Endocrinologia Diabetes Y Nutricion最新文献

英文中文

Effect of glucagon-like peptide-1 receptor agonists on the risk of major adverse limb events in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized clinical trials 胰高血糖素样肽-1受体激动剂对2型糖尿病患者主要肢体不良事件风险的影响：随机临床试验的系统回顾和荟萃分析

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-05-01 DOI: 10.1016/j.endien.2025.501562

Fernando Garagoli , Walter Masson , Leandro Barbagelata , Martín Lobo

Objective

To evaluate the effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on the risk of major adverse limb events (MALE).

Methods

We conducted a systematic review and meta-analysis of randomized clinical trials assessing the effects of GLP-1RAs therapy on peripheral arterial disease (PAD)-related outcomes in patients with type 2 diabetes mellitus (T2DM). This meta-analysis was performed according to PRISMA guidelines. The random-effects model was performed.

Results

A total of 6 randomized clinical trials were considered eligible for this systematic review. On the other hand, 4 clinical trials were included for the meta-analysis. A total of 15,427 subjects were allocated to the GLP-1RAs group, and 15,476 to the placebo group. Overall, this meta-analysis showed that the use of GLP-1RAs is associated with a lower risk of PAD-related events (OR, 0.78; 95%CI, 0.62–0.98, I² = 39%) vs the placebo group. The analytical evaluation did not suggest publication bias, and the sensitivity analysis demonstrated that the result was robust.

Conclusion

This meta-analysis demonstrated that the use of GLP-1RAs is associated with fewer PAD-related clinical events. Of note, despite the clinical significance of PAD, most analyzed studies did not specifically report on these events. Future studies should include PAD as a key endpoint. PROSPERO Registration: CRD42024565567.

目的评价胰高血糖素样肽-1受体激动剂（GLP-1RAs）对严重肢体不良事件（MALE）风险的影响。方法我们对随机临床试验进行了系统回顾和荟萃分析，评估GLP-1RAs治疗对2型糖尿病（T2DM）患者外周动脉疾病（PAD）相关结局的影响。本meta分析是根据PRISMA指南进行的。采用随机效应模型。结果共有6项随机临床试验被认为符合本系统评价。另一方面，4项临床试验被纳入meta分析。共有15427名受试者被分配到GLP-1RAs组，15476名受试者被分配到安慰剂组。总体而言，该荟萃分析显示，GLP-1RAs的使用与pad相关事件的风险较低相关(OR, 0.78；95%CI, 0.62-0.98, I2 = 39%)。分析评价未发现发表偏倚，敏感性分析表明结果稳健性。该荟萃分析表明，GLP-1RAs的使用与较少的pad相关临床事件相关。值得注意的是，尽管PAD具有临床意义，但大多数分析研究并未专门报道这些事件。未来的研究应包括PAD作为关键终点。普洛斯彼罗注册号：CRD42024565567。

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引用次数: 0

Multifocality of papillary thyroid carcinoma with low risk of recurrence: Prevalence, predictive markers, prognostic significance and initial surgical treatment 低复发风险的甲状腺乳头状癌的多灶性：患病率、预测指标、预后意义和初始手术治疗。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-05-01 DOI: 10.1016/j.endien.2025.501545

Luis García Pascual , Carlos Puig-Jové , Andreu Simó-Servat , Lluís García-González

Background and objective

The impact of multifocality on the prognosis of patients with papillary thyroid cancer is relevant when considering the choice of initial surgical treatment by hemithyroidectomy or total thyroidectomy. The aim of the study is to determine the prevalence of multifocality in our setting, its predictive markers and the rates of persistence, recurrence and mortality associated with papillary thyroid cancer with a low risk of recurrence in order to infer the most appropriate initial surgical treatment.

Patients and method

Retrospective observational cross-sectional study of 85 total thyroidectomies.

