Journal of Clinical and Translational Endocrinology最新文献

{"title":"Long-term primary pharmacotherapy of giant prolactinomas: A comparison of different cabergoline dosages","authors":"Hána Václav Jr. ,&nbsp;Vaněčková Manuela ,&nbsp;Kršek Michal ,&nbsp;Krausová Adéla ,&nbsp;Ježková Jana ,&nbsp;Kosák Mikuláš ,&nbsp;Diblík Pavel ,&nbsp;Netuka David ,&nbsp;Masopust Václav ,&nbsp;Májovský Martin ,&nbsp;Liščák Roman ,&nbsp;Hána Václav","doi":"10.1016/j.jcte.2025.100418","DOIUrl":"10.1016/j.jcte.2025.100418","url":null,"abstract":"<div><h3>Objectives</h3><div>Dopamine agonists serve as first-line therapies for most giant prolactinomas. The objective of this study was to assess the differential impact of dopamine agonist dosing strategies on biochemical (prolactin normalisation) and radiological (tumour size reduction) responses in patients with giant prolactinomas.</div></div><div><h3>Design</h3><div>A single-centre retrospective real-life 23-year follow-up study.</div></div><div><h3>Methods</h3><div>Thirty-three patients with giant prolactinomas (≥ 4 cm) were treated with primary pharmacotherapy. We assessed pituitary function, the effect of therapy and different dosing regimens on prolactin normalisation and tumour size, the effect of surgery for complications and the effect of radiotherapy in resistant patients.</div></div><div><h3>Results</h3><div>Out of thirty-three consecutive patients (mean age 42 years), 27 were men, and 6 were women. The baseline mean prolactin concentration was 7506 µg/L. The treatment of choice was cabergoline in 30 patients, terguride in 2 patients, and bromocriptine in 1 patient. In patients receiving a high dose of cabergoline (3.5 mg weekly), we observed a faster normalisation of prolactin but not faster reduction in tumour size than in patients receiving a low dose (1–2.5 mg weekly). A total of 9/33 (27 %) patients underwent surgery for complications, 3 of whom were irradiated by Leksell gamma knife for partial resistance. In 4/33 patients we were able to stop pharmacotherapy after 10–20 years of treatment. The remaining 29/33 patients remained on pharmacological treatment.</div></div><div><h3>Conclusions</h3><div>Dopamine agonists are safe and only required treatment in 2/3 of patients treated with pharmacotherapy as a first-line treatment. Higher doses of cabergoline accelerate prolactin normalisation but do not confer additional benefit in early tumour shrinkage.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100418"},"PeriodicalIF":3.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925081","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}

{"title":"The CuPeR model: A dynamic online tool for predicting Cushing’s disease persistence and recurrence after pituitary surgery","authors":"Guive Sharifi ,&nbsp;Elham Paraandavaji ,&nbsp;Nader Akbari Dilmaghani ,&nbsp;Tohid Emami Meybodi ,&nbsp;Ibrahim Mohammadzadeh ,&nbsp;Neginalsadat Sadeghi ,&nbsp;Amirali Vaghari ,&nbsp;Behnaz Niroomand ,&nbsp;Seyed Mohammad Tavangar ,&nbsp;Mohammad reza Mohajeri Tehrani ,&nbsp;Zahra Davoudi ,&nbsp;Marjan Mirsalehi ,&nbsp;Seyed Ali Mousavinejad ,&nbsp;Farzad Taghizadeh-Hesary","doi":"10.1016/j.jcte.2025.100417","DOIUrl":"10.1016/j.jcte.2025.100417","url":null,"abstract":"<div><h3>Objective</h3><div>Predicting postoperative persistence and recurrence of Cushing’s disease (CD) remains a clinical challenge, with no universally reliable models available. This study introduces the CuPeR model, an online dynamic nomogram developed to address these gaps by predicting postoperative outcomes in patients with CD undergoing pituitary surgery.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 211 patients treated for CD between 2010 and 2024 was analyzed. Key patient and tumor characteristics, imaging findings, and treatment details were evaluated. Multivariate logistic regression identified independent predictors of postoperative persistence or recurrence of CD (PoRP-CD), which were then incorporated into the CuPeR model using stepwise selection based on Akaike Information Criterion. Internal validation was performed using a testing dataset, and a user-friendly online nomogram was developed to facilitate immediate, patient-specific risk estimation in clinical practice.