract":"<div><h3>Background/Purpose of the study</h3><div>Type 2 diabetes mellitus (T2DM)—one of the fastest globally spreading diseases—is a chronic metabolic disorder characterized by elevated blood glucose levels. It has been suggested that the composition of gut microbiota plays key roles in the prevalence of T2DM. In this study, a novel approach of large-scale data mining and multivariate analysis of the gut microbiome of T2DM patients and healthy controls was conducted to find the key compositional differences in their microbiota and potential biomarkers of the disease.</div></div><div><h3>Methods</h3><div>First, suitable datasets were identified (9 in total with 946 samples), analyzed, and their operational taxonomic units (OTUs) were computed by identical parameters to increase accuracy. The following OTUs were merged and compared based on their health status, and compositional differences detected. For biomarker identification, the OTUs were subjected to 9 different attribute weighting models. Additionally, OTUs were independently analyzed by multivariate algorithms (LEfSe test) to verify the realized biomarkers.</div></div><div><h3>Results</h3><div>Overall, 23 genera and 4 phyla were identified as possible biomarkers. At genus level, the decrease of <em>Bacteroides</em>, <em>Methanobrevibacter</em>, <em>Paraprevotella</em>, and [<em>Eubacterium</em>] <em>hallii group</em> in T2DM and the increase of <em>Prevotella</em>, <em>Megamonas</em>, <em>Megasphaera</em>, <em>Ligilactobacillus</em>, and <em>Lachnoclostridium</em> were selected as biomarkers; and at phylum level, the increase of <em>Synergistota</em> and the decrease of <em>Euryarchaeota</em>, <em>Desulfobacterota</em> (<em>Thermodesulfobacteriota</em>), and <em>Ptescibacteria</em>.</div></div><div><h3>Conclusion</h3><div>This is the first study ever conducted to find the microbial compositional differences and biomarkers in T2DM using data mining models applied on a widespread metagenome dataset and verified by multivariate analysis.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501561"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184472","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 : 2025-06-01DOI: 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 : 2025-06-01DOI: 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 : 2025-06-01DOI: 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 : 2025-06-01DOI: 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 : 2025-06-01DOI: 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 : 2025-05-31DOI: 10.1016/j.endinu.2025.501610
Beatriz Brea Álvarez
{"title":"Técnicas avanzadas de diagnóstico por imagen en patología hipofisaria","authors":"Beatriz Brea Álvarez","doi":"10.1016/j.endinu.2025.501610","DOIUrl":"10.1016/j.endinu.2025.501610","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 7","pages":"Article 501610"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722756","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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