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Impact of BMI on serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D with calcifediol supplementation in young adults: a longitudinal study. 一项纵向研究:青壮年补充降钙素后体重指数对血清 25- 羟维生素 D 和 1,25- 二羟维生素 D 的影响。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI: 10.1007/s12020-024-03895-0
Liza Das, Naresh Sachdeva, Michael F Holick, Mahesh Devnani, Pinaki Dutta, Raman Kumar Marwaha

Background: High body mass index (BMI) is a risk factor for vitamin D deficiency. The rise in serum 25-hydroxyvitamin D [25(OH)D] concentrations following cholecalciferol supplementation is suboptimal, owing to adipose tissue sequestration and/or volumetric dilution. Calcifediol is a proven potent oral alternative for vitamin D supplementation, but whether BMI adversely affects its efficacy in raising 25(OH)D concentrations, is not well known.

Material and methods: Adults with serum concentrations of 25(OH)D < 30 ng/mL were recruited and stratified as normal, overweight, or obese using WHO criteria. Baseline evaluation included 25(OH)D, parathyroid hormone (PTH), and total 1,25-dihydroxyvitamin D [1,25(OH)2D] based on BMI category (n = 883). A subset of participants was supplemented with 50 µg calcifediol (n = 193) and assessed for the rise in serum concentrations of 25(OH)D at 3- and 6-months following supplementation.

Results: Participants were stratified as obese (11.2%), overweight (32.1%), or normal weight (56.7%). There were no significant baseline differences in serum concentrations of 25(OH)D among the groups (13.1 ± 6.4 vs 12.8 ± 6.8 vs 11.6 ± 6.6 ng/mL, p = 0.62). Similarly, PTH or 1,25(OH)2D concentrations were not different among the groups. On follow-up, 25(OH)D concentrations increased in all three groups at 3 and 6 months from baseline. The increase in 25(OH)D was 74.4 ng/mL (IQR 35.3-115.3) in obese, followed by overweight 62.2 ng/mL (18.1-98.7) and normal weight groups 47.1 ng/mL (17.5-89.7) at 3 months. 1,25(OH)2D also increased in all groups, without any significant intergroup differences (p > 0.05).

Conclusion: BMI does not impede the rise in 25(OH)D concentrations following supplementation with calcifediol in young adults with vitamin D deficiency.

背景:高体重指数(BMI)是维生素 D 缺乏的一个风险因素。补充胆钙化醇后,血清中 25- 羟维生素 D [25(OH)D] 浓度的升高并不理想,原因是脂肪组织螯合和/或体积稀释。骨化二醇已被证明是一种有效的口服维生素 D 补充剂,但体重指数是否会对其提高 25(OH)D 浓度的效果产生不利影响,目前尚不清楚:根据体重指数分类,对血清中 25(OH)D 浓度为 2D 的成人进行研究(n = 883)。对一部分参与者补充 50 µg 降钙二醇(n = 193),并在补充 3 个月和 6 个月后评估血清中 25(OH)D 浓度的上升情况:参与者被分为肥胖(11.2%)、超重(32.1%)或正常体重(56.7%)。各组血清中 25(OH)D 浓度的基线差异不大(13.1 ± 6.4 vs 12.8 ± 6.8 vs 11.6 ± 6.6 ng/mL,p = 0.62)。同样,各组间的 PTH 或 1,25(OH)2D 浓度也没有差异。在随访中,所有三组的 25(OH)D 浓度在 3 个月和 6 个月时都比基线时有所增加。肥胖组的 25(OH)D 浓度在 3 个月时增加了 74.4 纳克/毫升(IQR 35.3-115.3),其次是超重组 62.2 纳克/毫升(18.1-98.7)和正常体重组 47.1 纳克/毫升(17.5-89.7)。1,25(OH)2D 也在所有组别中增加,但组间差异不明显(P > 0.05):结论:维生素 D 缺乏的年轻人在补充降钙素后,体重指数不会阻碍 25(OH)D 浓度的上升。
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引用次数: 0
Adropin promotes testicular functions by modulating redox homeostasis in adult mouse. 阿托品通过调节成年小鼠的氧化还原稳态促进睾丸功能
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-06-15 DOI: 10.1007/s12020-024-03921-1
Shashank Tripathi, Shweta Maurya, Ajit Singh

Purpose: Adropin is an emerging metabolic hormone that has a role in regulating energy homeostasis. The present study aimed to explore the impact of adropin on redox homeostasis and its possible role in testicular functions in adult mouse testis.

Methods: Western blot, flow-cytometry, and TUNEL assay were performed to explore the impact of intra-testicular treatment of adropin (0.5 μg/testis) on testicular functions of adult mice. Hormonal assay was done by ELISA. Further, antioxidant enzyme activities were measured.

