Pub Date : 2026-03-01Epub Date: 2026-03-07DOI: 10.1016/j.endien.2026.501715
Juan A. García-Arnés , Lidia Fernández-Díaz , Fatima Herrera-Pérez , Natalia García-Casares , Marc S. Dawid-Milner
Sudomotor dysfunction is a frequent and early sign of diabetic neuropathy. It is a disorder of the autonomic nervous system that involves small fibers and is usually underdiagnosed despite the impact it has on the patients’ quality of life. Its study is recommended as a strategy for early detection as an indicator of dysautonomic dysfunction and management of later complications. Although it can be highly disabling, it often goes unnoticed, as it is considered less alarming than other dysautonomic symptoms. We present the case of a diabetic patient with sudomotor disfunction who underwent a comprehensive autonomic nervous system evaluation. Unlike most related studies, this case highlights a combination of compensatory hyperhidrosis and distal anhidrosis, underscoring the variability in clinical signs of sudomotor dysfunction. Additionally, it demonstrates the importance of autonomic testing in differential diagnosis and emphasizes the need for further research into its pathophysiological mechanisms and effective therapeutic strategies.
{"title":"Sudomotor dysfunction in type 1 diabetes: A case report","authors":"Juan A. García-Arnés , Lidia Fernández-Díaz , Fatima Herrera-Pérez , Natalia García-Casares , Marc S. Dawid-Milner","doi":"10.1016/j.endien.2026.501715","DOIUrl":"10.1016/j.endien.2026.501715","url":null,"abstract":"<div><div>Sudomotor dysfunction is a frequent and early sign of diabetic neuropathy. It is a disorder of the autonomic nervous system that involves small fibers and is usually underdiagnosed despite the impact it has on the patients’ quality of life. Its study is recommended as a strategy for early detection as an indicator of dysautonomic dysfunction and management of later complications. Although it can be highly disabling, it often goes unnoticed, as it is considered less alarming than other dysautonomic symptoms. We present the case of a diabetic patient with sudomotor disfunction who underwent a comprehensive autonomic nervous system evaluation. Unlike most related studies, this case highlights a combination of compensatory hyperhidrosis and distal anhidrosis, underscoring the variability in clinical signs of sudomotor dysfunction. Additionally, it demonstrates the importance of autonomic testing in differential diagnosis and emphasizes the need for further research into its pathophysiological mechanisms and effective therapeutic strategies.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 3","pages":"Article 501715"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391215","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 : 2026-03-01Epub Date: 2026-03-07DOI: 10.1016/j.endien.2026.501714
María D. Ballesteros-Pomar , María Antequera , Manuel Antonio Botana-López , Pilar Beato-Víbora , Luis Eduardo Lander , Paloma Moreno-Moreno , Juan Francisco Merino-Torres , Joana Nicolau , Luis Vázquez , Manel Puig-Domingo
Background
Endocrinology and Nutrition residency training in Spain (MIR program) is undergoing a major update for the first time since 2006, reflecting rapid advances in endocrine science, technology, and educational standards. Internationally, the European Society of Endocrinology (ESE) has introduced a unified curriculum to harmonize specialist training across Europe, highlighting core competencies and the need for longer training. This article outlines the renewed Spanish Endocrinology-Nutrition MIR program proposal, detailing its modernized curriculum, innovative assessment methods, and the debate on extending training duration.
Advances in modern endocrinology
The updated program highlights emerging areas such as molecular endocrinology, technology-enhanced diabetes care, diagnosis and prevention of arteriosclerotic vascular disease, metabolism and rare endocrine disorders, multidisciplinary obesity management, and the central role of nutrition in patient care. These priorities reflect current trends in clinical practice and the forefront of endocrine research.
Assessment innovation
New evaluation methods focus on competency-based training, with progressive responsibility, portfolios, workplace-based assessments and entrustable professional activities (EPAs) to ensure trainees attain defined skills. Formal examinations and objective assessments are introduced to standardize certification.
Training duration
A pivotal discussion is whether to extend the residency from 4 to 5 years. Given the breadth of endocrinology and ESE recommendations of a 6-year combined internal medicine–endocrinology training, Spanish experts argue a 5th year is “reasonable” to accommodate new technologies and growing complexity although no consensus has been attained so far.
Conclusion
The renewed program aligns with international standards and future-proofs endocrinologist training. It balances broad endocrine-nutrition competencies with specialized skills, modern assessment, and potentially longer training to produce experts equipped for evolving healthcare needs.
