Journal of Clinical and Translational Endocrinology最新文献

Effects of cyclic yoga on selected metabolic and hepatic parameters in diabetic women with fatty liver diseases: A clinical trial 循环瑜伽对糖尿病女性脂肪肝患者选定代谢和肝脏参数的影响：一项临床试验

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2026-02-01 DOI: 10.1016/j.jcte.2026.100431

Zahra Bayat , Seyedeh Soolmaz Mahdioun , Houshang Nemati , Fatemeh Rezvan Madani , Mehrali Rahimi , Hanieh Dehghan , Rozita Naseri , Seyed Mehdi Goosheh

Aims

Type 2 diabetes mellitus and non-alcoholic fatty liver disease increase cardiometabolic risk. This randomized controlled trial assessed the effects of cyclic yoga, a structured asana sequence, on anthropometric, glycemic, lipid, and hepatic parameters in overweight women with both conditions.

Methods

Forty overweight women (mean age 50.5 ± 5.5 years) with type 2 diabetes and non-alcoholic fatty liver disease were randomized to either an eight-week cyclic yoga intervention (three sessions/week) or a control group maintaining usual activities. Pre- and post-intervention, fasting blood glucose, glycated hemoglobin, insulin resistance, lipid profile, liver enzymes (alanine aminotransferase, aspartate aminotransferase), anthropometric parameters were measured and analyzed using repeated measures analysis of variance.

Results

The cyclic yoga group showed significant reductions in fasting blood glucose, glycated hemoglobin, insulin resistance, triglycerides, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, weight, body mass index, hip circumference, waist circumference, with increased high-density lipoprotein cholesterol compared to control group.

Conclusions

Cyclic yoga appears to improve glycemic control, lipid profiles, liver enzymes, and anthropometric indices in women with type 2 diabetes mellitus and non-alcoholic fatty liver disease. These findings suggest that cyclic yoga may be a safe, practical, and cost-effective complementary therapy to improve metabolic and hepatic health in this high-risk population, although larger and longer term studies are warranted.

目的：2型糖尿病和非酒精性脂肪肝增加心脏代谢风险。这项随机对照试验评估了循环瑜伽（一种结构化体式序列）对患有两种疾病的超重女性的人体测量、血糖、血脂和肝脏参数的影响。方法将40名超重的2型糖尿病和非酒精性脂肪性肝病女性（平均年龄50.5±5.5岁）随机分为8周循环瑜伽干预组（3次/周）和维持常规活动的对照组。测量干预前后空腹血糖、糖化血红蛋白、胰岛素抵抗、血脂、肝酶（丙氨酸转氨酶、天冬氨酸转氨酶）、人体测量参数，并采用重复测量方差分析进行分析。结果与对照组相比，循环瑜伽组空腹血糖、糖化血红蛋白、胰岛素抵抗、甘油三酯、低密度脂蛋白胆固醇、丙氨酸转氨酶、天冬氨酸转氨酶、体重、体质指数、臀围、腰围显著降低，高密度脂蛋白胆固醇显著升高。结论：循环瑜伽可以改善2型糖尿病和非酒精性脂肪肝患者的血糖控制、血脂、肝酶和人体测量指标。这些发现表明，循环瑜伽可能是一种安全、实用且具有成本效益的补充疗法，可以改善高危人群的代谢和肝脏健康，尽管需要进行更大规模和更长期的研究。

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引用次数: 0

Systemic MOTS-c levels are increased in adults with obesity in association with metabolic dysregulation and remain unchanged after weight loss 成人肥胖与代谢失调相关的全身MOTS-c水平升高，在减肥后保持不变

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-12-30 DOI: 10.1016/j.jcte.2025.100429

Se-Hee Yoon , Fei Yuan , Xiangyang Zhu , Hui Tang , Dilbar Abdurakhimoova , James Krier , Alfonso Eirin , Amir Lerman , Pinchas Cohen , Lilach O Lerman

Introduction

MOTS-c (mitochondrial open reading frame of the 12S rRNA type-c) is a mitochondrial-derived peptide and regulator of metabolic homeostasis. Although its role in glucose and lipid metabolism is emerging, changes in circulating MOTS-c with obesity remain unclear. We hypothesized that circulating MOTS-c concentrations would be altered in obese vs. lean adults in associations with altered metabolic and inflammatory markers.

Methods

Circulating MOTS-c levels, metabolic parameters, and inflammatory markers were compared between 22 lean controls and 32 obese participants scheduled for bariatric surgery. Longitudinal changes in weight, MOTS-c levels, and metabolic markers were also analyzed in 10 of the obese patients before and 6 months after bariatric surgery. Additionally, adipose tissue MOTS-c expression was assessed by immunofluorescence in lean kidney donors (n = 6) and obese (n = 14) subjects.

