Endocrinologia Diabetes Y Nutricion最新文献

英文中文

Familial hypogonadotropic hypogonadism: The convergence of two genetic defects 家族性促性腺功能减退症：两种遗传缺陷的汇合。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-02-01 DOI: 10.1016/j.endien.2025.501675

Luis Muñoz Arenas, Mercedes Senent Capote, Javier Olmedo Pérez-Montaut, Antonio Ballesteros Martín-Portugués, Esteban Sánchez-Toscano, Maria Gloria Baena-Nieto

引用次数: 0

Incidentally vs nonincidentally diagnosed paragangliomas: Experience of a tertiary referral center 偶然与非偶然诊断副神经节瘤：三级转诊中心的经验。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-02-01 DOI: 10.1016/j.endien.2025.501673

Patrícia Ferreira , Sara Ribeiro , Inês Meira , Marta Canha , Diana Festas Silva , Joana Queirós

Purpose

Incidental detection of paragangliomas (PGLs) is increasing due to the increased use and advancements in imaging modalities. Therefore, its clinical presentation is changing. We aimed to compare the clinical characteristics of incidentally discovered PGLs with the clinically suspected.

Methods

We conducted a retrospective cohort study with patients diagnosed with PGLs between 2004 and 2023 at a tertiary referral center. Our cohort was divided into 2 groups: clinically suspected PGLs and incidentally discovered PGLs. Data on age, tumor location, size, symptoms, metastasis, and genetic testing were collected and compared between the groups. A subgroup analysis was conducted to evaluate adrenal and extra-adrenal PGLs separately.

Results

Of the 140 included patients, 64.3% were diagnosed incidentally and 35.7% through clinical suspicion. Incidentalomas were older at diagnosis (54.6 ± 16.3 vs 46.2 ± 16.5 years; p = 0.002) and had smaller tumors (4.5 ± 2.5 cm vs 5.4 ± 2.4 cm; p = 0.030). Clinically suspected cases were more likely to have metastatic disease (16.3% vs 3.5%; p = 0.009) and exhibit classic symptoms, including palpitations (44.7% vs 8.4%; p < 0.001), sweating (29.8% vs 7.2%; p < 0.001), and headaches (29.8% vs 9.6%; p = 0.003). In addition, sustained hypertension was more common in the clinically suspected group (68.8% vs 47.1%; p = 0.016). In extra-adrenal PGLs, differences in tumor size and metastatic rates were more pronounced. Genetic testing showed a higher prevalence of mutations in the clinically suspected group (75% vs 47.6%; p = 0.003).

Conclusions

This study supports the shift in the predominant mode of paraganglioma presentation toward incidental findings. Enhanced recognition and proper follow up will refine the management of paragangliomas and ultimately improve patient outcomes.

目的：副神经节瘤（PGLs）的偶然检测正在增加，由于增加的使用和成像方式的进步。因此，其临床表现正在发生变化。我们的目的是比较偶然发现的pgl与临床怀疑的临床特征。方法：我们对2004年至2023年在三级转诊中心诊断为PGLs的患者进行了回顾性队列研究。我们的队列分为两组：临床怀疑的pgl和偶然发现的pgl。收集年龄、肿瘤位置、大小、症状、转移和基因检测的数据，并在组间进行比较。亚组分析分别评价肾上腺和肾上腺外pgl。结果：140例患者中，64.3%为偶然诊断，35.7%为临床怀疑。偶发瘤在诊断时年龄较大（54.6±16.3 vs 46.2±16.5;p=0.002），肿瘤较小（4.5±2.5cm vs 5.4±2.4cm; p=0.030）。临床疑似病例更有可能有转移性疾病（16.3% vs 3.5%; p=0.009），并表现出典型症状，包括心悸（44.7% vs 8.4%）。结论：该研究支持副神经节瘤主要表现模式向偶然发现的转变。增强识别和适当的随访将改进副神经节瘤的管理，并最终改善患者的预后。

