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Plasma oxytocin levels in response to glucagon in patients with arginine vasopressin deficiency (central diabetes insipidus) and healthy controls. 精氨酸加压素缺乏症(中枢性糖尿病)患者和健康对照组血浆催产素水平对胰高血糖素的反应。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-06-27 DOI: 10.1007/s12020-024-03920-2
Cihan Atila, Shalini Mekkattu, Rakithan Murugesu, Odile Gaisl, Nimmy Varghese, Anne Eckert, Mirjam Christ-Crain

Purpose: We recently demonstrated an additional oxytocin (OT) deficiency in patients with arginine vasopressin (AVP) deficiency (central diabetes insipidus) by using 3,4-methylenedioxy-methamphetamine (MDMA) as a novel provocation test. However, the implication of the MDMA provocation test in clinical practice might be challenging. Glucagon effectively stimulates vasopressinergic neurons with a strong increase in plasma copeptin. We therefore hypothesized that this provocation test might also stimulate OT.

Methods: This is a predefined secondary analysis of a prospective double-blind, randomised, placebo-controlled cross-over trial involving ten patients with AVP deficiency and ten sex- and body-mass index-matched healthy participants at the University Hospital Basel, Switzerland. Each participant underwent the glucagon test (s.c. injection of 1 mg glucagon) and placebo test (s.c. injection of 0.9% normal saline). Plasma OT levels were measured at baseline, 60, 120 and 180 min after injection. The primary objective was to determine whether glucagon stimulates OT and whether OT levels differ between patients with AVP deficiency and healthy participants. The primary outcome (maximum change in OT within 180 min) was compared between groups and conditions using a linear mixed effects model.

Results: In healthy participants, the median OT at baseline was 82.7 pg/ml [62.3-94.3] and slightly increased to a maximum of 93.3 pg/ml [87.2-121.1] after injection of glucagon, resulting in a change increase of 24.9 pg/ml [5.1-27.8]. Similarly, in patients with AVP deficiency, the median OT at baseline was 73.9 pg/ml [65.3-81.6] and slightly increased after glucagon injection to 114.9 pg/ml [70.9-140.9], resulting in a change increase of 36.8 pg/ml [-2.2 to 51.2]. The results from the mixed model showed no effect between glucagon compared to placebo on OT (difference: -0.5 pg/ml; 95%-CI [-25, 24]; p = 0.97) and no significant treatment-by-group interaction effect between patients compared to healthy participants (interaction: 28 pg/ml; 95%-CI [-7, 62]; p = 0.13).

Conclusion: We found no effect of glucagon on plasma OT levels and no difference between patients with AVP deficiency and healthy participants.

目的:最近,我们使用3,4-亚甲二氧基甲基苯丙胺(MDMA)作为一种新型激发试验,证实了精氨酸血管加压素(AVP)缺乏症(中枢性糖尿病)患者中存在额外的催产素(OT)缺乏症。然而,MDMA 激起试验对临床实践的影响可能具有挑战性。胰高血糖素能有效刺激血管加压素能神经元,使血浆中的 copeptin 大量增加。因此,我们假设这种激惹试验也可能刺激 OT:这是瑞士巴塞尔大学医院一项前瞻性双盲、随机、安慰剂对照交叉试验的预设二次分析,该试验涉及 10 名 AVP 缺乏症患者和 10 名性别和体重指数相匹配的健康参与者。每位参与者都接受了胰高血糖素试验(静脉注射 1 毫克胰高血糖素)和安慰剂试验(静脉注射 0.9% 生理盐水)。分别在基线、注射后 60、120 和 180 分钟测量血浆 OT 水平。主要目的是确定胰高血糖素是否会刺激 OT,以及 AVP 缺乏症患者和健康参与者的 OT 水平是否存在差异。采用线性混合效应模型对主要结果(180 分钟内 OT 的最大变化)进行组间和条件间比较:结果:在健康参与者中,基线 OT 中位数为 82.7 pg/ml [62.3-94.3],注射胰高血糖素后略有增加,最大值为 93.3 pg/ml [87.2-121.1],变化幅度为 24.9 pg/ml [5.1-27.8]。同样,在 AVP 缺乏症患者中,基线时的 OT 中位数为 73.9 pg/ml [65.3-81.6],注射胰高血糖素后略有增加,达到 114.9 pg/ml [70.9-140.9],导致变化增加 36.8 pg/ml [-2.2 至 51.2]。混合模型的结果显示,与安慰剂相比,胰高血糖素对OT没有影响(差异:-0.5 pg/ml;95%-CI [-25,24];p = 0.97),与健康参与者相比,患者与治疗组之间没有显著的交互作用(交互作用:28 pg/ml;95%-CI [-7,62];p = 0.13):我们发现胰高血糖素对血浆 OT 水平没有影响,AVP 缺乏症患者与健康参与者之间也没有差异。
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引用次数: 0
Relation between blood pressure time in range and composite cardiovascular outcomes in patients with primary aldosteronism: a retrospective case study. 原发性醛固酮增多症患者血压达标时间与心血管综合后果之间的关系:一项回顾性病例研究。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-07-17 DOI: 10.1007/s12020-024-03955-5
Fangfang Yan, Huangdao Yu, Liping Lan, Ziqing Xu, Jinyang Zeng, Bingkun Huang, Changqin Liu, Xuejun Li, Mingzhu Lin

Purpose: To investigate the association between blood pressure (BP) time in range (TIR) and composite cardiovascular outcomes in patients with primary aldosteronism (PA).

Methods: Between January 2019 and December 2021, 47 patients with PA were recruited from the First Affiliated Hospital of Xiamen University. Twenty-four-hour ambulatory BP monitoring (ABPM) and cardiovascular outcomes were assessed in all patients during the first diagnosis of PA.