Results

Prevalences: unifocal carcinoma: 68.2%; multifocal: 31.8%. Predictive markers of multifocality: multinodular ultrasound pattern (OR:17.069, 95% CI:2.989−97.454) and non-incidental finding (OR:7.569, 95% CI:2.363−24.242). In 66.6% of multifocal cases there was bilateral involvement, all of them had a bilateral multinodular ultrasound pattern. Multifocal cases received postoperative radioiodine more frequently (p < 0.001). During the follow-up of 95.5 ± 32.2 months there was one case of persistence and one of recurrence, both in the multifocal group (p:ns), at 12 and 71 months of follow-up. There was no mortality.

Conclusions

This is the first study in our country to estimate the prevalence of multifocality in papillary carcinoma with a low risk of recurrence and to show an excellent prognosis, with no differences compared to unifocal cases, considering that all cases have been treated with total thyroidectomy, but multifocal cases with radioiodine more frequently. Hemithyroidectomy could offer a similar prognosis to total thyroidectomy in cases with an ultrasound pattern of a single or unilateral multinodular nodule, but not in cases of bilateral multinodular thyroid.

背景与目的：多灶性对甲状腺乳头状癌患者预后的影响与选择甲状腺切除术或全甲状腺切除术的初始手术治疗相关。本研究的目的是确定在我们的环境中多灶性的患病率、其预测指标以及与低复发风险的甲状腺乳头状癌相关的持久性、复发率和死亡率，以便推断最合适的初始手术治疗。患者和方法：85例甲状腺全切除术的回顾性观察性横断面研究。结果：发病率：单灶性癌：68.2%；多病灶的:31.8%。多灶性的预测指标：多结节超声表现（OR:17.069, 95% CI:2.989-97.454）和非偶然发现（OR:7.569, 95% CI:2.363-24.242）。66.6%的多灶病例双侧受累，超声表现均为双侧多结节。结论：考虑到所有病例均行甲状腺全切除术，但多灶性病例放疗频率更高，这是我国首次对复发风险较低的乳头状癌中多灶性的患病率进行估计，且预后良好，与单灶性病例相比无差异。在超声表现为单侧或单侧多结节结节的病例中，半甲状腺切除术与全甲状腺切除术预后相似，但双侧甲状腺多结节病例则不然。

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引用次数: 0

Osteogenesis imperfecta type V: About a clinical case V型成骨不全症1例临床分析。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-05-01 DOI: 10.1016/j.endien.2025.501544

María Fernanda Reinoso Gomezcoello , Isabel Pavón de Paz , Cristina Navea Aguilera , Belén Gil Fournier , Ana María Bueno Sanchez , Guadalupe Guijarro de Armas , María Merino Viveros , Jose Antonio Rosado Sierra , Paloma Iglesias Bolaños , María Durán Martínez

Osteogenesis imperfecta (OI) is a rare inherited connective tissue disorder. It is characterized by short stature, fragility and decreased bone mass, which leads to multiple and recurrent fractures after low-energy trauma, which generates susceptibility to long bone deformity and vertebral compression. There are several types of OI, with types I to IV, in which the COL1A1 and COL1A2 genes are affected, being the most frequent. In recent years, the discovery of new forms of OI has led to research into the pathways critical aspects of bone metabolism, with new genes involved being identified. The mutation in IFITM5 has been identified as the cause of OI type V, of autosomal dominant inheritance. OI type V has distinctive clinical features including the development of hypertrophic callus after fracture, early calcification of the interosseous membrane in the forearm, and the presence of hyperdense metaphyseal bands.

The case of a patient with a novo mutation in IFITM5 is presented.

成骨不全症是一种罕见的遗传性结缔组织疾病。其特点是身材矮小、脆弱、骨量减少，导致低能创伤后多发、复发性骨折，易发生长骨畸形和椎体受压。有几种类型的成骨不全，从I型到IV型，其中COL1A1和COL1A2基因受到影响，是最常见的。近年来，新形式的成骨不全的发现导致了对骨代谢关键方面的研究，并发现了新的相关基因。IFITM5突变已被确定为常染色体显性遗传的OI V型的原因。V型成骨不全具有独特的临床特征，包括骨折后肥厚性骨痂的发展，前臂骨间膜的早期钙化，以及存在高密度的干骺端带。在IFITM5患者的新突变的情况下提出。