</div></div><div><h3>Results</h3><div>The final predictive model identified four key factors: symptom duration, MRI Hardy’s grade, tumor site, and prior pituitary surgery. Longer symptom duration and a history of prior surgery significantly increased the risk of recurrence, while bilateral tumor location reduced this risk. The model demonstrated an area under the receiver operating characteristic curve (AUC-ROC) of 0.70, with 83% accuracy, specificity of 96%, and sensitivity of 33%.</div></div><div><h3>Conclusions</h3><div>The CuPeR model may offer a practical tool for predicting PoRP-CD, enhancing preoperative decision-making by providing personalized risk assessments.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100417"},"PeriodicalIF":3.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913145","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}

{"title":"Relationships of triglyceride–glucose index and body mass index with 5-year all-cause mortality in patients with diabetes and comorbid hypertension: Evidence from two prospective cohort studies","authors":"Yilu Liu ,&nbsp;Hongzhao You ,&nbsp;Yingxuan Zhu ,&nbsp;Fang Luo ,&nbsp;Yanyan Zhao ,&nbsp;Dingyue Zhang ,&nbsp;Ying Xiao ,&nbsp;Shijie You ,&nbsp;Rui Zhang ,&nbsp;Yingdong Han ,&nbsp;Jing Li ,&nbsp;Shouling Wu ,&nbsp;Jiansong Yuan ,&nbsp;Shuohua Chen ,&nbsp;Weixian Yang","doi":"10.1016/j.jcte.2025.100416","DOIUrl":"10.1016/j.jcte.2025.100416","url":null,"abstract":"<div><h3>Aims</h3><div>To characterize the complex relationships of body mass index (BMI) and triglyceride–glucose index (TyG) with 5-year all-cause mortality in patients with diabetes mellitus and comorbid hypertension.</div></div><div><h3>Methods</h3><div>Overall, 5,728 patients from the 1999–2014 US National Health and Nutrition Examination Survey (NHANES) cycles and 3,456 from the 2005–2010 China Kailuan cycles were included. TyG was calculated as the logarithmic product of the fasting triglyceride and glucose concentrations.</div></div><div><h3>Results</h3><div>The prevalence of 5-year all-cause mortality was 8.4 % in the NHANES population and 9.2 % in the Kailuan cohort. TyG mediated the association between BMI and all-cause mortality, being responsible for 38.4 % in the NHANES database and 41.6 % in the Kailuan cohort. Significant multiplicative effects were identified between TyG and BMI, which were closer for patients with high BMI. When stratified by BMI and TyG, high-risk subgroups were identified and had higher risks of all-cause mortality than the intermediate- and low-risk subgroups (both log-rank <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>TyG mediated a considerable proportion of the effect of BMI on all-cause mortality in patients with diabetes and hypertension. The combination of BMI and TyG could be useful for the risk stratification of all-cause mortality. Measures aimed at weight loss might reduce the all-cause mortality risk associated with insulin resistance.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100416"},"PeriodicalIF":3.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890585","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}

{"title":"Association between cardiometabolic index and sarcopenia: 2011–2018 National Health and Nutrition Examination survey (NHANES)","authors":"Yi Shen,&nbsp;Jiayu Zhang,&nbsp;Xiuyue Qiu","doi":"10.1016/j.jcte.2025.100415","DOIUrl":"10.1016/j.jcte.2025.100415","url":null,"abstract":"<div><h3>Background</h3><div>The cardiometabolic index (CMI) is a reliable marker used to assess the degree of obesity and lipid metabolism disorders in individuals. Emerging evidence indicates that disorders of lipid metabolism and sarcopenia share a common pathophysiologic basis. However, few studies have investigated the association between CMI and sarcopenia. Therefore, this study aimed to find the possible correlation between CMI and sarcopenia.