Results

Circulating MOTS-c levels were significantly higher in obese compared to lean individuals (273 ± 56 vs. 223 ± 50 pg/mL; P < 0.01). BMI and HOMA-IR independently predicted elevated MOTS-c levels (P = 0.035 and P = 0.032, respectively). MOTS-c showed a biphasic relationship with HOMA-IR, rising sharply above HOMA-IR of ∼ 6.6 mmol/L×µU/mL. Adipose tissue MOTS-c did not differ between the groups or correlate with circulating MOTS-c. Despite significant BMI improvements post-surgery (P < 0.001), circulating MOTS-c levels remained unchanged (P = 0.913).

Conclusion

Circulating MOTS-c levels are elevated in obesity, exhibiting a nonlinear relationship with BMI and insulin resistance. MOTS-c may represent a compensatory metabolic response in obesity and insulin-resistant states, highlighting its potential as a clinical biomarker. This preliminary exploratory study warrants validation in larger and independent cohorts.

mots -c （12S rRNA -c型的线粒体开放阅读框）是一种线粒体衍生的肽，是代谢稳态的调节剂。尽管其在葡萄糖和脂质代谢中的作用正在显现，但循环MOTS-c在肥胖中的变化尚不清楚。我们假设，肥胖和瘦弱成人的循环MOTS-c浓度会随着代谢和炎症标志物的改变而改变。方法比较22名瘦对照组和32名肥胖手术患者的循环MOTS-c水平、代谢参数和炎症标志物。我们还分析了10名肥胖患者在减肥手术前和手术后6个月的体重、MOTS-c水平和代谢指标的纵向变化。此外，通过免疫荧光法评估瘦肾供者（n = 6）和肥胖（n = 14）受试者的脂肪组织MOTS-c表达。结果肥胖人群血液中MOTS-c水平明显高于瘦人（273±56比223±50 pg/mL； P < 0.01）。BMI和HOMA-IR独立预测MOTS-c水平升高（P分别= 0.035和P = 0.032）。MOTS-c与HOMA-IR呈双相关系，显著高于HOMA-IR约6.6 mmol/ lxµU/mL。脂肪组织MOTS-c在两组之间没有差异，也与循环MOTS-c无关。尽管术后BMI显著改善（P < 0.001），但循环MOTS-c水平保持不变（P = 0.913）。结论肥胖患者外周血MOTS-c水平升高，与BMI和胰岛素抵抗呈非线性关系。MOTS-c可能在肥胖和胰岛素抵抗状态下代表代偿性代谢反应，突出其作为临床生物标志物的潜力。这项初步的探索性研究需要在更大的独立队列中进行验证。

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引用次数: 0

Implementation of a Best Practice Advisory to alert inpatient providers of necessary discharge prescriptions for insulin and supplies for patients with diabetes 实施最佳实践咨询，提醒住院病人提供必要的胰岛素出院处方和糖尿病患者用品

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-12-22 DOI: 10.1016/j.jcte.2025.100428

Michelle D. Lundholm , Allison Weathers , Shannon Knapp , Pratibha P.R. Rao

Background

Medication discrepancies and omissions at hospital discharge are a common, preventable source of harm for patients with diabetes. Ensuring accurate prescriptions for insulin and diabetes supplies is critical for safe transitions of care. We aimed to evaluate the impact of a Best Practice Advisory (BPA) integrated into the electronic medical record (EMR) on the accuracy of diabetes-related discharge prescriptions.

Methods

This quality improvement initiative was implemented across seven hospitals within a large health system. The BPA was triggered in the EMR discharge navigator for patients evaluated by a Diabetes Care and Education Specialist (DCES), prompting providers to review and order recommended diabetes medications and supplies. BPA utilization data were collected from February to December 2022. A retrospective chart review of 100 consecutive eligible patients discharged in December 2022 seen by DCES was assessed for prescription accuracy and supply provision.

Results

The BPA was triggered 6,714 times for 2,266 patient encounters over 11 months. Among 100 reviewed patients (mean age 57 years, 58 % male, 76 % type 2 diabetes), insulin prescription accuracy at discharge was 99 %, and 88 % received all recommended diabetes supplies. Only 1 % of patients contacted the hospital post discharge for additional supplies, suggesting most omissions were clinically appropriate.

Conclusions

Integration of a BPA into the EMR significantly improved the accuracy and completeness of diabetes-related discharge prescriptions. This low-cost, sustainable digital intervention enhances patient safety and care quality, and represents a scalable model for improving discharge practices in inpatient settings.