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引用次数: 0

Outcomes of a population-based flash glucose monitoring program in adults with type 2 diabetes mellitus on intensive insulin therapy in Andalusia 安达卢西亚一项以人群为基础的成人2型糖尿病患者胰岛素强化治疗的瞬时血糖监测项目的结果

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-02-01 DOI: 10.1016/j.endien.2025.501661

Mercedes Peinado Ruíz , Beatriz Rodríguez Jiménez , Pablo Rodríguez de Vera Gómez , Nieves Lafuente Robles , Rafael Palomares Ortega , Francisco José Sánchez-Laguna , Inmaculada Vázquez Cruz , Eduardo Mayoral Sánchez , María Jesús Sanchez-Alvarez , Celia Fernandez-Delgado , Ismael Muñoz Martínez , María Asunción Martínez-Brocca

The implementation of flash glucose monitoring (FGM) in people with type 2 diabetes mellitus (T2DM) undergoing intensive insulin therapy represents an organizational challenge for health care systems.

Objective

To evaluate the outcomes of the FGM system rollout in adults with T2DM within the Andalusian Public Health System.

Methods

We conducted a cross-sectional, population-based descriptive study in Andalusia (Spain), analyzing the shared care model between Primary Care (PC) and Hospital Care (HC) for the implementation of FGM systems in adult patients with T2DM on intensive basal-bolus insulin therapy, 34 months after starting the program (program duration: from April 2022 to February 2025).

Results

A total of 25,052 active FGM users were identified (48.6% women; mean age, 69.0 ± 12.8 years) out of an estimated target population of 29,979 patients. The main indications for FGM use were functional disability or dependency (n = 4283; 17%), severe hypoglycemia (n = 1899; 7.4%), pregestational T2DM (n = 266; 1%), and frequent non-severe hypoglycemia (n = 9104; 36.2%). The remaining cohort (n = 9683; 38.4%) included individuals without prioritization criteria. The main indication setting was PC, where 23,669 devices (80.2%) were initiated. The permanent discontinuation rate was 15%, with no serious adverse events being reported. A total of 9185 active users (36.4%) had their glucose monitoring data integrated into the electronic health record (EHR) of the Andalusian Public Health System.

Conclusions

Coordinated action across health care levels is an effective strategy for equitable access to technologies such as FGM among Andalusian patients with T2DM on intensive insulin therapy. Integration of glucose data into the EHR is a key tool for ensuring continuity of care.

在接受胰岛素强化治疗的2型糖尿病（T2DM）患者中实施瞬时血糖监测（FGM）是卫生保健系统面临的一个组织挑战。目的：评估安达卢西亚公共卫生系统在成年T2DM患者中推行女性生殖器切割系统的结果。方法：我们在安达卢西亚（西班牙）进行了一项基于人群的横断面描述性研究，分析了初级保健（PC）和医院保健（HC）在项目开始34个月后（项目持续时间：2022年4月至2025年2月）对接受强化基础胰岛素治疗的成年T2DM患者实施女性生殖器切割系统的共享护理模式。结果：在估计的目标人群29,979例患者中，共确定了25,052例活跃的女性生殖器切割使用者（48.6%为女性，平均年龄69.0±12.8岁）。使用女性生殖器切割的主要适应症是功能残疾或依赖（n=4283, 17%）、严重低血糖（n=1899, 7.4%）、妊娠期T2DM （n=266, 1%）和频繁的非严重低血糖（n=9104, 36.2%）。其余队列（n=9683, 38.4%）包括没有优先级标准的个体。主要指示设置为PC，其中23,669个设备（80.2%）启动。永久停药率为15%，无严重不良事件报告。共有9185名活跃用户（36.4%）将血糖监测数据整合到安达卢西亚公共卫生系统的电子健康记录（EHR）中。结论：跨卫生保健水平的协调行动是安达卢西亚T2DM患者在强化胰岛素治疗中公平获得技术（如女性生殖器切割）的有效策略。将葡萄糖数据整合到电子病历中是确保护理连续性的关键工具。

