Journal of Endocrinological Investigation最新文献

Purpose: To investigate Anti-Müllerian Hormone (AMH) levels in women with anorexia nervosa (AN) compared to individuals with constitutional thinness (CT) and healthy controls, and to evaluate the association between AMH, body mass index (BMI), and weight recovery.

Methods: This monocentric cross-sectional study included 191 women with AN, 41 with CT, and 55 controls. A subgroup of 42 patients with AN was reassessed after weight recovery. Hormonal, metabolic, and psychological parameters were analyzed. AMH was measured using a validated electrochemiluminescence immunoassay. Comparisons and correlations were performed using nonparametric tests and Pearson coefficients.

Results: Mean AMH plasma level was higher in patients with AN (30.5 ± 1.6 pmol/l) than in controls (23.3 ± 2.5 pmol/l, p = 0.0252) and CT (21.4 ± 2.7 pmol/l, p = 0.0088). AMH was positively correlated with BMI, leptin, FSH, and LH in the AN group, and inversely associated with disease duration. AMH was the lowest in extreme undernutrition state (BMI ≤ 13 kg/m²: AMH: 19.5 ± 4.4pmol/l) and the highest in moderate undernutrition state (BMI 16.5-18.5 kg/m²: AMH:35.8 ± 3.1pmol/l; p = 0.0343 vs. previous). During weight recovery, AMH remained stable overall but tended to decrease in patients who regained menstrual cycles.

Conclusions: Mean AMH is globally elevated in AN, but modulated by nutritional status, being very low in extreme undernutrition and higher during partial recovery, remaining elevated with weight normalization in patients with persistent amenorrhea. AMH might reflect the severity of undernutrition in AN, with low AMH marking the most severe forms, and relatively higher AMH indicating some preserved or recoverable reproductive function, helping the clinician in assessing reproductive prognosis in AN.

Background and aims: The prevalence and impact on physical function of osteosarcopenia in the Chinese population remain unclear. The purpose of this study was to assess the prevalence of osteosarcopenia and its association with physical function in the elderly population of China.

Methods and results: A total of 519 participants (327 males, 192 females; mean age: 67.2 years) elderly people were recruited. Physical performance was evaluated using the Timed Up and Go test and the Short Physical Performance Battery (SPPB). Osteoporosis was diagnosed based on the 1994 WHO criteria, while sarcopenia was defined according to the AWGS guidelines. Osteosarcopenia was diagnosed when both sarcopenia and osteoporosis were present. Among the participants, osteosarcopenia was identified in 27 (5.20%), sarcopenia-alone in 6 (1.16%), and osteoporosis-alone in 257 (49.52%). Logistic regression analysis revealed that age (OR = 1.188, 95% CI: 1.085-1.300) and insufficient exercise (< 30 min/day) (OR = 5.606, 95% CI: 1.591-19.762) were significant associated factors for osteosarcopenia. Conversely, body mass index (OR = 0.569, 95% CI: 0.440-0.736), basal metabolic rate (OR = 0.992, 95% CI: 0.989-0.996), and weekly egg consumption (OR = 0.713, 95% CI: 0.564-0.900) were negatively associated with osteosarcopenia. Regarding physical function, individuals with osteosarcopenia exhibited significantly poorer physical performance, including longer times in the five-repetition sit-to-stand test, slower TUG times, reduced handgrip strength, lower SPPB scores, and slower gait speeds (P < 0.01-P < 0.001).

Conclusion: This study highlights the prevalence of osteosarcopenia and its impact on physical function in the elderly Chinese population. It identifies key associated factors that could guide the early recognition, diagnosis, and management of osteosarcopenia in China.

Introduction: This Position Statement presents the recommendations of the Italian Society of Endocrinology (SIE) to identify patients with Cushing's syndrome in specific clinical settings. We set two overarching research questions: 1. Which subjects should be screened ("who" should be screened)? 2. Which is the most appropriate first-line test ("how" to screen) for screening? All suggestions/recommendations are evidence-based and directed at endocrinologists and other physicians who deal with patients who have presumptive Cushing's syndrome.

Methods: The recommendations, developed by a SIE committee, were formulated based on eight short-reviews commissioned to experts of the SIE Pituitary and Adrenal Clubs. These short reviews, published in a special issue of the Journal of Endocrinological Investigation, reported a comprehensive review of the literature, and each of them answered the two research questions (who and how to screen for hypercortisolism) in a specific population: (1) patients with type 2 diabetes mellitus or obesity; (2) patients with arterial hypertension; (3) children and adolescents; (4) women with hyperandrogenism and/or menstrual irregularities; (5) patients with osteoporosis and/or fractures; (6) patients with mood disorders; (7) patients with adrenal and pituitary incidentaloma; (8) patients with unusual infections or thrombotic events. Finally, 24 recommendations were formulated, based on the quality of available evidence.

Conclusions: The evidence-based Position Statement provides clear and pragmatic advice regarding "who" and "how" to screen for Cushing's syndrome. The suggestions/recommendations are developed for all health care providers, not only endocrinologists, to raise awareness on the diagnosis of Cushing's syndrome.