Results: Adropin treatment significantly increased the sperm count and testicular testosterone by increasing the expression of GPR19 and steroidogenic proteins. Also, adropin treatment reduced the oxidative/nitrosative stress by facilitating the translocation of NRF2 and inhibiting NF-κB into the nucleus of germ cells. Enhanced nuclear translocation of NRF2 leads to elevated biosynthesis of antioxidant enzymes, evident by increased HO-1, SOD, and catalase activity that ultimately resulted into declined LPO levels in adropin-treated mice testes. Furthermore, adropin decreased nuclear translocation of NF-κB in germ cells, that resulted into decreased NO production leading to decreased nitrosative stress. Adropin/GPR19 signaling significantly increased its differentiation, proliferation, and survival of germ cells by elevating the expression of PCNA and declining caspase 3, cleaved caspase 3 expression, Bax/Bcl2 ratio, and TUNEL-positive cells. FACS analysis revealed that adropin treatment enhances overall turnover of testicular cells leading to rise in production of advanced germ cells, notably spermatids.

Conclusion: The present study indicated that adropin improves testicular steroidogenesis, spermatogenesis via modulating redox potential and could be a promising target for treating testicular dysfunctions.

目的:阿糖腺苷是一种新兴的代谢激素,在调节能量平衡方面发挥作用。本研究旨在探讨阿托品对氧化还原稳态的影响及其在成年小鼠睾丸功能中可能发挥的作用:方法:通过Western印迹、流式细胞术和TUNEL检测,探讨阿托品(0.5 μg/睾丸)睾丸内处理对成年小鼠睾丸功能的影响。激素测定采用酶联免疫吸附法。此外,还测定了抗氧化酶活性:结果:通过增加 GPR19 和类固醇生成蛋白的表达,阿托品能明显增加精子数量和睾丸睾酮。此外,阿托品还能促进 NRF2 转位并抑制 NF-κB 进入生殖细胞核,从而减少氧化/亚硝酸应激。NRF2的核转位增强会导致抗氧化酶的生物合成增加,HO-1、SOD和过氧化氢酶活性的增加就证明了这一点,最终导致阿托品处理的小鼠睾丸中LPO水平下降。此外,阿托品还减少了生殖细胞中 NF-κB 的核转位,从而减少了 NO 的产生,降低了亚硝基应激。阿托品/GPR19信号通过提高PCNA的表达,降低caspase 3、裂解caspase 3的表达、Bax/Bcl2比率和TUNEL阳性细胞,从而显著提高生殖细胞的分化、增殖和存活率。FACS分析表明,阿托品治疗可促进睾丸细胞的整体更替,导致高级生殖细胞(尤其是精母细胞)的生成增加:本研究表明,阿托品可通过调节氧化还原电位改善睾丸类固醇生成和精子生成,可能是治疗睾丸功能障碍的一个有前途的靶点。
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引用次数: 0
Immune checkpoint inhibitor-associated new-onset hypophysitis: a retrospective analysis using the FAERS. 与免疫检查点抑制剂相关的新发肾上腺皮质功能减退症:使用 FAERS 进行的回顾性分析。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-07-04 DOI: 10.1007/s12020-024-03949-3
Difei Lu, Jun Yao, Geheng Yuan, Ying Gao, Junqing Zhang, Xiaohui Guo

Background: Our study aimed to investigate the prevalence and demographic characteristics of immune checkpoint inhibitor-associated hypophysitis (ICI-hypophysitis) using data from the FAERS, and the risk factors of prognosis were explored.

Methods: In this retrospective study, all cases of newly-diagnosed hypophysitis associated with FDA approved ICIs from 1st January 2007 to 31st December 2022 were accumulated using FAERS. Demographic data including age, sex, body weight, the prognosis of cases, and other co-occurred endocrinopathies induced by ICIs were analyzed and compared between different subgroups of immunotherapy.

Results: The reporting frequency of ICI-hypophysitis was 1.46% (2343/160089). Patients on the combination therapy had higher risk of hypophysitis reporting, followed by anti-CTLA-4 agent compared with other monotherapies (p < 0.001). Male subjects displayed higher reporting risk of ICI-hypophysitis (p = 0.015). Patients on anti-PD-1 therapy or the combination therapy showed higher occurrence rate of type 1 diabetes (anti-PD-1 vs. anti-PD-L1 vs. anti-CTLA-4 vs. combination therapy, 4.2% vs. 0.7% vs. 0.3% vs. 8.4%, p < 0.001). The occurrence rate of new-onset thyroid diseases in patients receiving combination therapy was higher than anti-PD-1 monotherapy (12.3% vs. 8.4%, p = 0.010). Elder age, lung cancer, and renal cancer emerged to be positively associated with severe clinical outcomes [>65 years, OR 1.042, 95%CI (1.022-1.063), p < 0.001; lung cancer, OR 1.400, 95%CI (1.019-1.923), p = 0.038; renal cancer, OR 1.667, 95%CI (1.153-2.412), p = 0.007]. Anti-CTLA-4 monotherapy was discovered to be a protective factor of severe outcomes [OR 0.433, 95%CI (0.335-0.558), p < 0.001]. Female sex and co-occurrence of ICI-related diabetes exhibited lower risk of death [female, OR 0.571, 95%CI (0.361-0.903), p = 0.017; diabetes, OR 0.090, 95%CI (0.016-0.524), p = 0.007].