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引用次数: 0

ATA 2025: Less is more—Practical implications for the management of differentiated thyroid cancer ATA 2025：少即是多——分化型甲状腺癌治疗的实际意义

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-02-01 DOI: 10.1016/j.endien.2026.501760

Garcilaso Riesco Eizaguirre , Emma Anda Apiñániz , Cecilia Sánchez Ragnarsson , Jordi Lluis Reverter Calatayud , Carles Zafon

引用次数: 0

3, 2, 1! From GLP-2 to GLP-1 analog over a 10-year journey 3,2,1 ！从GLP-2到GLP-1模拟物经过10年的历程。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-01-01 DOI: 10.1016/j.endien.2025.501662

María Sara Tapia-Sanchiz, Miguel Antonio Sampedro-Núñez, Sara Jiménez-Blanco, Begoña Molina-Baena

Short bowel syndrome (SBS) represents one of the central conditions in clinical nutrition, with a complex and challenging management. Teduglutide, an analog of human glucagon-like peptide-2 (GLP-2), is the first approved long-term, non-symptomatic treatment for SBS. We present the case of a 62-year-old woman with SBS who required prolonged home parenteral nutrition (HPN). Following clinical stabilization, teduglutide was initiated, leading to significant clinical and nutritional improvement, including spontaneous closure of enterocutaneous fistulas and a 70% reduction in parenteral nutrition requirements. This allowed for a surgical reconstruction, after which she achieved full enteral autonomy, later developing grade 1 obesity. This case highlights the therapeutic potential of teduglutide as a bridging therapy and the remaining uncertainties regarding its long-term management.

短肠综合征（SBS）是临床营养的中心疾病之一，具有复杂和具有挑战性的管理。Teduglutide是一种类似于人胰高血糖素样肽-2 （GLP-2）的药物，是首个被批准用于SBS的长期无症状治疗药物。我们提出的情况下，62岁的妇女SBS谁需要延长家庭肠外营养（HPN）。在临床稳定后，开始使用teduglutide，导致显著的临床和营养改善，包括肠皮瘘的自发闭合和肠外营养需求减少70%。这允许手术重建，之后她实现了完全的肠内自主，后来发展为1级肥胖。该病例突出了特杜卢肽作为桥接疗法的治疗潜力，以及其长期管理的不确定性。

引用次数: 0

Implementation of cervical ultrasound and related techniques in endocrinology and nutrition services in Spain. ECOSEEN 2025 study 在西班牙的内分泌和营养服务中实施宫颈超声和相关技术。ECOSEEN 2025研究。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-01-01 DOI: 10.1016/j.endien.2025.501659

Jordi L. Reverter , Gonzalo Díaz Soto , Tomás Martin , Manuel Gargallo , Marcel Sambo , Iñaki Argüelles , Imaging and Associated Techniques Group of the Spanish Society of Endocrinology and Nutrition

Introduction

Before 2014, few Endocrinology and Nutrition Departments nationwide routinely used cervical ultrasound. Following the training activities promoted by the Thyroid Pathology Imaging Group, it is important to evaluate the current level of implementation of ultrasound and ultrasound-guided techniques in clinical practice.

Material and methods

A structured, self-administered survey was designed and sent electronically to hospitals throughout the country.

Results

Responses were received from a total of 101 hospitals. Ninety-three percent of the departments surveyed reported routine use of ultrasound in clinical practice, with specialized consultations in 71% of cases. Sixty percent performed fine-needle aspiration cytology, and 55% performed staging and follow-up of differentiated thyroid cancer. Among minimally invasive techniques (MIT), 42% of centers perform enolization of thyroid cysts and 12% offer thermal ablation techniques, with radiofrequency being the most commonly used modality. Eighty-six% of professionals have received training through the Applied Imaging Techniques for Thyroid Pathology Group of the SEEN (National Institute of Endocrinology and Nutrition). Currently, 56 centers offer specific ultrasound training for medical residents in the specialty.

