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Diabetes exerts a causal impact on the nervous system within the right hippocampus: substantiated by genetic data. 糖尿病对右侧海马体的神经系统产生因果影响:遗传数据证实了这一点。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 DOI: 10.1007/s12020-024-04081-y
Qian Long, Piao Huang, Jian Kuang, Yu Huang, Haixia Guan

Introduction: Diabetes and neuronal loss in the hippocampus have been observed to be correlated in several studies; however, the exact causality of this association remains uncertain. This study aims to explore the potential causal relationship between diabetes and the hippocampal nervous system.

Methods: We utilized the two-sample Mendelian randomization (MR) analysis to investigate the potential causal connection between diabetes and the hippocampal nervous system. The summary statistics of Genome-wide association study (GWAS) for diabetes and hippocampus neuroimaging measurement were acquired from published GWASs, all of which were based on European ancestry. Several two-sample MR analyses were conducted in this study, utilizing inverse-variance weighted (IVW), MR Egger, and Weight-median methods. To ensure the reliability of the results and identify any horizontal pleiotropy, sensitivity analyses were undertaken using Cochran's Q test and the MR-PRESSO global test.

Results: Causal associations were found between diabetes and the nervous system in the hippocampus. Type 1 and type 2 diabetes were both identified as having adverse causal connections with the right hippocampal nervous system. This was supported by specific ranges of IVW-OR values (P < 0.05). The consistency of the sensitivity analyses further reinforced the main findings, revealing no significant heterogeneity or presence of horizontal pleiotropy.

Conclusions: This study delved into the causal associations between diabetes and the hippocampal nervous system, revealing that both type 1 and type 2 diabetes have detrimental effects on the right hippocampal nervous system. Our findings have significant clinical implications as they indicate that diabetes may play a role in the decline of neurons in the right hippocampus among European populations, often resulting in cognitive decline.

引言多项研究发现,糖尿病与海马神经元的缺失存在相关性;然而,这种相关性的确切因果关系仍不确定。本研究旨在探讨糖尿病与海马神经系统之间的潜在因果关系:我们利用双样本孟德尔随机分析法(MR)研究糖尿病与海马神经系统之间的潜在因果关系。我们从已发表的全基因组关联研究(GWAS)中获取了糖尿病和海马神经影像测量的汇总统计数据,这些数据均基于欧洲血统。本研究采用反方差加权法(IVW)、MR Egger 法和权重中值法进行了多项双样本 MR 分析。为确保结果的可靠性并确定是否存在横向多效性,使用科克伦 Q 检验和 MR-PRESSO 全局检验进行了敏感性分析:结果:糖尿病与海马神经系统之间存在因果关系。1型和2型糖尿病均被认定与右侧海马神经系统有不利的因果关系。IVW-OR值的特定范围(P 结论)证实了这一点:本研究深入探讨了糖尿病与海马神经系统之间的因果关系,发现 1 型和 2 型糖尿病都会对右侧海马神经系统产生不利影响。我们的研究结果具有重要的临床意义,因为它们表明,在欧洲人群中,糖尿病可能是导致右侧海马神经元衰退的原因之一,而这种衰退往往会导致认知能力下降。
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引用次数: 0
The related factors affecting the relationship between HbA1c and glucose management indicator in adult T2D patients with good glycemic control. 影响血糖控制良好的成年 T2D 患者 HbA1c 与血糖管理指标之间关系的相关因素。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-30 DOI: 10.1007/s12020-024-04083-w
Zhigu Liu, Beisi Lin, Danrui Chen, Yanling Yang, Wei Jiang, Daizhi Yang, Jinhua Yan, Bin Yao, Xubin Yang, Wen Xu

Purpose: To explore the relationship between glucose management indicator (GMI) and HbA1c and find the affecting factors in adult T2D patients with good glycemic control.

Methods: Adult T2D patients with both HbA1c < 7% and time in range (TIR) > 70% were retrospectively analyzed. A significant difference between GMI and HbA1c was defined as an absolute value of hemoglobin glycation index (|HGI|, HbA1c minus GMI) ≥ 0.5%. Factors associated with high |HGI| were determined by logistic regression analysis. The performance of possible factors in predicting high |HGI| was verified by ROC curve analysis. And the linear relationship between GMI and HbA1c was also investigated.

Results: Of all the 94 patients (median HbA1c 6.18%, mean GMI 6.34%) included, 28.72% had an |HGI | ≥ 0.5% and only 15.96% had an |HGI | < 0.1%. Standard deviation of blood glucose (SDBG), a glycemic variability index, affected |HGI| (OR = 3.980, P = 0.001), and showed the best performance in predicting high |HGI| (AUC = 0.712, cutoff value = 1.63 mmol/L, P = 0.001). HbA1c was linearly correlated with GMI (β = 0.295, P = 0.004). Their correlation weakened after further adjusting for SDBG (β = 0.232, P = 0.012). Linear correlation between them was closer in patients with smaller SDBG ( < 1.63 mmol/L) than those with larger SDBG (P = 0.004).