{"title":"Looking into the future: The updated Endocrinology and Nutrition residency training program in Spain","authors":"María D. Ballesteros-Pomar , María Antequera , Manuel Antonio Botana-López , Pilar Beato-Víbora , Luis Eduardo Lander , Paloma Moreno-Moreno , Juan Francisco Merino-Torres , Joana Nicolau , Luis Vázquez , Manel Puig-Domingo","doi":"10.1016/j.endien.2026.501714","DOIUrl":"10.1016/j.endien.2026.501714","url":null,"abstract":"<div><h3>Background</h3><div>Endocrinology and Nutrition residency training in Spain (MIR program) is undergoing a major update for the first time since 2006, reflecting rapid advances in endocrine science, technology, and educational standards. Internationally, the European Society of Endocrinology (ESE) has introduced a unified curriculum to harmonize specialist training across Europe, highlighting core competencies and the need for longer training. This article outlines the renewed Spanish Endocrinology-Nutrition MIR program proposal, detailing its modernized curriculum, innovative assessment methods, and the debate on extending training duration.</div></div><div><h3>Advances in modern endocrinology</h3><div>The updated program highlights emerging areas such as molecular endocrinology, technology-enhanced diabetes care, diagnosis and prevention of arteriosclerotic vascular disease, metabolism and rare endocrine disorders, multidisciplinary obesity management, and the central role of nutrition in patient care. These priorities reflect current trends in clinical practice and the forefront of endocrine research.</div></div><div><h3>Assessment innovation</h3><div>New evaluation methods focus on competency-based training, with progressive responsibility, portfolios, workplace-based assessments and entrustable professional activities (EPAs) to ensure trainees attain defined skills. Formal examinations and objective assessments are introduced to standardize certification.</div></div><div><h3>Training duration</h3><div>A pivotal discussion is whether to extend the residency from 4 to 5 years. Given the breadth of endocrinology and ESE recommendations of a 6-year combined internal medicine–endocrinology training, Spanish experts argue a 5th year is “reasonable” to accommodate new technologies and growing complexity although no consensus has been attained so far.</div></div><div><h3>Conclusion</h3><div>The renewed program aligns with international standards and future-proofs endocrinologist training. It balances broad endocrine-nutrition competencies with specialized skills, modern assessment, and potentially longer training to produce experts equipped for evolving healthcare needs.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 3","pages":"Article 501714"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391217","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 : 2026-03-01Epub Date: 2026-02-05DOI: 10.1016/j.endien.2026.501689
Isabella Mattei, María Calatayud Gutiérrez, Carla Jimena Santiváñez Pérez
{"title":"Refractory hypothyroidism and treatment with subcutaneous levothyroxine: a case report","authors":"Isabella Mattei, María Calatayud Gutiérrez, Carla Jimena Santiváñez Pérez","doi":"10.1016/j.endien.2026.501689","DOIUrl":"10.1016/j.endien.2026.501689","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 3","pages":"Article 501689"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133315","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 : 2026-03-01Epub Date: 2026-02-05DOI: 10.1016/j.endien.2026.501713
Javier Lago Garma , Cristina Gil Mouce , Nazareth Rodríguez Novo , Olaia Díaz Trastoy , Alicia Santamaría Nieto , Patricia Pérez Castro , Carmen Díaz Ortega , Eva Fernández Rodríguez , Regina Palmeiro Carballeira , Iria Pinal Osorio , Alma Prieto Tenreiro , Paula Sánchez Sobrino , Cristina Tejera Pérez , Francisco Pita Gutiérrez , Rocío Villar Taibo , Alfonso Vidal Casariego
Introduction
Type 2 diabetes mellitus (T2DM) significantly impacts the patients' quality of life due to chronic complications and associated comorbidities. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated benefits in glycemic control. This study evaluates the effect of oral semaglutide on quality of life, metabolic parameters, and treatment adherence of T2DM patients.
Patients and methods
We conducted a multicenter prospective observational study Galicia (Spain). A total of 43 adult T2DM patients on oral semaglutide were evaluated at baseline and 3–6 months later using validated questionnaires (DTSQ and EuroQol), anthropometric measures, and metabolic parameters. Changes in quality of life, HbA1c, weight, lipid profile, and insulin dose were analyzed.