Conclusion

Over the last decade, ultrasound has been widely implemented in the Endocrinology and Nutrition Departments affiliated with the SEEN, including the incorporation of ultrasound-guided techniques into routine practice. However, the use of MIT such as thermal ablation is still limited, so it is considered necessary to strengthen both specific training and institutional support to promote its maximum implementation.

2014年以前，全国很少有内分泌营养科常规使用宫颈超声检查。随着甲状腺病理影像学组的培训活动，评估超声和超声引导技术在临床实践中的实施水平是很重要的。材料和方法：设计了一份结构化的、自我管理的调查，并以电子方式发送给全国各地的医院。结果：共收到101家医院的回复。93%的受访科室报告在临床实践中常规使用超声，71%的病例进行了专门咨询。60%的患者接受细针穿刺细胞学检查，55%的患者接受分化型甲状腺癌的分期和随访。在微创技术（MIT）中，42%的中心提供甲状腺囊肿烯醇化治疗，12%的中心提供热消融技术，其中射频是最常用的方式。86%的专业人员接受了美国国家内分泌与营养研究所甲状腺病理应用成像技术组的培训。目前，有56个中心为该专业的住院医师提供专门的超声培训。结论：在过去的十年中，超声在附属内分泌科和营养科得到了广泛的应用，包括将超声引导技术纳入常规实践。然而，热消融等麻省理工技术的应用仍然有限，因此有必要加强具体培训和制度支持，以促进其最大限度地实施。

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引用次数: 0

Polymorphisms in TLR4 and IL6 and their association with obesity and insulin resistance in a Venezuelan population 委内瑞拉人群中TLR4和IL6多态性及其与肥胖和胰岛素抵抗的关系

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-01-01 DOI: 10.1016/j.endien.2025.501657

Stefani Hernández Osorio , María Fátima Garcés , Eva Salazar Alcalá , José Manuel Pestana , Mercedes Fernández Mestre

Objective

This study investigated the association between genetic polymorphisms in the TLR4 (rs4986790 and rs4986791) and IL6 (rs1800795) genes with obesity in a Venezuelan population.

Methods

We conducted a retrospective case-control study with 207 unrelated Venezuelans (137 obese, 70 normal weight). Blood samples were obtained to measure glucose, cholesterol, triglycerides, HDL, insulin, and insulin resistance (HOMA-IR ≥ 2.6) and genotype the TLR4 (rs4986790 and rs4986791) and IL6 (rs1800795) polymorphisms using PCR-SSP. Statistical tests: Student's t-test, Pearson correlation coefficient, chi-square test, odds ratio (OR) with 95%CI were used.

Results

The relationship between obesity and insulin resistance (IR) was confirmed. Heterozygous genotypes A/G (TLR4 rs4986790, P = .012) and C/T (TLR4 rs4986791, P = .005) were more frequent in normal-weight individuals, while homozygous genotypes A/A (TLR4 rs4986790, P = .012) and C/C (TLR4 rs4986791, P = .005) were more frequent in obese individuals. The C allele and CC genotype of IL6 rs1800795 (P = .007) were associated with obesity. The IL6 C/C genotype was associated with higher insulin and HOMA in obese individuals. In obese individuals with IR, the CC genotype (TLR4 rs4986791, P = .03) was more common, as opposted to CT, which was less common (P = .03). The C/C genotype of IL6 rs1800795 was more frequent in obese individuals with IR (P < .0001). Obese individuals with IR and the AA genotype of TLR4 rs4986790 had higher BMI, HOMA-IR, and glucose.

Conclusion

These findings suggest that genetic variations in the TLR4 and IL6 genes may predispose to obesity and its metabolic complications in the Venezuelan population.