Conclusions: ICI-induced hypophysitis is male-predominant irAE, most commonly seen in patients on anti-CTLA-4 mono- or combination therapy. Awareness among clinicians is critical when patients with elder age, lung or renal cancer develop hypophysitis, which indicates poor clinical outcomes. Female sex, anti-CTLA-4 monotherapy and co-occurrence of ICI-related diabetes are protective risk factors for poor prognosis.

研究背景我们的研究旨在利用FAERS的数据调查免疫检查点抑制剂相关性肾上腺皮质功能减退症(ICI-hypophysitis)的发病率和人口统计学特征,并探讨预后的风险因素:在这项回顾性研究中,利用FAERS积累了2007年1月1日至2022年12月31日期间所有新诊断的与FDA批准的ICIs相关的肾上腺皮质功能减退症病例。研究分析了人口统计学数据,包括年龄、性别、体重、病例的预后以及 ICIs 诱发的其他并发内分泌疾病,并对不同免疫治疗亚组进行了比较:结果:ICI-肾上腺皮质炎的报告频率为1.46%(2343/160089)。与其他单一疗法相比,接受联合疗法的患者报告肾上腺皮质功能减退症的风险更高,其次是抗CTLA-4药物(P 65岁,OR 1.042,95%CI (1.022-1.063),P 结论:ICI诱发的肾上腺皮质功能减退症的发生率为1.46%(2343/160089):ICI诱发的肾上腺皮质功能减退症是一种以男性为主的irAE,最常见于接受抗CTLA-4单药或联合治疗的患者。当高龄、肺癌或肾癌患者出现肾上腺皮质功能减退症时,临床医生的认识至关重要,因为这预示着不良的临床预后。女性、抗CTLA-4单药治疗和合并ICI相关糖尿病是预后不良的保护性风险因素。
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引用次数: 0
Diabetes and obesity: the role of stress in the development of cancer. 糖尿病和肥胖症:压力在癌症发展中的作用。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-06-03 DOI: 10.1007/s12020-024-03886-1
Angelo Avogaro

Diabesity is a condition where an individual has both diabetes and obesity, which can lead to severe complications including cardiovascular disease, a leading cause of mortality. Recently, cancer has become a leading cause of excess hospitalizations, and both diabetes and obesity are associated with a higher risk of developing several types of cancer. In this review, we propose that chronic stress significantly increases this association. Managing diabetes and obesity is challenging as they both cause significant distress. The relationship between stress and cancer is interconnected, with anxiety and depression being common in cancer patients. Cancer diagnosis and treatment can cause lasting changes in the body's neuroendocrine system, with stress causing an excessive release of catecholamines and prostaglandins in patients undergoing cancer surgery, which promotes the spread of cancer to other parts of the body. Furthermore, stress could significantly increase the risk of cancer in patients with diabetes, obesity, or both.

糖尿病肥胖症是一种同时患有糖尿病和肥胖症的病症,可导致严重的并发症,包括心血管疾病,这是导致死亡的一个主要原因。最近,癌症已成为住院人数过多的主要原因,而糖尿病和肥胖都与罹患几种癌症的风险较高有关。在这篇综述中,我们提出慢性压力会显著增加这种关联。管理糖尿病和肥胖症具有挑战性,因为它们都会给患者带来巨大的痛苦。压力与癌症之间的关系是相互关联的,焦虑和抑郁在癌症患者中很常见。癌症的诊断和治疗会对人体的神经内分泌系统造成持久的改变,压力会导致接受癌症手术的患者过度释放儿茶酚胺和前列腺素,从而促进癌症向身体其他部位扩散。此外,压力会大大增加糖尿病、肥胖或两者兼有的患者罹患癌症的风险。
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引用次数: 0
iGlarLixi for type 2 diabetes: a systematic review and meta-analysis. iGlarLixi 治疗 2 型糖尿病:系统回顾和荟萃分析。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-05-13 DOI: 10.1007/s12020-024-03868-3
Yang Liu, Congxin Li, Xuejing Li, Jie Yang, Yingying Zheng, Fan Li, Xianying Wang

Objectives: To assess the efficacy and tolerability of iGlarLixi-a novel, fixed-ratio, soluble combination of insulin glargine and lixisenatide-for the treatment of type 2 diabetes (T2D).

Methods: The PubMed, Embase, Cochrane Library and ClinicalTrials.gov databases were searched from inception to November 15, 2023 to identify randomized controlled trials (RCTs) comparing iGlarLixi with a placebo or any other antidiabetic agent in adults with T2D. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated to evaluate the outcomes.

Results: A total of 10 trials enrolling 6071 T2D patients were included. Compared with placebos or other antidiabetic agents, iGlarLixi exerted beneficial effects on changes in HbA1c, the percentage of patients who achieved an HbA1c < 7%, the percentage of patients who achieved an HbA1c < 6.5%, the percentage of patients who achieved an HbA1c < 7.0% without weight gain and/or without severe or blood glucose-confirmed hypoglycemic episodes, changes in fasting plasma glucose, and changes in self-measured plasma glucose. Regarding safety, iGlarLixi did not increase the incidence of severe hypoglycemia or serious adverse events but did increase the incidence of gastrointestinal adverse events, symptomatic hypoglycemia, and adverse events (e.g., nausea, vomiting, diarrhea).

