Pub Date : 2025-02-01DOI: 10.1016/j.endien.2025.101528
Mariana Ornelas, Eduarda Resende, Pedro Gouveia, Maritza Sá, Margarida Ferreira
A 30-year pregnant woman was unexpectedly diagnosed with pheochromocytoma during obstetric follow-up. The patient – initially treated with optimal medical therapy – underwent elective C-section followed by right adrenalectomy. In the postoperative period, complete tumor resection was confirmed by negative biochemical tests. Ten years later, the patient developed new symptoms suggestive of catecholaminergic hypersecretion and biochemical tests documented increased urinary fractionated metanephrines. In the postoperative biochemical testing and imaging, persistent disease was documented. During follow-up, repeated imaging modalities evidenced the presence of hepatic and peritoneal metastasis. Genetic testing documented a germline pathogenic variant (c.410-2A>C) in the TMEM-127 gene, a rare pheochromocytoma etiology that typically presents as unilateral adrenal lesion with rare metastatic behavior. The authors underline less frequent findings described in the literature – bilaterality and metastatic behavior – and emphasize the absence of aggressive prognostic markers at initial clinical presentation.
{"title":"TMEM-127 gene mutation: A rare genetic entity associated with metastatic bilateral pheochromocytoma","authors":"Mariana Ornelas, Eduarda Resende, Pedro Gouveia, Maritza Sá, Margarida Ferreira","doi":"10.1016/j.endien.2025.101528","DOIUrl":"10.1016/j.endien.2025.101528","url":null,"abstract":"<div><div>A 30-year pregnant woman was unexpectedly diagnosed with pheochromocytoma during obstetric follow-up. The patient – initially treated with optimal medical therapy – underwent elective C-section followed by right adrenalectomy. In the postoperative period, complete tumor resection was confirmed by negative biochemical tests. Ten years later, the patient developed new symptoms suggestive of catecholaminergic hypersecretion and biochemical tests documented increased urinary fractionated metanephrines. In the postoperative biochemical testing and imaging, persistent disease was documented. During follow-up, repeated imaging modalities evidenced the presence of hepatic and peritoneal metastasis. Genetic testing documented a germline pathogenic variant (c.410-2A>C) in the TMEM-127 gene, a rare pheochromocytoma etiology that typically presents as unilateral adrenal lesion with rare metastatic behavior. The authors underline less frequent findings described in the literature – bilaterality and metastatic behavior – and emphasize the absence of aggressive prognostic markers at initial clinical presentation.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 2","pages":"Article 101528"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429360","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 : 2025-02-01DOI: 10.1016/j.endien.2025.101533
Pablo Expósito-Campos , Marcelino Gómez Balaguer , Felipe Hurtado Murillo , Alberto Pena Dubra , Luis Francisco de Miguel Rodríguez , Pablo Fernández Collazo , Elisa Tadeo Morant , Inés Modrego Pardo , Carlos Morillas Ariño
Introduction
Not all individuals referred to gender identity units receive gender-affirming medical treatment (GAMT). However, there is a paucity of literature examining the reasons for this. This study aimed to investigate the reasons for not initiating GAMT in individuals who initially reported gender identity concerns and requested body changes in a gender identity unit in Spain, all of whom underwent psychological assessment and counseling.
Material and methods
We retrospectively reviewed a total of 457 health histories and collected basic socio-demographic data and information on reasons for not initiating GAMT. This information was grouped into categories based on thematic similarity following consensus among the authors.
Results
We identified a total of 62 patients who did not start GAMT. A total of 26 were deemed ineligible for issues related to mental health, identity development, and inadequate understanding of the GAMT protocol. The remaining 36 patients were counseled and followed up for a mean of 8.4 months. We categorized the reasons for not starting GAMT into 4 groups: (A) failure to meet criteria for gender incongruence/dysphoria (four patients); (B) premature termination of the assessment/counseling process (11 patients); (C) gender identity-related doubts and/or desistance of the transgender identity (12 patients); and (D) discontinued desire for GAMT (9 patients).