出院时用药不一致和遗漏是糖尿病患者常见的、可预防的伤害来源。确保胰岛素和糖尿病供应的准确处方对于护理的安全过渡至关重要。我们旨在评估将最佳实践咨询（BPA）集成到电子病历（EMR）中对糖尿病相关出院处方准确性的影响。方法在一个大型卫生系统内的七家医院实施了这一质量改进计划。BPA在糖尿病护理和教育专家（DCES）评估的患者的EMR出院导航器中触发，促使提供者审查并订购推荐的糖尿病药物和用品。BPA利用数据收集于2022年2月至12月。对DCES于2022年12月连续出院的100名符合条件的患者进行回顾性图表回顾，评估处方准确性和供应情况。结果11个月2266例患者BPA触发6714次。在100名患者（平均年龄57岁，58%为男性，76%为2型糖尿病）中，出院时胰岛素处方的准确性为99%，88%的患者接受了所有推荐的糖尿病供应。只有1%的患者在出院后联系医院寻求额外的供应，这表明大多数遗漏在临床上是适当的。结论将BPA集成到EMR中可显著提高糖尿病相关出院处方的准确性和完整性。这种低成本、可持续的数字干预提高了患者安全和护理质量，并代表了一种可扩展的模式，可以改善住院患者的出院实践。

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引用次数: 0

Remnant cholesterol inflammatory index and MASLD in U.S. adults: mediation role of triglyceride-glucose index 残余胆固醇炎症指数和MASLD在美国成人：甘油三酯-葡萄糖指数的中介作用

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-12-17 DOI: 10.1016/j.jcte.2025.100427

Qiqi Hang , Ting Xu , Jiajie Guo , Ruixuan Li , Kang Zhao , Yinnig Guo , Lu Shao , Hanfei Zhu , Qin Xu , Minghui Ji

Background

Metabolic dysfunction–associated steatotic liver disease (MASLD) is driven by dyslipidemia and chronic inflammation. We proposed a novel biomarker, the Remnant Cholesterol Inflammatory Index (RCII), and evaluated its association with MASLD, considering mediation via insulin resistance (TyG index).

Methods

In 3,232 U.S. adults from NHANES 2015–2020 (709 with MASLD), participants were divided into RCII tertiles. Multivariable logistic regression, restricted cubic splines, threshold analysis, subgroup interaction tests, ROC curves, XGBoost SHAP, and mediation analysis were used to assess relationships and mechanisms.

Results

Compared with the lowest tertile, the highest RCII tertile had an OR of 9.578 (95 % CI 6.420–14.291; P < 0.001) for MASLD. A nonlinear association was identified, with a stronger slope below RCII = 3.640 (1-unit increase associated with 76.1 % higher odds). Significant interaction was observed by smoking status. In SHAP ranking, RCII was the sole lipid-class feature among the top five predictors. ROC showed AUC = 0.747 for RCII versus 0.732 for RC, both outperforming TC/LDL-C. TyG index mediated 32.4 % of RCII’s total effect on MASLD (P < 0.001).

Conclusions

RCII is a robust lipid–inflammation marker that outperforms conventional lipids in predicting MASLD. Its association is partly mediated by insulin resistance, supporting RCII’s use in MASLD risk stratification and early prevention.

代谢功能障碍相关的脂肪变性肝病（MASLD）是由血脂异常和慢性炎症驱动的。我们提出了一种新的生物标志物，残余胆固醇炎症指数（RCII），并评估了其与MASLD的关系，考虑了胰岛素抵抗（TyG指数）的中介作用。方法在NHANES 2015-2020的3232名美国成年人中（709名患有MASLD），参与者被分为RCII组。采用多变量logistic回归、受限三次样条、阈值分析、亚组交互检验、ROC曲线、XGBoost SHAP和中介分析来评估关系和机制。结果与最低指标比较，RCII最高指标与MASLD的OR为9.578 （95% CI 6.420 ~ 14.291; P < 0.001）。在RCII = 3.640以下存在较强的非线性关联（每增加1个单位，风险增加76.1%）。吸烟状况观察到显著的相互作用。在SHAP排名中，RCII是前五大预测因子中唯一的脂类特征。ROC显示，RCII的AUC = 0.747， RC为0.732，两者均优于TC/LDL-C。TyG指数介导了RCII对MASLD总效应的32.4% （P < 0.001）。结论srcii是一种强有力的脂质炎症标志物，在预测MASLD方面优于常规脂质标志物。其关联部分由胰岛素抵抗介导，支持RCII在MASLD风险分层和早期预防中的应用。

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引用次数: 0

Continuous glucose monitoring reveals high prevalence of hyperglycaemia in patients prior to pancreatic surgery: A pilot study 连续血糖监测显示胰腺手术前高血糖患者的高患病率：一项试点研究

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-12-03 DOI: 10.1016/j.jcte.2025.100426

Heleen Driessens , Josephine A.C. Woldring , Maarten W. Nijkamp , Peter R. van Dijk , Joost M. Klaase

Aims

Patients with pancreatic tumours are at increased risk of diabetes mellitus (DM) and hyperglycaemia and a subsequent higher risk of developing postoperative complications. Continuous glucose monitoring (CGM) can be used to assess the prevalence of hyperglycaemia in pancreatic surgery patients.