</div></div><div><h3>Methods</h3><div>This study used cross-sectional research methods to investigate data on CMI, sarcopenia, and other covariates among participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. We explored the relationship between CMI and sarcopenia through multivariate linear and logistic regression, and we performed sensitivity and subgroup analyses. Also, receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) were utilized to evaluate the performance of CMI in identifying sarcopenia.</div></div><div><h3>Results</h3><div>Of the 4,808 adults aged 20 to 59 included in this study, 428 (8.90 %) were identified as having sarcopenia. A significant nonlinear association between CMI and sarcopenia was demonstrated in a generalized additive model (GAM). After inclusion of all covariates, CMI showed a significant association with the prevalence of sarcopenia (OR = 1.173(1.086–1.267), <em>P</em> &lt; 0.001). CMI got an AUC of 0.69 in identifying sarcopenia. Finally, subgroup analyses showed that the association between CMI and sarcopenia was particularly pronounced in individuals who differed in marital status, poverty-to-income ratio, alcohol consumption, patients without diabetes, and patients with hypertension (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that an elevated CMI was associated with an increased prevalence of sarcopenia. The finding suggests that CMI could serve as a potential marker for sarcopenia, highlighting the need for further research to explore the relationship between dyslipidemia and sarcopenia.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100415"},"PeriodicalIF":3.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885405","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}

{"title":"The relationship between sarcopenic obesity and prediabetes in adolescents: Analysis of the national health and nutrition examination survey from 2011 to 2016","authors":"Gang Cheng ,&nbsp;Ying Zhou ,&nbsp;Yan Wang,&nbsp;Li Tao,&nbsp;Jianghong Xu","doi":"10.1016/j.jcte.2025.100414","DOIUrl":"10.1016/j.jcte.2025.100414","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to observe the relationship between sarcopenic obesity and prediabetes in adolescents. Methods: A cross-sectional retrospective study was conducted on United States adolescents aged 12–19 years. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2011–2012, 2013–2014, and 2015–2016 cycles. Sarcopenic obesity was defined as waist circumference at or above the 90th percentile for age and sex and appendicular skeletal muscle mass divided by weight below the lower quintile for age and sex.</div></div><div><h3>Results</h3><div>The prevalence of prediabetes was 22.2 % in the normal group, 15.0 % in the sarcopenia alone group, 22.3 % in the obesity alone group, and 36.9 % in the sarcopenic obesity group. In univariate logistic regression, adolescents with sarcopenic obesity had a higher odds of prediabetes compared to the normal group (odds ratio = 2.048, 95 % CI: 1.125–3.728, <em>P</em> = 0.020). After adjusting for confounders, the odds remained significantly elevated (adjusted odds ratio = 2.060, 95 % CI: 1.178–3.604, <em>P</em> = 0.012).</div></div><div><h3>Conclusion</h3><div>The present study demonstrates that sarcopenic obesity was closely associated with an increased odds of prediabetes in United States adolescents.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100414"},"PeriodicalIF":3.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879078","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}

{"title":"Utilizing near-peer teaching to expand obesity medicine training within an internal medicine residency curriculum","authors":"Ann Forrest ,&nbsp;Maria Gabriela Negron Marte ,&nbsp;Amanda George ,&nbsp;Li Liu ,&nbsp;Stéphanie B. Mayer","doi":"10.1016/j.jcte.2025.100411","DOIUrl":"10.1016/j.jcte.2025.100411","url":null,"abstract":"<div><h3>Objectives</h3><div>Obesity management is within the scope of an internist’s practice in the primary care setting; however, physicians feel unprepared to address the topic. Many internal medicine (IM) residency programs struggle to include obesity management in their curricula. The objective of our study is to assess the self-reported knowledge and comfort of IM residents when addressing overweight and obesity following a near-peer teaching session on the subject.