Journal of Endocrinological Investigation最新文献

Purpose: Thyroid Eye Disease (TED) is the most common thyroid-related autoimmune inflammatory disorder. Despite a surge in TED-related publications over the past five years-matching the total output of the preceding sixteen years-a systematic bibliometric analysis remains absent. This study aims to systematically map the knowledge structure, research hotspots, and future trends in TED research.

Methods: Publications related to TED from 2004 to 2024 were retrieved from the Web of Science Core Collection database. VOSviewer, CiteSpace, and the R package "Bibliometrix" were utilized for bibliometric analysis.

Results: A total of 4,306 publications from 91 countries, led by the United States and China, were included. The number of TED publications has shown a consistent upward trend. The leading research institution was the University of Pisa. Among scientific journals, the Journal of Clinical Endocrinology & Metabolism, THYROID, Journal of Endocrinological Investigation, and Ophthalmic Plastic and Reconstructive Surgery, had the highest number of publications. The 15,766 contributing authors were led by Smith, Kahaly, Marino, Yoon, and Marcocci in terms of publication volume. Bartalena was identified as the most frequently co-cited author. TED research focuses foremost on mechanisms (pathogenesis, immunity, autoantibodies), treatment (management, therapy, orbital complications), and epidemiology (prevalence, diagnosis, risk factors). Artificial intelligence, disease activity, hearing loss, teprotumumab, dysthyroid optic neuropathy, inflammation, and magnetic resonance imaging are the primary keywords of emerging research hotspots.

Conclusion: Our study represents the first comprehensive bibliometric analysis of TED, summarizing its knowledge mapping, research hotspots, and frontiers, while providing valuable insights for scholars in the field.

Purpose: The genetic background and catecholamine phenotype of pheochromocytomas and paragangliomas (PPGLs) influence the age at diagnosis. However, few studies have systematically investigated clinical features of older patients with PPGLs. This study was based on one of the largest PPGL cohorts in China and aimed to summarize the clinical and genetic characteristics of older PPGL patients, especially concerning intraoperative hemodynamics and genetic background.

Methods: This retrospective study involved 897 patients with abdominal PPGLs from two Chinese centers. DNA from tumor samples was sequenced using next-generation sequencing. Clinical information, intraoperative hemodynamic data, and pathogenic variants were collected and compared between younger (≤ 50 years) and older (> 50 years) patients.

Results: Older patients had a higher rate of incidental tumors (40.5% vs. 48.2%, P = 0.022), fewer typical catecholamine-related symptoms (49.8% vs. 42.4%, P = 0.032), lower plasma normetanephrine levels (7.61 vs. 5.17, P = 0.003) and higher proportion exceeding the normal glycemic range (21.7% vs. 34.4%, P = 0.01) compared to younger patients. The proportion of older patients receiving α-adrenergic receptor blockers for preoperative preparation decreased to 74% compared to 82.4% in younger patients (P = 0.003). During surgery, older patients showed hemodynamic changes indicative of vascular and cardiac aging. Specifically, older patients had lower minSBP, DBP, minMAP, and heart rate, while the SBP fluctuation was higher (P = 0.008). Additionally, younger patients have significantly higher mutation rates for SDHB (5.5% vs. 1.0%, P < 0.001) and VHL (13.3% vs. 7.3%, P = 0.003). HRAS mutations are more prevalent in older patients (10.5% vs. 21.3%, P < 0.001). IDH1 mutations occurred exclusively in older patients (0.56%, 5/887).

Conclusion: Older patients with PPGLs have unique clinical and genetic characteristics. These differences highlight the importance of personalized diagnosis and treatment for various age groups, particularly in developing preoperative preparation strategies to improve vascular and cardiac function in older patients.

Purpose: Subtotal parathyroidectomy (STP) is the preferred surgery for MEN1-related primary hyperparathyroidism (PHPT), balancing recurrence and complication risks. MEN1-negative patients show a milder disease course, supporting the hypothesis that post-operative outcomes may also differ between MEN1-positive and MEN1-negative patients.

Methods: We conducted a retrospective study of 101 MEN1 patients undergoing parathyroidectomy to compare PHPT outcomes by genetic status and surgical approach. MEN1-positive patients mainly received total parathyroidectomy (TP) or STP, while MEN1-negative patients underwent less than subtotal parathyroidectomy (LSTP).

Results: No significant differences were found between MEN1-positive and MEN1-negative patients in remission (p = 0.423), recurrence (p = 0.509) or persistence (p = 0.814) rates, regardless of surgical approach. Chronic postsurgical hypoparathyroidism occurred only in MEN1-positive patients (12.7%). In a sub-analysis of LSTP cases, MEN1-negative patients showed significantly better outcomes, with higher remission (47.6% vs. 16.6%, p = 0.01), and lower recurrence and persistence. Among MEN1-positive patients, TP or STP led to better outcomes compared to LSTP, with higher remission (60.5% vs. 16.7%, p = 0.00005), and lower recurrence and persistence. Recurrence occurred earlier after LSTP (84.0 vs. 160.0 months, p = 0.032).

Conclusions: MEN1 genetic status and surgical strategy both shape PHPT outcomes. MEN1-positive patients benefit from more extensive surgery, performed at high-volume centers, whereas MEN1-negative patients have more favorable outcomes with limited resections, though their remission still trails that of sporadic PHPT. These differences underscore the need for individualized surgical planning.