Methods

This single-centre observational pilot study (2023–2025) included 15 patients with DM type 2 or new onset DM (HbA1c ≥ 48 mmol/mol (6.5 %)) undergoing pancreatic surgery. Blinded CGM was performed for 2 weeks preoperatively and 2 weeks perioperatively. Primary outcome was time above range (TAR)(glucose > 10.0 mmol/l (180.2 mg/dl)) as a percentage of total CGM wear time. Secondary outcomes were time below and in range, glucose metrics, difference in preoperative HbA1c and patient satisfaction regarding CGM wear.

Results

In total, 5 patients had new-onset DM, 6 suboptimal controlled DM (HbA1c ≥ 53 mmol/mol (7.0 %)) and 4 optimal controlled DM (HbA1c < 53 mmol/mol (7.0 %)) at baseline. Median preoperative TAR (>10.0 mmol/L (180.2 mg/dl)) was highest in the suboptimal controlled DM group (59.7 % [35.1–68.6]), compared to 7.9 % [0.9–19.4] in the optimal controlled and 16.7 % [7.7–23.7] in the new-onset DM group. Perioperatively, the optimal controlled DM group had the highest TAR (26.7 % [11.3–49.0]) while the new-onset and suboptimal controlled DM group had TARs of 4.6 % [1.2–9.6] and 16.3 % [11.5–23.4], respectively.

Conclusions

Blinded CGM revealed frequent pre- and perioperative hyperglycaemia and high inter-individual variability in TAR among patients with (new-onset) DM undergoing pancreatic surgery. These findings support the need for stricter and more individualized glucose monitoring. This could optimize preoperative glucose management and thereby possibly reduce postoperative complications.

目的胰腺肿瘤患者患糖尿病（DM）和高血糖的风险增加，随后发生术后并发症的风险也增加。连续血糖监测（CGM）可用于评估胰腺手术患者高血糖的患病率。方法本单中心观察性试点研究（2023-2025）纳入15例接受胰腺手术的2型糖尿病或新发糖尿病（HbA1c≥48 mmol/mol(6.5%)）患者。术前2周、围术期2周进行盲法CGM。主要终点是超过范围的时间（TAR）（葡萄糖10.0 mmol/l (180.2 mg/dl)）占总CGM磨损时间的百分比。次要结局是低于和在范围内的时间、血糖指标、术前HbA1c的差异和患者对CGM磨损的满意度。结果5例患者为新发糖尿病，6例为控制不佳糖尿病（HbA1c≥53 mmol/mol(7.0%)）， 4例为控制不佳糖尿病（HbA1c≥53 mmol/mol(7.0%)）。术前TAR中位数（10.0 mmol/L (180.2 mg/dl)）在次优控制DM组最高（59.7%[35.1-68.6]），而最佳控制DM组为7.9%[0.9-19.4]，新发DM组为16.7%[7.7-23.7]。围手术期，最佳控制DM组的TAR最高（26.7%[11.3-49.0]），而新发DM组和次最佳控制DM组的TAR分别为4.6%[1.2-9.6]和16.3%[11.5-23.4]。结论：盲法CGM显示，在接受胰腺手术的（新发）糖尿病患者中，术前和围手术期高血糖发生率较高，TAR个体间差异较大。这些发现支持了更严格、更个性化的血糖监测的必要性。这可以优化术前血糖管理，从而可能减少术后并发症。

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引用次数: 0

Non-alcoholic fatty pancreas disease (NAFPD) as a pre-neoplastic niche: Metabolic and inflammatory Gateways to pancreatic ductal adenocarcinoma 非酒精性脂肪性胰腺疾病（NAFPD）作为肿瘤前生态位：胰腺导管腺癌的代谢和炎症通道

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-11-06 DOI: 10.1016/j.jcte.2025.100424

Hope Onohuean , Ngozi F. Nnolum-Orji , Sarad Pawar Naik Bukke , Kasim Sakran Abass , Abdullateef Isiaka Alagbonsi , Yahya E. Choonara

Non-alcoholic fatty pancreas disease (NAFPD), marked by ectopic triglyceride accumulation in the exocrine pancreas, is increasingly observed yet its recognition as a cancer-predisposing condition remains limited. We synthesize evidence supporting NAFPD as an early and modifiable niche for pancreatic ductal adenocarcinoma (PDAC), using a PRISMA-ScR-guided framework. The findings were synthesized into three domains: epidemiological risk, metabolic–inflammatory signaling, and immune–stromal remodeling. Mechanisms include palmitate-induced ER stress, ROS-driven NLRP3–IL-1β and STAT5 signaling, and KRAS^G12D-mediated lipotoxicity. Lipid-laden stellate cells promote fibrosis, immunosuppression, and epithelial–mesenchymal transition. NAFPD may represent an early, modifiable PDAC niche, warranting further imaging–omic studies and targeted prevention trials.