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引用次数: 0

Transgender women and competitive sports: Considerations from Endocrinology 跨性别女性和竞技体育：来自内分泌学的考虑。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-04-01 DOI: 10.1016/j.endien.2025.101539

Laura Cuadrado Clemente , María Miguélez González , Patricia Cabrera García , Mercedes Noval Font , Élida Alfaro Gandarillas , Marcelino Gómez Balaguer , Nieves Palacios Gil de Antuñano

Introduction

The participation of transgender women (TW) in high-level competitive sports increases every year, as does the interest of sports organizations in finding solutions that allow their inclusion without compromising the principle of equity governing high-level sports. However, the binary categorization of sports, influenced by the impact of sex hormone on physical performance, creates challenges for the inclusion of TW in the female category. This study aimed to understand the impact of gender-affirming hormone therapy (GAHT) on various athletic performance variables and to compare results with those obtained in cisgender populations.

Methods

Review of cross-sectional and longitudinal studies that included TW (preferably athletes) undergoing GAHT.

Results

Significant decreases in hematocrit, total serum testosterone, lean body mass, strength, and muscle area were observed after 12 mo of GAHT, with increases in fat mass. Grip strength was higher in TW compared to cisgender females (CW) in the long term. TW showed better performance in sports involving the upper body.

Conclusions

At least 2 years of postpubertal GAHT are necessary to achieve a significant reduction in the effects of male hormones on various physiological parameters. The scientific evidence regarding the impact of GAHT on physical performance is insufficient. Long-term studies are needed, incorporating new biomarkers and morphofunctional parameters, to allow for comparisons of athletic performance across different disciplines between TW and CW.

导言：变性妇女（TW）参与高水平竞技体育运动的人数逐年增加，体育组织也希望找到既能让她们参与进来，又不损害高水平体育运动公平原则的解决方案。然而，受性激素对身体表现的影响，体育运动的二元分类对将 TW 纳入女性类别造成了挑战。本研究旨在了解性别确认激素疗法（GAHT）对各种运动表现变量的影响，并将结果与在顺性别人群中获得的结果进行比较：方法：回顾包括接受 GAHT 治疗的 TW（最好是运动员）的横断面和纵向研究：结果：接受 GAHT 12 个月后，观察到血细胞比容、血清总睾酮、瘦体重、力量和肌肉面积显著下降，脂肪量增加。与同性女性（CW）相比，TW 的握力在长期内更高。TW在涉及上半身的运动中表现更好：结论：要显著降低雄性激素对各种生理参数的影响，青春期后的 GAHT 至少需要 2 年的时间。GAHT 对身体表现影响的科学证据尚不充分。需要结合新的生物标志物和形态功能参数进行长期研究，以便对 TW 和 CW 在不同项目中的运动表现进行比较。

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引用次数: 0

Trans and cis women in sport: Citius, altius, fortius, sed aequitas 体育运动中的跨性别和顺性别女性：Citius， altius, fortius, sed aequitas。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-04-01 DOI: 10.1016/j.endien.2025.501547

Óscar Moreno-Perez , Inés Modrego-Pardo

引用次数: 0

Clinical characteristics and management of type 2 diabetes in primary care in Spain. SED2 Study 西班牙初级保健中2型糖尿病的临床特点和管理中国研究。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-04-01 DOI: 10.1016/j.endien.2025.501543

Violeta Antonio-Arques , Berta Fernandez Camins , Bogdan Vlacho , Joan Barrot , Jorge Navarro Pérez , Edelmiro Menéndez Torre , Didac Mauricio , Josep Franch-Nadal

Introduction

Type 2 diabetes mellitus (DM2) is a prevalent chronic disease with major complications. Primary care (PC) plays a crucial role in the management of this disease.

Objectives

To evaluate the organization and resources available in PC for the care of patients with DM2 in Spain.

Material and methods

Descriptive, cross-sectional, observational study in 65 health centers (HC) selected by opportunistic sampling. Data were collected through a structured survey.