Conclusions: iGlarLixi showed improved efficacy and safety in patients with T2D. Additional large, multicenter RCTs are warranted to obtain deeper insights into the efficacy and safety of iGlarLixi, thereby providing guidance for clinical treatment decisions.

目的评估 iGlarLixi- 一种新型、固定比值、可溶性格列美脲胰岛素和利塞那肽复方制剂治疗 2 型糖尿病(T2D)的疗效和耐受性:方法:对 PubMed、Embase、Cochrane Library 和 ClinicalTrials.gov 数据库进行了检索,检索时间从开始到 2023 年 11 月 15 日,目的是找出将 iGlarLixi 与安慰剂或其他任何抗糖尿病药物进行比较的随机对照试验 (RCT)。通过计算风险比(RRs)和平均差异(MDs)以及95%置信区间(CIs)来评估结果:结果:共纳入了 10 项试验,6071 名 T2D 患者参与了试验。与安慰剂或其他抗糖尿病药物相比,iGlarLixi对HbA1c的变化、HbA1c达标患者的比例产生了有益的影响 结论:iGlarLixi对T2D患者的疗效和安全性均有改善。为了更深入地了解 iGlarLixi 的疗效和安全性,从而为临床治疗决策提供指导,有必要进行更多的大型多中心 RCT 研究。
{"title":"iGlarLixi for type 2 diabetes: a systematic review and meta-analysis.","authors":"Yang Liu, Congxin Li, Xuejing Li, Jie Yang, Yingying Zheng, Fan Li, Xianying Wang","doi":"10.1007/s12020-024-03868-3","DOIUrl":"10.1007/s12020-024-03868-3","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the efficacy and tolerability of iGlarLixi-a novel, fixed-ratio, soluble combination of insulin glargine and lixisenatide-for the treatment of type 2 diabetes (T2D).</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane Library and ClinicalTrials.gov databases were searched from inception to November 15, 2023 to identify randomized controlled trials (RCTs) comparing iGlarLixi with a placebo or any other antidiabetic agent in adults with T2D. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated to evaluate the outcomes.</p><p><strong>Results: </strong>A total of 10 trials enrolling 6071 T2D patients were included. Compared with placebos or other antidiabetic agents, iGlarLixi exerted beneficial effects on changes in HbA1c, the percentage of patients who achieved an HbA1c < 7%, the percentage of patients who achieved an HbA1c < 6.5%, the percentage of patients who achieved an HbA1c < 7.0% without weight gain and/or without severe or blood glucose-confirmed hypoglycemic episodes, changes in fasting plasma glucose, and changes in self-measured plasma glucose. Regarding safety, iGlarLixi did not increase the incidence of severe hypoglycemia or serious adverse events but did increase the incidence of gastrointestinal adverse events, symptomatic hypoglycemia, and adverse events (e.g., nausea, vomiting, diarrhea).</p><p><strong>Conclusions: </strong>iGlarLixi showed improved efficacy and safety in patients with T2D. Additional large, multicenter RCTs are warranted to obtain deeper insights into the efficacy and safety of iGlarLixi, thereby providing guidance for clinical treatment decisions.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917313","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
Radiological evolution of pituitary hyperplasia in primary hypothyroidism and its differentiation from nonfunctioning pituitary adenoma coexisting with primary hypothyroidism. 原发性甲状腺功能减退症垂体增生的放射学演变及其与原发性甲状腺功能减退症并存的无功能垂体腺瘤的鉴别。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-08-08 DOI: 10.1007/s12020-024-03983-1
Siddu Nikith, Brijesh Krishnappa, Shilpa Lakkundi, Sumit Thakar, Anurag Lila, Aditi Goyal, Umalakshmi Annavarapu, S L Sagar Reddy, Dhananjaya Melkunte Shanthaiah, Tushar Bandgar, Saritha Aryan, Vijaya Sarathi

Purpose: In a patient with elevated thyroid stimulating hormone (TSH, >50 µIU/ml) with sellar mass, it is crucial to differentiate isolated pituitary hyperplasia (IPH) from primary hypothyroidism coexisting with nonfunctioning pituitary adenoma (PHCNFPA) pre-operatively to avoid unwarranted surgery in the former condition. Here, we describe patients having pituitary mass/enlargement with markedly elevated TSH (>50 µIU/ml) and attempt to find the differentiating features between IPH and PHCNFPA.

Methods: This is a retrospective study conducted at a tertiary care center. Case records of patients presenting between January 2020 and December 2022 with elevated TSH (>50 µIU/ml) for whom magnetic resonance imaging (MRI) of the sella was available were reviewed. Demographic details, symptomatology, clinical examination findings, thyroid function tests, data on pituitary hormonal excess and deficiencies, MRI findings, and details regarding levothyroxine supplementation were noted. Based on the final diagnosis, the patients were categorized into two groups: PHCNFPA and IPH.