Results
Oral semaglutide significantly improved quality of life according to the visual analog scale (from 62.8 to 72.6 points; p < 0.001) and DTSQ questionnaire (from 28.2 to 33.0 points; p < 0.001). Significant reductions were observed in HbA1c (8.3% to 7.2%; p < 0.001) and body weight (−4.9%; p = 0.018). The most common adverse effects were nausea and vomiting, reported by 39.5% of patients, with no impact on the overall quality of life.
Conclusion
Oral semaglutide significantly improves quality of life and metabolic parameters in T2DM patients, with good tolerance and low discontinuation rates. These findings support its utility in the comprehensive management of T2DM.
{"title":"Impact of oral semaglutide on quality of life and metabolic parameters in patients with type 2 diabetes mellitus: A multicenter observational study","authors":"Javier Lago Garma , Cristina Gil Mouce , Nazareth Rodríguez Novo , Olaia Díaz Trastoy , Alicia Santamaría Nieto , Patricia Pérez Castro , Carmen Díaz Ortega , Eva Fernández Rodríguez , Regina Palmeiro Carballeira , Iria Pinal Osorio , Alma Prieto Tenreiro , Paula Sánchez Sobrino , Cristina Tejera Pérez , Francisco Pita Gutiérrez , Rocío Villar Taibo , Alfonso Vidal Casariego","doi":"10.1016/j.endien.2026.501713","DOIUrl":"10.1016/j.endien.2026.501713","url":null,"abstract":"<div><h3>Introduction</h3><div>Type 2 diabetes mellitus (T2DM) significantly impacts the patients' quality of life due to chronic complications and associated comorbidities. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated benefits in glycemic control. This study evaluates the effect of oral semaglutide on quality of life, metabolic parameters, and treatment adherence of T2DM patients.</div></div><div><h3>Patients and methods</h3><div>We conducted a multicenter prospective observational study Galicia (Spain). A total of 43 adult T2DM patients on oral semaglutide were evaluated at baseline and 3–6 months later using validated questionnaires (DTSQ and EuroQol), anthropometric measures, and metabolic parameters. Changes in quality of life, HbA1c, weight, lipid profile, and insulin dose were analyzed.</div></div><div><h3>Results</h3><div>Oral semaglutide significantly improved quality of life according to the visual analog scale (from 62.8 to 72.6 points; <em>p</em> < 0.001) and DTSQ questionnaire (from 28.2 to 33.0 points; <em>p</em> < 0.001). Significant reductions were observed in HbA1c (8.3% to 7.2%; <em>p</em> < 0.001) and body weight (−4.9%; <em>p</em> = 0.018). The most common adverse effects were nausea and vomiting, reported by 39.5% of patients, with no impact on the overall quality of life.</div></div><div><h3>Conclusion</h3><div>Oral semaglutide significantly improves quality of life and metabolic parameters in T2DM patients, with good tolerance and low discontinuation rates. These findings support its utility in the comprehensive management of T2DM.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 3","pages":"Article 501713"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133367","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 : 2026-03-01Epub Date: 2026-03-07DOI: 10.1016/j.endien.2026.501674
João D. Martins, Débora Silveira, Henrique Pina, Inês Manique, Sílvia Guerra, Cristina Valadas
Background and aims
People with type 2 diabetes (T2DM) face higher cardiovascular risk, making lipid control essential. The European Society of Cardiology (ESC) updated its clinical practice guidelines in 2023, introducing the SCORE2-Diabetes risk calculator. This study evaluates lipid control, lipid-lowering therapy, and CV risk reclassification in full compliance with the 2021 and 2023 ESC clinical practice guidelines.
Methods and results
We analyzed T2DM patients (40–69 years) treated at our hospital Endocrinology-Diabetes outpatient clinic from January through October 2023. Hospital records and the Portuguese National Health System database were used to assess CV risk, LDL-c target achievement, risk classification changes, and lipid-lowering therapy, including statin potency. The study included a total of 214 individuals (mean age, 58.5 years; 61.2% men). Under the 2021 ESC clinical practice guidelines, a total of 38.3% patients were categorized as very high risk, 51.9% as high risk, and 9.8% as moderate risk, with LDL-c targets met in 22.0%, 29.7%, and 47.6%, respectively. Under the 2023 clinical practice guidelines, 43.0% were very high risk; 25.7%, high risk; 24.8%, moderate risk; and 6.5%, low risk, with LDL-c targets met in 21.7%, 29.1%, 54.7%, and 71.4%, respectively. Risk classification changed for 32.7% of patients. Regarding treatment, 23.83% were not on lipid-lowering therapy, while 26.17% used high-intensity statins.