非酒精性脂肪性胰腺疾病（NAFPD），以外分泌胰腺的异位甘油三酯积累为特征，越来越多的人观察到它，但它作为一种癌症易感性疾病的认识仍然有限。我们综合证据支持NAFPD作为胰腺导管腺癌（PDAC）的早期和可修改的利基，使用prisma - scr指导框架。这些发现被综合到三个领域：流行病学风险、代谢炎症信号和免疫基质重塑。机制包括棕榈酸诱导的内质网应激，ros驱动的NLRP3-IL-1β和STAT5信号，以及KRAS^ g12d介导的脂肪毒性。脂质星状细胞促进纤维化、免疫抑制和上皮间质转化。NAFPD可能代表了早期的、可改变的PDAC生态位，需要进一步的成像组学研究和有针对性的预防试验。

引用次数: 0

Insulin dose adjustment policy for certified diabetes care and education specialists: Safe and effective 经认证的糖尿病护理和教育专家的胰岛素剂量调整政策：安全有效

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-11-01 DOI: 10.1016/j.jcte.2025.100423

Jeannine C. Leverenz , Lauren Horton , Barry Conrad , Shannon Lin , Annette Chmielewski , Franziska K. Bishop , Melissa Quaid , Priya Prahalad , David M. Maahs

In 4T Study 1, youth with new-onset type 1 diabetes started a continuous glucose monitor (CGM) soon after diagnosis and received remote CGM data review and dose changes by a Certified Diabetes Care and Education Specialist (CDCES) via secure portal messaging. We describe the CDCES policy to make incremental dose adjustments and report its safety and effectiveness, which facilitated patients’ reaching and maintaining targets. We aim to publish this data-supported CDCES protocol to facilitate use at other diabetes centers who may restrict CDCES from adjusting insulin doses.

The CDCESs and Pediatric Endocrinologists agreed on criteria for making dose changes. CDCESs made insulin dose adjustments and consulted with Pediatric Endocrinologists per protocol and as needed. CDCES sent messages with suggested dose adjustments and behavior changes via secure portal messaging.

In the first year, a total of 1564 remote patient monitoring messages were sent to 133 participants. Most messages were triggered by low time-in-range (TIR, 70–180 mg/dl [63 %]), hypoglycemia (39 %), decline in TIR (13 %), or insufficient CGM wear time (7 %). There were 3 episodes of severe hypoglycemia, none adjudicated related to the CDCES dosing protocol. At one year, the mean time <70 mg/dl was <2 %, and the A1C target of <7 % was met by 64 %.

We created a policy for CDCESs to adjust insulin doses and increase patient interaction between visits. The results demonstrate that CDCES can work at the top of their certification to adjust insulin doses to achieve target goals without decreasing safety.

在4T研究1中，新发1型糖尿病的青少年在诊断后不久开始持续血糖监测（CGM），并通过安全门户信息接收认证糖尿病护理和教育专家（CDCES）的远程CGM数据审查和剂量变化。我们描述了CDCES政策进行增量剂量调整，并报告了其安全性和有效性，促进了患者达到和维持目标。我们的目标是发表这一数据支持的CDCES方案，以方便其他可能限制CDCES调整胰岛素剂量的糖尿病中心使用。CDCESs和儿科内分泌学家就改变剂量的标准达成一致。CDCESs根据方案和需要调整胰岛素剂量并咨询儿科内分泌学家。CDCES通过安全门户消息发送建议剂量调整和行为改变的消息。在第一年，总共向133名参与者发送了1564条远程患者监测信息。大多数信息由低时间范围（TIR, 70-180 mg/dl[63%]）、低血糖（39%）、TIR下降（13%）或CGM磨损时间不足（7%）触发。有3次严重低血糖发作，均与CDCES给药方案无关。在一年的时间里，平均70毫克/分升达到2%，糖化血红蛋白7%的目标达到64%。我们为CDCESs制定了一项政策，以调整胰岛素剂量并增加患者就诊之间的互动。结果表明，CDCES可以在其认证的顶部调整胰岛素剂量以达到目标，而不会降低安全性。

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引用次数: 0

Insights into intramuscular adipose–muscle signaling in the diabetic lower extremity 糖尿病下肢肌内脂肪-肌肉信号传导的研究

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-10-28 DOI: 10.1016/j.jcte.2025.100422

Chang Gui , Dakota R. Kamm , Jeremie L.A. Ferey , Kathryn L. Bohnert , Jeremy J. McCormick , Mary K. Hastings , Gretchen A. Meyer