Results: Five and 11 patients were diagnosed with PHCNFPA and IPH, respectively. The median (IQR) age at presentation of patients with PHCNFPA was significantly higher than that of IPH patients [37 (28-60.5) vs. 21 (10-21.5) years, p: 0.002]. A longer duration of hypothyroid symptoms was noted in the IPH group whereas visual field defects and corticotropin deficiency were more frequent and the pituitary lesion size was greater in PHCNFPA. Thyroid function tests were not different between the two groups. The pituitary enlargement in IPH was initially an increase in pituitary height that progressed to symmetrical nipple-, dome- or tent-shaped enlargement. Besides this characteristic enlargement pattern, isointense appearance on T1-weighted and T2-weighted images, homogeneous contrast enhancement, and prompt regression of pituitary lesion with levothyroxine replacement were characteristic of IPH whereas heterogeneous enhancement, cystic/hemorrhagic change, and ≥Knosp III invasion were characteristic of PHCNFPA. Peripheral rim enhancement and Knosp I-II parasellar extension were not uncommon in patients with IPH and did not distinguish it from PHCNFPA.

Conclusions: The present study reports the radiological evolution of IPH and a unique series of PHCNFPA along with the distinguishing characteristics between them.

目的:对于促甲状腺激素(TSH,>50 µIU/ml)升高并伴有蝶窦肿块的患者,术前区分孤立性垂体增生症(IPH)和原发性甲状腺功能减退症并存无功能垂体腺瘤(PHCNFPA)至关重要,以避免对前者进行不必要的手术。在此,我们描述了垂体肿块/增大伴 TSH 明显升高(>50 µIU/ml)的患者,并试图找出 IPH 和 PHCNFPA 的区别特征:这是一项在一家三级医疗中心进行的回顾性研究。研究回顾了2020年1月至2022年12月期间因TSH升高(>50 µIU/ml)而就诊的患者病例记录,这些患者均可进行脊髓磁共振成像(MRI)检查。病例中记录了详细的人口统计学资料、症状、临床检查结果、甲状腺功能检测、垂体激素过多和缺乏的数据、核磁共振成像结果以及补充左甲状腺素的详细情况。根据最终诊断结果,患者被分为两组:结果:结果:分别有 5 名和 11 名患者被诊断为 PHCNFPA 和 IPH。PHCNFPA患者发病时的中位年龄(IQR)明显高于IPH患者[37(28-60.5)岁 vs. 21(10-21.5)岁,P:0.002]。IPH组患者甲减症状持续时间更长,而PHCNFPA组患者视野缺损和促肾上腺皮质激素缺乏的发生率更高,垂体病变面积更大。两组患者的甲状腺功能检测结果没有差异。IPH患者的垂体增大最初表现为垂体高度增加,随后发展为对称性乳头状、圆顶状或帐篷状增大。除这一特征性增大模式外,T1 加权和 T2 加权图像上的等密度外观、均质对比度增强和左甲状腺素替代后垂体病变迅速消退是 IPH 的特征性表现,而异质增强、囊性/出血性改变和≥Knosp III 侵袭是 PHCNFPA 的特征性表现。周围边缘强化和KnospⅠ-Ⅱ期髌旁扩展在IPH患者中并不少见,但并不能将其与PHCNFPA区分开来:本研究报告了 IPH 和一系列独特的 PHCNFPA 的放射学演变,以及它们之间的区别特征。
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引用次数: 0
Adherence to the dietary approaches to stop hypertension diet reduces the risk of diabetes mellitus: a systematic review and dose-response meta-analysis. 坚持高血压饮食疗法可降低糖尿病风险:系统综述和剂量反应荟萃分析。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-05-30 DOI: 10.1007/s12020-024-03882-5
Xiyan Quan, Xiaoming Shen, Chun Li, Yayuan Li, Tiangang Li, Baifan Chen

Background: Despite several epidemiological studies reporting a significant association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of diabetes mellitus, the results remain controversial. In this systematic review and meta-analysis, we aimed to summarize the existing evidence from published observational studies and evaluate the dose-response relationship between adherence to the DASH diet and diabetes mellitus risk.

Methods: We performed a systematic search for relevant articles published up to September 2023 using electronic databases of PubMed, Embase, Scopus, and China National Knowledge Infrastructure (CNKI). A random-effects model was applied to calculate the combined relative risks (RR) with 95% confidence intervals (CIs) for the highest compared to the lowest categories of DASH score in relation to diabetes mellitus risk. Heterogeneity among the included studies was assessed using the Cochran's Q test and I-squared (I2) statistic. Literature search, study selection, data extraction, and quality assessment were performed by two independent reviewers.

Results: Fifteen studies involving 557,475 participants and 57,064 diabetes mellitus cases were eligible for our analyses. Pooled analyses from included studies showed that high adherence to the DASH diet was significantly associated with a reduced risk of diabetes mellitus (RR: 0.82; 95% CI: 0.76-0.90, P < 0.001). Moreover, the dose-response meta-analysis revealed a linear trend between adherence to the DASH diet and diabetes mellitus (RR:0.99; 95%CI: 0.97-1.02, Pdose-response = 0.546, Pnonlinearity = 0.701). Subgroup analyses further revealed a significant inverse association between adherence to the DASH diet and diabetes mellitus risk in case-control studies (RR: 0.65; 95%CI: 0.29-1.43, P < 0.001), with a marginal inverse association in cohort studies (RR:0.83; 95%CI: 0.76-0.91, P < 0.001). Additionally, we conducted analyses separately by comparison and found a significant inverse association between DASH diet and diabetes mellitus risk in T3 vs T1 comparison studies (RR = 0.74; 95%CI: 0.64-0.86, P = 0.012).

