Despite several factors are associated with worse disease-free survival (DFS) and prognosis in medullary thyroid carcinoma (MTC) patients, the effect of microscopic extrathyroidal extension (mETE) on the prognosis and DFS is not well understood. This study aims to evaluate the impact of mETE on DFS and prognosis in patients with MTC.
Methods
This multicenter study included 208 patients with MTC (17.8% with hereditary disease). Patients with mETE were compared to those without mETE in terms of clinical and histopathological variables.
Results
Among the 208 patients, 16.3% (n = 34) had mETE on histopathological analysis. Patients with mETE were more likely to have larger tumors, higher serum calcitonin (CTN) levels before and after surgery, increased rates of neck lymph node (LN) and distant metastasis, multifocal disease, and advanced disease stage. Kaplan–Meier analysis showed a significantly lower DFS in patients with mETE than those without mETE (14.7% vs. 71.3%, log-rank p < 0.001). However, mETE was not an independent contributing factor for persistent/recurrent disease, whereas neck LN involvement was the strongest independent contributing factor for persistent/recurrent disease (HR: 1.1; 95% CI 0.4–1.8, p = 0.76 and HR: 9.6; 95% CI 1.21–76.9, p = 0.03, respectively).
Conclusion
mETE in patients with MTC is associated with a lower DFS, larger tumor sizes, a higher likelihood of neck LN and distant metastasis, advanced stage, higher serum CTN levels, multifocality, and persistent/recurrent disease. However, mETE was not an independent predictor of persistent/recurrent disease. Further studies with a larger number of patients with mETE could further clarify the impact of mETE on the prognosis of MTC.
目的：尽管多种因素与甲状腺髓样癌（MTC）患者较差的无病生存（DFS）和预后有关，但显微甲状腺外展（mETE）对预后和DFS的影响尚不清楚。本研究旨在评价mETE对MTC患者DFS及预后的影响。方法本研究纳入208例MTC患者（17.8%为遗传性疾病）。将mETE患者与未mETE患者在临床和组织病理学变量方面进行比较。结果208例患者中，16.3% （n = 34）的组织病理学分析为mETE。mETE患者更可能有较大的肿瘤，术前和术后血清降钙素（CTN）水平较高，颈部淋巴结（LN）和远处转移、多灶性疾病和晚期疾病的发生率增加。Kaplan-Meier分析显示，mETE患者的DFS显著低于非mETE患者（14.7% vs. 71.3%, log-rank p < 0.001）。然而，mETE不是持续/复发性疾病的独立影响因素，而颈部LN受累是持续/复发性疾病的最强独立影响因素（HR: 1.1; 95% CI 0.4-1.8, p = 0.76; HR: 9.6; 95% CI 1.21-76.9, p = 0.03）。结论MTC患者的mete与较低的DFS、较大的肿瘤大小、较高的颈部LN和远处转移可能性、晚期、较高的血清CTN水平、多灶性和持续/复发性疾病相关。然而，mETE并不是疾病持续/复发的独立预测因子。更多mETE患者的进一步研究可以进一步阐明mETE对MTC预后的影响。
{"title":"The impact of microscopic extrathyroidal extension on the prognosis of medullary thyroid carcinoma: A multicenter cohort study","authors":"Beyza Olcay Ozturk , Umran Keskin , Serhat Uysal , Aysa Hacioglu , Seda Karsli , Burak Andac , Umit Nur Ozbay , Hulyanur Sodan , Sebnem Burhan , Coskun Ates , Ugur Avci , Faruk Kilinc , Selvinaz Erol , Merve Catak , Zafer Pekkolay , Gulhan Akbaba , Goknur Yorulmaz , Sakin Tekin , Birol Topcu , Mazhar Muslum Tuna , Sayid Shafi Zuhur","doi":"10.1016/j.endien.2025.501633","DOIUrl":"10.1016/j.endien.2025.501633","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite several factors are associated with worse disease-free survival (DFS) and prognosis in medullary thyroid carcinoma (MTC) patients, the effect of microscopic extrathyroidal extension (mETE) on the prognosis and DFS is not well understood. This study aims to evaluate the impact of mETE on DFS and prognosis in patients with MTC.</div></div><div><h3>Methods</h3><div>This multicenter study included 208 patients with MTC (17.8% with hereditary disease). Patients with mETE were compared to those without mETE in terms of clinical and histopathological variables.