Results: The mean age of the patients was 48.8 ± 11.4 years. Compared to PA without composite cardiovascular outcomes, the nighttime systolic BP TIR [31.2% (6.2%, 81.2%) vs. 11.5% (0.0%, 29.7%), p = 0.02] and defined daily dose (DDDs) of antihypertensive medication [2.0 (1.0, 2.8) vs. 1.0 (1.0, 2.0), p = 0.03] were lower in PA patients with composite cardiovascular outcomes, while higher glucose (5.0 ± 1.0 mmol/L vs. 5.9 ± 1.5 mmol/L) and prevalence of a history of alcohol intake was higher in PA patients with composite cardiovascular outcomes. There were no differences in age, sex, BMI, smoking, duration of hypertension, lipid levels, aldosteronism, clinic BP, 24-hour mean BP, daytime or nighttime BP, percentage of nocturnal SBP or DBP decline, 24-hour BP TIR, daytime BP TIR, or nighttime DBP TIR between the two groups. After adjusting for confounding factors, nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes (adjusted OR = 0.92 [95% CI 0.86, 0.99]) in multiple logistic regression analysis.

Conclusion: Nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes in patients with PA.

目的:研究原发性醛固酮增多症(PA)患者血压(BP)在范围内的时间(TIR)与心血管综合结局之间的关系:方法:2019年1月至2021年12月期间,从厦门大学附属第一医院招募了47名PA患者。对所有首次确诊 PA 的患者进行 24 小时动态血压监测(ABPM)和心血管预后评估:结果:患者的平均年龄为(48.8 ± 11.4)岁。与没有综合心血管结果的 PA 相比,有夜间收缩压 TIR [31.2% (6.2%, 81.2%) vs. 11.5% (0.0%, 29.7%),p = 0.02]和抗高血压药物定义日剂量 (DDDs) [2.0 (1.0, 2.8) vs. 1.0 (1.0, 2.0),p = 0.03]的比例较低,而血糖(5.0 ± 1.0 mmol/L vs. 5.9 ± 1.5 mmol/L)较高和有饮酒史的比例较高。两组患者在年龄、性别、体重指数、吸烟、高血压持续时间、血脂水平、醛固酮增多症、门诊血压、24 小时平均血压、白天或夜间血压、夜间 SBP 或 DBP 下降百分比、24 小时血压 TIR、白天血压 TIR 或夜间 DBP TIR 方面没有差异。调整混杂因素后,在多重逻辑回归分析中,夜间收缩压TIR与心血管综合结果显著相关(调整后OR = 0.92 [95% CI 0.86, 0.99]):结论:在 PA 患者中,夜间收缩压 TIR 与心血管综合结果有显著相关性。
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引用次数: 0
Analysis of T follicular and T peripheral helper lymphocytes in autoimmune thyroid disease. 自身免疫性甲状腺疾病中T滤泡和T外周辅助淋巴细胞的分析。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 DOI: 10.1007/s12020-024-03686-7
Raquel Sánchez-Gutiérrez, Rebeca Martínez-Hernández, Ana Serrano-Somavilla, Miguel Sampedro-Nuñez, Alejandra Mendoza-Pérez, José Luis Muñoz de Nova, Marlen Vitales-Noyola, Roberto González-Amaro, Mónica Marazuela

Purpose: Peripheral helper T (Tph) cells have an important role in the induction of humoral immune responses and autoantibody production. Accordingly, it is feasible that this lymphocyte subset has a relevant role in the pathogenesis of autoimmune thyroid diseases (AITD). In this study we aim to analyze the levels and function of Tph cells in blood samples from patients with AITD.

Methods: We performed an observational study with cases and controls. Blood samples were obtained from nineteen patients with Hashimoto's thyroiditis (HT), twenty-four with Graves' disease (GD), and fifteen healthy controls. In addition, the levels of follicular T helper (Tfh) cells and Tph cells, the release of interleukin-21 (IL-21) by these lymphocytes and the number of plasmablasts were analyzed by multi-parametric flow cytometry analyses.

Results: Increased percentages of Tfh and Tph lymphocytes were detected in patients with HT and GD. Furthermore, an enhanced synthesis of the cytokine IL-21 by these cells was observed. Accordingly, we detected significant higher percentages of plasmablasts in patients with GD, and these values tended to be also higher in HT patients. Moreover, significant positive associations were observed between the levels of Tfh or Tph and the number of plasmablast or anti-TSHR Ab titers in patients with AITD.

Conclusion: Our data suggest that Tph lymphocytes may have a relevant role in the pathogenesis of AITD.

目的:外周辅助性 T(Tph)细胞在诱导体液免疫反应和自身抗体产生方面起着重要作用。因此,该淋巴细胞亚群可能在自身免疫性甲状腺疾病(AITD)的发病机制中扮演重要角色。本研究旨在分析 AITD 患者血液样本中 Tph 细胞的水平和功能:我们对病例和对照组进行了观察研究。我们采集了 19 名桥本氏甲状腺炎(HT)患者、24 名巴塞杜氏病(GD)患者和 15 名健康对照者的血液样本。此外,还通过多参数流式细胞术分析了滤泡T辅助细胞(Tfh)和Tph细胞的水平、这些淋巴细胞释放的白细胞介素-21(IL-21)以及浆细胞的数量:结果:在 HT 和 GD 患者中检测到 Tfh 和 Tph 淋巴细胞百分比增加。此外,还观察到这些细胞合成细胞因子 IL-21 的能力增强。相应地,我们在 GD 患者中检测到明显较高比例的浆细胞,这些数值在 HT 患者中也有较高的趋势。此外,在 AITD 患者中还观察到 Tfh 或 Tph 水平与浆细胞数量或抗 TSHR Ab 滴度之间存在明显的正相关:我们的数据表明,Tph 淋巴细胞可能在 AITD 的发病机制中起着重要作用。
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引用次数: 0
Impact of thyroid carcinoma invasion of recurrent laryngeal nerve on cervical lymph node metastasis. 甲状腺癌侵犯喉返神经对颈淋巴结转移的影响
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-05-20 DOI: 10.1007/s12020-024-03879-0
Feng Zhu, YiBin Shen, LiXian Zhu, LinHui Chen, FuQiang Li, XiaoJun Xie, YiJun Wu

Purpose: Papillary thyroid carcinoma (PTC) has a favorable prognosis. However, involvement of the recurrent laryngeal nerve (RLN) significantly increases the risk of recurrence. RLN invasion was an important factor in determining the extent of thyroid surgery. The purpose of this study was to compare clinicopathologic features and characterize risk factors of central and lateral lymph node metastasis (LLNM) of RLN invasion in patients with PTC.