Conclusions
GAMT is not the endpoint for all individuals seeking care, and reasons for not starting GAMT are heterogeneous and sometimes complex. Psychological assessment and counseling remain important features of quality gender-affirming care, and current debates about access to GAMT should take these experiences into account to better inform its future provision.
{"title":"Psychological assessment and counseling remain important features of quality care: A descriptive study of individuals who did not start gender-affirming medical treatment in a gender identity unit in Spain","authors":"Pablo Expósito-Campos , Marcelino Gómez Balaguer , Felipe Hurtado Murillo , Alberto Pena Dubra , Luis Francisco de Miguel Rodríguez , Pablo Fernández Collazo , Elisa Tadeo Morant , Inés Modrego Pardo , Carlos Morillas Ariño","doi":"10.1016/j.endien.2025.101533","DOIUrl":"10.1016/j.endien.2025.101533","url":null,"abstract":"<div><h3>Introduction</h3><div>Not all individuals referred to gender identity units receive gender-affirming medical treatment (GAMT). However, there is a paucity of literature examining the reasons for this. This study aimed to investigate the reasons for not initiating GAMT in individuals who initially reported gender identity concerns and requested body changes in a gender identity unit in Spain, all of whom underwent psychological assessment and counseling.</div></div><div><h3>Material and methods</h3><div>We retrospectively reviewed a total of 457 health histories and collected basic socio-demographic data and information on reasons for not initiating GAMT. This information was grouped into categories based on thematic similarity following consensus among the authors.</div></div><div><h3>Results</h3><div>We identified a total of 62 patients who did not start GAMT. A total of 26 were deemed ineligible for issues related to mental health, identity development, and inadequate understanding of the GAMT protocol. The remaining 36 patients were counseled and followed up for a mean of 8.4 months. We categorized the reasons for not starting GAMT into 4 groups: (A) failure to meet criteria for gender incongruence/dysphoria (four patients); (B) premature termination of the assessment/counseling process (11 patients); (C) gender identity-related doubts and/or desistance of the transgender identity (12 patients); and (D) discontinued desire for GAMT (9 patients).</div></div><div><h3>Conclusions</h3><div>GAMT is not the endpoint for all individuals seeking care, and reasons for not starting GAMT are heterogeneous and sometimes complex. Psychological assessment and counseling remain important features of quality gender-affirming care, and current debates about access to GAMT should take these experiences into account to better inform its future provision.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 2","pages":"Article 101533"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.endien.2025.101527
Luis Agustín Ramírez Stieben , María Lorena Brance , Marina Verónica Belardinelli , Diamela Bolzán , Estefanía Pustilnik , Rodolfo Néstor Feldman , Lucas Ricardo Brun
Introduction
Parathyroid hormone (PTH) and vitamin D are essential components in mineral metabolism. Our aims were to estimate the thresholds of 25-hydroxyvitamin D [25(OH)D] and estimated glomerular filtration rate (eGFR) that inhibit PTH, establish PTH reference intervals (RIs), and the stratify need based on age and gender.
Materials and methods
We conducted a cross-sectional study on participants older than 18 years. Segmented regressions (SR) were performed to determine the thresholds of 25(OH)D and eGFR in relation to PTH levels. Multivariate regression was used to evaluate the associations between PTH and 25(OH)D, gender, age, eGFR, and season. To establish the PTH RIs, extreme percentiles were calculated.
Results
A total of 2794 subjects were analyzed (women, 77.56%). Multivariate regression indicated that age, gender, 25(OH)D, and eGFR explained PTH variation. SR demonstrated that PTH stabilized when eGFR > 46.64 mL/min/1.73 m2, and PTH increased when 25(OH)D was <15.8 ng/mL. Stratification by gender and age revealed different RIs, with women and over 70 years showing higher limits.
Conclusion
Our study suggests a stabilization point in PTH with an eGFR > 46.64 mL/min/1.73 m2, indicating a significant interaction between renal function and PTH regulation. Additionally, the significant increase in PTH in individuals with 25(OH)D < 15.8 ng/mL emphasizes the importance of vitamin D in regulation. An association between age and PTH was also evident, particularly a substantial increase after the age of 70. Finally, we established the need to define partitioned RIs for PTH based on age and gender.
