Journal of the ASEAN Federation of Endocrine Societies最新文献

Objective: This study aims to provide a visual analysis of the research hotspots and frontiers in the field of obesity-related executive functions using bibliometric methods.

Methodology: Our analysis is based on 5814 English-language documents retrieved from the Web of Science Core Collection database. CiteSpace 6.2.R4 software was utilized to conduct bibliometric analysis. The study examines the trends, key players, and thematic evolution in obesity-related executive function research over the past decade.

Results: The number of publications in this domain has exhibited a steady linear growth trend, with American institutions and scholars leading in research contributions. The current research focus encompasses co-occurrence and cluster analysis of keywords and references, as well as the brain and associated cognitive functions. Our bibliometric analysis reveals a shift in focus towards the brain, cognition, executive functions, the prefrontal cortex and other related topics in obese individuals, in addition to established areas such as metabolic syndromes, insulin resistance, diabetes, gut microbiota, and dietary intake.

Conclusion: This study highlights new entry points for aspiring researchers in the field of obesity and executive functions. Future research directions may include a deeper exploration of the relationship between obesity and specific components of executive functions, such as working memory, inhibitory control, cognitive flexibility, and planning.

The majority of parathyroid adenomas can be localized preoperatively using various imaging techniques. The success rate of focused parathyroidectomy exceeds 95% when performed by an experienced surgeon. Here, we report an apparent failure of focused right inferior parathyroidectomy performed for a preoperatively detected parathyroid adenoma. This misinterpretation arose due to macrofollicular growth pattern of the resected parathyroid adenoma, which mimicked thyroid tissue. The patient subsequently underwent re-exploration, including intraoperative ultrasound, which revealed that the culprit gland had, in fact, been successfully removed during the initial surgery. This finding was also supported by a significant decrease in the intraoperative parathyroid hormone level, as compared to the pre-operative level. This case highlights the rare macrofollicular histology of parathyroid adenoma and underscores the importance of a multidisciplinary team in successfully treating the condition.

Diabetic striatopathy is a rare, acute neurological complication of diabetes mellitus which presents with non-ketotic hyperglycemia and involuntary movements, specifically hemichorea or hemiballismus. Striatal abnormalities on neuroimaging have been reported in most, but not all cases. This case report aims to increase awareness that diabetic striatopathy can be a presenting symptom of diabetes mellitus. A 92-year-old Filipino female with no history of diabetes presented with acute onset of focal clonic flexion of the left upper extremity for a few hours, which progressed to right hemifacial spasm. She was diagnosed with a hyperosmolar hyperglycemic state and was treated accordingly. Cranial CT scan findings were unremarkable. There was an immediate resolution of her neurologic symptoms after the correction of hyperglycemia. The diagnosis of diabetic striatopathy highlights the importance of increasing awareness and understanding of this condition among clinicians to prevent delayed diagnosis and treatment. Screening for hyperglycemia is advisable for patients with involuntary movements. The prognosis for diabetic striatopathy is good with prompt glycemic control in most cases.

Background: Pituitary adenomas comprise approximately 20% of surgically resected intracranial tumors. This study aimed to collect local data on the post-operative neurologic, visual and endocrine outcomes of patients with pituitary macroadenoma.

Methodology: This is a retrospective study of patients with pituitary macroadenoma who underwent neurosurgery at the Philippine General Hospital between 2017 to 2022. Data on demographics, clinical signs and symptoms, neuro-ophthalmologic examination findings, hormonal and radiologic studies, type of surgery, and post-operative outcomes were collected. Statistical analyses were done to compare the neurologic, ophthalmologic and endocrine status pre- and post-operatively.

Results: A total of 122 patients were included. The mean age was 44.18 years, and majority (50.82%) were female. The most common presentation was blurring of vision. Most tumors were non-functioning (77.87%). Among the functioning adenomas, the most common was acromegaly. The median tumor size was 3.5 cm, and the median time to surgery was 18 months. Microscopic transsphenoidal surgery was the most common approach (60.83%) followed by endoscopic resection (24.17%). There was significant improvement in visual acuity post-operatively (p >0.05), by approximately one line in the Snellen chart. There was also some improvement in post-operative endocrine function, manifested as a significant decrease in the use of hormone replacement therapy. Factors such as age, sex, type of adenoma, tumor size, timing of surgery, surgical approach, post-operative complications and adjuvant radiation were not significantly associated with the visual and endocrine outcomes (p >0.005).

Conclusion: This is the first local study to comprehensively assess the entirety of post-operative outcomes among pituitary macroadenoma patients. Our results showed that even patients with longstanding visual and endocrine deficits may still improve with surgery.

Objective: Previous studies have indicated that clinical hypogonadism is common among males with type 2 diabetes mellitus (T2DM). However, the reported prevalence varies due to the diverse diagnostic criteria used in these studies. This study aims to determine the prevalence of clinical hypogonadism among Malaysian T2DM males and their associated factors.