Methods: A retrospective review was conducted of 130 patients with PTCs who had exclusive tumor involvement of the RLN at our institution between January 2014 and February 2019. All patients underwent total thyroidectomy and high-dose radioactive iodine (RAI) therapy. The clinicopathologic factors and prognostic outcomes of the patients with solitary and multiple RLN involvements were compared. Kaplan-Meier method was performed to compare the outcomes of tumor recurrence. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with LLNM.

Results: The invasion of the RLN was similar on both sides, with 58.5% on the right, 40.0% on the left, and 1.5% on both sides. Significant differences were observed in tumor size (p < 0.001), lymph node metastasis classification (p = 0.002), RLN resection (p < 0.001), and thyroglobulin (p = 0.010) in the solitary and multiple groups. During the median follow-up of 67 months, 9 (6.9%) patients developed recurrence. There were no statistical differences in recurrence for age, tumor size, gender, multifocality, lymph node metastasis (LNM), and RLN resection. According to receiver operating characteristic (ROC) curve analyses, a cut-off of tumor size > 1.7 cm was identified as the most sensitive and specific predictor of RLN with multiple involvements or LNM invasion. Univariate and multivariate analyses revealed that central lymph node metastasis (CLNM) and RLN invasion by LNM can serve as independent risk factors for LLNM (p = 0.006 and p < 0.001, respectively).

Conclusion: Our results indicate that recurrence was comparable in patients with solitary and multiple RLN involvements. Multiple RLN involvement was associated with pathological features such as larger tumors, RLN resection, and LLNM. The presence of LNM invading RLN and multiple nerve involvement increases the risk of intraoperative RLN resection. A higher risk of multiple invasion or LNM invasion should be considered when tumor size > 1.7 cm. The presence of CLNM and RLN invaded by LNM were independent predictors for LLNM, which could aid surgeons in deciding on lateral lymph node dissection.

目的:甲状腺乳头状癌(PTC)预后良好。然而,喉返神经(RLN)受累会显著增加复发风险。喉返神经受累是决定甲状腺手术范围的一个重要因素。本研究的目的是比较PTC患者的临床病理特征,并分析RLN侵犯中央和外侧淋巴结转移(LLNM)的风险因素:本院对2014年1月至2019年2月期间肿瘤完全累及RLN的130例PTC患者进行了回顾性研究。所有患者均接受了甲状腺全切除术和高剂量放射性碘(RAI)治疗。比较了单发和多发RLN受累患者的临床病理因素和预后结果。采用卡普兰-梅耶法比较肿瘤复发的预后。采用单变量和多变量逻辑回归分析来确定与LLNM相关的风险因素:两侧RLN受侵情况相似,右侧为58.5%,左侧为40.0%,两侧均为1.5%。肿瘤大小差异显著(P 1.7 cm被认为是预测RLN多发受累或LNM侵犯的最敏感和特异的指标。单变量和多变量分析表明,中心淋巴结转移(CLNM)和LNM侵犯RLN可作为LLNM的独立危险因素(P = 0.006和P 结论:我们的结果表明,复发率和淋巴结转移率在两侧淋巴结转移率中相当:我们的研究结果表明,单发和多发RLN受累患者的复发率相当。多发性 RLN 受累与较大肿瘤、RLN 切除和 LLNM 等病理特征有关。LNM侵犯RLN和多神经受累会增加术中切除RLN的风险。当肿瘤大小大于 1.7 厘米时,应考虑多发性侵犯或 LNM 侵犯的更高风险。CLNM和LNM侵犯RLN是LLNM的独立预测因素,这有助于外科医生决定是否进行侧淋巴结清扫。
{"title":"Impact of thyroid carcinoma invasion of recurrent laryngeal nerve on cervical lymph node metastasis.","authors":"Feng Zhu, YiBin Shen, LiXian Zhu, LinHui Chen, FuQiang Li, XiaoJun Xie, YiJun Wu","doi":"10.1007/s12020-024-03879-0","DOIUrl":"10.1007/s12020-024-03879-0","url":null,"abstract":"<p><strong>Purpose: </strong>Papillary thyroid carcinoma (PTC) has a favorable prognosis. However, involvement of the recurrent laryngeal nerve (RLN) significantly increases the risk of recurrence. RLN invasion was an important factor in determining the extent of thyroid surgery. The purpose of this study was to compare clinicopathologic features and characterize risk factors of central and lateral lymph node metastasis (LLNM) of RLN invasion in patients with PTC.</p><p><strong>Methods: </strong>A retrospective review was conducted of 130 patients with PTCs who had exclusive tumor involvement of the RLN at our institution between January 2014 and February 2019. All patients underwent total thyroidectomy and high-dose radioactive iodine (RAI) therapy. The clinicopathologic factors and prognostic outcomes of the patients with solitary and multiple RLN involvements were compared. Kaplan-Meier method was performed to compare the outcomes of tumor recurrence. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with LLNM.</p><p><strong>Results: </strong>The invasion of the RLN was similar on both sides, with 58.5% on the right, 40.0% on the left, and 1.5% on both sides. Significant differences were observed in tumor size (p < 0.001), lymph node metastasis classification (p = 0.002), RLN resection (p < 0.001), and thyroglobulin (p = 0.010) in the solitary and multiple groups. During the median follow-up of 67 months, 9 (6.9%) patients developed recurrence. There were no statistical differences in recurrence for age, tumor size, gender, multifocality, lymph node metastasis (LNM), and RLN resection. According to receiver operating characteristic (ROC) curve analyses, a cut-off of tumor size > 1.7 cm was identified as the most sensitive and specific predictor of RLN with multiple involvements or LNM invasion. Univariate and multivariate analyses revealed that central lymph node metastasis (CLNM) and RLN invasion by LNM can serve as independent risk factors for LLNM (p = 0.006 and p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Our results indicate that recurrence was comparable in patients with solitary and multiple RLN involvements. Multiple RLN involvement was associated with pathological features such as larger tumors, RLN resection, and LLNM. The presence of LNM invading RLN and multiple nerve involvement increases the risk of intraoperative RLN resection. A higher risk of multiple invasion or LNM invasion should be considered when tumor size > 1.7 cm. The presence of CLNM and RLN invaded by LNM were independent predictors for LLNM, which could aid surgeons in deciding on lateral lymph node dissection.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"654-663"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Left ventricular subclinical systolic myocardial dysfunction assessed by speckle-tracking in patients with Cushing's syndrome. 通过斑点追踪技术评估库欣综合征患者的左心室亚临床收缩性心肌功能障碍。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-07-29 DOI: 10.1007/s12020-024-03980-4
Jiewen Jin, Wei He, Rong Huang, Pengyuan Zhang, Xiaoying He, Yang Peng, Zhihong Liao, Haipeng Xiao, Yanbing Li, Hai Li