Conclusions: Even in adult T2D patients with good glycemic control, the discrepancy between GMI and HbA1c existed. Their relationship was affected by glycemic variability. SDBG mainly accounted for this consequence.

Trial registration: Chinese clinical trial registry ( www.chictr.org.cn ), ChiCTR2000034884, 2020-07-23.

目的:探讨血糖管理指标(GMI)与 HbA1c 的关系,并找出血糖控制良好的成年 T2D 患者的影响因素:对 HbA1c 均为 70% 的成年 T2D 患者进行回顾性分析。血红蛋白糖化指数(|HGI|,HbA1c 减去血红蛋白糖化指数)的绝对值≥ 0.5%即为血红蛋白糖化指数与 HbA1c 之间存在明显差异。通过逻辑回归分析确定了与高|HGI|相关的因素。通过 ROC 曲线分析验证了可能的因素在预测高 HGI 方面的性能。此外,还研究了 GMI 与 HbA1c 之间的线性关系:结果:在纳入的所有 94 名患者(中位数 HbA1c 6.18%,平均 GMI 6.34%)中,28.72% 的患者 HGI ≥ 0.5%,只有 15.96% 的患者 HGI ≥ 0.5%:即使在血糖控制良好的成年 T2D 患者中,GMI 和 HbA1c 之间也存在差异。它们之间的关系受到血糖变化的影响。SDBG是造成这一结果的主要原因:中国临床试验注册中心 ( www.chictr.org.cn ), ChiCTR2000034884, 2020-07-23.
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引用次数: 0
Autoimmune thyroiditis incidence in a large population-based study in northeastern Italy. 意大利东北部一项大型人群研究中的自身免疫性甲状腺炎发病率。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-29 DOI: 10.1007/s12020-024-04072-z
Simona Censi, Laura Salmaso, Filippo Ceccato, Fiammetta Battheu, Cristina Clausi, Ilaria Piva, Ugo Fedeli, Loris Bertazza, Susi Barollo, Mario Saia, Caterina Mian

Purpose: An improvement in iodine status in the Veneto region (Italy) in the last decade has been documented. Our aim was to estimate the incidence of autoimmune thyroiditis (AT) in this region over the period 2012-2022.

Methods: A retrospective population-based study conducted in Veneto using the population registry and administrative health databases. We documented incident hyperthyroidism from 2013 to 2022 to exclude prevalent cases and calculated standardised incidence rates (IR) per 10,000 person-years by age and sex.

Results: We identified 65,379 incident cases (IR: 13.38), 5.44-fold higher in females than in males. IR decreased from 15.86 (95% CI: 15.50, 16.21) in 2013 to 12.35 (95% CI: 12.04, 12.67) in 2022. The decline was evident only in females, with a documented reduction in IR from 27.26 (95% CI: 26.61, 27.91) in 2013 to 20.49 (95% CI: 19.92, 21.07) in 2022 (P = 0.002). The decrease was sharper in females aged 15-54 years (IR from 37.86 (95%CI: 36.79, 38.94) in 2013 to 27.40 (95% CI: 26.44, 28.36) in 2022; P < 0.001) than in those aged ≥55 years (IR from 20.06 (95% CI: 19.13, 20.99) in 2013 to 16.56 (95% CI: 15.78, 17.35) in 2022; P = 0.034). In 2020, an out-of-trend decrease in AT incidence was documented, corresponding with the SARS-CoV-2 pandemic, with a realignment to the trend in the subsequent years.

Conclusions: A decline in AT was documented in the Veneto region in the last decade, paralleling improvement in the iodine status. The reduction was significant only among females, particularly in reproductive age.

目的:过去十年中,威尼托大区(意大利)的碘状况有所改善。我们的目的是估算2012-2022年间该地区自身免疫性甲状腺炎(AT)的发病率:在威尼托进行的一项基于人口的回顾性研究使用了人口登记和行政健康数据库。我们记录了2013年至2022年期间发生的甲状腺机能亢进症,排除了流行病例,并按年龄和性别计算了每万人年的标准化发病率(IR):我们发现了65379例发病病例(IR:13.38),女性发病率是男性的5.44倍。IR从2013年的15.86(95% CI:15.50,16.21)下降到2022年的12.35(95% CI:12.04,12.67)。只有女性的 IR 下降明显,从 2013 年的 27.26(95% CI:26.61, 27.91)下降到 2022 年的 20.49(95% CI:19.92, 21.07)(P = 0.002)。15-54 岁女性的下降幅度更大(IR 从 2013 年的 37.86(95%CI:36.79, 38.94)下降到 2022 年的 27.40(95%CI:26.44, 28.36);P 结论:过去十年中,威尼托大区的甲状腺肿大有所下降,同时碘状况也有所改善。只有女性,尤其是育龄女性的碘摄入量明显下降。
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引用次数: 0
Proangiogenic effect of thyrotropin receptor stimulating antibody in human umbilical vein endothelial cells. 促甲状腺激素受体刺激抗体在人脐静脉内皮细胞中的促血管生成作用。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-25 DOI: 10.1007/s12020-024-04048-z
Yue Yuan, Xingjia Li, Wenjing Ni, Wenbin Huang, Guofang Chen, Shuhang Xu, Chao Liu

Objective: This study aims to investigate the role of TRAb in the angiogenesis associated with Graves' disease (GD) and to elucidate its underlying mechanisms.