</div></div><div><h3>Methods</h3><div>A near-peer teaching session on the topic of overweight and obesity was presented in morning report format for IM residents. Pre-session, immediate post-session, and three-month follow-up surveys were completed to compare comfort and self-reported knowledge on obesity management in relation to the session. Z-test was used to analyze answers between survey time points.</div></div><div><h3>Results</h3><div>Out of fifty-one eligible residents, forty-one residents attended the teaching session. Thirty-three residents responded to the pre-session survey, twenty-five to the immediate post-session survey, and eighteen to the three-month follow-up survey. At baseline, residents recognized obesity as a chronic medical condition and were willing to address the topic with patients. Between pre- and immediate post-session surveys, residents demonstrated increased self-reported knowledge in recognizing BMI cutoffs, criteria for bariatric surgery, comfort offering dietary advice, documentation of obesity as a diagnosis, awareness of obesity management tools including nutrition services and willingness to provide them to patients. At the three-month follow-up survey, there was retention of BMI cutoffs and nutrition service availability, but there were partial losses in self-reported knowledge of criteria for bariatric surgery and locating obesity management tools.</div></div><div><h3>Conclusions</h3><div>A near-peer led teaching session in a morning report style format can increase residents’ self-reported knowledge and comfort when addressing overweight and obesity, without overburdening the curriculum. Spaced review of the topic may overcome the partial knowledge losses seen in our IM resident population.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100411"},"PeriodicalIF":3.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772476","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}

{"title":"DiaBar: Predicting type 2 diabetes remission post-metabolic surgery utilizing mRNA expression profiles from subcutaneous adipose tissue","authors":"Jonas Wagner ,&nbsp;Manfred Wischnewsky ,&nbsp;Patricia von Kroge ,&nbsp;Helge Wilhelm Thies ,&nbsp;Pia Roser ,&nbsp;Stefan Wolter ,&nbsp;Thilo Hackert ,&nbsp;Jakob Izbicki ,&nbsp;Oliver Mann ,&nbsp;Anna Duprée","doi":"10.1016/j.jcte.2025.100410","DOIUrl":"10.1016/j.jcte.2025.100410","url":null,"abstract":"<div><h3>Background</h3><div>Subcutaneous adipose tissue (SAT) is a metabolic organ, which is involved in the pathogenesis of type 2 diabetes (T2D). Methods to predict diabetes remission after metabolic surgery exist, however their prediction accuracy still needs improvement. We hypothesized, that gene expression profiles in the SAT could predict diabetes remission after metabolic surgery more accurately than any current methods.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we identified individuals who underwent metabolic surgery. We collected SAT biopsies during the surgery and analyzed the expression of <em>HMGA2</em>, <em>PPARG</em>, <em>ADIPOQ</em> and, <em>IL6</em>. The American Diabetes Association criteria were used to define partial and complete remission. Univariate generalized linear models, tree decision algorithms (Exhausted Chaid, CART and Quinlan’s C5 with adaptive boosting) and, multilayer perceptron networks were used to develop classifiers for patients with no, partial or complete remission (DiaBar).</div></div><div><h3>Results</h3><div>In this study 106 patients were included, 66 (62.3%) patients had T2D the remaining 40 (37.7%) were patients with prediabetes. Complete and partial remission were achieved by 69 (65.1%) and 20 (18.9%) patients respectively. Using a multilayer perceptron, we achieved an overall accuracy of 98.0% (remission: no 100%; partial 90.0%; complete 100%). The validated DiaRem Score was used as the comparative score, which had an overall accuracy for classifying patients with complete, partial or no remission of 74.7%.</div></div><div><h3>Conclusions</h3><div>Using gene expression profiles from the SAT, we developed the DiaBar test, which accurately predicts diabetes remission after metabolic surgery and seems to be superior to the DiaRem score.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100410"},"PeriodicalIF":4.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694403","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}