Purpose: Two-dimensional speckle tracking echocardiography is a novel ultrasound technique, which can detect early subclinical myocardial dysfunction with high sensitivity. The purpose of this study was to explore the value of speckle tracking echocardiography in the evaluation of subclinical myocardial injury in patients with Cushing's syndrome.

Methods: 35 patients with Cushing's syndrome and 29 healthy controls matched for age, sex, BMI, and systolic blood pressure were included in the study. All subjects were assessed using both conventional Doppler echocardiography and speckle tracking echocardiography. Among patients, they were further divided into inactive group (n = 7) and active group (n = 28) based on cortisol levels. Trend analysis was used among patients in different disease activity. Correlation analysis and linear regression analysis were used to explore influence factors related to subclinical myocardial dysfunction.

Results: Left ventricular ejection fraction value showed no statistical difference between patients Cushing's syndrome and control group. However, GLS and LVSD, show significant differences in Cushing's syndrome group. Also, among active Cushing's syndrome group, inactive Cushing's syndrome group and control group, GLS (-15.4 ± 3.0 vs -18.1 ± 3.1 vs-19.4 ± 2.4, P < 0001) and LVSD (48.9 ± 21.5 vs 43.5 ± 17.9 vs 28.5 ± 8.3, P < 0001) changed significantly with the disease activity status. In addition, GLS and LVSD were both linearly corrected with 24-hour urinary cortisol level.

Conclusion: GLS and LVSD are sensitive parameters in detecting and monitoring subclinical myocardial systolic dysfunction in patients with Cushing's syndrome. Myocardial injury is linearly correlated with cortisol level, which can be partially reversed after the biochemical control of cortisol.

目的:二维斑点追踪超声心动图是一种新型超声技术,可高灵敏度地检测早期亚临床心肌功能障碍。本研究旨在探讨斑点追踪超声心动图在评估库欣综合征患者亚临床心肌损伤中的价值。所有受试者均使用传统多普勒超声心动图和斑点追踪超声心动图进行评估。根据皮质醇水平将患者分为非活动组(7 人)和活动组(28 人)。对不同疾病活动度的患者进行趋势分析。采用相关分析和线性回归分析来探讨与亚临床心肌功能障碍相关的影响因素:结果:库欣综合征患者的左心室射血分数与对照组无统计学差异。但是,库欣综合征组的 GLS 和 LVSD 有显著差异。此外,在活动性库欣综合征组、非活动性库欣综合征组和对照组中,GLS(-15.4 ± 3.0 vs -18.1 ± 3.1 vs-19.4 ± 2.4,P 结论:GLS 和 LVSD 是库欣综合征患者的敏感指标:GLS和LVSD是检测和监测库欣综合征患者亚临床心肌收缩功能障碍的敏感参数。心肌损伤与皮质醇水平呈线性相关,在对皮质醇进行生化控制后可部分逆转。
{"title":"Left ventricular subclinical systolic myocardial dysfunction assessed by speckle-tracking in patients with Cushing's syndrome.","authors":"Jiewen Jin, Wei He, Rong Huang, Pengyuan Zhang, Xiaoying He, Yang Peng, Zhihong Liao, Haipeng Xiao, Yanbing Li, Hai Li","doi":"10.1007/s12020-024-03980-4","DOIUrl":"10.1007/s12020-024-03980-4","url":null,"abstract":"<p><strong>Purpose: </strong>Two-dimensional speckle tracking echocardiography is a novel ultrasound technique, which can detect early subclinical myocardial dysfunction with high sensitivity. The purpose of this study was to explore the value of speckle tracking echocardiography in the evaluation of subclinical myocardial injury in patients with Cushing's syndrome.</p><p><strong>Methods: </strong>35 patients with Cushing's syndrome and 29 healthy controls matched for age, sex, BMI, and systolic blood pressure were included in the study. All subjects were assessed using both conventional Doppler echocardiography and speckle tracking echocardiography. Among patients, they were further divided into inactive group (n = 7) and active group (n = 28) based on cortisol levels. Trend analysis was used among patients in different disease activity. Correlation analysis and linear regression analysis were used to explore influence factors related to subclinical myocardial dysfunction.</p><p><strong>Results: </strong>Left ventricular ejection fraction value showed no statistical difference between patients Cushing's syndrome and control group. However, GLS and LVSD, show significant differences in Cushing's syndrome group. Also, among active Cushing's syndrome group, inactive Cushing's syndrome group and control group, GLS (-15.4 ± 3.0 vs -18.1 ± 3.1 vs-19.4 ± 2.4, P < 0001) and LVSD (48.9 ± 21.5 vs 43.5 ± 17.9 vs 28.5 ± 8.3, P < 0001) changed significantly with the disease activity status. In addition, GLS and LVSD were both linearly corrected with 24-hour urinary cortisol level.</p><p><strong>Conclusion: </strong>GLS and LVSD are sensitive parameters in detecting and monitoring subclinical myocardial systolic dysfunction in patients with Cushing's syndrome. Myocardial injury is linearly correlated with cortisol level, which can be partially reversed after the biochemical control of cortisol.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"841-849"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychological impacts of lobectomy and total thyroidectomy in PTC measuring 1 to 4 cm with low to intermediate risk of recurrence. 对复发风险为中低的 1 至 4 厘米 PTC 进行甲状腺叶切除术和全甲状腺切除术的心理影响。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-06-01 DOI: 10.1007/s12020-024-03893-2
Ziyang Ye, Lanlan Wang, Genpeng Li, Pan Zhang, Tao Wei, Jingqiang Zhu, Zhihui Li, Jianyong Lei, Juxiang Gou, Huairong Tang