Intramuscular adipose tissue (IMAT) has been proposed to directly contribute to myofiber dysfunction through paracrine signaling. The impacts of this signaling beyond contributing to myofiber insulin resistance are largely unknown. This study aims to explore the human IMAT transcriptome, with a focus on its potential role in myoblast fusion deficits in advanced muscle pathology. Using a within-subjects design, we compared IMAT to subcutaneous (SQ) fat in individuals with and without diabetes undergoing below-knee amputation. We hypothesized that IMAT from the diabetic group would exhibit a pro-inflammatory profile, similar to diabetic SQ, and that inflammatory secreted factors from IMAT progenitors would impair cultured myoblast fusion. Instead, we found that the IMAT transcriptome from the diabetic group exhibited reduced enrichment of inflammatory pathways compared with SQ and less transcriptional evidence for immune cell infiltration. While IMAT featured a mostly anti-myogenic transcriptional profile for secreted cytokines, media conditioned by IMAT progenitors did not uniquely impair fusion of cultured myoblasts compared with SQ. Surprisingly, the diabetic status of the myoblast donor predicted myoblast fusion, with reduced fusion rates in diabetic myoblasts exposed to conditioned media from all adipose sources. This suggests that IMAT-myoblast signaling may be detrimental to regeneration in diabetes, but that the effect is driven in part by an intrinsic difference in diabetic myoblasts’ sensitivity to IMAT secreted factors. This emphasizes the insight that can be gained from disease-state matched and mismatched culture models and highlights the need to better understand how diabetes impacts myoblasts and their interaction with the disease environment.

肌内脂肪组织（IMAT）已被提出通过旁分泌信号直接参与肌纤维功能障碍。除了促进肌纤维胰岛素抵抗外，这种信号的影响在很大程度上是未知的。本研究旨在探索人类IMAT转录组，重点关注其在晚期肌肉病理中成肌细胞融合缺陷中的潜在作用。采用受试者内设计，我们比较了接受膝下截肢的糖尿病患者和非糖尿病患者的IMAT和皮下脂肪（SQ）。我们假设来自糖尿病组的IMAT会表现出类似于糖尿病SQ的促炎特征，并且来自IMAT祖细胞的炎症分泌因子会损害培养的成肌细胞融合。相反，我们发现，与SQ相比，糖尿病组的IMAT转录组炎症途径的富集程度降低，免疫细胞浸润的转录证据也较少。虽然IMAT对分泌的细胞因子具有主要的抗肌原性转录特征，但与SQ相比，由IMAT祖细胞调节的培养基并没有唯一地损害培养成肌细胞的融合。令人惊讶的是，成肌细胞供体的糖尿病状态预测成肌细胞融合，暴露于所有脂肪来源的条件培养基中的糖尿病成肌细胞融合率降低。这表明IMAT-成肌细胞信号可能对糖尿病的再生有害，但这种影响部分是由糖尿病成肌细胞对IMAT分泌因子敏感性的内在差异驱动的。这强调了可以从疾病状态匹配和不匹配培养模型中获得的见解，并强调了更好地了解糖尿病如何影响成肌细胞及其与疾病环境的相互作用的必要性。

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引用次数: 0

Alternative approaches to glucose measurements during oral glucose tolerance testing in youth with cystic fibrosis: a mixed methods pilot study 青年囊性纤维化患者口服葡萄糖耐量试验中葡萄糖测量的替代方法：一项混合方法试点研究

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-10-17 DOI: 10.1016/j.jcte.2025.100421

Seema Meighan , Robert J. Gallop , Melissa S. Putman , Andrea Kelly , Brynn E. Marks

Background

Adherence to annual OGTT screening for cystic fibrosis-related diabetes (CFRD) is poor. In this mixed methods study we assessed the accuracy, feasibility, and acceptability of alternative approaches to glucose measurements during an OGTT.

Methods

Standard OGTT with plasma glucose sampling at 0, 60, and 120-min was conducted in 14 youth ≥ 10 years of age with CF. A self-administered OGTT kit (Digostics, GTT@home) measuring capillary glucose and Dexcom G7 continuous glucose monitoring (CGM) were performed concomitantly with OGTT. CGM glucose values were recorded at 5-minute intervals for 20-minutes after each time point to account for lag. Plasma OGTT glucose and glucose tolerance categories [normal (NGT), impaired (IGT), indeterminate (INDET), and CFRD] were compared with these same outcomes as defined by the self-administered kit and CGM. Younden’s index was used to determine the optimal CGM timepoint for categorization of glucose tolerance, and ROC curves were used to identify the optimal glucose thresholds. Participants and their parents were interviewed to understand their experience with alternative testing approaches.

Results

Based on plasma glucose, participants were characterized as NGT (n = 8), IGT (n = 5), and CFRD (n = 1). Whereas the GTT@home correctly categorized glucose tolerance in 6 participants (43 %), CGM correctly categorized 13 (93 %). The CGM glucose at 125 min was identified as the timepoint at which the measured glucose yielded maximum discrimination for all categories of glucose tolerance (AUC for NGT = 0.979, IGT = 0.867, CFRD = 1.0). A CGM glucose threshold of 154 mg/dL demonstrated 100 % sensitivity and 87.5 % specificity for identifying NGT; for IGT a threshold of 182 mg/dL exhibited 80 % sensitivity and 88.9 % specificity. Parent-child dyads valued convenience during OGTT screening, but expressed concerns about glucose measurement accuracy and performing medical procedures in the home.

Conclusions

CGM glucose values during OGTT may offer an accurate assessment of glucose tolerance categories, though this approach may require further refinement for patient acceptability.