Methods: Human thyroid follicular epithelial cells (Nthy-ori 3-1) and human umbilical vein endothelial cells (HUVECs) were treated with the monoclonal thyroid-stimulating antibody M22 and thyroid-stimulating hormone (TSH) at various concentrations. Cell viability, migration, and tube formation were evaluated using CCK-8, wound healing, and tube formation assays, respectively. Protein expressions of TSHR receptor (TSHR) and phosphorylated AKT (p-AKT) in M22-induced HUVECs were quantified via Western blotting. Proteomic analysis was employed to identify changes in protein expression profiles and relevant signaling pathways in GD specimens. Immunofluorescence assays were conducted to detect and localize the expressions of CD34 and PROX1 in GD specimens and normal thyroid tissues.

Results: M22 stimulated the proliferation of Nthy-ori 3-1 cells and HUVECs in a dose-dependent manner, while TSH exhibited an inverted U-shaped dose-response effect. M22 also dose-dependently promoted angiogenesis, and more effectively induced tube formation in HUVECs compared to TSH, although the difference was not statistically significant. A total of 16 proteins were significantly upregulated and 24 were downregulated in M22-induced HUVECs. Notably, PROX1, the most significantly upregulated protein, is closely associated with angiogenesis. Immunofluorescence confirmed that PROX1 was significantly more expressed in thyroid tissues from GD patients compared to normal tissues adjacent to papillary thyroid cancer (PTC), and it co-localized with CD34.

Conclusion: TRAb enhances angiogenesis and upregulates PROX1 expression in HUVECs, suggesting a novel possible mechanism for goiter formation in GD.

研究目的方法:用不同浓度的单克隆促甲状腺抗体M22和促甲状腺激素(TSH)处理人甲状腺滤泡上皮细胞(Nthy-ori 3-1)和人脐静脉内皮细胞(HUVECs)。分别使用 CCK-8、伤口愈合和管形成试验评估细胞活力、迁移和管形成。通过 Western 印迹对 M22 诱导的 HUVEC 中 TSHR 受体(TSHR)和磷酸化 AKT(p-AKT)的蛋白表达进行量化。蛋白质组分析用于确定广东样本中蛋白质表达谱的变化和相关信号通路。免疫荧光试验检测了CD34和PROX1在GD标本和正常甲状腺组织中的表达:结果:M22以剂量依赖的方式刺激Nthy-ori 3-1细胞和HUVEC的增殖,而TSH表现出倒U形的剂量反应效应。M22 对血管生成也有剂量依赖性的促进作用,与 TSH 相比,M22 能更有效地诱导 HUVECs 中血管管的形成,但差异无统计学意义。在 M22 诱导的 HUVECs 中,共有 16 种蛋白质被显著上调,24 种被下调。值得注意的是,上调最明显的蛋白 PROX1 与血管生成密切相关。免疫荧光证实,与邻近甲状腺乳头状癌(PTC)的正常组织相比,PROX1在GD患者甲状腺组织中的表达明显增加,并且与CD34共定位:结论:TRAb可促进血管生成并上调HUVECs中PROX1的表达,这可能是GD患者甲状腺肿形成的一种新机制。
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引用次数: 0
Combined LT3 and LT4 therapy for precision medicine: easier with TTCombo system. LT3和LT4联合疗法用于精准医疗:使用TTCombo系统更轻松。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-25 DOI: 10.1007/s12020-024-04084-9
Elisa Gatta, Salvatore Ippolito, Carlo Cappelli

Hypothyroidism is typically treated with levothyroxine monotherapy. However, despite normalized serum thyroid-stimulating hormone levels, 5-10% of patients continue to experience persistent symptoms, raising concerns about the adequacy of thyroxine monotherapy. Combination therapy with levothyroxine and liothyronine has been proposed as an alternative, but it presents practical challenges, including dosing complexity, the short half-life of triiodothyronine, increased monitoring requirements, and potential adverse effects. Moreover, there is no clear consensus within the medical community regarding the superiority of combination therapy over levothyroxine monotherapy, although some studies indicate potential benefits in specific patient populations. Genetic factors, such as polymorphisms in the DIO2 gene, may influence individual responses to therapy, further complicating treatment. To address the limitations of combination therapy, we propose a novel approach: TTCombo. This digital health technology delivers personalized doses of levothyroxine and liothyronine, improving treatment adherence and optimizing outcomes. By providing individualized, physiologically tailored hormone replacement, TTCombo has the potential to revolutionize hypothyroidism management and enhance patient quality of life.