Results

Half of the HCs have a diabetes referent, two thirds have specific protocols and almost 90% involve nurses in diabetes education. Access to non-mydriatic retinography is limited (38.5%) and its interpretation varies. Diabetic foot examination is mainly performed by nurses (47.7%) and there is the possibility of referral to vascular surgery or specialized units in most cases. The most frequent analytical tests are the HbA1c every 6 mo (67.7%). 63.1% of the HCs can perform telematic consultations to hospital specialists and most of them have access to patients’ medical records at the hospital. Significant variations are observed in some aspects between autonomous communities.

Conclusions

Care for patients with DM2 in PC in Spain is uneven and presents opportunities for improvement. Comprehensive diabetes care in PC needs to be strengthened, including the training of professionals, the implementation of protocols and the provision of adequate resources. Measures are needed to reduce variations in care between autonomous communities.

2型糖尿病（DM2）是一种常见的慢性疾病。初级保健（PC）在该病的管理中起着至关重要的作用。目的：评价西班牙PC护理DM2患者的组织和资源。材料和方法：描述性、横断面、观察性研究，在65个卫生中心（HC）通过机会抽样选择。数据是通过结构化调查收集的。结果：一半的保健中心有糖尿病患者，三分之二有具体的方案，近90%的保健中心有护士参与糖尿病教育。非散束视网膜造影的机会有限（38.5%），其解释各不相同。糖尿病足检查主要由护士进行（47.7%），大多数病例有转诊到血管外科或专科的可能性。最常见的分析检测是每6个月检测一次HbA1c（67.7%）。63.1%的健康中心可以向医院专家进行远程咨询，其中大多数可以访问医院的患者医疗记录。各自治区之间在某些方面存在显著差异。结论：西班牙PC患者对DM2的护理参差不齐，存在改善的机会。需要加强PC的全面糖尿病护理，包括专业人员的培训、方案的实施和提供充足的资源。需要采取措施减少各自治区之间在护理方面的差异。

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引用次数: 0

Alterations in MORC2 gene and DIGFAN syndrome: A rare cause of short stature MORC2 基因的改变与 DIGFAN 综合征：导致身材矮小的罕见病因

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-04-01 DOI: 10.1016/j.endien.2025.101537

Enrique Palomo Atance , Prado Sánchez Ruiz , Elena Reyzábal Ereño , Paola Sánchez Tudela , Laura Acero García de la Santa

引用次数: 0

Combined adalimumab and etonogestrel/ethinylestradiol therapy associated with hypertriglyceridemia-induced pancreatitis in a young woman with hidradenitis suppurativa 阿达木单抗和炔雌孕酮/炔雌醇联合治疗与高甘油三酯血症诱导的化脓性汗腺炎年轻女性胰腺炎相关

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-04-01 DOI: 10.1016/j.endien.2025.101536

Darko Siuka , Matej Rakusa

引用次数: 0

Deciphering deleterious missense variants in the MC4R gene in the pathogenesis of obesity 在肥胖的发病机制中破译MC4R基因中的有害错义变异

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-04-01 DOI: 10.1016/j.endien.2025.501559

Meriem El Fessikh , Hanaa Skhoun , Zohra Ouzzif , Jamila El Baghdadi

The MC4R gene plays a critical role in regulating food intake, making it an important model for studying genetic mutations that impact the protein function. This study aimed to identify the most deleterious functional and structural variants in individuals with obesity by analyzing SNPs from the NCBI dbSNP database and selecting pathogenic variants from ClinVar. Bioinformatics tools were employed to predict deleterious SNPs, and conservation analysis was performed using ConSurf. Stability predictions were made with MUpro, I-Mutant2.0, and iStable. The 3D structure of the MC4R protein was examined using YASARA view. A total of 20 out of 348 missense mutations were associated with obesity. Fifteen of these variants were predicted to be the most deleterious. Eight variants located in conserved regions were found to significantly reduce protein stability and cause structural changes (S58C, E61K, N62S, I69R, D90N, R165Q, P299H, and I316S), indicating their potential as obesity biomarkers and therapeutic targets.