Conclusion
Lipid control in T2DM remains suboptimal, especially in high-risk patients. While improvements are being made, tools such as the SCORE2-Diabetes may improve individualized treatment and reduce cardiovascular events.
{"title":"Lipid management in individuals with type 2 diabetes mellitus: Analysis of a hospital-based series","authors":"João D. Martins, Débora Silveira, Henrique Pina, Inês Manique, Sílvia Guerra, Cristina Valadas","doi":"10.1016/j.endien.2026.501674","DOIUrl":"10.1016/j.endien.2026.501674","url":null,"abstract":"<div><h3>Background and aims</h3><div>People with type 2 diabetes (T2DM) face higher cardiovascular risk, making lipid control essential. The European Society of Cardiology (ESC) updated its clinical practice guidelines in 2023, introducing the SCORE2-Diabetes risk calculator. This study evaluates lipid control, lipid-lowering therapy, and CV risk reclassification in full compliance with the 2021 and 2023 ESC clinical practice guidelines.</div></div><div><h3>Methods and results</h3><div>We analyzed T2DM patients (40–69 years) treated at our hospital Endocrinology-Diabetes outpatient clinic from January through October 2023. Hospital records and the Portuguese National Health System database were used to assess CV risk, LDL-c target achievement, risk classification changes, and lipid-lowering therapy, including statin potency. The study included a total of 214 individuals (mean age, 58.5 years; 61.2% men). Under the 2021 ESC clinical practice guidelines, a total of 38.3% patients were categorized as very high risk, 51.9% as high risk, and 9.8% as moderate risk, with LDL-c targets met in 22.0%, 29.7%, and 47.6%, respectively. Under the 2023 clinical practice guidelines, 43.0% were very high risk; 25.7%, high risk; 24.8%, moderate risk; and 6.5%, low risk, with LDL-c targets met in 21.7%, 29.1%, 54.7%, and 71.4%, respectively. Risk classification changed for 32.7% of patients. Regarding treatment, 23.83% were not on lipid-lowering therapy, while 26.17% used high-intensity statins.</div></div><div><h3>Conclusion</h3><div>Lipid control in T2DM remains suboptimal, especially in high-risk patients. While improvements are being made, tools such as the SCORE2-Diabetes may improve individualized treatment and reduce cardiovascular events.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 3","pages":"Article 501674"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391017","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 : 2026-02-01Epub Date: 2025-12-13DOI: 10.1016/j.endien.2025.501676
Dolores Tejedo-Flors , Thalía Argüello-Gordillo , Elena Argente-Martínez , Beatriz López-Muñoz , Pedro López-Mondéjar
{"title":"Ovarian metastasis in a young woman with follicular thyroid carcinoma: A differential diagnosis with struma ovarii","authors":"Dolores Tejedo-Flors , Thalía Argüello-Gordillo , Elena Argente-Martínez , Beatriz López-Muñoz , Pedro López-Mondéjar","doi":"10.1016/j.endien.2025.501676","DOIUrl":"10.1016/j.endien.2025.501676","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 2","pages":"Article 501676"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758003","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 : 2026-02-01Epub Date: 2026-02-10DOI: 10.1016/j.endien.2025.501677
Daniel de Luis, David Primo, Olatz Izaola, Juan José López Gómez
Objectives
Oncostatin-M (OSM) and leukemia inhibitor factor (LIF) have shown relationship with muscle catabolism in Disease Related Malnutrition (DRM). We aimed to investigate the role of OSM and LIF in sarcopenia among patients with cancer and DRM.
Design and methods
33 cancer patients with DRM were included. Muscle mass assessment via ultrasound at the rectus femoris (RF) level, bioimpedance (skeletal muscle mass (SMM), appendicular SMM (aSMM), and the aSMM index (aSMMI)), and circulating OSM and LIF levels were evaluated. Confirmed sarcopenia was diagnosed based on the criteria of low muscle strength combined with an abnormal aSMMI.