</div></div><div><h3>Results</h3><div>Among the 208 patients, 16.3% (<em>n</em> <!-->=<!--> <!-->34) had mETE on histopathological analysis. Patients with mETE were more likely to have larger tumors, higher serum calcitonin (CTN) levels before and after surgery, increased rates of neck lymph node (LN) and distant metastasis, multifocal disease, and advanced disease stage. Kaplan–Meier analysis showed a significantly lower DFS in patients with mETE than those without mETE (14.7% vs. 71.3%, log-rank <em>p</em> <!--><<!--> <!-->0.001). However, mETE was not an independent contributing factor for persistent/recurrent disease, whereas neck LN involvement was the strongest independent contributing factor for persistent/recurrent disease (HR: 1.1; 95% CI 0.4–1.8, <em>p</em> <!-->=<!--> <!-->0.76 and HR: 9.6; 95% CI 1.21–76.9, <em>p</em> <!-->=<!--> <!-->0.03, respectively).</div></div><div><h3>Conclusion</h3><div>mETE in patients with MTC is associated with a lower DFS, larger tumor sizes, a higher likelihood of neck LN and distant metastasis, advanced stage, higher serum CTN levels, multifocality, and persistent/recurrent disease. However, mETE was not an independent predictor of persistent/recurrent disease. Further studies with a larger number of patients with mETE could further clarify the impact of mETE on the prognosis of MTC.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501633"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766124","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 : 2025-12-01DOI: 10.1016/j.endien.2025.501632
Bryan-Josué Flores-Robles , Juan Antonio López Martín , María Jesús Chinchetru Ranedo , José Miguel Lázaro Guevara , José Fernando Marín Díez , Núria Guañabens
{"title":"Gastroileal bypass reversal as a treatment for iatrogenic hyperparathyroidism and refractory hypocalcemia","authors":"Bryan-Josué Flores-Robles , Juan Antonio López Martín , María Jesús Chinchetru Ranedo , José Miguel Lázaro Guevara , José Fernando Marín Díez , Núria Guañabens","doi":"10.1016/j.endien.2025.501632","DOIUrl":"10.1016/j.endien.2025.501632","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501632"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309619","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 : 2025-12-01DOI: 10.1016/j.endien.2025.501630
María Carmen Dameto Pons, Elena González Arnáiz, María Antequera González, Xavier F. Pérez Candel, Diana Ariadel Cobo, Javier Castañón Alonso, María D. Ballesteros Pomar
Immunotherapy is an increasingly used treatment for different types of cancer. The most widely used are cytotoxic T-lymphocyte antigen 4 (CTLA-4) inhibitors, PD-1 ligand (PD-L1) inhibitors and PD-1 receptor inhibitors. All of them can produce endocrine autoimmune side effects in multiple organs. The most frequent are thyroid disorders and hypophysitis although, less frequently, they can also cause autoimmune adrenalitis and autoimmune diabetes. Thyroid involvement is usually transient but can become chronic in the form of hypothyroidism in more than 50% of cases. Diabetes is due to autoimmune destruction of pancreatic β-cells, in many cases abrupt and irreversible. The 2 entities occur more frequently with PD-1 or PD-L1 inhibitors. This is the case of a patient with cutaneous melanoma on pembrolizumab who simultaneously developed thyroiditis and fulminant autoimmune diabetes.