{"title":"PTH levels and establishment of reference intervals: Impact of vitamin D and renal function","authors":"Luis Agustín Ramírez Stieben , María Lorena Brance , Marina Verónica Belardinelli , Diamela Bolzán , Estefanía Pustilnik , Rodolfo Néstor Feldman , Lucas Ricardo Brun","doi":"10.1016/j.endien.2025.101527","DOIUrl":"10.1016/j.endien.2025.101527","url":null,"abstract":"<div><h3>Introduction</h3><div>Parathyroid hormone (PTH) and vitamin D are essential components in mineral metabolism. Our aims were to estimate the thresholds of 25-hydroxyvitamin D [25(OH)D] and estimated glomerular filtration rate (eGFR) that inhibit PTH, establish PTH reference intervals (RIs), and the stratify need based on age and gender.</div></div><div><h3>Materials and methods</h3><div>We conducted a cross-sectional study on participants older than 18 years. Segmented regressions (SR) were performed to determine the thresholds of 25(OH)D and eGFR in relation to PTH levels. Multivariate regression was used to evaluate the associations between PTH and 25(OH)D, gender, age, eGFR, and season. To establish the PTH RIs, extreme percentiles were calculated.</div></div><div><h3>Results</h3><div>A total of 2794 subjects were analyzed (women, 77.56%). Multivariate regression indicated that age, gender, 25(OH)D, and eGFR explained PTH variation. SR demonstrated that PTH stabilized when eGFR<!--> <!-->><!--> <!-->46.64<!--> <!-->mL/min/1.73<!--> <!-->m<sup>2</sup>, and PTH increased when 25(OH)D was <15.8<!--> <!-->ng/mL. Stratification by gender and age revealed different RIs, with women and over 70 years showing higher limits.</div></div><div><h3>Conclusion</h3><div>Our study suggests a stabilization point in PTH with an eGFR<!--> <!-->><!--> <!-->46.64<!--> <!-->mL/min/1.73<!--> <!-->m<sup>2</sup>, indicating a significant interaction between renal function and PTH regulation. Additionally, the significant increase in PTH in individuals with 25(OH)D<!--> <!--><<!--> <!-->15.8<!--> <!-->ng/mL emphasizes the importance of vitamin D in regulation. An association between age and PTH was also evident, particularly a substantial increase after the age of 70. Finally, we established the need to define partitioned RIs for PTH based on age and gender.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 2","pages":"Article 101527"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429053","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 : 2025-02-01DOI: 10.1016/j.endien.2025.101522
Guillermo Ropero-Luis , Alberto Ruiz-Cantero , Ricardo Gómez-Huelgas
Introduction
Few studies have explored the characteristics of hospitalized patients with hypercalcemia. Our goal was to analyze clinical–epidemiological features, mortality, and incidence of hypercalcemia in Spanish adult inpatients.
Materials and methods
We conducted a retrospective study using Spain's nationwide hospital database (“Conjunto Mínimo Básico de Datos Hospitalización”, CMBD-H), analyzing all hospital discharges from 2001 through 2015. Hypercalcemia was defined according to ICD-9-CM code 275.42. We examined causes, sex, median age, length of stay, and in-hospital mortality. Annual rates, adjusted for age and sex, were analyzed too.
Results
A total of 41,103 cases of hypercalcemia were analyzed out of 59,978,703 hospital discharges. Median age was 70 (interquartile range [IQR], 59–79), with 51.3% males. Internal Medicine had the most discharges (32.8%). Hypercalcemia was the leading cause in 11.4% of cases. Most common etiologies were cancer (83.8%) and hyperparathyroidism (15.1%). Neoplasms were more prevalent in males and older patients. Mean incidence was 0.7/1000 admissions, with a 7.1% annual growth rate. The overall in-hospital mortality rate was 27.1%, which remained unchanged over the study period. Factors associated with mortality included increasing age (OR, 1.01; 95% CI, 1.01–1.02), male sex (1.60; 1.53–1.68), emergency admission (1.43; 1.34–1.52), hypercalcemia as main diagnosis (1.89; 1.74–2.06), and neoplasm (5.24; 4.92–5.58).