Conclusion: The findings of this study demonstrate a protective association between adherence to the DASH diet and risk of diabetes mellitus. However, further prospective cohort studies and randomized controlled trials are needed to validate these findings.

背景:尽管多项流行病学研究报告称,坚持DASH饮食与糖尿病风险之间存在显著关联,但研究结果仍存在争议。在本系统综述和荟萃分析中,我们旨在总结已发表的观察性研究中的现有证据,并评估坚持 DASH 饮食与糖尿病风险之间的剂量-反应关系:我们使用PubMed、Embase、Scopus和中国国家知识基础设施(CNKI)等电子数据库对截至2023年9月发表的相关文章进行了系统检索。采用随机效应模型计算了DASH评分最高和最低类别与糖尿病风险的合并相对风险(RR)及95%置信区间(CI)。使用 Cochran's Q 检验和 I-squared (I2) 统计量评估了纳入研究之间的异质性。文献检索、研究选择、数据提取和质量评估由两名独立审稿人完成:共有 15 项研究符合我们的分析条件,涉及 557475 名参与者和 57064 个糖尿病病例。纳入研究的汇总分析表明,DASH饮食的高依从性与糖尿病风险的降低显著相关(RR:0.82;95% CI:0.76-0.90,P剂量-反应=0.546,P非线性=0.701)。亚组分析进一步显示,在病例对照研究中,坚持 DASH 饮食与糖尿病风险之间存在显著的反比关系(RR:0.65;95%CI:0.29-1.43,P 结论:DASH 饮食对糖尿病有保护作用:本研究结果表明,坚持 DASH 饮食与糖尿病风险之间存在保护性联系。然而,还需要进一步的前瞻性队列研究和随机对照试验来验证这些发现。
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引用次数: 0
C-reactive protein to albumin ratio and risk of incident metabolic syndrome in community-dwelling adults: longitudinal findings over a 12-year follow-up period. 社区居住成年人的 C 反应蛋白与白蛋白比值与代谢综合征发病风险:12 年随访的纵向研究结果。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-05-21 DOI: 10.1007/s12020-024-03875-4
Taekyeong Lim, Yong-Jae Lee

Aim: The C-reactive protein to albumin (CRP/Alb) ratio has emerged as a novel biomarker for various inflammatory diseases. This study aimed to evaluate the association between the CRP/Alb ratio and incident metabolic syndrome (MetS) with a large-sample, community-based Korean cohort over a 12-year follow-up period.

Materials and methods: Among 10,030 participants, a total of 6205 participants aged 40-69 years without MetS were selected from the Korean Genome and Epidemiology Study (KoGES). The baseline CRP/Alb ratio was divided into quartiles. The definition of newly developed MetS was the one proposed by the 2009 Joint Interim Statement of Circulation. Hazard ratios (HRs) with 95% confidence intervals (CIs) for incident MetS were calculated using multivariable Cox proportional hazards regression models after adjusting for potentially confounding variables.

Results: During the 12-year follow-up period, MetS developed in 2535 subjects (40.9%, 2535/6205) with an incidence rate of 5.6-11.9 (over 2 years). Compared to the reference first quartiles, the HRs (95% CIs) of incident MetS in the second, third, and fourth quartiles increased in a dose-response manner. Compared to the reference quartile, the HRs (95% CIs) of the incidence of MetS for the second, third, and fourth quartiles of CRP/Alb ratio were 1.12 (0.99-1.27), 1.24 (1.11-1.40), and 1.51 (1.34-1.69) after adjusting for age, sex, smoking status, alcohol intake, physical activity, total cholesterol, mean arterial pressure, HOMA-IR, and total energy intake.

Conclusions: High CRP/Alb ratio at baseline may be a useful surrogate indicator of future incident MetS.