Purpose: To investigate the implications of Lobectomy (LT) or total thyroidectomy (TT) on psychological distress and sleep quality in PTC patients with a low to intermediate risk of recurrence and tumors measuring 1 to 4 cm.

Methods: Patients who were admitted to our hospital between July 2021 and July 2022 were prospectively enrolled in this survey. Psychological distress and sleep quality were assessed at hospitalization, discharge, and 1, 3, and 6 months post-treatment using validated scales. Participants were divided into LT and TT groups, with propensity score matching (PSM) applied for analyses.

Results: Among 525 eligible PTC patients, 440 patients completed all the questionnaires throughout the follow-up. After PSM, 166 patients underwent LT, and 166 patients underwent TT were enrolled. The psychological distress and sleep quality of patients in the LT group remained relatively stable during the 6-month follow-up, but patients in the TT group may have faced greater sleep quality concerns in the longitudinal assessment. Additionally, the sleep quality of the TT group was also worse than that of the LT group postoperatively.

Conclusions: The sleep quality rather than other psychological distress of patients with PTC with a low to intermediate risk of recurrence is associated with the extent of surgery.

目的:调查甲状腺叶切除术(LT)或全甲状腺切除术(TT)对复发风险为中低且肿瘤大小为1至4厘米的PTC患者的心理压力和睡眠质量的影响:本调查对 2021 年 7 月至 2022 年 7 月期间入住本院的患者进行了前瞻性登记。在住院、出院、治疗后 1、3 和 6 个月时使用有效量表评估心理困扰和睡眠质量。参与者被分为LT组和TT组,并采用倾向得分匹配法(PSM)进行分析:在 525 名符合条件的 PTC 患者中,有 440 名患者在整个随访期间完成了所有问卷调查。经过倾向得分匹配后,166 名患者接受了 LT 治疗,166 名患者接受了 TT 治疗。在 6 个月的随访中,LT 组患者的心理压力和睡眠质量保持相对稳定,但 TT 组患者在纵向评估中可能面临更大的睡眠质量问题。此外,TT 组术后的睡眠质量也比 LT 组差:结论:中低复发风险的PTC患者的睡眠质量而非其他心理困扰与手术程度有关。
{"title":"Psychological impacts of lobectomy and total thyroidectomy in PTC measuring 1 to 4 cm with low to intermediate risk of recurrence.","authors":"Ziyang Ye, Lanlan Wang, Genpeng Li, Pan Zhang, Tao Wei, Jingqiang Zhu, Zhihui Li, Jianyong Lei, Juxiang Gou, Huairong Tang","doi":"10.1007/s12020-024-03893-2","DOIUrl":"10.1007/s12020-024-03893-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the implications of Lobectomy (LT) or total thyroidectomy (TT) on psychological distress and sleep quality in PTC patients with a low to intermediate risk of recurrence and tumors measuring 1 to 4 cm.</p><p><strong>Methods: </strong>Patients who were admitted to our hospital between July 2021 and July 2022 were prospectively enrolled in this survey. Psychological distress and sleep quality were assessed at hospitalization, discharge, and 1, 3, and 6 months post-treatment using validated scales. Participants were divided into LT and TT groups, with propensity score matching (PSM) applied for analyses.</p><p><strong>Results: </strong>Among 525 eligible PTC patients, 440 patients completed all the questionnaires throughout the follow-up. After PSM, 166 patients underwent LT, and 166 patients underwent TT were enrolled. The psychological distress and sleep quality of patients in the LT group remained relatively stable during the 6-month follow-up, but patients in the TT group may have faced greater sleep quality concerns in the longitudinal assessment. Additionally, the sleep quality of the TT group was also worse than that of the LT group postoperatively.</p><p><strong>Conclusions: </strong>The sleep quality rather than other psychological distress of patients with PTC with a low to intermediate risk of recurrence is associated with the extent of surgery.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"682-691"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuous glucose monitoring profile in COVID-19 patients with and without diabetes receiving methylprednisolone. 接受甲基强的松龙治疗的 COVID-19 型糖尿病患者和非糖尿病患者的连续血糖监测概况。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-05-31 DOI: 10.1007/s12020-024-03841-0
Xingxing He, Guangchen Duan, Jingyi Lu, Yaxin Wang, Jinghao Cai, Yiqing Tong, Wei Wu, Xiaojing Ma, Qiming Feng, Jian Zhou

Purpose: Methylprednisolone is widely used during the COVID-19 epidemic. We aimed to evaluate the glucose profile of COVID-19 patients with and without diabetes receiving methylprednisolone.