背景：囊性纤维化相关性糖尿病（CFRD）的年度OGTT筛查的依从性很差。在这项混合方法研究中，我们评估了OGTT期间葡萄糖测量替代方法的准确性、可行性和可接受性。方法对14例年龄≥10岁的CF患者分别在0、60、120分钟进行标准OGTT及血浆血糖采集，同时使用OGTT检测试剂盒（Digostics, GTT@home）测定毛细血管血糖，同时进行Dexcom G7连续血糖监测（CGM）。每隔5分钟记录CGM葡萄糖值，每隔20分钟记录一次，以解释滞后。将血浆OGTT葡萄糖和葡萄糖耐量类别[正常（NGT）、受损（IGT）、不确定（INDET）和CFRD]与自用试剂盒和CGM定义的相同结果进行比较。采用Younden’s指数确定葡萄糖耐量分类的最佳CGM时间点，采用ROC曲线确定最佳葡萄糖阈值。参与者和他们的父母接受了采访，以了解他们对替代测试方法的经验。结果根据血浆葡萄糖水平，参与者分为NGT （n = 8）、IGT （n = 5）和CFRD （n = 1）。GTT@home正确分类了6名参与者（43%）的葡萄糖耐量，而CGM正确分类了13名参与者（93%）。125 min时的CGM葡萄糖被确定为测量葡萄糖对所有类别葡萄糖耐量的最大区分时间点（NGT的AUC = 0.979, IGT = 0.867, CFRD = 1.0）。CGM葡萄糖阈值为154 mg/dL，检测NGT的敏感性为100%，特异性为87.5%；对于IGT， 182 mg/dL的阈值显示80%的敏感性和88.9%的特异性。父母和孩子对OGTT筛查的便利性很重视，但对血糖测量的准确性和在家中执行医疗程序表示担忧。结论OGTT期间的scgm血糖值可以提供准确的葡萄糖耐量分类评估，尽管该方法可能需要进一步改进以使患者可接受。

{"title":"Alternative approaches to glucose measurements during oral glucose tolerance testing in youth with cystic fibrosis: a mixed methods pilot study","authors":"Seema Meighan , Robert J. Gallop , Melissa S. Putman , Andrea Kelly , Brynn E. Marks","doi":"10.1016/j.jcte.2025.100421","DOIUrl":"10.1016/j.jcte.2025.100421","url":null,"abstract":"<div><h3>Background</h3><div>Adherence to annual OGTT screening for cystic fibrosis-related diabetes (CFRD) is poor. In this mixed methods study we assessed the accuracy, feasibility, and acceptability of alternative approaches to glucose measurements during an OGTT.</div></div><div><h3>Methods</h3><div>Standard OGTT with plasma glucose sampling at 0, 60, and 120-min was conducted in 14 youth ≥ 10 years of age with CF. A self-administered OGTT kit (Digostics, GTT@home) measuring capillary glucose and Dexcom G7 continuous glucose monitoring (CGM) were performed concomitantly with OGTT. CGM glucose values were recorded at 5-minute intervals for 20-minutes after each time point to account for lag. Plasma OGTT glucose and glucose tolerance categories [normal (NGT), impaired (IGT), indeterminate (INDET), and CFRD] were compared with these same outcomes as defined by the self-administered kit and CGM. Younden’s index was used to determine the optimal CGM timepoint for categorization of glucose tolerance, and ROC curves were used to identify the optimal glucose thresholds. Participants and their parents were interviewed to understand their experience with alternative testing approaches.</div></div><div><h3>Results</h3><div>Based on plasma glucose, participants were characterized as NGT (n = 8), IGT (n = 5), and CFRD (n = 1). Whereas the GTT@home correctly categorized glucose tolerance in 6 participants (43 %), CGM correctly categorized 13 (93 %). The CGM glucose at 125 min was identified as the timepoint at which the measured glucose yielded maximum discrimination for all categories of glucose tolerance (AUC for NGT = 0.979, IGT = 0.867, CFRD = 1.0). A CGM glucose threshold of 154 mg/dL demonstrated 100 % sensitivity and 87.5 % specificity for identifying NGT; for IGT a threshold of 182 mg/dL exhibited 80 % sensitivity and 88.9 % specificity. Parent-child dyads valued convenience during OGTT screening, but expressed concerns about glucose measurement accuracy and performing medical procedures in the home.</div></div><div><h3>Conclusions</h3><div>CGM glucose values during OGTT may offer an accurate assessment of glucose tolerance categories, though this approach may require further refinement for patient acceptability.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"42 ","pages":"Article 100421"},"PeriodicalIF":3.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hormone responses to buserelin in polycystic ovary syndrome and in eumenorrheic women with hyperandrogenism/hyperandrogenemia, and the relationship of these responses with insulin resistance 多囊卵巢综合征和伴有高雄激素症/高雄激素血症的痛经妇女对布瑟林的激素反应及其与胰岛素抵抗的关系

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology

Pub Date : 2025-10-02 DOI: 10.1016/j.jcte.2025.100420

Salvatore Benvenga , Michele Russo , Fausto Famà , Gianpiero Forte , Vittorio Unfer

We compared 37 women with polycystic ovary syndrome (PCOS) with 24 women with eumenorrhea plus hyperandrogenism and/or hyperandrogenemia without ultrasound evidence of PCO morphology (EuHyperA) to assess their hormone responses to a GnRH-agonist (buserelin). Following our recent paper on PCOS and EuHyperA, we selected patients who performed the 2 h-oral glucose tolerance test (OGTT), and stratified them according to presence/absence of insulin resistance (IR), viz. HOMA-index ≥ 2.5.