MC4R基因在调节食物摄入中起着至关重要的作用，使其成为研究影响蛋白质功能的基因突变的重要模型。本研究旨在通过分析NCBI dbSNP数据库中的snp和从ClinVar中选择致病变异，确定肥胖个体中最有害的功能和结构变异。利用生物信息学工具预测有害snp，并使用ConSurf进行保守性分析。使用MUpro、I-Mutant2.0和iStable进行稳定性预测。使用YASARA视图检测MC4R蛋白的三维结构。348个错义突变中有20个与肥胖有关。据预测，其中15种变异是最有害的。发现8个位于保守区域的变异（S58C、E61K、N62S、I69R、D90N、R165Q、P299H和I316S）显著降低了蛋白质稳定性并导致结构变化，表明它们有潜力成为肥胖生物标志物和治疗靶点。

引用次数: 0

Hyperglycemia-related risk factors in enteral nutrition in non-critically ill patients 非危重病人肠内营养中的高血糖相关危险因素

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion

Pub Date : 2025-03-01 DOI: 10.1016/j.endien.2025.101534

Esther Delgado-García , Juan José López-Gómez , Rebeca Jiménez-Sahagún , Emilia Gómez-Hoyos , Ana Ortolá-Buigues , Paloma Pérez-López , Beatriz Torres-Torres , Daniel A. De Luis-Román

Introduction

Carbohydrate metabolism can change in hospitalized patients due to stress, or the use of enteral nutrition (EN). The aim of this study was to determine the risk factors triggering these changes.

Material and Methods

We conducted a retrospective observational study in non-diabetic patients with low levels of stress on EN. Five groups were categorized based on changes to the metabolism of hydrocarbons produced before or after EN: plasma glycemia prior to EN >126 mg/dL (stress hyperglycemia – SH) (35.1%); plasma glycaemia prior to EN <126 mg/dL (non-HE) (64.89%). Hyperglycemia with EN (HyperEN): at least, two capillary blood glucose readings >140 mg/dL or 1 >180 mg/dL during EN (71%); non-HyperEN: capillary blood glucose readings with EN <140 mg/dL (29%).

Results

A total of 131 patients were included (45.8% men) with a median age of 81 (71–87) years. A total of 52 patients exceeded 180 mg/dL at one measurement, and 24 patients required insulin detemir with a median of 16 (12–27) IU per day. Risk factors for HyperEN were identified as patient age (OR, 1.186; 95% CI, 1.051–1.341; p < 0.01) and duration of nutritional treatment (OR, 1.320; 95% CI, 1.086–1.605; p < 0.01).

Conclusions

Our study shows a high prevalence of carbohydrate metabolism disorders in hospitalized patients on total EN, with age and duration of nutritional treatment being the main risk factors.

住院患者的碳水化合物代谢可因压力或肠内营养（EN）的使用而改变。这项研究的目的是确定引发这些变化的危险因素。材料与方法我们对低水平EN应激的非糖尿病患者进行了回顾性观察研究。根据EN前后产生的碳氢化合物代谢变化分为五组：EN前血浆血糖126 mg/dL（应激性高血糖- SH）（35.1%）；enlt前血糖126 mg/dL（非he）（64.89%）。高血糖伴EN (HyperEN): EN期间至少两次毛细血管血糖读数为140 mg/dL或1 180 mg/dL (71%)；非hyperen：毛细管血糖读数，EN <140 mg/dL（29%）。结果共纳入131例患者，其中男性45.8%，中位年龄81（71 ~ 87）岁。共有52名患者在一次测量中超过180 mg/dL， 24名患者需要胰岛素，中位数为16 (12-27)IU /天。HyperEN的危险因素确定为患者年龄(OR, 1.186；95% ci, 1.051-1.341；p & lt;0.01)和营养治疗时间(OR, 1.320；95% ci, 1.086-1.605；p & lt;0.01)。结论sour研究显示总EN住院患者碳水化合物代谢紊乱发生率较高，年龄和营养治疗时间是主要危险因素。

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