{"title":"Pembrolizumab-induced dual endocrine disruption: A case report","authors":"María Carmen Dameto Pons, Elena González Arnáiz, María Antequera González, Xavier F. Pérez Candel, Diana Ariadel Cobo, Javier Castañón Alonso, María D. Ballesteros Pomar","doi":"10.1016/j.endien.2025.501630","DOIUrl":"10.1016/j.endien.2025.501630","url":null,"abstract":"<div><div>Immunotherapy is an increasingly used treatment for different types of cancer. The most widely used are cytotoxic T-lymphocyte antigen 4 (CTLA-4) inhibitors, PD-1 ligand (PD-L1) inhibitors and PD-1 receptor inhibitors. All of them can produce endocrine autoimmune side effects in multiple organs. The most frequent are thyroid disorders and hypophysitis although, less frequently, they can also cause autoimmune adrenalitis and autoimmune diabetes. Thyroid involvement is usually transient but can become chronic in the form of hypothyroidism in more than 50% of cases. Diabetes is due to autoimmune destruction of pancreatic β-cells, in many cases abrupt and irreversible. The 2 entities occur more frequently with PD-1 or PD-L1 inhibitors. This is the case of a patient with cutaneous melanoma on pembrolizumab who simultaneously developed thyroiditis and fulminant autoimmune diabetes.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501630"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766126","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 : 2025-12-01DOI: 10.1016/j.endien.2025.501640
Francisco Pita Gutiérrez , Irene Breton Lesmes , Julia Álvarez Hernández , María D. Ballesteros-Pomar , Rocío Campos del Portillo , Ana Hernández Moreno , Francisco Botella Romero
Introduction
Despite the available scientific evidence, the use of enteral tube feeding in people with advanced dementia is currently controversial. Given this situation, and following the position paper promoted by the SEEN (Spanish Society of Endocrinology and Nutrition), a consensus is sought to contribute to improving the management of this condition.
Material and methods
A Delphi consultation was conducted, a formal and systematic method for obtaining consensus. The project was developed in the following stages: (1) questionnaire development by the Scientific Committee; (2) first round of Delphi consultation; (3) second round of Delphi consultation, and; (4) a meeting to present the results.
Results
A total of 340 expert members of the SEEN Nutrition Department were invited to participate through the society itself. Of these, 128 panellists completed the questionnaire in the first round (response rate of 38%) and 53 in the second round (response rate of 41%, compared to the first round). Of the 24 statements initially proposed, 14 (58%) reached consensus. Of these, 13 achieved this goal in the first round and one in the second.
Conclusions
Advanced dementia represents a significant challenge for both healthcare professionals and patients' families, raising ethical and practical dilemmas regarding appropriate treatment and management to improve the quality of life of those affected. This paper draws several key conclusions that can guide the care and attention of these patients.
{"title":"Delphi Consensus of the Nutrition Area of the SEEN (NutriSEEN) on the use of enteral tube nutrition in people with advanced dementia","authors":"Francisco Pita Gutiérrez , Irene Breton Lesmes , Julia Álvarez Hernández , María D. Ballesteros-Pomar , Rocío Campos del Portillo , Ana Hernández Moreno , Francisco Botella Romero","doi":"10.1016/j.endien.2025.501640","DOIUrl":"10.1016/j.endien.2025.501640","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the available scientific evidence, the use of enteral tube feeding in people with advanced dementia is currently controversial. Given this situation, and following the position paper promoted by the SEEN (Spanish Society of Endocrinology and Nutrition), a consensus is sought to contribute to improving the management of this condition.</div></div><div><h3>Material and methods</h3><div>A Delphi consultation was conducted, a formal and systematic method for obtaining consensus. The project was developed in the following stages: (1) questionnaire development by the Scientific Committee; (2) first round of Delphi consultation; (3) second round of Delphi consultation, and; (4) a meeting to present the results.</div></div><div><h3>Results</h3><div>A total of 340 expert members of the SEEN Nutrition Department were invited to participate through the society itself. Of these, 128 panellists completed the questionnaire in the first round (response rate of 38%) and 53 in the second round (response rate of 41%, compared to the first round). Of the 24 statements initially proposed, 14 (58%) reached consensus. Of these, 13 achieved this goal in the first round and one in the second.</div></div><div><h3>Conclusions</h3><div>Advanced dementia represents a significant challenge for both healthcare professionals and patients' families, raising ethical and practical dilemmas regarding appropriate treatment and management to improve the quality of life of those affected. This paper draws several key conclusions that can guide the care and attention of these patients.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501640"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309630","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 : 2025-12-01DOI: 10.1016/j.endien.2025.501730
Ildefonso Hernández-Aguado , Elisa Chilet-Rosell
{"title":"The unavoidable decision for medical societies: Commercial drift or integrity","authors":"Ildefonso Hernández-Aguado , Elisa Chilet-Rosell","doi":"10.1016/j.endien.2025.501730","DOIUrl":"10.1016/j.endien.2025.501730","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501730"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766084","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 : 2025-12-01DOI: 10.1016/j.endien.2025.501646
Carmen Sánchez Blanco , Marina García Cancelo , Cristina González Martínez , Leire Cardo González , Marta Diéguez Felechosa
Introduction
Although former studies indicated that Asturias (Spain) is an iodine-sufficient region, preliminary data suggest this trend may be changing.