甲状腺功能减退症通常采用左甲状腺素单药治疗。然而,尽管血清促甲状腺激素水平已恢复正常,但仍有5%-10%的患者症状持续存在,这不禁让人担心甲状腺素单一疗法是否足够。有人提出用左甲状腺素和利奥甲状腺原氨酸联合治疗作为替代方案,但这一方案面临着实际挑战,包括用药复杂、三碘甲状腺原氨酸半衰期短、监测要求增加以及潜在的不良反应。此外,虽然一些研究表明联合疗法对特定患者群体有潜在益处,但对于联合疗法是否优于左甲状腺素单药疗法,医学界尚未达成明确共识。遗传因素(如 DIO2 基因的多态性)可能会影响个体对治疗的反应,从而使治疗更加复杂。为了解决联合疗法的局限性,我们提出了一种新方法:TTCombo。这种数字健康技术可提供个性化剂量的左甲状腺素和甲状腺原氨酸,从而提高治疗依从性并优化治疗效果。TTCombo 可提供个性化、符合生理特点的激素替代品,有望彻底改变甲状腺功能减退症的治疗方法,提高患者的生活质量。
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引用次数: 0
Co-expression of multiple transcription factors is associated with clinical features and endocrine prognosis in growth hormone-secreting pituitary adenomas. 多种转录因子的共同表达与分泌生长激素的垂体腺瘤的临床特征和内分泌预后有关。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-25 DOI: 10.1007/s12020-024-04082-x
Yu Zhang, Hanlu Tang, Shiwei Li, Zhixu Bie, Xin Ma, Hongyu Wu, Gemingtian Liu, Xingchao Wang, Pinan Liu, Zhijun Yang

Background: The types of growth hormone-secreting pituitary adenomas are diverse, we have found that there are significant differences in clinical features and prognosis between PIT-1 single-cell spectrum growth hormone adenomas and growth hormone phenotypic polyhormonal adenomas.

Methods: This study examined a cohort of 193 patients with growth hormone-secreting pituitary adenoma (GHPA), stratifying them into two groups: PIT-1 single transcription factor positive growth hormone adenoma (STF-GHPA) and Multiple transcription factor-positive growth hormone-secreting adenomas (MTF-GHPA). The objective was to compare these two groups' clinical characteristics. Within the MTF-GHPA group, we further subtyped them based on transcription factors to evaluate potential variations in clinical manifestations. Logistic regression analyses were employed to develop a risk factor model for investigating factors influencing hormone remission.

Results: There were no statistically significant differences in terms of age, gender, serum GH, and IGF-1 levels between patients diagnosed with MTF-GHPA and STF-GHPA. However, patients with MTF-GHPA exhibited a higher proportion of hypopituitarism compared to those with STF-GHPA. Furthermore, MTF-GHPA were characterized by smaller tumor size and less invasiveness, as indicated by lower Knosp classes. However, patients with MTF-GHPA have a lower rate of hormonal remission (30.8%) and more postoperative complications (31.0%), which means that STF-GHPA (hormonal remission:71.6%; postoperative complications:13.4%) has a better endocrine outcome than MTF-GHPA patients. Between the PIT-1 + SF-1+ and PIT-1 + TPIT+ subtypes within MTF-GHPA, significant differences were also observed in tumor size, endocrine outcomes, and postoperative complications. Risk factors influencing hormonal remission for GHPA included preoperative GH level, primary/recurrent, extent of resection, and transcription factor expression.

Conclusion: Co-expression of multiple transcription factors is an important factor associated with clinical behavior and endocrine outcomes in patients with GHPA.

背景:分泌生长激素的垂体腺瘤类型多种多样,我们发现PIT-1单细胞谱生长激素腺瘤与生长激素表型多激素腺瘤在临床特征和预后方面存在显著差异:本研究对193例生长激素分泌型垂体腺瘤(GHPA)患者进行了研究,将其分为两组:PIT-1单转录因子阳性生长激素腺瘤(STF-GHPA)和多转录因子阳性生长激素分泌腺瘤(MTF-GHPA)。目的是比较这两组肿瘤的临床特征。在 MTF-GHPA 组中,我们根据转录因子对其进行了进一步细分,以评估临床表现的潜在差异。我们采用逻辑回归分析建立了一个风险因素模型,用于研究影响激素缓解的因素:结果:被诊断为MTF-GHPA和STF-GHPA的患者在年龄、性别、血清GH和IGF-1水平方面均无统计学差异。然而,与 STF-GHPA 患者相比,MTF-GHPA 患者垂体功能减退的比例更高。此外,MTF-GHPA 的特点是肿瘤体积较小,侵袭性较低,Knosp 分级也较低。然而,MTF-GHPA 患者的激素缓解率较低(30.8%),术后并发症较多(31.0%),这意味着 STF-GHPA (激素缓解率:71.6%;术后并发症:13.4%)的内分泌疗效优于 MTF-GHPA 患者。在MTF-GHPA中的PIT-1 + SF-1+亚型和PIT-1 + TPIT+亚型之间,肿瘤大小、内分泌疗效和术后并发症也存在显著差异。影响GHPA激素缓解的风险因素包括术前GH水平、原发性/复发性、切除范围和转录因子表达:结论:多种转录因子的共同表达是与GHPA患者临床表现和内分泌结果相关的重要因素。
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引用次数: 0
Neutrophil-lymphocyte ratio is a predictor for all-cause and cardiovascular mortality in individuals with prediabetes in a National study. 在一项全国性研究中,中性粒细胞-淋巴细胞比率是糖尿病前期患者全因死亡率和心血管死亡率的预测因子。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-23 DOI: 10.1007/s12020-024-04075-w
Gaiying Dong, Xiaofan Gu, Chunhua Qiu, Yanlin Xie, Zhiwen Hu, Liangliang Wu