Results
The average age was 66.5 ± 15.5 years. The gender distribution was 16 females (48.5%) and 17 males (51.5%). Sixteen patients (48.5%) were diagnosed with sarcopenia. Patients with sarcopenia showed worse values: phase angle (−0.4 ± 0.1°; p = 0.01), reactance (−4.9 ± 1.8 Ω; p = 0.03), SMM (−2.0 ± 0.3 kg; p = 0.03), aSMM (−1.6 ± 0.2 kg; p = 0.03), aSMMI (−0.6 ± 0.2 kg/m2; p = 0.02), muscle area RF (−0.7 ± 0.2 cm2; p = 0.04), Y-axis RF (−0.4 ± 0.1 cm; p = 0.03), muscle strength (−8.1 ± 1.5 kg; p = 0.01) and albumin levels (−0.3 ± 0.1 g/dl; p = 0.03). Circulating levels of OSM and LIF were elevated in patients with sarcopenia, with values of 10.6 ± 1.3 pg/ml (p = 0.01) and 6.4 ± 2.3 pg/ml (p = 0.02), respectively. Logistic regression analysis indicated a significant OR (odds ratio) of sarcopenia associated with elevated median levels of OSM (OR = 3.6, 95% CI = 1.4–9.9; p = 0.01) and LIF-1 (OR = 3.3, 95% CI = 1.3–10.1; p = 0.01)
Conclusion
High levels of serum OSM and LIF-1 were closely associated with sarcopenia in patients with cancer and DRM.
{"title":"Influence of oncostatin M and leukemia inhibitor factor on sarcopenia in individuals with cancer and malnutrition","authors":"Daniel de Luis, David Primo, Olatz Izaola, Juan José López Gómez","doi":"10.1016/j.endien.2025.501677","DOIUrl":"10.1016/j.endien.2025.501677","url":null,"abstract":"<div><h3>Objectives</h3><div>Oncostatin-M (OSM) and leukemia inhibitor factor (LIF) have shown relationship with muscle catabolism in Disease Related Malnutrition (DRM). We aimed to investigate the role of OSM and LIF in sarcopenia among patients with cancer and DRM.</div></div><div><h3>Design and methods</h3><div>33 cancer patients with DRM were included. Muscle mass assessment via ultrasound at the rectus femoris (RF) level, bioimpedance (skeletal muscle mass (SMM), appendicular SMM (aSMM), and the aSMM index (aSMMI)), and circulating OSM and LIF levels were evaluated. Confirmed sarcopenia was diagnosed based on the criteria of low muscle strength combined with an abnormal aSMMI.</div></div><div><h3>Results</h3><div>The average age was 66.5<!--> <!-->±<!--> <!-->15.5 years. The gender distribution was 16 females (48.5%) and 17 males (51.5%). Sixteen patients (48.5%) were diagnosed with sarcopenia. Patients with sarcopenia showed worse values: phase angle (−0.4<!--> <!-->±<!--> <!-->0.1°; <em>p</em> <!-->=<!--> <!-->0.01), reactance (−4.9<!--> <!-->±<!--> <!-->1.8<!--> <!-->Ω; <em>p</em> <!-->=<!--> <!-->0.03), SMM (−2.0<!--> <!-->±<!--> <!-->0.3<!--> <!-->kg; <em>p</em> <!-->=<!--> <!-->0.03), aSMM (−1.6<!--> <!-->±<!--> <!-->0.2<!--> <!-->kg; <em>p</em> <!-->=<!--> <!-->0.03), aSMMI (−0.6<!--> <!-->±<!--> <!-->0.2<!--> <!-->kg/m<sup>2</sup>; <em>p</em> <!-->=<!--> <!-->0.02), muscle area RF (−0.7<!--> <!-->±<!--> <!-->0.2<!--> <!-->cm<sup>2</sup>; <em>p</em> <!-->=<!--> <!-->0.04), <em>Y</em>-axis RF (−0.4<!--> <!-->±<!--> <!-->0.1<!--> <!-->cm; <em>p</em> <!-->=<!--> <!-->0.03), muscle strength (−8.1<!--> <!-->±<!--> <!-->1.5<!--> <!-->kg; <em>p</em> <!-->=<!--> <!-->0.01) and albumin levels (−0.3<!--> <!-->±<!--> <!-->0.1<!--> <!-->g/dl; <em>p</em> <!-->=<!--> <!-->0.03). Circulating levels of OSM and LIF were elevated in patients with sarcopenia, with values of 10.6<!--> <!-->±<!--> <!-->1.3<!--> <!-->pg/ml (<em>p</em> <!-->=<!--> <!-->0.01) and 6.4<!--> <!-->±<!--> <!-->2.3<!--> <!-->pg/ml (<em>p</em> <!-->=<!--> <!-->0.02), respectively. Logistic regression analysis indicated a significant OR (odds ratio) of sarcopenia associated with elevated median levels of OSM (OR<!--> <!-->=<!--> <!-->3.6, 95% CI<!--> <!-->=<!--> <!-->1.4–9.9; <em>p</em> <!-->=<!--> <!-->0.01) and LIF-1 (OR<!--> <!-->=<!--> <!-->3.3, 95% CI<!--> <!-->=<!--> <!-->1.3–10.1; <em>p</em> <!-->=<!--> <!-->0.01)</div></div><div><h3>Conclusion</h3><div>High levels of serum OSM and LIF-1 were closely associated with sarcopenia in patients with cancer and DRM.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 2","pages":"Article 501677"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183118","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 : 2026-02-01Epub Date: 2026-02-10DOI: 10.1016/j.endien.2025.501685