目的:C反应蛋白与白蛋白(CRP/Alb)的比值已成为各种炎症性疾病的新型生物标志物。本研究旨在通过一项为期 12 年的大样本社区韩国队列随访,评估 CRP/Alb 比值与代谢综合征(MetS)发病率之间的关联:在韩国基因组与流行病学研究(KoGES)的 10,030 名参与者中,共选取了 6205 名年龄在 40-69 岁之间、无代谢综合征的参与者。基线 CRP/Alb 比率被分为四等分。新发 MetS 的定义是 2009 年《循环》联合临时声明提出的定义。在调整了潜在的混杂变量后,使用多变量考克斯比例危险回归模型计算了MetS发病的危险比(HRs)和95%置信区间(CIs):在12年的随访期间,2535名受试者(40.9%,2535/6205)出现了MetS,发病率为5.6-11.9(2年以上)。与参考的第一四分位数相比,第二、第三和第四四分位数的 MetS 发病 HRs(95% CIs)以剂量反应的方式增加。与参考四分位数相比,在调整年龄、性别、吸烟状况、酒精摄入量、体力活动、总胆固醇、平均动脉压、HOMA-IR和总能量摄入量后,CRP/Alb比值第二、第三和第四四分位数的MetS发病率的HRs(95% CIs)分别为1.12(0.99-1.27)、1.24(1.11-1.40)和1.51(1.34-1.69):结论:基线时的高 CRP/Alb 比率可能是未来发生 MetS 的有用替代指标。
{"title":"C-reactive protein to albumin ratio and risk of incident metabolic syndrome in community-dwelling adults: longitudinal findings over a 12-year follow-up period.","authors":"Taekyeong Lim, Yong-Jae Lee","doi":"10.1007/s12020-024-03875-4","DOIUrl":"10.1007/s12020-024-03875-4","url":null,"abstract":"<p><strong>Aim: </strong>The C-reactive protein to albumin (CRP/Alb) ratio has emerged as a novel biomarker for various inflammatory diseases. This study aimed to evaluate the association between the CRP/Alb ratio and incident metabolic syndrome (MetS) with a large-sample, community-based Korean cohort over a 12-year follow-up period.</p><p><strong>Materials and methods: </strong>Among 10,030 participants, a total of 6205 participants aged 40-69 years without MetS were selected from the Korean Genome and Epidemiology Study (KoGES). The baseline CRP/Alb ratio was divided into quartiles. The definition of newly developed MetS was the one proposed by the 2009 Joint Interim Statement of Circulation. Hazard ratios (HRs) with 95% confidence intervals (CIs) for incident MetS were calculated using multivariable Cox proportional hazards regression models after adjusting for potentially confounding variables.</p><p><strong>Results: </strong>During the 12-year follow-up period, MetS developed in 2535 subjects (40.9%, 2535/6205) with an incidence rate of 5.6-11.9 (over 2 years). Compared to the reference first quartiles, the HRs (95% CIs) of incident MetS in the second, third, and fourth quartiles increased in a dose-response manner. Compared to the reference quartile, the HRs (95% CIs) of the incidence of MetS for the second, third, and fourth quartiles of CRP/Alb ratio were 1.12 (0.99-1.27), 1.24 (1.11-1.40), and 1.51 (1.34-1.69) after adjusting for age, sex, smoking status, alcohol intake, physical activity, total cholesterol, mean arterial pressure, HOMA-IR, and total energy intake.</p><p><strong>Conclusions: </strong>High CRP/Alb ratio at baseline may be a useful surrogate indicator of future incident MetS.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071579","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
Retrospective analysis of thyroid incidentalomas detected by [68Ga]Ga-PSMA-11 PET/CT. 通过[68Ga]Ga-PSMA-11 PET/CT检测到的甲状腺偶发瘤的回顾性分析。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-05-10 DOI: 10.1007/s12020-024-03847-8
İlkcan Çerçi Koçar, Pınar Pelin Özcan, Zehra Pınar Koç, Mehmet Süle, Esen Akbay, Ramazan Gen, Kerem Sezer

Background: Prostate cancer patients, undergo imaging procedures, with [68Ga]Ga-PSMA-11 PET/CT (prostate-specific membrane antigen based positron emission tomography/computed tomography) utilized for primary and secondary staging. PSMA thyroid incidentalomas (PTI) are discovered in the thyroid gland while imaging prostate cancer patients with [68Ga]Ga-PSMA-11 PET/CT.

Aims: The aim of the study was to determine the clinical significance of PTIs detected on [68Ga]Ga-PSMA-11 PET/CT. Another goal was to identify a possible threshold for the maximum standardized uptake value (SUVmax), above which a malignant growth could be suspected.

Study design: A retrospective cross-sectional study.

Methods: 769 patients with prostat cancer who underwent [68Ga]Ga-PSMA-11 PET/CT scans in the nuclear medicine department of a tertiary care hospital between January 2020 and December 2022 were retrospectively screened in this study. We analyzed 67 patients in whom PTI was detected. Patients who exceeded the inclusion criteria had their thyroid ultrasonography and ultrasonography -guided fine needle aspiration findings analyzed.

Results: PTI was discovered in 67 patients (8%). 42 patients who met the inclusion and exclusion criteria were included in the study. Of the 4 malignant patients (9.5%) in the study population, 2 were classified as TIRADS 3 and 2 were classified as TIRADS 4. The cut-off SUVmax value was found to be 5.6. With 100% sensitivity and 47.37% specificity, a cutoff SUVmax of 5.3 was determined through receiver-operator characteristic analysis in order to predict malignant cytology.

Conclusion: PTI is a significant clinical finding; most of diffuse and focal uptakes are frequently related to benign diseases. Each center should establish its own a possible SUVmax cut-off over which a malignant lesion should be suspected.

