Journal of the ASEAN Federation of Endocrine Societies最新文献

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation and neural crest tumor (ROHHAD-NET) though a rare disease, is potentially fatal. It is of utmost importance to be understood and urgently diagnosed. We hereby report a series of three cases, the first of its kind from India. Children older than 18 months old usually exhibit rapid weight growth as a presenting symptom. Hypothalamic dysfunction could lead to endocrine issues, respiratory dysfunction and autonomic dysregulation. Over the years, with variable timing, one or more signs of hypothalamic dysfunction appear: hyperprolactinemia, growth hormone deficiency, central hypothyroidism, central adrenal insufficiency or Cushing syndrome, early or delayed puberty, water-electrolyte balance disorders. The diagnosis is difficult because there is no reliable test, and the treatment is mainly supportive. All the three children who were thriving well, presented with rapid weight gain and then developed symptoms of hypothalamic dysfunction. While in one a neural crest tumor was incidentally detected, the second had persistent hypernatremia and the third child presented with intestinal obstruction. The varied presentation and vague symptom spectrum exhibit a diagnostic challenge to the clinician and underscores the importance of creating awareness. An individualized strategic approach is needed as it is clinically difficult to distinguish ROHHAD syndrome from other obesity syndromes of genetic origin.

Adrenal myelolipoma (AML) is a rare, benign, asymptomatic, nonfunctioning tumor of the adrenal cortex detected incidentally. AML can be accompanied by several other endocrine disorders simultaneously. Here, we report a case of a 36-year-old female with primary hypothyroidism and metabolic syndrome accompanied by severe hypertension and pheochromocytoma. However, the histopathological examination of the excised adrenal gland confirmed myelolipoma. Following surgery, her plasma nor-metanephrine levels decreased to normal values and the patient became normotensive, which suggested that the mass was functioning.

Background and objective: Although nutritional assessment tools have been available internationally, local data for their use in foreseeing adverse outcomes among admitted patients are currently unavailable. The primary objective of this study was to determine the association of nutritional status using Short Nutritional Assessment Questionnaire (SNAQ) and malnutrition risk using the Malnutrition Screening Tool (MST) with intensive care unit (ICU) admission and in-hospital mortality.

Methodology: This was a prospective-cohort study which included 122 purposively-selected adult participants who were non-intubated, admitted for medical and surgical management, stayed for at least 24 hours, had no COVID-19 infection, and were not admitted in any critical care unit. The SNAQ and MST questionnaires, which are validated tools and consists of two to three easy-to-answer questions, were used among the participants and their scores were tallied in order to get their nutritional status and malnutrition risk. Primary endpoints measured were the length of hospital stay, incidence of mortality, and ICU admission rate. Comorbidities were taken into account using the Charlson Comorbidity Index.

Results: Categorizing the SNAQ scores showed 33.61% were severely malnourished, which was similar when using the MST classification, wherein 34.43% were at risk of malnutrition. None of the participants were admitted to the ICU. Malnutrition risk and nutritional status was not significantly associated with 30-day in-hospital mortality (p >0.05). On the other hand, results of the Cox proportional hazards showed that SNAQ and MST significantly predicted the hazard of 30-day in-hospital mortality, increasing the hazard of mortality by 2.58 times and 3.67 times, respectively, for every 1-unit increase in SNAQ and MST scores. Similarly, nutritional status using the SNAQ classification indicated the severely malnourished category significantly predicted the hazard of mortality, increasing it by 9.22 times for those who are severely malnourished. Also, malnutrition risk using the MST classification indicated that those who were at risk of malnutrition were 9.80 times greater hazard of mortality than those who were not at risk of malnutrition.

Conclusion: The MST and SNAQ classification are screening tools for nutritional status (SNAQ) and malnutrition risk (MST) that can be administered at the onset of the patient's hospital course and have been demonstrated in this study to predict 30-day in-hospital mortality. It is important to note that none of the patients included in this study required intensive care unit admission.

A 25-year-old woman presented with metastatic pancreatic neuroendocrine tumor with carcinoid syndrome. She was refractory to octreotide and did not respond well to chemotherapy. Although surgical debulking remains the primary approach for managing these tumours, it entails inherent risks, including potentially exacerbating carcinoid syndrome. We strategically delivered the one Peptide Receptor Radionuclide Therapy cycle before tumor debulking, a decision that yielded a remarkable response, stabilizing her condition.

Background: As a developing nation, there has been an increasing trend in non-communicable diseases, including diabetes mellitus (DM) in Indonesia. However, a remarkable proportion of DM cases in this archipelagic country is likely undiagnosed.

Objective: This study assessed the sociodemographic and lifestyle factors related to undiagnosed DM in Indonesians.