Pablo Fernández Velasco , Lucia Estévez Asensio , Beatriz Torres Torres , Ana Ortolá Buigues , Emilia Gómez Hoyos , Esther Delgado García , Daniel de Luis Román , Gonzalo Díaz Soto
Purpose
Adrenal insufficiency (AI) is traditionally diagnosed using the corticotropin stimulation test (CST) with a cortisol threshold of 18.0 μg/dL. However, newer immunoassays suggest revising this threshold to enhance diagnostic accuracy. This study aimed to evaluate the diagnostic performance of baseline cortisol (CB) and stimulated cortisol levels at 30 min (C30 min) and 60 min (C60 min) post-CST, using a revised threshold of 15.6 μg/dL.
Methods
This retrospective study analyzed a total of 140 patients with suspected AI who underwent CST from 2016 to 2022. Demographic, clinical, and biochemical data were collected. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis to compare the performance of the traditional 18.0 μg/dL threshold with the proposed 15.6 μg/dL cutoff.
Results
The study population had a mean age of 45.6 ± 19.3 years (68.6%, women). Mean cortisol levels were CB 12.3 ± 5.7 μg/dL, C30 min 20.2 ± 6.7 μg/dL, and C60 min 22.9 ± 7.8 μg/dL. A strong correlation was observed between CB and maximum stimulated cortisol (R = 0.610, p = 0.0003.) The revised 15.6 μg/dL threshold reduced false-positive diagnoses by 17.9% (p = 0.029). ROC analysis demonstrated high diagnostic accuracy for CB (AUC, 0.901), with CB > 13.1 μg/dL predicted a normal response, and CB < 1.5 μg/dL was always suggestive of pathology.
Conclusion
The revised 15.6 μg/dL cortisol threshold enhances CST diagnostic accuracy by reducing false positives and avoiding unnecessary glucocorticoid therapy. Additionally, CB alone showed strong predictive value, and a single C30 min measurement may be sufficient for diagnosis in most cases. Further validation studies across different immunoassay platforms are necessary.
{"title":"New cortisol assay-specific thresholds for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation","authors":"Pablo Fernández Velasco , Lucia Estévez Asensio , Beatriz Torres Torres , Ana Ortolá Buigues , Emilia Gómez Hoyos , Esther Delgado García , Daniel de Luis Román , Gonzalo Díaz Soto","doi":"10.1016/j.endien.2025.501685","DOIUrl":"10.1016/j.endien.2025.501685","url":null,"abstract":"<div><h3>Purpose</h3><div>Adrenal insufficiency (AI) is traditionally diagnosed using the corticotropin stimulation test (CST) with a cortisol threshold of 18.0<!--> <!-->μg/dL. However, newer immunoassays suggest revising this threshold to enhance diagnostic accuracy. This study aimed to evaluate the diagnostic performance of baseline cortisol (CB) and stimulated cortisol levels at 30<!--> <!-->min (C30<!--> <!-->min) and 60<!--> <!-->min (C60<!--> <!-->min) post-CST, using a revised threshold of 15.6<!--> <!-->μg/dL.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed a total of 140 patients with suspected AI who underwent CST from 2016 to 2022. Demographic, clinical, and biochemical data were collected. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis to compare the performance of the traditional 18.0<!--> <!-->μg/dL threshold with the proposed 15.6<!