Conclusions
This is the largest and most comprehensive general study on in-hospital hypercalcemia conducted to this date. The rate of hypercalcemia in hospitalized patients is increasing, likely due to the growing number of cancer inpatients. Hypercalcemia was associated with high mortality.
前言很少有研究探讨住院患者高钙血症的特点。我们的目的是分析西班牙成年住院患者的临床流行病学特征、死亡率和高钙血症发生率。材料和方法我们使用西班牙全国医院数据库（“Conjunto Mínimo Básico de Datos Hospitalización”，CMBD-H）进行了一项回顾性研究，分析了2001年至2015年所有医院的出院情况。根据ICD-9-CM代码275.42定义高钙血症。我们检查了病因、性别、年龄中位数、住院时间和住院死亡率。根据年龄和性别调整后的年增长率也进行了分析。结果在599787703例出院患者中，共分析高钙血症41103例。中位年龄为70岁（四分位间距[IQR]， 59-79），男性占51.3%。内科出院最多（32.8%）。高钙血症是主要原因，占11.4%。最常见的病因是癌症（83.8%）和甲状旁腺功能亢进（15.1%）。肿瘤在男性和老年患者中更为普遍。平均发病率为0.7/1000，年增长率为7.1%。总体住院死亡率为27.1%，在研究期间保持不变。与死亡率相关的因素包括年龄增长(OR, 1.01；95% CI, 1.01-1.02)，男性(1.60；1.53-1.68)，急诊入院(1.43；1.34-1.52)，高钙血症为主要诊断(1.89；1.74-2.06)，肿瘤(5.24；4.92 - -5.58)。这是迄今为止对院内高钙血症进行的最大规模、最全面的一般性研究。住院患者的高钙血症率正在上升，可能是由于癌症住院患者数量的增加。高钙血症与高死亡率相关。
{"title":"Analysis of hypercalcemia in hospitalized patients in Spain from 2001 through 2015","authors":"Guillermo Ropero-Luis , Alberto Ruiz-Cantero , Ricardo Gómez-Huelgas","doi":"10.1016/j.endien.2025.101522","DOIUrl":"10.1016/j.endien.2025.101522","url":null,"abstract":"<div><h3>Introduction</h3><div>Few studies have explored the characteristics of hospitalized patients with hypercalcemia. Our goal was to analyze clinical–epidemiological features, mortality, and incidence of hypercalcemia in Spanish adult inpatients.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective study using Spain's nationwide hospital database (“Conjunto Mínimo Básico de Datos Hospitalización”, CMBD-H), analyzing all hospital discharges from 2001 through 2015. Hypercalcemia was defined according to ICD-9-CM code 275.42. We examined causes, sex, median age, length of stay, and in-hospital mortality. Annual rates, adjusted for age and sex, were analyzed too.</div></div><div><h3>Results</h3><div>A total of 41,103 cases of hypercalcemia were analyzed out of 59,978,703 hospital discharges. Median age was 70 (interquartile range [IQR], 59–79), with 51.3% males. Internal Medicine had the most discharges (32.8%). Hypercalcemia was the leading cause in 11.4% of cases. Most common etiologies were cancer (83.8%) and hyperparathyroidism (15.1%). Neoplasms were more prevalent in males and older patients. Mean incidence was 0.7/1000 admissions, with a 7.1% annual growth rate. The overall in-hospital mortality rate was 27.1%, which remained unchanged over the study period. Factors associated with mortality included increasing age (OR, 1.01; 95% CI, 1.01–1.02), male sex (1.60; 1.53–1.68), emergency admission (1.43; 1.34–1.52), hypercalcemia as main diagnosis (1.89; 1.74–2.06), and neoplasm (5.24; 4.92–5.58).</div></div><div><h3>Conclusions</h3><div>This is the largest and most comprehensive general study on in-hospital hypercalcemia conducted to this date. The rate of hypercalcemia in hospitalized patients is increasing, likely due to the growing number of cancer inpatients. Hypercalcemia was associated with high mortality.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 2","pages":"Article 101522"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429052","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 : 2025-01-01DOI: 10.1016/j.endien.2024.07.004
Pilar Santa Cruz-Álvarez , Carmen Amelia Ruiz-Trillo , Ana Pérez-Morales , Ana Cortés-Lerena , Carmen Gamero-Dorado , Miguel Garrido-Bueno
Introduction
The transition of adolescents from pediatric to adult hospitals is a planned and guided process that involves changes in the focus, style, and location of care. During this period, complications are common in those with type 1 diabetes mellitus (T1DM). The objective of this study was to understand the influence of a nurse-led structured therapeutic education program on maintaining glycemic control and emotional wellbeing in these adolescents.