Objective
To determine the prevalence of iodine deficiency in pregnant women in Asturias.
Material and methods
We designed an observational, prospective, multicenter study. The urinary iodine concentration (UIC) of 371 pregnant women was analyzed between November 2021 and March 2023. Participants were recruited from the three central areas of the Principality of Asturias (Areas III, IV, and V). The project received approval from the Research Ethics Committee of the Principality of Asturias (RECPA).
Results
A total of 52% of pregnant women had urinary iodine levels indicative of iodine deficiency (< 150 μg/L). The average UIC in our cohort was 146 μg/L. We compared thyroid-stimulating hormone (TSH) levels between pregnant women with iodine deficiency and those with sufficient iodine, but found no statistically significant differences in TSH levels between the two groups. We also couldn't establish statistically significant links between iodine deficiency status and body mass index (BMI), number of previous births, nationality, or age. Furthermore, iodine deficiency did not show a significant link to obstetric complications such such as hypertension during pregnancy or premature birth.
Conclusions
These findings support the hypothesis of an increase in iodine deficiency during the first trimester of pregnancy in our population. This highlights the urgent need to review our supplementation strategies and nutritional education programs.
{"title":"Current status of iodisation in pregnant women in Asturias, Spain","authors":"Carmen Sánchez Blanco , Marina García Cancelo , Cristina González Martínez , Leire Cardo González , Marta Diéguez Felechosa","doi":"10.1016/j.endien.2025.501646","DOIUrl":"10.1016/j.endien.2025.501646","url":null,"abstract":"<div><h3>Introduction</h3><div>Although former studies indicated that Asturias (Spain) is an iodine-sufficient region, preliminary data suggest this trend may be changing.</div></div><div><h3>Objective</h3><div>To determine the prevalence of iodine deficiency in pregnant women in Asturias.</div></div><div><h3>Material and methods</h3><div>We designed an observational, prospective, multicenter study. The urinary iodine concentration (UIC) of 371 pregnant women was analyzed between November 2021 and March 2023. Participants were recruited from the three central areas of the Principality of Asturias (Areas III, IV, and V). The project received approval from the Research Ethics Committee of the Principality of Asturias (RECPA).</div></div><div><h3>Results</h3><div>A total of 52% of pregnant women had urinary iodine levels indicative of iodine deficiency (< 150 μg/L). The average UIC in our cohort was 146 μg/L. We compared thyroid-stimulating hormone (TSH) levels between pregnant women with iodine deficiency and those with sufficient iodine, but found no statistically significant differences in TSH levels between the two groups. We also couldn't establish statistically significant links between iodine deficiency status and body mass index (BMI), number of previous births, nationality, or age. Furthermore, iodine deficiency did not show a significant link to obstetric complications such such as hypertension during pregnancy or premature birth.</div></div><div><h3>Conclusions</h3><div>These findings support the hypothesis of an increase in iodine deficiency during the first trimester of pregnancy in our population. This highlights the urgent need to review our supplementation strategies and nutritional education programs.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501646"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309585","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 : 2025-12-01DOI: 10.1016/j.endien.2025.501643
Irene Breton , Igotz Aranbarri , Anastasia Lampropoulou , Jennifer Redondo-Antón , Javier Ágreda , Atif Adam , Esther Artime
Introduction
The epIdeMiology landscape PAtient Care paThways of Obesity (IMPACT-O) study was a multi-country, retrospective cohort study that utilised healthcare databases to determine the landscape/impact of overweight and obesity. Here we describe the sociodemographic, clinical and treatment characteristics of adults with a first record of overweight/obesity or obesity in Spain between 2018 and 2022.
Materials and methods
The IQVIA longitudinal patient database in Spain was used to identify individuals with a first record of overweight/obesity, as determined by diagnosis codes and/or body mass index (BMI) measurements (overweight/obesity cohort: BMI ≥25 kg/m2; obesity cohort: BMI ≥30 kg/m2), in the years 2018–2022. Demographic and clinical parameters, including obesity-related complications (ORCs), as recorded by primary care providers and specialists contributing to the database, were described.