Methodology: A total of 360 participants who fulfilled the inclusion criteria were included in this study. Their socio-demographic and clinical parameters were documented and a total testosterone level was sampled from a morning fasting serum. Patients with serum total testosterone of 8-12 nmol/L had their serum total testosterone repeated and their symptoms assessed with the Aging Male Symptoms (AMS) scale. Clinical hypogonadism was diagnosed with total testosterone <12 nmol/L and cfT <0.255 nmol/L, in addition to an AMS score of >26.

Results: The prevalence of clinical hypogonadism among Malaysian T2DM males was 17.5% (n = 63), with 55.6% of them having hypogonadotropic hypogonadism. There is a significant association between clinical hypogonadism with waist circumference >94 cm (p <0.001), obesity (p <0.001), hypertension (p = 0.010), coronary artery disease (p = 0.014) and peripheral artery disease (p = 0.022). There is a significant difference in the weight (p = 0.001), BMI (p <0.001), waist circumference P <0.001), serum HDL-C levels (p <0.001), serum triglycerides levels (p = 0.001) and serum TyG index (p <0.001). Diabetic males with increasing age (adjusted OR = 1.070, 95% CI 1.004-1.146, p = 0.038), presence of coronary artery diseases (adjusted OR = 2.08, 95% CI 1.220-10.219, p = 0.020) and low total testosterone (adjusted OR = 2.451, 95% CI 1.908-3.155, p <0.001) are at higher risk of developing clinical hypogonadism.

Conclusion: This study is the first in the Asian region to use stricter criteria for diagnosing hypogonadism. Despite these stringent criteria, the prevalence of hypogonadism remains significantly high among Malaysian T2DM males. It is particularly common in diabetic males over 35 years old with coronary artery disease, regardless of A1c control and the duration of diabetes.

Occult ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is a relatively rare form of ACTH-dependent Cushing's Syndrome (CS). We describe a middle-aged female with symptomatic CS, where despite thorough investigations including hormone suppression testing, multiple imaging modalities, and inferior petrosal sinus sampling (IPSS), an ectopic source could not be demonstrated. Our case demonstrates that ketoconazole can be an effective therapeutic to suppress cortisol production even when the source of ectopic ACTH production is unknown. However, long-term evaluation is required.

Background: This first clinical practice guideline (CPG) on osteoporosis prevention and management in the Philippines is the output of a shared undertaking by a multidisciplinary CPG development team spearheaded by the Osteoporosis Society of the Philippines Foundation, Inc. and joined by the Philippine Academy of Family Physicians; the Philippine College of Endocrinology, Diabetes, and Metabolism; the Philippine Orthopedic Association; the Philippine Obstetrics and Gynecological Society and the Philippine Rheumatology Association. This guideline seeks to augment and update the "Consensus statements on osteoporosis diagnosis, prevention and management in the Philippines," initially published in 2011, incorporating evidence-based practices developed in the last decade.

Methodology: The steering committee formulated and prioritized clinical questions based on meetings and stakeholder consultations. A PICO (population, intervention, comparator, outcome) format was used to develop clinical questions and guide the systematic search for evidence. The development of guidelines followed the ADAPTE process. Once completed, panel discussions were done using the Evidence to Decision Framework. After the panel discussions, the final recommendations were revised.

Results: Thirty-four recommendations were formulated to address 27 clinical questions related to screening, prevention, diagnosis, pharmacologic and nonpharmacologic treatment, surgical management, follow-up, and continuity of care. With these recommendations, the developers aim to establish a standard of care in the prevention, diagnosis and management of osteoporosis and fragility fractures in both in-patient and out-patient cases that are appropriate to the Philippine context. Specifically, the CPG development group aims to use these recommendations to define the standard of care for osteoporosis as part of universal healthcare services once the program is implemented nationally. Relevant stakeholders may also use the recommendations to inform public and private payor policies for patients with fragility fractures, as well as by local government units or private companies looking to establish orthogeriatric centers with fracture liaison services.

Conclusion: This guideline is helpful for physicians and other allied health personnel in screening, diagnosis, management and prevention of primary osteoporosis and fragility fractures among postmenopausal women and older men.

Objective: Obesity is a major global health concern characterized by an accumulation of excessive body fat, dyslipidaemia and low vitamin D levels. This study aimed to assess the relationship between dyslipidaemia and vitamin D status in obese individuals and the risk of atherogenesis.

Methodology: In this cross-sectional study, 140 participants aged 18 to 65 years, were categorized into 4 equal groups of 35 each, based on their body mass index BMI. Baseline and demographic data were obtained using a semi-structured questionnaire. The serum levels of vitamin D, total cholesterol (TC), triglyceride (TG) and HDL-cholesterol (HDL-c) were measured using standard methods. Low-density lipoprotein cholesterol (LDL-c) and atherogenic index in plasma (AIP) were calculated.

Results: The vitamin D status was sufficient in all groups but its concentrations decline significantly as BMI increases. Serum TC, TG, LDL-c concentration significantly increases as BMI increases, but HDL-c concentration decreases. The AIP increases as BMI increases.

Conclusion: The study provided possible evidence to support the association between dyslipidaemia and inadequate vitamin D status in this cohort of adults with obesity in Ibadan, Nigeria.