Purpose: We aimed to investigate the value of the neutrophil-lymphocyte ratio (NLR) in predicting the all-cause and cardiovascular mortality risk of individuals with prediabetes.

Methods: A total of 11,504 prediabetic patients from the National Health and Nutrition Examination Survey (NHANES) 2003-2016 were included in the present study. Mortality and the underlying cause of death were ascertained by linkage to National Death Index records through December 31, 2019. Restricted cubic spline (RCS) analysis was conducted to visualize the association between the NLR and mortality risk. The optimal NLR cutoff value corresponding to the most significant correlation with survival outcomes was calculated by the maximally selected rank statistics method (MSRSM). Weighted multivariable Cox regression models and subgroup analyses were used to calculate HRs and 95% CIs for all-cause and cardiovascular mortality.

Results: During a median follow-up of 101 months (interquartile range, 64.0-138.0 months), 1654 (14.38%) deaths were documented, including 422 (3.67%) and 1232 (10.71%) due to cardiovascular and non-cardiovascular events, respectively. RCS regression analysis indicated that the NLR was positively associated with all-cause and cardiovascular mortality. Individuals were divided into lower (≤2.94) and higher (>2.94) NLR groups using the MSRSM. In the multivariable-adjusted model, compared with the lower NLR group, the higher NLR group had a HR of 1.63 (95% CI, 1.38-1.93) and 2.19 (95% CI, 1.55-3.01) for all-cause and cardiovascular mortality, respectively.

Conclusions: The NLR was a valuable marker for predicting all-cause and cardiovascular mortality risk in prediabetic patients.

目的:我们旨在研究中性粒细胞-淋巴细胞比值(NLR)在预测糖尿病前期患者全因和心血管死亡风险方面的价值:本研究共纳入了 11504 名来自 2003-2016 年美国国家健康与营养调查(NHANES)的糖尿病前期患者。通过链接至2019年12月31日的国家死亡指数记录,确定了死亡率和基本死因。为了直观地显示 NLR 与死亡风险之间的关系,我们进行了限制性三次样条曲线(RCS)分析。通过最大选择秩统计法(MSRSM)计算出与生存结果相关性最显著的最佳NLR截断值。加权多变量 Cox 回归模型和亚组分析用于计算全因死亡率和心血管死亡率的 HRs 和 95% CIs:中位随访时间为 101 个月(四分位间范围为 64.0-138.0 个月),记录的死亡人数为 1654 人(14.38%),其中心血管事件和非心血管事件死亡人数分别为 422 人(3.67%)和 1232 人(10.71%)。RCS回归分析表明,NLR与全因死亡率和心血管死亡率呈正相关。使用 MSRSM 将个体分为 NLR 较低(≤2.94)和较高(>2.94)两组。在多变量调整模型中,与低NLR组相比,高NLR组的全因死亡率和心血管死亡率的HR分别为1.63(95% CI,1.38-1.93)和2.19(95% CI,1.55-3.01):NLR是预测糖尿病前期患者全因和心血管死亡风险的重要指标。
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引用次数: 0
COVID19 infection and vaccination and the risk of pituitary apoplexy: an entangled yarn. COVID19 感染和疫苗接种与垂体性脑瘫的风险:纠缠不清的纱线。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-21 DOI: 10.1007/s12020-024-04078-7
Alberto Ragni, Emilia Biamonte, Beatrice Cavigiolo, Edoardo Luigi Maria Mollero, Giulia Bendotti, Enrico Gabellieri, Paola Leporati, Marco Gallo

Purpose: Pituitary apoplexy (PA) has been increasingly reported in association with both infection from and vaccination for COVID19. Our aim was to analyse the available published cases and compare the clinical characteristics in the two groups (infection vs vaccination).

Methods: We systematically reviewed the published literature for all cases of PA associated with COVID19 infection or vaccination. We also presented two cases managed at our Centre.