Methods: 36 patients with COVID-19 admitted to hospital were included: 17 with and 19 without diabetes. Methylprednisolone 40 mg was administered at about 9:00 a.m. Glucose levels were assessed by blinded intermittently scanned continuous glucose monitoring (isCGM) for an average of 6.8 ± 2.4 days. Excess hyperglycemia was defined as time above range (TAR) > 10.0 mmol/L (TAR>10.0) ≥ 25%, or TAR > 13.9 mmol/L (TAR>13.9) ≥ 10%.

Results: Glucose management indicator (GMI) was significantly higher than the admission glycated hemoglobin A1c (HbA1c) level in patients without diabetes [6.7 (6.1-7.0) % vs. 5.9 (5.9-6.1) %, P < 0.001], while no significant difference was found in patients with diabetes [9.0 (7.5-9.5) % vs. 8.9 (7.5-10.2) %, P > 0.05]. The difference between GMI and HbA1c (∆GMI-HbA1c) in patients without diabetes was significantly higher than in patients with diabetes [0.7 (0.2-1.0) % vs. -0.2 (-1.5-0.5) %, P = 0.005]. The circadian patterns of glucose were similar in the two groups. In patients without diabetes, excess hyperglycemia occurred in 31.6% (6/19) of participants, with 31.6% (6/19) having a TAR>10.0 ≥ 25%, while 21.1% (4/19) had a TAR>13.9 ≥ 10%.

Conclusion: The impact of methylprednisolone on glycemia was more pronounced in COVID-19 patients without diabetes, compared to those with diabetes. A significant burden of methylprednisolone-induced hyperglycemia was observed in patients without diabetes.

目的:甲基强的松龙在COVID-19流行期间被广泛使用。我们旨在评估接受甲基强的松龙治疗的 COVID-19 患者的血糖情况:方法:纳入36名住院的COVID-19患者:17名糖尿病患者和19名非糖尿病患者。通过盲法间歇扫描连续血糖监测(isCGM)评估血糖水平,平均为 6.8 ± 2.4 天。过量高血糖的定义是超过量程时间(TAR)> 10.0 mmol/L (TAR>10.0) ≥ 25%,或 TAR>13.9 mmol/L (TAR>13.9) ≥ 10%:无糖尿病患者的血糖管理指标(GMI)明显高于入院时的糖化血红蛋白 A1c(HbA1c)水平[6.7 (6.1-7.0) % vs. 5.9 (5.9-6.1) %,P 0.05]。无糖尿病患者的 GMI 与 HbA1c 之间的差异(∆GMI-HbA1c)明显高于糖尿病患者[0.7 (0.2-1.0) % vs. -0.2 (-1.5-0.5) %,P = 0.005]。两组患者的昼夜血糖模式相似。在无糖尿病的患者中,31.6%(6/19)的参与者出现过量高血糖,其中 31.6%(6/19)的 TAR>10.0 ≥ 25%,而 21.1%(4/19)的 TAR>13.9 ≥ 10%:结论:与糖尿病患者相比,甲基强的松龙对 COVID-19 患者血糖的影响更为明显。在无糖尿病的患者中,观察到甲基强的松龙诱发的高血糖负担很重。
{"title":"Continuous glucose monitoring profile in COVID-19 patients with and without diabetes receiving methylprednisolone.","authors":"Xingxing He, Guangchen Duan, Jingyi Lu, Yaxin Wang, Jinghao Cai, Yiqing Tong, Wei Wu, Xiaojing Ma, Qiming Feng, Jian Zhou","doi":"10.1007/s12020-024-03841-0","DOIUrl":"10.1007/s12020-024-03841-0","url":null,"abstract":"<p><strong>Purpose: </strong>Methylprednisolone is widely used during the COVID-19 epidemic. We aimed to evaluate the glucose profile of COVID-19 patients with and without diabetes receiving methylprednisolone.</p><p><strong>Methods: </strong>36 patients with COVID-19 admitted to hospital were included: 17 with and 19 without diabetes. Methylprednisolone 40 mg was administered at about 9:00 a.m. Glucose levels were assessed by blinded intermittently scanned continuous glucose monitoring (isCGM) for an average of 6.8 ± 2.4 days. Excess hyperglycemia was defined as time above range (TAR) > 10.0 mmol/L (TAR<sub>>10.0</sub>) ≥ 25%, or TAR > 13.9 mmol/L (TAR<sub>>13.9</sub>) ≥ 10%.</p><p><strong>Results: </strong>Glucose management indicator (GMI) was significantly higher than the admission glycated hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) level in patients without diabetes [6.7 (6.1-7.0) % vs. 5.9 (5.9-6.1) %, P < 0.001], while no significant difference was found in patients with diabetes [9.0 (7.5-9.5) % vs. 8.9 (7.5-10.2) %, P > 0.05]. The difference between GMI and HbA<sub>1c</sub> (∆GMI-HbA<sub>1c</sub>) in patients without diabetes was significantly higher than in patients with diabetes [0.7 (0.2-1.0) % vs. -0.2 (-1.5-0.5) %, P = 0.005]. The circadian patterns of glucose were similar in the two groups. In patients without diabetes, excess hyperglycemia occurred in 31.6% (6/19) of participants, with 31.6% (6/19) having a TAR<sub>>10.0</sub> ≥ 25%, while 21.1% (4/19) had a TAR<sub>>13.9</sub> ≥ 10%.</p><p><strong>Conclusion: </strong>The impact of methylprednisolone on glycemia was more pronounced in COVID-19 patients without diabetes, compared to those with diabetes. A significant burden of methylprednisolone-induced hyperglycemia was observed in patients without diabetes.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"556-563"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of gastric electrical rhythm in patients with type 2 diabetes mellitus. 分析 2 型糖尿病患者的胃电节律。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-06-11 DOI: 10.1007/s12020-024-03908-y
Xixi Wang, Lianhua Ma, Miao Jiang, Hong Zhu, Chendong Ni, Xiaohua Yang, Ji Hu, Hong-Hong Zhang