Results
The overweight/obesity cohort included 25,016 individuals, and the obesity cohort 13,441 individuals. Most individuals with overweight/obesity (60.1%) and obesity (63.6%) presented with ≥1 ORCs. The most frequent ORCs among people with obesity were hypertension (25.3%), dyslipidaemia (19.8%), anxiety (19.0%), osteoarthritis (14.3%), low-back pain (10.9%) and depression (10.9%). The proportion of individuals receiving pharmacological therapies with an effect on weight was <1%. There were no records of lifestyle interventions or bariatric surgery in the database for this population.
Conclusions
This study highlights the high ORC burden at first documented diagnosis of overweight/obesity. Very few individuals with obesity in Spain receive pharmacological treatment with an effect on weight. Patient management could be improved by systematically recording all interventions in this population.
{"title":"The overweight and obesity landscape in Spain: Data from the Spanish cohort of the multi-country IMPACT-O study","authors":"Irene Breton , Igotz Aranbarri , Anastasia Lampropoulou , Jennifer Redondo-Antón , Javier Ágreda , Atif Adam , Esther Artime","doi":"10.1016/j.endien.2025.501643","DOIUrl":"10.1016/j.endien.2025.501643","url":null,"abstract":"<div><h3>Introduction</h3><div>The epIdeMiology landscape PAtient Care paThways of Obesity (IMPACT-O) study was a multi-country, retrospective cohort study that utilised healthcare databases to determine the landscape/impact of overweight and obesity. Here we describe the sociodemographic, clinical and treatment characteristics of adults with a first record of overweight/obesity or obesity in Spain between 2018 and 2022.</div></div><div><h3>Materials and methods</h3><div>The IQVIA longitudinal patient database in Spain was used to identify individuals with a first record of overweight/obesity, as determined by diagnosis codes and/or body mass index (BMI) measurements (overweight/obesity cohort: BMI ≥25<!--> <!-->kg/m<sup>2</sup>; obesity cohort: BMI ≥30<!--> <!-->kg/m<sup>2</sup>), in the years 2018–2022. Demographic and clinical parameters, including obesity-related complications (ORCs), as recorded by primary care providers and specialists contributing to the database, were described.</div></div><div><h3>Results</h3><div>The overweight/obesity cohort included 25,016 individuals, and the obesity cohort 13,441 individuals. Most individuals with overweight/obesity (60.1%) and obesity (63.6%) presented with ≥1 ORCs. The most frequent ORCs among people with obesity were hypertension (25.3%), dyslipidaemia (19.8%), anxiety (19.0%), osteoarthritis (14.3%), low-back pain (10.9%) and depression (10.9%). The proportion of individuals receiving pharmacological therapies with an effect on weight was <1%. There were no records of lifestyle interventions or bariatric surgery in the database for this population.</div></div><div><h3>Conclusions</h3><div>This study highlights the high ORC burden at first documented diagnosis of overweight/obesity. Very few individuals with obesity in Spain receive pharmacological treatment with an effect on weight. Patient management could be improved by systematically recording all interventions in this population.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 10","pages":"Article 501643"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766123","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 : 2025-10-29DOI: 10.1016/j.endien.2025.501624
Cristina Mª Díaz Perdigones , Daniel Hinojosa Nogueira , Alba Rodríguez Muñoz , Alba Subiri Verdugo , Alberto Vilches-Pérez , Virginia Mela , Francisco J. Tinahones , Isabel Moreno Indias
Obesity is a growing public health problem. In recent decades, scientific evidence has linked gut microbiota to obesity. This systematic review summarizes current knowledge on the composition and functional differences in gut microbiota between individuals with obesity and those with normal weight. Following PRISMA 2020 recommendations, studies published in adult populations between January 2014 and May 2024 were reviewed. PubMed, Web of Science, and Scopus databases were searched for observational studies that had used advanced sequencing methods, such as 16S rRNA and shotgun metagenomics, to assess gut microbiota. The quality of these studies was also analyzed using the Newcastle-Ottawa scale. Our review of 16 studies shows a reduction in microbial diversity in individuals with obesity. In addition, a higher relative abundance of the phylum Firmicutes, the families Enterobacteriaceae, Gemellaceae, Prevotellaceae, Streptococcaceae and Veillonellaceae, as well as the genera Blautia, Butyricimonas, Collinsella, Megamonas, and Streptococcus, while beneficial bacteria such as the families Porphyromonadaceae and Rikenellaceae, and the genera Bifidobacterium spp. and Faecalibacterium prausnitzii, were depleted. Functional analysis showed a tendency to an increase in metabolic pathways associated with carbohydrate and lipid metabolism, with reduced pathways related to short-chain fatty acid production. Obesity is associated with altered gut microbiota composition and function. However, the variability across studies regarding population characteristics, dietary pattern, and sequencing techniques limits the comparability of findings. Future research should prioritize standardized methodologies and confounding factors to elucidate the role of the gut microbiome in obesity.