目的：本研究探讨了委内瑞拉人群中TLR4 （rs4986790和rs4986791）和IL6 （rs1800795）基因多态性与肥胖的关系。方法：我们对207名委内瑞拉人（137名肥胖，70名正常体重）进行了回顾性病例对照研究。采集血样，测定血糖、胆固醇、甘油三酯、HDL、胰岛素和胰岛素抵抗（HOMA-IR≥2.6），并利用PCR-SSP对TLR4 （rs4986790和rs4986791）和IL6 （rs1800795）多态性进行基因分型。统计学检验：采用学生t检验、Pearson相关系数、卡方检验、比值比（OR）， 95%CI。结果：肥胖与胰岛素抵抗（IR）的关系得到证实。杂合子基因型A/G (TLR4 rs4986790, P =；012)和C/T (TLR4 rs4986791, P =。而纯合子基因型A/A (TLR4 rs4986790, P =。012)和C/C (TLR4 rs4986791, P =。2005)在肥胖人群中更为常见。IL6 rs1800795的C等位基因和CC基因型与肥胖相关（P = 0.007）。在肥胖个体中，IL6 C/C基因型与较高的胰岛素和HOMA相关。在肥胖IR患者中，CC基因型(TLR4 rs4986791, P =。03)较常见，而CT较不常见（P = .03）。il - 6 rs1800795的C/C基因型在肥胖IR患者中更为常见(P结论：这些发现表明，TLR4和il - 6基因的遗传变异可能易导致委内瑞拉人群的肥胖及其代谢并发症。

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引用次数: 0

Enhancing levothyroxine dosing accuracy post-total thyroidectomy using body fat percentage 利用体脂率提高甲状腺全切除术后左旋甲状腺素给药准确性

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-01-01 DOI: 10.1016/j.endien.2025.501645

Ana M. Díaz Abram , Federico Volpi , Estefanía Chumbiauca , Marta García Goñi , Juan C. Galofré

引用次数: 0

Continuity of care in obesity clinical care 肥胖症临床护理的连续性。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-01-01 DOI: 10.1016/j.endien.2025.501658

Irene Bretón , José Manuel Fernández García , Nuria Vilarrasa , Violeta Ramírez Arroyo , Ani de Hollanda , Guadalupe Blay Cortés , María D. Ballesteros-Pomar , on behalf of SEEN, SEMERGEN, semFYC and SEMG

Obesity is a chronic, multifactorial and relapsing disease with a great impact on public health. Due to its high prevalence and complications, it is essential to coordinate clinical care in different health care settings in order to improve the clinical evaluation and treatment of people with obesity and to optimize the use of health care resources. This document, prepared by experts from the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of General Practitioners (SEMG) proposes a comprehensive clinical approach to obesity, based on effective coordination between Primary Care and Endocrinology and Nutrition Departments.

肥胖是一种慢性、多因素、反复发作的疾病，对公众健康有很大影响。由于其高患病率和并发症，协调不同卫生保健机构的临床护理，以提高对肥胖患者的临床评价和治疗，优化卫生保健资源的利用是必不可少的。该文件由西班牙内分泌与营养学会（SEEN）、西班牙初级保健医师学会（SEMERGEN）、西班牙家庭与社区医学学会（semFYC）和西班牙全科医生学会（SEMG）的专家编写，提出了一种基于初级保健和内分泌与营养部门有效协调的综合临床方法。

引用次数: 0

Beyond vectorial bioelectrical impedance: Assessing body composition changes with novel electrical parameters in obese osteoarthritis patients on a meal-replacement diet 超越矢量生物电阻抗：用新的电参数评估肥胖骨关节炎患者在代餐饮食中的身体成分变化

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2026-01-01 DOI: 10.1016/j.endien.2025.501644

José-Joaquín Alfaro-Martínez , David Primo-Martín , César Gonzalvo-Díaz , Olatz Izaola-Jauregui , Marina Jara-Vidal , Lourdes García-Blasco , Beatriz Ramos-Bachiller , Diego Bellido-Guerrero , Daniel A. De Luis-Román , Juan José López-Gómez

Background

Rapid weight loss with restricted diets can cause muscle mass decline. The aim of this work is to evaluate a new method for representing the raw electrical values obtained in the bioelectrical impedance analysis (BIA) in patients with obesity and osteoarthritis undergoing a meal-replacement diet.