{"title":"Association of the time in targeted blood glucose range of 140 to 180 mg/dL with the mortality of critically ill patients with diabetes: analysis of the MIMIC-IV database","authors":"Huimin Ye ,&nbsp;Zilan Ma ,&nbsp;Qunchuan Zong ,&nbsp;Qiang Zhu ,&nbsp;Yufei Yan ,&nbsp;Shengmei Yang ,&nbsp;Pengyue Xiang ,&nbsp;Huajie Zou","doi":"10.1016/j.jcte.2025.100413","DOIUrl":"10.1016/j.jcte.2025.100413","url":null,"abstract":"<div><h3>Background</h3><div>Time in range (TIR), a glycemic control metric, is increasingly linked to diabetes outcomes. A target of 140–180 mg/dL is recommended for critically ill hyperglycemic patients.</div></div><div><h3>Methods</h3><div>This cohort study analyzed 6,047 critically ill diabetic patients (median age 68, 62.3 % male) from the MIMIC-IV database. TIR (140–180 mg/dL) was defined as the percentage of time within the target glucose range over 24 h. Patients were stratified by TIR quartiles. Outcomes included all-cause mortality, ICU mortality, in-hospital mortality, and 28-day mortality. Cox models assessed TIR-outcomes relationships.</div></div><div><h3>Results</h3><div>Higher TIR correlated with lower mortality. Adjusted HRs for all-cause mortality were 1.00 (Q1), 0.63 (Q2), 0.56 (Q3), and 0.65 (Q4) (<em>p</em> for trend &lt; 0.001). Similar trends were observed for in-hospital mortality (Q4 vs. Q1: HR 0.79, 95% CI: 0.64–0.97). Each 10 % TIR increase reduced all-cause mortality by 8 % (HR 0.92, 95 % CI: 0.88–0.95). Nonlinear dose–response relationships were significant (<em>p</em> &lt; 0.001), with stronger effects in patients &lt; 60, males, and those with myocardial infarction or cancer history (<em>p</em> for interaction &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Higher TIR (140–180 mg/dL) is associated with reduced mortality in critically ill diabetic patients, suggesting that TIR is a valuable metric for glycemic management in the ICU.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100413"},"PeriodicalIF":4.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704757","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}

{"title":"Mild hyperprolactinemia in women with polycystic ovary syndrome. Insights from a large cross-sectional study","authors":"Manuel Luque-Ramírez,&nbsp;Alejandra Quintero-Tobar,&nbsp;María Ángeles Martínez-García,&nbsp;Sara de Lope Quiñones,&nbsp;María Insenser,&nbsp;Lía Nattero-Chávez,&nbsp;Héctor Francisco Escobar-Morreale","doi":"10.1016/j.jcte.2025.100412","DOIUrl":"10.1016/j.jcte.2025.100412","url":null,"abstract":"<div><h3>Background</h3><div>Hyperprolactinemia is an exclusion criterion for polycystic ovary syndrome (PCOS), albeit PCOS itself is argued to induce mild hyperprolactinemia. We aimed to study the prevalence and causes of hyperprolactinemia in patients with PCOS.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study including 336 premenopausal patients with PCOS and 90 nonhyperandrogenic controls referred to our clinics (referral population). We also studied an unselected population of premenopausal individuals who attended our center for voluntary blood donation (14 patients with PCOS and 207 non-hyperandrogenic controls). The main outcome measure was the percentage of individuals with hyperprolactinemia.