肥胖是一个日益严重的公共健康问题。近几十年来，科学证据表明肠道微生物群与肥胖有关。这篇系统综述总结了目前关于肥胖个体和正常体重个体之间肠道微生物群组成和功能差异的知识。根据PRISMA 2020的建议，对2014年1月至2024年5月期间发表的成人研究进行了回顾。PubMed， Web of Science和Scopus数据库检索了使用先进测序方法（如16S rRNA和shotgun宏基因组学）评估肠道微生物群的观察性研究。这些研究的质量也用纽卡斯尔-渥太华量表进行了分析。我们对16项研究的回顾表明，肥胖个体的微生物多样性减少。此外，厚壁菌门、Enterobacteriaceae、Gemellaceae、Prevotellaceae、Streptococcaceae和Veillonellaceae以及Blautia属、Butyricimonas、Collinsella、Megamonas和Streptococcus等有益菌的相对丰度较高，而Porphyromonadaceae和Rikenellaceae、Bifidobacterium spp.和Faecalibacterium prausnitzii等有益菌的相对丰度则相对较少。功能分析显示，与碳水化合物和脂质代谢相关的代谢途径有增加的趋势，与短链脂肪酸产生相关的代谢途径减少。肥胖与肠道菌群组成和功能的改变有关。然而，关于人群特征、饮食模式和测序技术的研究差异限制了研究结果的可比性。未来的研究应优先考虑标准化的方法和混杂因素，以阐明肠道微生物群在肥胖中的作用。
{"title":"Taxonomic and functional characteristics of the gut microbiota in obesity: A systematic review","authors":"Cristina Mª Díaz Perdigones , Daniel Hinojosa Nogueira , Alba Rodríguez Muñoz , Alba Subiri Verdugo , Alberto Vilches-Pérez , Virginia Mela , Francisco J. Tinahones , Isabel Moreno Indias","doi":"10.1016/j.endien.2025.501624","DOIUrl":"10.1016/j.endien.2025.501624","url":null,"abstract":"<div><div>Obesity is a growing public health problem. In recent decades, scientific evidence has linked gut microbiota to obesity. This systematic review summarizes current knowledge on the composition and functional differences in gut microbiota between individuals with obesity and those with normal weight. Following PRISMA 2020 recommendations, studies published in adult populations between January 2014 and May 2024 were reviewed. PubMed, Web of Science, and Scopus databases were searched for observational studies that had used advanced sequencing methods, such as 16S rRNA and shotgun metagenomics, to assess gut microbiota. The quality of these studies was also analyzed using the Newcastle-Ottawa scale. Our review of 16 studies shows a reduction in microbial diversity in individuals with obesity. In addition, a higher relative abundance of the phylum <em>Firmicutes</em>, <em>the families Enterobacteriaceae</em>, <em>Gemellaceae</em>, <em>Prevotellaceae</em>, <em>Streptococcaceae</em> and <em>Veillonellaceae</em>, as well as the genera <em>Blautia</em>, <em>Butyricimonas</em>, <em>Collinsella</em>, <em>Megamonas</em>, and <em>Streptococcus</em>, while beneficial bacteria such as the families <em>Porphyromonadaceae</em> and <em>Rikenellaceae</em>, and the genera <em>Bifidobacterium</em> spp<em>.</em> and <em>Faecalibacterium prausnitzii</em>, were depleted. Functional analysis showed a tendency to an increase in metabolic pathways associated with carbohydrate and lipid metabolism, with reduced pathways related to short-chain fatty acid production. Obesity is associated with altered gut microbiota composition and function. However, the variability across studies regarding population characteristics, dietary pattern, and sequencing techniques limits the comparability of findings. Future research should prioritize standardized methodologies and confounding factors to elucidate the role of the gut microbiome in obesity.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 9","pages":"Article 501624"},"PeriodicalIF":1.8,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374546","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 : 2025-10-29DOI: 10.1016/j.endien.2025.501623
Lili Wang , Linjun Zheng , Jiayu Hu , Nongnong Zhao
Background
Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM), and left ventricular diastolic dysfunction (LVDD) is considered one of the earliest markers of myocardial dysfunction. Fragmented QRS (fQRS) and microalbuminuria (MAU) are important biomarkers of cardiac electrophysiological changes and CVD, but their relationship with LVDD in T2DM remains unclear. This study aims to explore the impact of fQRS and MAU on LVDD in T2DM patients and to analyze whether the association between fQRS and LVDD differs across varying MAU statuses.