Aim: To analysis the change of electrogastrogram (EGG) in patients with type 2 diabetes mellitus (T2DM), and evaluate the prevalence of abnormal gastric electrical rhythm (AGER) and its relative influencing factors.

Methods: A total of 65 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from Dec. 2020 to Dec. 2021 were included in the cross-sectional study. General information, clinical data, and medical history data of all study subjects, including name, gender, body mass index (BMI), duration of diabetes, anti-diabetic therapies, high blood pressure (HBP) history, smoking history, and medication history, were completely collected. The results of laboratory tests, including biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2 h postprandial C-peptide, 24 h urine total protein (24 hUTP), urine microalbumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were recorded. EGG, Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying ultrasound, fundus examination, carotid artery ultrasonography, cardiac autonomic function test, heart rate variability (HRV) were all examined and recorded as well. According to the results of EGG, the subjects were divided into normal gastric electrical rhythm (NGER) group and abnormal gastric electrical rhythm (AGER) group.

Results: (1) Fasting blood glucose (FBG), HbA1c, the presence of diabetic peripheral neuropathy (DPN) and diabetic cardiac autonomic neuropathy (DCAN) were significantly higher in the AGER group (p < 0.05). Low frequency (LF) and high frequency (HF), the indicators of HRV, were significantly lower in the AGER group (p < 0.05). In addition, the prevalence of feeling excessively full after meals, loss of appetite, and stomach or belly visibly larger after meals of gastrointestinal symptoms of gastroparesis were significantly higher in the AGER group (p < 0.05). Multiple logistic regression analysis showed that FBG and the prevalence of DCAN were the independent risk factors.

Conclusion: AGER was associated with high FBG and the presence of DCAN. EGG examination is recommended for patients with gastrointestinal symptoms and clues of DCAN.

目的:分析2型糖尿病(T2DM)患者胃电图(EGG)的变化,评估异常胃电节律(AGER)的发生率及其相关影响因素:方法:纳入2020年12月至2021年12月在苏州大学附属第二医院住院治疗的65例T2DM患者。完整收集所有研究对象的一般信息、临床数据和病史数据,包括姓名、性别、体重指数(BMI)、糖尿病病程、抗糖尿病治疗、高血压(HBP)史、吸烟史和用药史。此外,还记录了实验室检查结果,包括生化指标、糖化血红蛋白(HbA1c)、空腹血糖肽、餐后 2 小时血糖肽、24 小时尿总蛋白(24 hUTP)、尿微量白蛋白肌酐比值(UACR)和估计肾小球滤过率(eGFR)。此外,还检查并记录了 EGG、胃痉挛卡迪纳尔症状指数(GCSI)、胃排空超声、眼底检查、颈动脉超声、心脏自主神经功能测试、心率变异性(HRV)。结果:(1) AGER 组的空腹血糖(FBG)、HbA1c、糖尿病周围神经病变(DPN)和糖尿病心脏自主神经病变(DCAN)均显著升高(p 结论:AGER 与空腹血糖(FBG)、HbA1c、糖尿病周围神经病变(DPN)和糖尿病心脏自主神经病变(DCAN)相关:AGER 与高 FBG 和出现 DCAN 相关。建议对有胃肠道症状和 DCAN 线索的患者进行 EGG 检查。
{"title":"Analysis of gastric electrical rhythm in patients with type 2 diabetes mellitus.","authors":"Xixi Wang, Lianhua Ma, Miao Jiang, Hong Zhu, Chendong Ni, Xiaohua Yang, Ji Hu, Hong-Hong Zhang","doi":"10.1007/s12020-024-03908-y","DOIUrl":"10.1007/s12020-024-03908-y","url":null,"abstract":"<p><strong>Aim: </strong>To analysis the change of electrogastrogram (EGG) in patients with type 2 diabetes mellitus (T2DM), and evaluate the prevalence of abnormal gastric electrical rhythm (AGER) and its relative influencing factors.</p><p><strong>Methods: </strong>A total of 65 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from Dec. 2020 to Dec. 2021 were included in the cross-sectional study. General information, clinical data, and medical history data of all study subjects, including name, gender, body mass index (BMI), duration of diabetes, anti-diabetic therapies, high blood pressure (HBP) history, smoking history, and medication history, were completely collected. The results of laboratory tests, including biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2 h postprandial C-peptide, 24 h urine total protein (24 hUTP), urine microalbumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were recorded. EGG, Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying ultrasound, fundus examination, carotid artery ultrasonography, cardiac autonomic function test, heart rate variability (HRV) were all examined and recorded as well. According to the results of EGG, the subjects were divided into normal gastric electrical rhythm (NGER) group and abnormal gastric electrical rhythm (AGER) group.</p><p><strong>Results: </strong>(1) Fasting blood glucose (FBG), HbA1c, the presence of diabetic peripheral neuropathy (DPN) and diabetic cardiac autonomic neuropathy (DCAN) were significantly higher in the AGER group (p < 0.05). Low frequency (LF) and high frequency (HF), the indicators of HRV, were significantly lower in the AGER group (p < 0.05). In addition, the prevalence of feeling excessively full after meals, loss of appetite, and stomach or belly visibly larger after meals of gastrointestinal symptoms of gastroparesis were significantly higher in the AGER group (p < 0.05). Multiple logistic regression analysis showed that FBG and the prevalence of DCAN were the independent risk factors.</p><p><strong>Conclusion: </strong>AGER was associated with high FBG and the presence of DCAN. EGG examination is recommended for patients with gastrointestinal symptoms and clues of DCAN.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"612-619"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Androgen-induced upregulation of CFTR in pancreatic β-cell contributes to hyperinsulinemia in PCOS model. 更正:雄激素诱导的胰腺β细胞 CFTR 上调导致多囊卵巢综合征模型出现高胰岛素血症。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 DOI: 10.1007/s12020-024-03821-4
Mengzhu Sun, Yong Wu, Chun Yuan, Jingya Lyu, Xinyi Zhao, Ye Chun Ruan, Jinghui Guo, Hui Chen, Wen Qing Huang
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引用次数: 0
BMI z-score as a prognostic factor for height velocity in children treated with recombinant human growth hormone due to idiopathic growth hormone deficiency. 将 BMI z 分数作为因特发性生长激素缺乏症而接受重组人生长激素治疗的儿童身高速度的预后因素。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-08-06 DOI: 10.1007/s12020-024-03984-0
Joanna Budzulak, Katarzyna Anna Majewska, Andrzej Kędzia