Methodology: This cross-sectional study analyzed secondary data from the 2018 Indonesian Basic Health Research (Riskesdas). It involved 3,755 study subjects, 3,619 individuals with high blood glucose levels meeting the DM criteria and 136 individuals with controlled DM. Multivariable regression analysis examined the associations between sociodemographic and lifestyle factors and undiagnosed diabetes.

Results: The study revealed that 80% of the DM cases among the subjects were undiagnosed. Multivariable analysis confirmed that age group, area of residence, employment, wealth quintiles and physical activity were significantly associated with higher odds of undiagnosed diabetes. Notably, sex, smoking status and vegetable consumption did not show any association with the diagnosis status of diabetes.

Conclusion: A significant portion of DM cases in Indonesia remain undiagnosed, especially among young adults, rural residents, agricultural workers and lower socioeconomic groups. Improved healthcare access, targeted screening and enhanced health education are essential to ensure early diagnosis and effective management of diabetes.

Background: Bisphenol A (BPA) is a widely used industrial element. Recently it is suspected that BPA may disrupt the endocrine system to influence the manifestations of polycystic ovary syndrome (PCOS).

Objective: This study aimed to assess serum BPA level and its association with manifestations of PCOS in women.

Methodology: This cross-sectional study included 40 young adults with PCOS and 38 age-matched control women [23.0 (20.0, 29.0) vs. 25.0 (21.0, 29.0), years, median (IQR), p = 0.406]. After a thorough clinical examination, fasting blood was collected in the follicular phase of the menstrual cycle to measure glucose, lipids, insulin, luteinizing hormone, folliclestimulating hormone, total testosterone, sex hormone binding globulin, dehydroepiandrosterone sulfate, and BPA. Glucose was measured by glucose oxidase, lipids by glycerol phosphate dehydrogenase-peroxidase, all hormones including SHBG by chemiluminescent immunoassay and BPA by sandwiched enzyme-linked immunosorbent assay. Insulin resistance was measured using homeostasis model assessment of insulin resistance.

Result: Women with PCOS had significantly higher BPA levels (ng/mL) than the control group [27.30 (25.60, 33.40) vs. 24.0 (15.58, 28.70), median (IQR), p = 0.001]. Using the 75^th percentile value of the control group, 15 (37.5%) women with PCOS had high BPA levels. Those with high BPA levels had a significantly higher frequency of menstrual regulation / abortion among women with PCOS [53.8% vs. 0%, p= 0.005]. Women with PCOS with a history of menstrual regulation / abortion [36.7 ± 4.9 vs. 28.5 ± 6.4, mean ± SD, p = 0.004] and subfertility [34.3 ± 6.8 vs. 28.5 ± 6.4, mean ± SD, p = 0.031] had higher levels of BPA than those without the histories. Serum BPA had no significant association or correlation with any androgenic and metabolic manifestations.

Conclusion: Raised BPA level may be associated with adverse reproductive features in PCOS.

Introduction: Caring for persons with diabetes involves a holistic approach. Addressing diabetes distress is crucial to achieve optimal health outcomes for persons with diabetes. This study aims to validate a Filipino version of the diabetes distress scale (DDS).

Methodology: We conducted forward and backward translations to construct a Filipino version from the validated English questionnaire. We performed statistical analysis to check internal consistency and validation and to correlate diabetes distress with glycemic control based on the subjects' HbA1c levels.

Results: We included one hundred and seventy patients (170) seen at the Outpatient Diabetes Clinic in the analysis. Of the participants, 13 (7.6%) have Type 1 Diabetes Mellitus (T1DM), while the rest have Type 2 (T2DM). We found physician distress (PD) to be significantly associated with having T1DM. All domains in the Filipino DDS showed good internal consistency, ranging from 0.81 to 0.85. We used factor analysis to extract four factors similar to the original diabetes distress scale. We did not find any significant correlation between diabetes distress and HbA1c level.

Conclusion: The Filipino DDS showed good internal reliability and had consistent results similar to the original diabetes distress scale. However, we did not find a significant correlation between diabetes-related distress and the HbA1c level.

Pituitary adenomas account for 10 to 15% of all intracranial masses and are the most common type of pituitary disorder. Their clinical manifestations can vary based on the tumor size and whether they secrete excess hormones. Occasionally, they are incidentally diagnosed following an imaging procedure for other indications (pituitary incidentaloma). The Pituitary Working Group of the Indonesian Society of Endocrinology has identified pituitary adenoma as a priority and has called for the development of updated evidence-based practice guidelines. These guidelines aim to provide evidence-based, comprehensive and multidisciplinary recommendations for diagnosing pituitary adenomas in Indonesia and to navigate the limitations of diagnosing pituitary adenomas in Indonesia.