--> <!-->μg/dL cutoff.</div></div><div><h3>Results</h3><div>The study population had a mean age of 45.6<!--> <!-->±<!--> <!-->19.3 years (68.6%, women). Mean cortisol levels were CB 12.3<!--> <!-->±<!--> <!-->5.7<!--> <!-->μg/dL, C30<!--> <!-->min 20.2<!--> <!-->±<!--> <!-->6.7<!--> <!-->μg/dL, and C60<!--> <!-->min 22.9<!--> <!-->±<!--> <!-->7.8<!--> <!-->μg/dL. A strong correlation was observed between CB and maximum stimulated cortisol (<em>R</em> <!-->=<!--> <!-->0.610, <em>p</em> <!-->=<!--> <!-->0.0003.) The revised 15.6<!--> <!-->μg/dL threshold reduced false-positive diagnoses by 17.9% (<em>p</em> <!-->=<!--> <!-->0.029). ROC analysis demonstrated high diagnostic accuracy for CB (AUC, 0.901), with CB<!--> <!-->><!--> <!-->13.1<!--> <!-->μg/dL predicted a normal response, and CB<!--> <!--><<!--> <!-->1.5<!--> <!-->μg/dL was always suggestive of pathology.</div></div><div><h3>Conclusion</h3><div>The revised 15.6<!--> <!-->μg/dL cortisol threshold enhances CST diagnostic accuracy by reducing false positives and avoiding unnecessary glucocorticoid therapy. Additionally, CB alone showed strong predictive value, and a single C30<!--> <!-->min measurement may be sufficient for diagnosis in most cases. Further validation studies across different immunoassay platforms are necessary.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 2","pages":"Article 501685"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183096","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 : 2026-02-01Epub Date: 2025-12-04DOI: 10.1016/j.endien.2025.501672
Jhosmer Ballena-Caicedo , Fiorella E. Zuzunaga-Montoya , Juan Carlos Bustamante-Rodríguez , Nataly Mayely Sanchez-Tamay , Luisa Erika Milagros Vásquez-Romero , Joan A. Loayza-Castro , Carmen Inés Gutierrez De Carrillo , Víctor Juan Vera-Ponce
Introduction
Dyslipidemias are a significant risk factor for cardiovascular diseases. In Peru, nutritional transition and lifestyle changes may be contributing to an increase in the incidence of these metabolic disorders, particularly among the working population.
Objective
To determine the incidence of dyslipidemias and evaluate associated occupational factors in Peruvian workers.
Methods
A retrospective cohort study was conducted using electronic medical records from 4,200 workers attending an occupational health clinic between 2013 and 2022. Incidence rates of hypertriglyceridemia, hypercholesterolemia, and combined dyslipidemia were calculated. Specific occupational factors (type of work, sitting time, and night shift work) were analyzed using Cox regression models adjusted for age (with splines) and sex.
Results
The incidence of hypercholesterolemia (87.22 cases per 1,000 person-years; 95% CI: 79.99–94.45) was significantly higher than that of hypertriglyceridemia (65.71 cases per 1,000 person-years; 95% CI: 59.71–71.72). Combined dyslipidemia showed an incidence of 48.28 cases per 1,000 person-years (95% CI: 43.60–52.97). Workers in social services had a higher risk of developing dyslipidemias (aHR: 1.78; 95% CI: 1.27–2.49) compared to office workers. Prolonged sitting time (>4 h) was significantly associated with an increased risk of hypertriglyceridemia (aHR: 1.28; 95% CI: 1.05–1.56) and combined dyslipidemia (aHR: 1.42; 95% CI: 1.15–1.76).
Conclusions
The high incidence of dyslipidemias—particularly hypercholesterolemia—may reflect the increasing consumption of ultra-processed foods and the ongoing nutritional transition in the Peruvian population. Occupational factors play a crucial role in the development of these metabolic disorders, highlighting the need for specific preventive strategies in the workplace.