Methods

We conducted a 1-group intervention study with meal-replacement diet for 3 months in patients with osteoarthritis prior to orthopedic surgery. Anthropometry and BIA was registered at baseline (B) and 3 months (3M) after the intervention. We have calculated traditional estimations of body composition over the raw electrical parameters of BIA parameters and a new bioelectrical impedance vector analysis (BIVA) based method to detect nutrition (NP), hydration (HP) and fat (FP) parameters without estimation.

Results

A total of 272 patients (23.16% men; 76.84% women) were analyzed. There was a correlation between NP and body composition estimates (body cell mass [BCM] standardized by height (BCM/h): men: 0.96; p < 0.01; women: 0.88; p < 0.01). The correlation coefficient between HP and estimated total body water was 0.769 for men and 0.63 for women (p < 0.01 in both cases). The correlation coefficient between FP and estimated fat mass (FM) standardized by height was 0.83 for men and 0.89 for women (p < 0.01). There was a significant decrease in body weight (B: 99.33(15.0) kg; 3M: 92.03(16.0) kg; p < 0.01); and FM (B: 49.93(6.67) kg; 3M: 44.22(9.08) kg). There was no difference in BCM and fat free mass. In new parameters a decrease in NP (B: +0.50(0.31); 3M: +0.42(0.42); p = 0.03) and FP (B: +0.49(0.17) was reported; 3M: +0.38(0.16); p < 0.01), although there was no difference in HP.

Conclusions

The new interpretation of BIVA as NP and HP have a high correlation with the body composition parameters estimated by regression models, and they report changes in body composition after a partial meal-replacement diet such as regression equations.

背景：限制饮食的快速减肥会导致肌肉质量下降。这项工作的目的是评估一种新的方法来表示在进行代餐饮食的肥胖和骨关节炎患者的生物电阻抗分析（BIA）中获得的原始电值。方法对骨科手术前骨关节炎患者进行为期3个月的代餐饮食干预研究。在基线(B)和干预后3个月（3M）记录人体测量和BIA。我们计算了基于BIA参数的原始电参数的传统身体成分估计值，以及一种新的基于生物电阻抗矢量分析（BIVA）的检测营养（NP）、水合（HP）和脂肪（FP）参数的方法。结果共分析272例患者，其中男性23.16%，女性76.84%。NP与身体成分估计值（身高标准化的体细胞质量[BCM] (BCM/h)）之间存在相关性：男性：0.96；p < 0.01；女性:0.88;p < 0.01)。HP与估计的总体内水分之间的相关系数男性为0.769，女性为0.63（两种情况的p <； 0.01）。男性的FP与身高标准化的估计脂肪量（FM）的相关系数为0.83，女性为0.89 （p < 0.01）。体重显著下降(B: 99.33(15.0) kg；3M: 92.03(16.0) kg；p < 0.01)；FM (B): 49.93(6.67) kg；3米：44.22（9.08）公斤。BCM和无脂质量无显著差异。在新参数下，NP (B)降低：+0.50(0.31)；3 m: + 0.42 (0.42);p = 0.03)和FP (B: +0.49(0.17))；3 m: + 0.38 (0.16);p < 0.01)，但HP无差异。结论BIVA的新解释为NP和HP与回归模型估计的体成分参数具有高度相关性，它们报告了部分代餐饮食后体成分的变化，如回归方程。

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