Materials and methods
Monocentric quasi-experimental clinical trial of a single group. SPSS and R-Commander were used for statistical analysis, including Student's t-test, Wilcoxon test, Cohen's d, Rosenthal's r, and multivariate linear regression analysis.
Results
A total of 15 adolescents with a 5-to-17-year history of the disease participated in the study. They had a BMI of 18–26.3 kg/m2 and were on basal-bolus therapy. No significant differences were found in glycemic control and emotional wellbeing between baseline values and at 3 months. A significant difference in self-care was observed at 12 months. Family function and eating disorders were positively associated at baseline, 3 months, and 12 months.
Conclusions
The structured therapeutic education program for adolescents with T1DM transitioning from pediatric to adult care maintains glycemic control and emotional wellbeing.
{"title":"Nurse-led therapeutic patient education program on glycemic control and emotional wellbeing in adolescents with type 1 diabetes mellitus during hospital transition","authors":"Pilar Santa Cruz-Álvarez , Carmen Amelia Ruiz-Trillo , Ana Pérez-Morales , Ana Cortés-Lerena , Carmen Gamero-Dorado , Miguel Garrido-Bueno","doi":"10.1016/j.endien.2024.07.004","DOIUrl":"10.1016/j.endien.2024.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The transition of adolescents from pediatric to adult hospitals is a planned and guided process that involves changes in the focus, style, and location of care. During this period, complications are common in those with type 1 diabetes mellitus (T1DM). The objective of this study was to understand the influence of a nurse-led structured therapeutic education program on maintaining glycemic control and emotional wellbeing in these adolescents.</div></div><div><h3>Materials and methods</h3><div>Monocentric quasi-experimental clinical trial of a single group. SPSS and R-Commander were used for statistical analysis, including Student's <em>t</em>-test, Wilcoxon test, Cohen's d, Rosenthal's r, and multivariate linear regression analysis.</div></div><div><h3>Results</h3><div>A total of 15 adolescents with a 5-to-17-year history of the disease participated in the study. They had a BMI of 18–26.3<!--> <!-->kg/m<sup>2</sup> and were on basal-bolus therapy. No significant differences were found in glycemic control and emotional wellbeing between baseline values and at 3 months. A significant difference in self-care was observed at 12 months. Family function and eating disorders were positively associated at baseline, 3 months, and 12 months.</div></div><div><h3>Conclusions</h3><div>The structured therapeutic education program for adolescents with T1DM transitioning from pediatric to adult care maintains glycemic control and emotional wellbeing.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 1","pages":"Pages 14-25"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899316","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 : 2025-01-01DOI: 10.1016/j.endien.2024.12.004
Ana M. Wägner , Marta Hernández García
{"title":"Status of type 1 diabetes mellitus prevention: promises and realities","authors":"Ana M. Wägner , Marta Hernández García","doi":"10.1016/j.endien.2024.12.004","DOIUrl":"10.1016/j.endien.2024.12.004","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 1","pages":"Pages 1-3"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899353","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 : 2025-01-01DOI: 10.1016/j.endien.2024.12.001
Marga Giménez , Antoni Castells , David Font , Josep Vidal , Ignacio Conget
{"title":"Towards a personalised digital care in type 1 diabetes. Are we ready?","authors":"Marga Giménez , Antoni Castells , David Font , Josep Vidal , Ignacio Conget","doi":"10.1016/j.endien.2024.12.001","DOIUrl":"10.1016/j.endien.2024.12.001","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 1","pages":"Pages 47-49"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899359","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 : 2025-01-01DOI: 10.1016/j.endien.2024.12.006
Giovana Longo-Silva , Renan Serenini , Anny Pedrosa , Márcia Lima , Larissa Soares , Júlia Melo , Risia Menezes
Introduction
In recent years, the focus of research on obesity and its management has expanded beyond traditional dietary factors to include the timing of food intake – in relation to the body's circadian rhythms – known as chrononutrition. However, chrononutrition patterns remain largely unexplored in low-medium income countries. Our study aimed to investigate the association between chrononutrition patterns and BMI.