IR impacted on the PCOS group since IR-yes-PCOS women had significantly higher body weight, BMI, total testosterone (TT), free androgen index (FAI), and 17-hydroxyprogesterone (17-OHP), borderline higher delta-4 androstenedione (Δ4-ASD) and ovarian volume, and significantly lower sex hormone-binding globulin (SHBG) vs IR-no-PCOS. IR-no-EuHyperA had significantly higher follicle-stimulating hormone (FSH), borderline higher dehydroepiandrosterone sulfate (DHEAS) and borderline lower 17-OHP vs IR-no-PCOS. IR-yes-EuHyperA had significantly higher DHEAS, borderline lower TT and FAI vs IR-yes-PCOS.

The insulin curve was significantly higher in the IR-yes vs IR-no-PCOS, and IR-yes vs IR-no-EuHyperA. Compared to PCOS, EuHyperA had insignificantly lower glucose and insulin responses regardless of IR status.

After steroidogenic ovarian stimulation (24 h-buserelin test), IR presence vs IR absence impacted on 4 curves in PCOS (significantly higher TT, borderline higher 17-OHP, significantly lower Δ4-ASD and DHEAS), and only one curve in EuHyperA (significantly higher TT). IR-no-EuHyperA had two curves significantly lower than IR-no-PCOS (Δ4-ASD and TT). Instead, IR-yes-EuHyperA had significantly lower Δ4-ASD, TT and 17-OHP curves, and significantly higher DHEAS curve vs IR-yes-PCOS.

In conclusion, of 35 parameters (baseline, OGTT-related, buserelin-related), 28 (80%) were statistically similar in EuHyperA vs PCOS regardless of IR status. However, IR presence impacted on more parameters in PCOS than EuHyperA. Given the known ovary sparing by IR in PCOS, it appears that IR exacerbates androgen production of PCOS women more markedly than EuHyperA women.

我们比较了37名患有多囊卵巢综合征（PCOS）的女性和24名没有超声显示PCOS形态（EuHyperA）的痛经合并雄激素过多和/或雄激素过多的女性，以评估她们对gnrh激动剂（buserelin）的激素反应。根据我们最近关于PCOS和EuHyperA的论文，我们选择了接受2小时口服葡萄糖耐量试验（OGTT）的患者，并根据是否存在胰岛素抵抗（IR）（即HOMA-index≥2.5）对他们进行分层。IR对PCOS组有影响，因为IR-有PCOS的女性体重、BMI、总睾酮（TT）、游离雄激素指数（FAI）和17-羟孕酮（17-OHP）明显高于无PCOS的女性，δ -4雄烯二酮（Δ4-ASD）和卵巢体积呈边缘性升高，性激素结合球蛋白（SHBG）明显低于IR-无PCOS的女性。与IR-no-PCOS相比，IR-no-EuHyperA的促卵泡激素（FSH）显著升高，脱氢表雄酮硫酸酯（DHEAS）水平升高，17-OHP水平降低。与IR-yes-PCOS相比，IR-yes-EuHyperA的DHEAS明显升高，TT和FAI边缘性降低。胰岛素曲线在ir -存在与ir -不存在pcos， ir -存在与ir -不存在euhypera患者中显著升高。与PCOS相比，无论IR状态如何，EuHyperA的血糖和胰岛素反应均不显著降低。激素性卵巢刺激（24 h-buserelin试验）后，IR的存在与不存在影响PCOS的4条曲线（TT显著升高，17-OHP临界升高，Δ4-ASD和DHEAS显著降低），而EuHyperA只有一条曲线（TT显著升高）。IR-no-EuHyperA有两条曲线明显低于IR-no-PCOS （Δ4-ASD和TT）。与IR-yes-PCOS相比，IR-yes-EuHyperA的Δ4-ASD、TT和17-OHP曲线显著降低，DHEAS曲线显著升高。总之，在35个参数（基线，ogtt相关，buserelin相关）中，28个（80%）在EuHyperA和PCOS中具有统计学上的相似性，无论IR状态如何。然而，与EuHyperA相比，IR的存在对PCOS的参数影响更多。鉴于已知的PCOS中IR对卵巢的保护作用，似乎IR比EuHyperA女性更明显地加剧了PCOS女性的雄激素分泌。

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引用次数: 0