Results: Collectively, fortythree cases were analysed. Patients with PA after COVID19 vaccination (n = 7), compared with patients with PA after COVID19 infection (n = 36), were significantly younger (p = 0.009) and had a more abrupt onset of PA (p = 0.022), but showed a milder hormonal involvement (p = 0.008) and a lower rate of persistent hypopituitarism during follow-up (p = 0.001). Patients in the vaccination group did not have clinical risk factors for PA, although this difference did not reach statistical significance.

Conclusions: PA associated with COVID19 is a rare but clinically significant entity, although pathophysiological details of this association are lacking. Given the significantly different clinical presentation, we could speculate that PA induced by COVID19 vaccination might represent a distinct clinical entity, with different pathophysiological mechanism, compared to PA from COVID19 infection.

目的:越来越多的报道显示,垂体性脑瘫(PA)与感染COVID19和接种COVID19疫苗有关。我们的目的是分析已发表的病例,并比较两组病例(感染与接种)的临床特征:我们系统回顾了已发表的文献中所有与 COVID19 感染或接种疫苗相关的 PA 病例。我们还介绍了本中心处理的两例病例:结果:共分析了 43 个病例。接种 COVID19 疫苗后出现 PA 的患者(n = 7)与感染 COVID19 后出现 PA 的患者(n = 36)相比,年龄明显更小(p = 0.009),发病更突然(p = 0.022),但激素受累程度较轻(p = 0.008),随访期间垂体功能持续减退的比例较低(p = 0.001)。接种疫苗组的患者没有PA的临床风险因素,但这一差异未达到统计学意义:结论:与 COVID19 相关的 PA 虽然罕见,但具有重要的临床意义,尽管这种关联的病理生理学细节尚不清楚。鉴于临床表现明显不同,我们可以推测,与感染 COVID19 引起的 PA 相比,接种 COVID19 引起的 PA 可能是一个不同的临床实体,具有不同的病理生理机制。
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引用次数: 0
Serum phoenixin levels in girls with central precocious puberty and premature thelarche. 中枢性性早熟和月经提前女孩的血清凤凰素水平。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-20 DOI: 10.1007/s12020-024-04074-x
Yujie Qin, Hongyang Deng, Lujie Liu, Meng Li, Jiong Yang, Chenglin Zhang, Jing Zhou, Yanfeng Xiao

Background and aim: Phoenixin (PNX), a newly discovered neuropeptide associated with reproduction, has been speculated to be involved in precocious puberty. Therefore, we assessed serum PNX levels in girls with precocious puberty.

Methods: Serum phoenixin-14 (PNX-14) and phoenixin-20 (PNX-20) levels were determined in girls with central precocious puberty (CPP) and premature thelarche (PT) and in healthy controls (n = 58 per group). Spearman's correlation was used to analyze the correlations between variables. Receiver operating characteristic curves were used to evaluate the performance of PNX for the diagnosis of CPP. Significant predictors of serum PNX levels were determined using least absolute shrinkage and selection operator regression and multiple linear regression analyses.

Results: Serum PNX-14 and PNX-20 levels were significantly higher in girls with CPP than in the controls; however, no significant differences in serum PNX-14 and PNX-20 levels were observed between girls with PT and the controls. PNX-20 levels were positively correlated with basal luteinizing hormone (LH) levels, peak LH levels, the peak LH to follicle-stimulating hormone (FSH) ratio, and estradiol levels. No significant correlation was observed between PNX-14 levels and any of these parameters. Multivariate linear regression analysis revealed that PNX-20 levels exhibited the strongest correlation with peak LH/FSH values. The areas under the curve (AUCs) of PNX-14 and PNX-20 for predicting CPP were 0.628 (cut-off value, 100.12 pg/mL; sensitivity, 44.6%; specificity, 77.6%) and 0.775 (cut-off value, 360.03 pg/mL; sensitivity, 66.5%; specificity, 79.3%), respectively. When these two indicators were combined, the AUC was 0.785.

Conclusions: Serum PNX levels may be associated with precocious puberty in girls and can be used as an auxiliary CPP indicator. However, given the low sensitivity and specificity of PNX, it should not be used as a single diagnostic indicator of CPP.