Purposes: Controversy has emerged regarding the impact of non-nutritive sweeteners (NNS) on body weight. This systematic review and meta-analysis of randomized controlled trials aims to assess the effect of NNS intake on body weight change.

Results: Of the 3327 studies retrieved, 19 met the eligibility criteria for inclusion in the meta-analysis. Compared to the control group, the experimental group that replaced daily caloric sugars with NNS showed significant weight change (MD = -0.79 kg; 95% CI: [-1.55, -0.04]; P = 0.04; I² = 84) When grouped by study duration, the effect of NNS intervention on weight change was significant in studies lasting less than 18 weeks (MD = -0.91 kg; 95% CI: [-1.70, -0.12]; P = 0.02), but minimal in studies longer than 18 weeks (P = 0.51). According to the weight status of the participants, the effect of NNS on body weight was statistically significant only in the normal weight group (MD = -0.97 kg; 95% CI: [-1.40, -0.54]; P < 0.01) and the mixed weight group (comprising normal and overweight individuals) (MD= -1.59 kg, 95% CI: [-2.62, -0.57]; P < 0.01), not in the obese group (MD = -0.646 kg; 95% CI: [-1.839, 0.546]; P = 0.29). In the comparator group, NNS had a greater effect only when compared with caloric sugars (MD= -0.94 kg, P = 0.04). Significant weight differences were also observed in the population with diabetes (MD = -1.56 kg, P < 0.01), but not in the nondiabetic population.

Conclusion: Our study indicates that replacing sugar with NNS leads to weight loss, particularly in normal-weight participants who received the intervention for less than 18 weeks and those with diabetes. For the overweight, it is still advisable to focus on active weight intervention strategies, using NNS only as an auxiliary measure to replace the caloric sugars in the daily diet during weight intervention. This information can inform evidence-based clinical decision-making.

Purpose: To identify clinical and sociodemographic factors that predict follow-up discontinuation and rehospitalisation after multidisciplinary residential rehabilitation for severe obesity, thereby defining high-risk patient profiles and guiding tailored retention strategies.

Methods: We retrospectively followed 1,851 adults with obesity discharged from a multidisciplinary residential programme between 2015 and 2018 (median BMI 42 kg m⁻²). Dropout, defined as more than twelve months without contact, was studied with discrete-time survival models; time to rehospitalisation was analysed with Cox regression.

Results: Within twelve months 1,513 patients (87%) discontinued follow-up. Each five-year increase in age lowered drop-out risk (HR 0.97, 95% CI 0.94-0.99, p = 0.004); diabetes had a similar protective effect (HR 0.89, 0.79-1.00, p = 0.0455). Rehospitalisation occurred in 591 patients (32%). Risk increased with age (5-years increment; HR = 1.05, 95% CI 1.01-1.09, p = 0.0191), baseline BMI (HR = 1.04, 95% CI 1.03-1.05, p < 0.0001), diabetes (HR = 1.22, 95% CI 1.02-1.30, p = 0.0306) and eating disorders (HR = 1.48, 95% CI 1.07-2.05, p = 0.0193).

Discussion: Maintaining the benefits of residential rehabilitation is important. In our cohort, 87% of patients dropped out of follow-up within one year and 32% were readmitted. Two distinct profiles emerged: younger and non-diabetic subjects were prone to dropout, while patients with higher BMI, diabetes, or eating disorders were at higher risk of rehospitalization. Early identification of these groups may suggest flexible, technology-assisted follow-up for working-age patients and integrated metabolic-psychiatric care for complex cases, safeguarding outcomes and optimizing resources.

Background: Effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on genital cancer risk remains unclear.

Objective: The objective of this study was to investigate the impact of SGLT2 inhibitors/SGLT2 inhibition on genital cancer risk.

Methods: We systematically searched PubMed, Web of Science, EU Clinical Trials Register, and ClinicalTrials.gov for large randomized controlled trials up to June 4, 2025. The Mantel-Haenszel method was applied, with risk ratios (RRs) and 95% confidence intervals (CIs) used for dichotomous outcomes. In the Mendelian randomization study, genetic variants in SLC5A2 served as instrumental variables to investigate the causal relationship between SGLT2 inhibition and genital cancers.

Results: A total of 15 studies (16 trials) involving 101,430 patients were included. SGLT2 inhibitors did not significantly reduce genital cancer risk compared to placebo (RR 1.10; 95% CI 0.93-1.31; P = 0.28; moderate certainty of evidence), with consistent findings across subgroup analyses. No significant effects of SGLT2 inhibitors were observed for cervical, endometrial, ovarian, prostate, uterine, penile, or vulvar cancers. Dapagliflozin potentially increased the risk of male genital cancers (RR 1.31; 95% CI 0.99-1.74; P = 0.06). SGLT2 inhibition significantly reduced testicular [odds ratio (OR) 0.012; 95% CI 0.001-0.220; P = 0.003] and cervical (OR 0.013; 95% CI 0.001-0.122; P = 1.615 × 10 - 4) cancer risks. Pooled results from both discovery and replication cohorts demonstrated that SGLT2 inhibition reduced cervical cancer risk (OR 0.016; 95% CI 0.002-0.116; P < 0.0001).

Conclusion: SGLT2 inhibitors exhibited a neutral overall risk profile for genital cancers, while genetic evidence demonstrated beneficial effects specifically for cervical cancer.