Material and methods
Utilizing data from the virtual Survey SONAR-Brazil (n = 2137,18–65 y), we defined the following chrononutrition patterns: 1. The clock time of the first, mid, and last eating events; 2. Morning and evening latencies (from wake-up time until the first eating event, and from the last eating event until bedtime); and 3. Eating window. Linear regression analyses assessed associations between chrononutrition variables and BMI. Quantile regression and restricted cubic splines were used to explore distributional correlations and association shapes.
Results
Among all participants, BMI increased with each additional hour of the first eating event (β = 0.17; 95% CI, 0.05,0.29; P = 0.005), morning latency (β = 0.27; 95% CI, 0.12,0.42; P < 0.001), and eating midpoint (β = 0.21; 95% CI, 0.05,0.38; P = 0.01) and the effect was even stronger with higher BMI percentiles. There was no effect of eating times among intermediate and late chronotypes. However, among early types, positive associations were seen between the BMI and the timing of the first eating event, morning latency, and eating midpoint, as well as a negative association with evening eating.
Conclusions
Our findings suggest that delaying the first eating event, the eating midpoint, and extending morning latency are associated with higher BMI, particularly in early chronotypes. These results highlight the importance of aligning eating patterns with chronotypes and support personalized dietary recommendations.
{"title":"Chrononutrition patterns and their association with body weight: Differences across multiple chronotypes","authors":"Giovana Longo-Silva , Renan Serenini , Anny Pedrosa , Márcia Lima , Larissa Soares , Júlia Melo , Risia Menezes","doi":"10.1016/j.endien.2024.12.006","DOIUrl":"10.1016/j.endien.2024.12.006","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, the focus of research on obesity and its management has expanded beyond traditional dietary factors to include the timing of food intake – in relation to the body's circadian rhythms – known as chrononutrition. However, chrononutrition patterns remain largely unexplored in low-medium income countries. Our study aimed to investigate the association between chrononutrition patterns and BMI.</div></div><div><h3>Material and methods</h3><div>Utilizing data from the virtual Survey SONAR-Brazil (<em>n</em> <!-->=<!--> <!-->2137,18–65 y), we defined the following chrononutrition patterns: 1. The clock time of the first, mid, and last eating events; 2. Morning and evening latencies (from wake-up time until the first eating event, and from the last eating event until bedtime); and 3. Eating window. Linear regression analyses assessed associations between chrononutrition variables and BMI. Quantile regression and restricted cubic splines were used to explore distributional correlations and association shapes.</div></div><div><h3>Results</h3><div>Among all participants, BMI increased with each additional hour of the first eating event (<em>β</em> <!-->=<!--> <!-->0.17; 95% CI, 0.05,0.29; <em>P</em> <!-->=<!--> <!-->0.005), morning latency (<em>β</em> <!-->=<!--> <!-->0.27; 95% CI, 0.12,0.42; <em>P</em> <!--><<!--> <!-->0.001), and eating midpoint (<em>β</em> <!-->=<!--> <!-->0.21; 95% CI, 0.05,0.38; <em>P</em> <!-->=<!--> <!-->0.01) and the effect was even stronger with higher BMI percentiles. There was no effect of eating times among intermediate and late chronotypes. However, among early types, positive associations were seen between the BMI and the timing of the first eating event, morning latency, and eating midpoint, as well as a negative association with evening eating.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that delaying the first eating event, the eating midpoint, and extending morning latency are associated with higher BMI, particularly in early chronotypes. These results highlight the importance of aligning eating patterns with chronotypes and support personalized dietary recommendations.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 1","pages":"Pages 4-13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966785","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 : 2025-01-01DOI: 10.1016/j.endien.2024.12.005
Hamlet Ghukasyan , Denilsa Dinis Pedro Navalha , Ignacio Pérez Romero , Maria Vitória Prato Wolwacz , Artur Ghahramanyan , Cristiane Wen Tsing Ngan , Maria Helena Siqueira Tavares de Melo , Caroline Serafim Dagostin , Luis Gómez-Lechón Quirós
Introduction
Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) were shown to lower hyperuricemic events in patients with type 2 diabetes mellitus (T2DM), the extent of this effect in the general population is yet to be elucidated. We performed an updated systematic review and meta-analysis on a large sample of patients with and without T2DM to evaluate the influence of SGLT2i therapy on clinically relevant hyperuricemic events, defined as the composite of acute gout flare episodes, acute anti-gout management or urate-lowering therapy initiation. Furthermore, we conducted a multivariate meta-regression to assess the relationship between different covariates and the pooled effect size.