Methods
A total of 374 patients with T2DM were ultimately enrolled in this study. Twelve-lead electrocardiography (ECG) and echocardiography were performed, and the patients’ baseline characteristics, laboratory results, and echocardiographic parameters were collected. Univariate and multivariate logistic regression analyses were conducted to assess the association between fQRS, MAU, and LVDD in T2DM patients. A stratified analysis was performed to examine the relationship between fQRS and LVDD across different MAU statuses.
Results
The mean age of the T2DM patients was 57.19 ± 12.47 years, and 62.57% were male. fQRS, MAU, and age were independent risk factors for LVDD in patients with T2DM. The risk of developing LVDD was 3.72 times higher in patients with fQRS compared to those without fQRS [95% CI = 2.125–6.513, P < 0.0001]. The risk of LVDD was 4.05 times higher in patients with MAU compared to those without MAU [95% CI = 2.252–7.282, P < 0.0001]. For each additional year of age, the risk of LVDD increased by 5.2% [95% CI = 1.022–1.084, P = 0.001]. Stratified analysis based on MAU status revealed that in patients without MAU, the association between fQRS and LVDD was stronger [OR = 7.084, 95% CI = 3.255–15.419, P < 0.0001]. However, in patients with MAU, the relationship between fQRS and LVDD was no longer significant [OR = 1.499, 95% CI = 0.603–3.722, P = 0.383].
Conclusions
Our study found that both fQRS and MAU are independent risk factors for LVDD in patients with T2DM. The presence of fQRS increased the risk of LVDD by 3.72 times, while MAU increased the risk by 4.05 times. Stratified analysis further revealed that in patients without MAU, the association between fQRS and LVDD was significantly stronger (OR = 7.084, P < 0.0001), while in patients with MAU, this association was no longer significant (P = 0.383). These findings suggest that combining the detection of fQRS and MAU may provide valuab
背景：心血管疾病（CVD）是2型糖尿病（T2DM）患者死亡的主要原因，而左室舒张功能障碍（LVDD）被认为是心肌功能障碍的最早标志之一。碎片化QRS （fQRS）和微量白蛋白尿（MAU）是心脏电生理变化和CVD的重要生物标志物，但它们与T2DM患者LVDD的关系尚不清楚。本研究旨在探讨fQRS和MAU对T2DM患者LVDD的影响，并分析fQRS与LVDD的相关性是否因MAU状态的不同而不同。方法共纳入374例T2DM患者。行十二导联心电图（ECG）和超声心动图，收集患者的基线特征、实验室结果和超声心动图参数。进行单因素和多因素logistic回归分析，评估T2DM患者fQRS、MAU和LVDD之间的关系。对不同MAU状态下fQRS和LVDD之间的关系进行了分层分析。结果T2DM患者平均年龄57.19±12.47岁，男性占62.57%。fQRS、MAU和年龄是T2DM患者LVDD的独立危险因素。fQRS患者发生LVDD的风险是无fQRS患者的3.72倍[95% CI = 2.125-6.513, P < 0.0001]。MAU患者发生LVDD的风险是无MAU患者的4.05倍[95% CI = 2.252-7.282, P < 0.0001]。每增加一岁，LVDD的风险增加5.2% [95% CI = 1.022-1.084, P = 0.001]。基于MAU状态的分层分析显示，在无MAU患者中，fQRS与LVDD的相关性更强[OR = 7.084, 95% CI = 3.255-15.419, P < 0.0001]。而在MAU患者中，fQRS与LVDD的关系不再显著[OR = 1.499, 95% CI = 0.603-3.722, P = 0.383]。结论本研究发现fQRS和MAU均为T2DM患者LVDD的独立危险因素。fQRS的存在使LVDD的风险增加了3.72倍，MAU的存在使LVDD的风险增加了4.05倍。分层分析进一步发现，在无MAU患者中，fQRS与LVDD的相关性显著增强（OR = 7.084, P < 0.0001），而在有MAU患者中，这种相关性不再显著（P = 0.383）。这些研究结果表明，fQRS和MAU的联合检测可能为T2DM患者心血管风险评估提供有价值的信息，有助于制定个性化的干预策略，最终改善患者预后。