{"title":"Prevalence, incidence, and occupational risk markers of dyslipidemia in Peruvian workers","authors":"Jhosmer Ballena-Caicedo , Fiorella E. Zuzunaga-Montoya , Juan Carlos Bustamante-Rodríguez , Nataly Mayely Sanchez-Tamay , Luisa Erika Milagros Vásquez-Romero , Joan A. Loayza-Castro , Carmen Inés Gutierrez De Carrillo , Víctor Juan Vera-Ponce","doi":"10.1016/j.endien.2025.501672","DOIUrl":"10.1016/j.endien.2025.501672","url":null,"abstract":"<div><h3>Introduction</h3><div>Dyslipidemias are a significant risk factor for cardiovascular diseases. In Peru, nutritional transition and lifestyle changes may be contributing to an increase in the incidence of these metabolic disorders, particularly among the working population.</div></div><div><h3>Objective</h3><div>To determine the incidence of dyslipidemias and evaluate associated occupational factors in Peruvian workers.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using electronic medical records from 4,200 workers attending an occupational health clinic between 2013 and 2022. Incidence rates of hypertriglyceridemia, hypercholesterolemia, and combined dyslipidemia were calculated. Specific occupational factors (type of work, sitting time, and night shift work) were analyzed using Cox regression models adjusted for age (with splines) and sex.</div></div><div><h3>Results</h3><div>The incidence of hypercholesterolemia (87.22 cases per 1,000 person-years; 95% CI: 79.99–94.45) was significantly higher than that of hypertriglyceridemia (65.71 cases per 1,000 person-years; 95% CI: 59.71–71.72). Combined dyslipidemia showed an incidence of 48.28 cases per 1,000 person-years (95% CI: 43.60–52.97). Workers in social services had a higher risk of developing dyslipidemias (aHR: 1.78; 95% CI: 1.27–2.49) compared to office workers. Prolonged sitting time (>4 h) was significantly associated with an increased risk of hypertriglyceridemia (aHR: 1.28; 95% CI: 1.05–1.56) and combined dyslipidemia (aHR: 1.42; 95% CI: 1.15–1.76).</div></div><div><h3>Conclusions</h3><div>The high incidence of dyslipidemias—particularly hypercholesterolemia—may reflect the increasing consumption of ultra-processed foods and the ongoing nutritional transition in the Peruvian population. Occupational factors play a crucial role in the development of these metabolic disorders, highlighting the need for specific preventive strategies in the workplace.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 2","pages":"Article 501672"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688529","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 : 2026-02-01Epub Date: 2025-12-13DOI: 10.1016/j.endien.2025.501687
Juan José Díez , Manuel Gargallo Fernández , José Antonio Gimeno Orna , Elena González Arnaiz , Isabel Huguet Moreno , Sílvia Martínez Couselo , María Miguélez González , María Julia Ocón , Gilberto Pérez López , Francisco Pita Gutiérrez , Jordi Luis Reverter Calatayud , Cristina Tejera Pérez , Eulàlia Urgell Rull , Alberto Fernández
Low-value clinical practices – defined as diagnostic or therapeutic interventions that provide limited clinical benefit and may be associated with unnecessary risks or costs – remain common in endocrinology and nutrition. The Spanish Society of Endocrinology and Nutrition (SEEN) presents this second edition as an updated set of recommendations on “what not to do” in clinical practice, developed by its sections and working groups. The methodological process included the selection of relevant topics, systematic literature review, and multidisciplinary consensus. Key areas addressed include diabetes, obesity, nutrition, gonads, lipids, laboratory, mineral metabolism, and imaging, identifying low-value interventions and offering alternatives based on the best available evidence. The implementation of these recommendations aims to optimize care quality, reduce risks, and contribute to the sustainability of the healthcare system.
{"title":"Second edition of the “do not do” recommendations from the Spanish Society of Endocrinology and Nutrition (SEEN)","authors":"Juan José Díez , Manuel Gargallo Fernández , José Antonio Gimeno Orna , Elena González Arnaiz , Isabel Huguet Moreno , Sílvia Martínez Couselo , María Miguélez González , María Julia Ocón , Gilberto Pérez López , Francisco Pita Gutiérrez , Jordi Luis Reverter Calatayud , Cristina Tejera Pérez , Eulàlia Urgell Rull , Alberto Fernández","doi":"10.1016/j.endien.2025.501687","DOIUrl":"10.1016/j.endien.2025.501687","url":null,"abstract":"<div><div>Low-value clinical practices – defined as diagnostic or therapeutic interventions that provide limited clinical benefit and may be associated with unnecessary risks or costs – remain common in endocrinology and nutrition. The Spanish Society of Endocrinology and Nutrition (SEEN) presents this second edition as an updated set of recommendations on “what not to do” in clinical practice, developed by its sections and working groups. The methodological process included the selection of relevant topics, systematic literature review, and multidisciplinary consensus. Key areas addressed include diabetes, obesity, nutrition, gonads, lipids, laboratory, mineral metabolism, and imaging, identifying low-value interventions and offering alternatives based on the best available evidence. The implementation of these recommendations aims to optimize care quality, reduce risks, and contribute to the sustainability of the healthcare system.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 2","pages":"Article 501687"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758058","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}
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