Materials and methods
We systematically searched all reported outcomes of interest in patients on SGLT2i (PROSPERO: CRD42023442077) across PubMed, Scopus and Cochrane databases looking for randomized controlled trials, observational studies and post-hoc analyses since inception until August 2023.
Results
Data from seven randomized controlled trials and seven observational studies were included for a total of 464,009 patients, 13,370 of whom did not have T2DM. A total of 50% of the patients included were on SGLT2i. The pooled analysis demonstrated that SGLT2i reduce clinically relevant hyperuricemic events by 33% (HR, 0.67; 95% CI, 0.59–0.77; I2 = 83%) regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on chronic kidney disease (CKD) showed a positive correlation on the pooled effect size.
Conclusions
SGLT2i reduce the risk of developing hyperuricemic events regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on CKD showed a significant impact on the main outcome. Further studies are essential to investigate more conclusively the extent of these beneficial effects.
{"title":"Reducing hyperuricemic events with SGLT2 inhibitors: An updated systematic review with meta-regression","authors":"Hamlet Ghukasyan , Denilsa Dinis Pedro Navalha , Ignacio Pérez Romero , Maria Vitória Prato Wolwacz , Artur Ghahramanyan , Cristiane Wen Tsing Ngan , Maria Helena Siqueira Tavares de Melo , Caroline Serafim Dagostin , Luis Gómez-Lechón Quirós","doi":"10.1016/j.endien.2024.12.005","DOIUrl":"10.1016/j.endien.2024.12.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) were shown to lower hyperuricemic events in patients with type 2 diabetes mellitus (T2DM), the extent of this effect in the general population is yet to be elucidated. We performed an updated systematic review and meta-analysis on a large sample of patients with and without T2DM to evaluate the influence of SGLT2i therapy on clinically relevant hyperuricemic events, defined as the composite of acute gout flare episodes, acute anti-gout management or urate-lowering therapy initiation. Furthermore, we conducted a multivariate meta-regression to assess the relationship between different covariates and the pooled effect size.</div></div><div><h3>Materials and methods</h3><div>We systematically searched all reported outcomes of interest in patients on SGLT2i (PROSPERO: CRD42023442077) across PubMed, Scopus and Cochrane databases looking for randomized controlled trials, observational studies and post-hoc analyses since inception until August 2023.</div></div><div><h3>Results</h3><div>Data from seven randomized controlled trials and seven observational studies were included for a total of 464,009 patients, 13,370 of whom did not have T2DM. A total of 50% of the patients included were on SGLT2i. The pooled analysis demonstrated that SGLT2i reduce clinically relevant hyperuricemic events by 33% (HR, 0.67; 95% CI, 0.59–0.77; <em>I</em><sup>2</sup> <!-->=<!--> <!-->83%) regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on chronic kidney disease (CKD) showed a positive correlation on the pooled effect size.</div></div><div><h3>Conclusions</h3><div>SGLT2i reduce the risk of developing hyperuricemic events regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on CKD showed a significant impact on the main outcome. Further studies are essential to investigate more conclusively the extent of these beneficial effects.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 1","pages":"Pages 26-36"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966789","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号