{"title":"The association between fragmented QRS and left ventricular diastolic dysfunction in type 2 diabetes patients with or without microalbuminuria","authors":"Lili Wang , Linjun Zheng , Jiayu Hu , Nongnong Zhao","doi":"10.1016/j.endien.2025.501623","DOIUrl":"10.1016/j.endien.2025.501623","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM), and left ventricular diastolic dysfunction (LVDD) is considered one of the earliest markers of myocardial dysfunction. Fragmented QRS (fQRS) and microalbuminuria (MAU) are important biomarkers of cardiac electrophysiological changes and CVD, but their relationship with LVDD in T2DM remains unclear. This study aims to explore the impact of fQRS and MAU on LVDD in T2DM patients and to analyze whether the association between fQRS and LVDD differs across varying MAU statuses.</div></div><div><h3>Methods</h3><div>A total of 374 patients with T2DM were ultimately enrolled in this study. Twelve-lead electrocardiography (ECG) and echocardiography were performed, and the patients’ baseline characteristics, laboratory results, and echocardiographic parameters were collected. Univariate and multivariate logistic regression analyses were conducted to assess the association between fQRS, MAU, and LVDD in T2DM patients. A stratified analysis was performed to examine the relationship between fQRS and LVDD across different MAU statuses.</div></div><div><h3>Results</h3><div>The mean age of the T2DM patients was 57.19<!--> <!-->±<!--> <!-->12.47 years, and 62.57% were male. fQRS, MAU, and age were independent risk factors for LVDD in patients with T2DM. The risk of developing LVDD was 3.72 times higher in patients with fQRS compared to those without fQRS [95% CI<!--> <!-->=<!--> <!-->2.125–6.513, <em>P</em> <!--><<!--> <!-->0.0001]. The risk of LVDD was 4.05 times higher in patients with MAU compared to those without MAU [95% CI<!--> <!-->=<!--> <!-->2.252–7.282, <em>P</em> <!--><<!--> <!-->0.0001]. For each additional year of age, the risk of LVDD increased by 5.2% [95% CI<!--> <!-->=<!--> <!-->1.022–1.084, <em>P</em> <!-->=<!--> <!-->0.001]. Stratified analysis based on MAU status revealed that in patients without MAU, the association between fQRS and LVDD was stronger [OR<!--> <!-->=<!--> <!-->7.084, 95% CI<!--> <!-->=<!--> <!-->3.255–15.419, <em>P</em> <!--><<!--> <!-->0.0001]. However, in patients with MAU, the relationship between fQRS and LVDD was no longer significant [OR<!--> <!-->=<!--> <!-->1.499, 95% CI<!--> <!-->=<!--> <!-->0.603–3.722, <em>P</em> <!-->=<!--> <!-->0.383].</div></div><div><h3>Conclusions</h3><div>Our study found that both fQRS and MAU are independent risk factors for LVDD in patients with T2DM. The presence of fQRS increased the risk of LVDD by 3.72 times, while MAU increased the risk by 4.05 times. Stratified analysis further revealed that in patients without MAU, the association between fQRS and LVDD was significantly stronger (OR<!--> <!-->=<!--> <!-->7.084, <em>P</em> <!--><<!--> <!-->0.0001), while in patients with MAU, this association was no longer significant (<em>P</em> <!-->=<!--> <!-->0.383). These findings suggest that combining the detection of fQRS and MAU may provide valuab","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 9","pages":"Article 501623"},"PeriodicalIF":1.8,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374549","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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