背景和目的:凤凰素(PNX)是一种新发现的与生殖有关的神经肽,有人推测它与性早熟有关。因此,我们对性早熟女孩的血清 PNX 水平进行了评估:方法:测定中枢性性早熟(CPP)和早熟(PT)女孩以及健康对照组(每组 58 人)的血清凤凰素-14(PNX-14)和凤凰素-20(PNX-20)水平。斯皮尔曼相关法用于分析变量之间的相关性。接收者操作特征曲线用于评估 PNX 诊断 CPP 的性能。使用最小绝对缩减和选择运算符回归及多元线性回归分析确定了血清 PNX 水平的重要预测因子:结果:CPP女孩的血清PNX-14和PNX-20水平明显高于对照组;但PT女孩的血清PNX-14和PNX-20水平与对照组无明显差异。PNX-20水平与基础黄体生成素(LH)水平、LH峰值水平、LH峰值与卵泡刺激素(FSH)比率以及雌二醇水平呈正相关。而 PNX-14 水平与这些参数均无明显相关性。多变量线性回归分析显示,PNX-20 水平与 LH/FSH 峰值的相关性最强。PNX-14 和 PNX-20 预测 CPP 的曲线下面积(AUC)分别为 0.628(临界值,100.12 pg/mL;灵敏度,44.6%;特异性,77.6%)和 0.775(临界值,360.03 pg/mL;灵敏度,66.5%;特异性,79.3%)。将这两个指标合并后,AUC 为 0.785:血清 PNX 水平可能与女孩性早熟有关,可作为 CPP 的辅助指标。然而,鉴于 PNX 的敏感性和特异性较低,不应将其作为 CPP 的单一诊断指标。
{"title":"Serum phoenixin levels in girls with central precocious puberty and premature thelarche.","authors":"Yujie Qin, Hongyang Deng, Lujie Liu, Meng Li, Jiong Yang, Chenglin Zhang, Jing Zhou, Yanfeng Xiao","doi":"10.1007/s12020-024-04074-x","DOIUrl":"https://doi.org/10.1007/s12020-024-04074-x","url":null,"abstract":"<p><strong>Background and aim: </strong>Phoenixin (PNX), a newly discovered neuropeptide associated with reproduction, has been speculated to be involved in precocious puberty. Therefore, we assessed serum PNX levels in girls with precocious puberty.</p><p><strong>Methods: </strong>Serum phoenixin-14 (PNX-14) and phoenixin-20 (PNX-20) levels were determined in girls with central precocious puberty (CPP) and premature thelarche (PT) and in healthy controls (n = 58 per group). Spearman's correlation was used to analyze the correlations between variables. Receiver operating characteristic curves were used to evaluate the performance of PNX for the diagnosis of CPP. Significant predictors of serum PNX levels were determined using least absolute shrinkage and selection operator regression and multiple linear regression analyses.</p><p><strong>Results: </strong>Serum PNX-14 and PNX-20 levels were significantly higher in girls with CPP than in the controls; however, no significant differences in serum PNX-14 and PNX-20 levels were observed between girls with PT and the controls. PNX-20 levels were positively correlated with basal luteinizing hormone (LH) levels, peak LH levels, the peak LH to follicle-stimulating hormone (FSH) ratio, and estradiol levels. No significant correlation was observed between PNX-14 levels and any of these parameters. Multivariate linear regression analysis revealed that PNX-20 levels exhibited the strongest correlation with peak LH/FSH values. The areas under the curve (AUCs) of PNX-14 and PNX-20 for predicting CPP were 0.628 (cut-off value, 100.12 pg/mL; sensitivity, 44.6%; specificity, 77.6%) and 0.775 (cut-off value, 360.03 pg/mL; sensitivity, 66.5%; specificity, 79.3%), respectively. When these two indicators were combined, the AUC was 0.785.</p><p><strong>Conclusions: </strong>Serum PNX levels may be associated with precocious puberty in girls and can be used as an auxiliary CPP indicator. However, given the low sensitivity and specificity of PNX, it should not be used as a single diagnostic indicator of CPP.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478854","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
Visceral adipose tissue, epicardial fat, and hepatic steatosis in polycystic ovary syndrome: a study of ectopic fat stores and metabolic dysfunction. 多囊卵巢综合征的内脏脂肪组织、心外膜脂肪和肝脂肪变性:异位脂肪储存和代谢功能障碍研究。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-19 DOI: 10.1007/s12020-024-04077-8
Rebeca Bandeira de Melo Cavalcante, Lenora Maria Camarate Silveira Martins Leão, Ana Beatriz Winter Tavares, Karynne Grutter Lopes, Carlos Terra, Angelo Antunes Salgado, Luiz Guilherme Kraemer-Aguiar

Purpose: In polycystic ovary syndrome (PCOS), ectopic fat accumulation remains debatable. Therefore, intra-abdominal, hepatic, and epicardial fat were compared between PCOS women and body mass index (BMI)-matched controls and their associations with metabolic and hormonal parameters were explored. Furthermore, the performance of echocardiographic epicardial adipose tissue thickness (EATT) and hepatic steatosis measurement using transient elastography-based controlled attenuation parameter (TE-CAP) in screening abdominal visceral adipose tissue (VAT) was originally evaluated.

Methods: Women aged 18-39 years with BMI < 35 kg/m² were recruited. PCOS was defined by the Rotterdam criteria. All participants underwent clinical and laboratory exams, dual-energy X-ray absorptiometry (DXA), TE-CAP, and echocardiography. A receiver operating characteristic curve was applied to evaluate the accuracy and optimal cutoff values of TE-CAP and EATT in predicting DXA-measured VAT.