</div></div><div><h3>Results</h3><div>As a whole, 39 out of 647 participants showed increased basal prolactin concentrations (6.0%, 95%CI: 4.4; 8.1) regardless of having PCOS or being a control, in both referral and unselected populations. In the referral population, 18 out of 31 individuals with hyperprolactinemia (58.0%, 95%CI: 40.8; 73.6) showed normal prolactin concentrations after appropriate resting, suggesting venipuncture stress-related hyperprolactinemia, and another nine participants (29.0%, 95%IC: 16.1; 46.6) did so after pre-analytical polyethylene-glycol precipitation of serum, indicating macroprolactinemia. There were differences in these figures between patients with PCOS and controls. In the unselected population, three out of eight participants with hyperprolactinemia (37.5%, 95%IC: 13.7; 69.4) had macroprolactinemia, and stress-related hyperprolactinemia accounted for another 62.5% (95%IC: 30.6; 86.3) of cases.</div></div><div><h3>Conclusions</h3><div>Hyperprolactinemia is equally likely among patients with PCOS and non-hyperandrogenic individuals. The most common causes of mild hyperprolactinemia in this population are venipuncture stress and macroprolactinemia that must not preclude a diagnosis of PCOS if suggested by signs and symptoms.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100412"},"PeriodicalIF":4.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687285","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}

{"title":"Enrollment in a fracture liaison service does not guarantee post fracture follow-up","authors":"Craig R. Jenkins,&nbsp;Jessica D. Collier,&nbsp;Claire I. Yee,&nbsp;Blake T. Langlais,&nbsp;Jaxon K. Quillen,&nbsp;Patricia M. Verona,&nbsp;Michael D. Whitaker,&nbsp;Curtiss B. Cook","doi":"10.1016/j.jcte.2025.100409","DOIUrl":"10.1016/j.jcte.2025.100409","url":null,"abstract":"<div><h3>Objective</h3><div>To assess post fracture outpatient follow-up adherence in a cohort of patients enrolled in a fracture liaison service (FLS).</div></div><div><h3>Methods</h3><div>We analyzed FLS registry data for patients who were hospitalized with fragility fractures from June 2020 through December 2022 and determined the proportion of patients who kept their follow-up appointments in outpatient endocrinology and orthopedic clinics.</div></div><div><h3>Results</h3><div>We identified 295 patients who were eligible for the FLS pathway; from this group, 57 declined an endocrinology follow-up visit. Of the remaining 238 patients, 95 (40 %) had appointments but subsequently canceled and 7 (3 %) did not show up for their appointments. No follow-up information was documented for 77 patients (32 %). Thus, only 59 of 238 (25 %) kept their appointments in endocrinology. In the univariate analyses, age, severity of illness, and discharge status were associated with follow-up adherence only in the orthopedic cohort (<em>P</em> ≤ 0.02). However, the adjusted analyses did not identify any variables that were associated with follow-up adherence in either the endocrinology or orthopedic cohorts.</div></div><div><h3>Conclusion</h3><div>Post fracture outpatient follow-up was lower for the endocrinology cohort, as compared with the orthopedic cohort, even among patients enrolled in an FLS. Factors that were previously postulated to influence follow-up, including those described in this study, showed no association with appointment-keeping behavior. Possibly, the importance of osteoporosis treatment is not emphasized or the treatment options are unappealing to our patient population. Further study is needed to determine the specific obstacles contributing to the low endocrine post fracture follow-up rate.</div></div><div><h3>Key Message</h3><div>Fracture liaison services can reliably reduce future fracture events, but follow-up adherence after hospitalization remains challenging. We compared the rates of endocrinology vs orthopedic follow-up in a single cohort of patients hospitalized for fragility fractures and assessed variables that potentially contributed to the lower endocrinology follow-up rate (eg, travel distance, age, marital status). However, no factors were identified as having a significant effect. These data show that the specific obstacles previously thought to contribute to lower-than-expected post fracture follow-up rates are misleading, and novel approaches are needed to address this widespread issue.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"41 ","pages":"Article 100409"},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654219","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}