Purpose: Growth hormone deficiency (GHD) causes growth disturbances during childhood. The most recommended treatment of GHD is the administration of recombinant human growth hormone (rhGH). Recent studies have proved that well-nourished GHD children respond better to rhGH therapy compared to undernourished individuals. The aim of this study was to analyze nutritional status along with height velocity in GHD children during the first two years of rhGH therapy, and to estimate the optimal BMI z-score range in which these children achieve the best growth results.

Methods: This retrospective analysis included 80 prepubertal idiopathic GHD children treated with rhGH. Anthropometric data were obtained from medical records made at an initial visit and then follow-up visits after 12 and 24 months of treatment. The body mass index (BMI) was calculated and standardized into z-score, basing on Cole's LMS method. Then, the BMI z-score was analyzed in relation to the parameters of growth response.

Results: The higher the BMI z-score at treatment entry, the greater the increase in height during the first twelve months of rhGH therapy. BMI z-score ≥0 noted at the beginning of each year of the treatment are associated with significantly better growth increments throughout the first and the second years of the therapy.

Conclusion: Prepubertal idiopathic GHD children with BMI z-score below 0 would probably benefit from the improvement of their nutritional status prior to the rhGH treatment beginning. It seems that increasing BMI z-score to obtain values between 0 and 1 would be optimal for the growth process.

目的:生长激素缺乏症(GHD)会导致儿童生长障碍。治疗生长激素缺乏症最推荐的方法是使用重组人生长激素(rhGH)。最近的研究证明,与营养不良的儿童相比,营养良好的 GHD 儿童对 rhGH 治疗的反应更好。本研究的目的是分析GHD儿童在接受rhGH治疗的头两年中的营养状况和身高速度,并估算这些儿童获得最佳生长效果的最佳BMI z分数范围:这项回顾性分析包括80名接受rhGH治疗的青春期前特发性GHD儿童。人体测量数据来自首次就诊时的医疗记录,以及治疗12个月和24个月后的随访记录。根据科尔的LMS方法,计算出身体质量指数(BMI),并将其标准化为z-score。然后,分析体重指数 z 值与生长反应参数的关系:结果:开始治疗时的体重指数z-分数越高,在接受rhGH治疗的前12个月中身高增长越快。每年治疗开始时的BMI z-score≥0与治疗第一年和第二年的显著增高有关:结论:BMI z-score低于0的青春期前特发性GHD儿童可能会在开始rhGH治疗前从营养状况的改善中受益。看来,将体重指数z-score提高到0到1之间的数值对生长过程是最理想的。
{"title":"BMI z-score as a prognostic factor for height velocity in children treated with recombinant human growth hormone due to idiopathic growth hormone deficiency.","authors":"Joanna Budzulak, Katarzyna Anna Majewska, Andrzej Kędzia","doi":"10.1007/s12020-024-03984-0","DOIUrl":"10.1007/s12020-024-03984-0","url":null,"abstract":"<p><strong>Purpose: </strong>Growth hormone deficiency (GHD) causes growth disturbances during childhood. The most recommended treatment of GHD is the administration of recombinant human growth hormone (rhGH). Recent studies have proved that well-nourished GHD children respond better to rhGH therapy compared to undernourished individuals. The aim of this study was to analyze nutritional status along with height velocity in GHD children during the first two years of rhGH therapy, and to estimate the optimal BMI z-score range in which these children achieve the best growth results.</p><p><strong>Methods: </strong>This retrospective analysis included 80 prepubertal idiopathic GHD children treated with rhGH. Anthropometric data were obtained from medical records made at an initial visit and then follow-up visits after 12 and 24 months of treatment. The body mass index (BMI) was calculated and standardized into z-score, basing on Cole's LMS method. Then, the BMI z-score was analyzed in relation to the parameters of growth response.</p><p><strong>Results: </strong>The higher the BMI z-score at treatment entry, the greater the increase in height during the first twelve months of rhGH therapy. BMI z-score ≥0 noted at the beginning of each year of the treatment are associated with significantly better growth increments throughout the first and the second years of the therapy.</p><p><strong>Conclusion: </strong>Prepubertal idiopathic GHD children with BMI z-score below 0 would probably benefit from the improvement of their nutritional status prior to the rhGH treatment beginning. It seems that increasing BMI z-score to obtain values between 0 and 1 would be optimal for the growth process.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"782-789"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Endocrine
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