Results: The study included 35 women with PCOS and 37 controls. PCOS women exhibited higher levels of androgens, insulin resistance (IR) parameters, LDL-cholesterol, triglycerides, VAT, and EATT. VAT correlated with IR and triglycerides, whereas EATT correlated with HDL-cholesterol. In PCOS women aged 18-29, the cutoff values of CAP and EATT for VAT were 198.0 and 3.07, respectively, with CAP showing higher area under the curves (AUC). In PCOS women aged 30-39, the cutoff values were 209.5 and 3.36, respectively, with EATT showing higher AUC.

Conclusion: VAT correlates with more metabolic parameters in PCOS than TE-CAP or EATT. TE-CAP is useful for VAT screening in PCOS patients aged 18-39 years, whereas EATT is effective and outperforms CAP in those aged 30-39 years.

目的:在多囊卵巢综合征(PCOS)中,异位脂肪堆积仍有争议。因此,研究人员比较了多囊卵巢综合征女性和体重指数(BMI)匹配对照组的腹腔内脂肪、肝脏脂肪和心外膜脂肪,并探讨了它们与代谢和激素参数的关系。此外,还对超声心动图心外膜脂肪组织厚度(EATT)和使用基于瞬态弹性成像的受控衰减参数(TE-CAP)测量肝脏脂肪变性筛查腹部内脏脂肪组织(VAT)的性能进行了初步评估:方法:年龄为 18-39 岁、体重指数为 BMI 的女性:研究包括 35 名患有多囊卵巢综合症的女性和 37 名对照组女性。多囊卵巢综合征妇女的雄激素、胰岛素抵抗(IR)参数、低密度脂蛋白胆固醇、甘油三酯、VAT 和 EATT 水平较高。VAT 与 IR 和甘油三酯相关,而 EATT 与高密度脂蛋白胆固醇相关。在 18-29 岁的多囊卵巢综合征女性中,CAP 和 EATT 的 VAT 临界值分别为 198.0 和 3.07,其中 CAP 的曲线下面积(AUC)更高。在 30-39 岁的多囊卵巢综合症女性中,CAP 和 EATT 的临界值分别为 209.5 和 3.36,其中 EATT 的曲线下面积(AUC)更高:结论:与 TE-CAP 或 EATT 相比,VAT 与多囊卵巢综合征中更多的代谢参数相关。TE-CAP可用于18-39岁多囊卵巢综合症患者的VAT筛查,而EATT对30-39岁的多囊卵巢综合症患者有效且优于CAP。
{"title":"Visceral adipose tissue, epicardial fat, and hepatic steatosis in polycystic ovary syndrome: a study of ectopic fat stores and metabolic dysfunction.","authors":"Rebeca Bandeira de Melo Cavalcante, Lenora Maria Camarate Silveira Martins Leão, Ana Beatriz Winter Tavares, Karynne Grutter Lopes, Carlos Terra, Angelo Antunes Salgado, Luiz Guilherme Kraemer-Aguiar","doi":"10.1007/s12020-024-04077-8","DOIUrl":"https://doi.org/10.1007/s12020-024-04077-8","url":null,"abstract":"<p><strong>Purpose: </strong>In polycystic ovary syndrome (PCOS), ectopic fat accumulation remains debatable. Therefore, intra-abdominal, hepatic, and epicardial fat were compared between PCOS women and body mass index (BMI)-matched controls and their associations with metabolic and hormonal parameters were explored. Furthermore, the performance of echocardiographic epicardial adipose tissue thickness (EATT) and hepatic steatosis measurement using transient elastography-based controlled attenuation parameter (TE-CAP) in screening abdominal visceral adipose tissue (VAT) was originally evaluated.</p><p><strong>Methods: </strong>Women aged 18-39 years with BMI < 35 kg/m² were recruited. PCOS was defined by the Rotterdam criteria. All participants underwent clinical and laboratory exams, dual-energy X-ray absorptiometry (DXA), TE-CAP, and echocardiography. A receiver operating characteristic curve was applied to evaluate the accuracy and optimal cutoff values of TE-CAP and EATT in predicting DXA-measured VAT.</p><p><strong>Results: </strong>The study included 35 women with PCOS and 37 controls. PCOS women exhibited higher levels of androgens, insulin resistance (IR) parameters, LDL-cholesterol, triglycerides, VAT, and EATT. VAT correlated with IR and triglycerides, whereas EATT correlated with HDL-cholesterol. In PCOS women aged 18-29, the cutoff values of CAP and EATT for VAT were 198.0 and 3.07, respectively, with CAP showing higher area under the curves (AUC). In PCOS women aged 30-39, the cutoff values were 209.5 and 3.36, respectively, with EATT showing higher AUC.</p><p><strong>Conclusion: </strong>VAT correlates with more metabolic parameters in PCOS than TE-CAP or EATT. TE-CAP is useful for VAT screening in PCOS patients aged 18-39 years, whereas EATT is effective and outperforms CAP in those aged 30-39 years.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478858","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
期刊
Endocrine
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