背景:前列腺癌患者接受[68Ga]Ga-PSMA-11 PET/CT(基于前列腺特异性膜抗原的正电子发射断层扫描/计算机断层扫描)成像程序,用于一级和二级分期。目的:该研究旨在确定[68Ga]Ga-PSMA-11 PET/CT检测到的PTI的临床意义。另一个目的是确定最大标准化摄取值(SUVmax)的可能阈值,超过该值则可怀疑为恶性增生:方法:本研究回顾性筛选了一家三甲医院核医学科在 2020 年 1 月至 2022 年 12 月期间接受[68Ga]Ga-PSMA-11 PET/CT 扫描的 769 例前列腺癌患者。我们分析了 67 例检测出 PTI 的患者。对超过纳入标准的患者的甲状腺超声检查和超声引导下细针穿刺结果进行了分析:结果:67 名患者(8%)发现了 PTI。符合纳入和排除标准的 42 名患者被纳入研究。在研究人群中的 4 名恶性患者(9.5%)中,2 人被归类为 TIRADS 3,2 人被归类为 TIRADS 4。通过接收器-操作者特征分析,确定SUVmax的临界值为5.3,其敏感性为100%,特异性为47.37%,可用于预测恶性细胞学检查:结论:PTI 是一项重要的临床发现;大多数弥漫性和局灶性上皮往往与良性疾病有关。结论:PTI 是一项重要的临床发现;大多数弥漫性和局灶性摄片通常与良性疾病有关。每个中心都应确定自己可能的 SUVmax 临界值,超过该值就应怀疑恶性病变。
{"title":"Retrospective analysis of thyroid incidentalomas detected by [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT.","authors":"İlkcan Çerçi Koçar, Pınar Pelin Özcan, Zehra Pınar Koç, Mehmet Süle, Esen Akbay, Ramazan Gen, Kerem Sezer","doi":"10.1007/s12020-024-03847-8","DOIUrl":"10.1007/s12020-024-03847-8","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer patients, undergo imaging procedures, with [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT (prostate-specific membrane antigen based positron emission tomography/computed tomography) utilized for primary and secondary staging. PSMA thyroid incidentalomas (PTI) are discovered in the thyroid gland while imaging prostate cancer patients with [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT.</p><p><strong>Aims: </strong>The aim of the study was to determine the clinical significance of PTIs detected on [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT. Another goal was to identify a possible threshold for the maximum standardized uptake value (SUVmax), above which a malignant growth could be suspected.</p><p><strong>Study design: </strong>A retrospective cross-sectional study.</p><p><strong>Methods: </strong>769 patients with prostat cancer who underwent [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT scans in the nuclear medicine department of a tertiary care hospital between January 2020 and December 2022 were retrospectively screened in this study. We analyzed 67 patients in whom PTI was detected. Patients who exceeded the inclusion criteria had their thyroid ultrasonography and ultrasonography -guided fine needle aspiration findings analyzed.</p><p><strong>Results: </strong>PTI was discovered in 67 patients (8%). 42 patients who met the inclusion and exclusion criteria were included in the study. Of the 4 malignant patients (9.5%) in the study population, 2 were classified as TIRADS 3 and 2 were classified as TIRADS 4. The cut-off SUVmax value was found to be 5.6. With 100% sensitivity and 47.37% specificity, a cutoff SUVmax of 5.3 was determined through receiver-operator characteristic analysis in order to predict malignant cytology.</p><p><strong>Conclusion: </strong>PTI is a significant clinical finding; most of diffuse and focal uptakes are frequently related to benign diseases. Each center should establish its own a possible SUVmax cut-off over which a malignant lesion should be suspected.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899960","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
Prediction of TNFRSF9 expression and molecular pathological features in thyroid cancer using machine learning to construct Pathomics models. 利用机器学习构建病理组学模型,预测甲状腺癌中 TNFRSF9 的表达和分子病理特征。
IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-05-16 DOI: 10.1007/s12020-024-03862-9
Ying Liu, Junping Zhang, Shanshan Li, Wen Chen, Rongqian Wu, Zejin Hao, Jixiong Xu

Background: The TNFRSF9 molecule is pivotal in thyroid carcinoma (THCA) development. This study utilizes Pathomics techniques to predict TNFRSF9 expression in THCA tissue and explore its molecular mechanisms.

Methods: Transcriptome data, pathology images, and clinical information from the cancer genome atlas (TCGA) were analyzed. Image segmentation and feature extraction were performed using the OTSU's algorithm and pyradiomics package. The dataset was split for training and validation. Features were selected using maximum relevance minimum redundancy recursive feature elimination (mRMR_RFE) and modeling conducted with the gradient boosting machine (GBM) algorithm. Model evaluation included receiver operating characteristic curve (ROC) analysis. The Pathomics model output a probabilistic pathomics score (PS) for gene expression prediction, with its prognostic value assessed in TNFRSF9 expression groups. Subsequent analysis involved gene set variation analysis (GSVA), immune gene expression, cell abundance, immunotherapy susceptibility, and gene mutation analysis.

Results: High TNFRSF9 expression correlated with worsened progression-free interval (PFI) and acted as an independent risk factor [hazard ratio (HR) = 2.178, 95% confidence interval (CI) 1.045-4.538, P = 0.038]. Nine pathohistological features were identified. The GBM Pathomics model demonstrated good prediction efficacy [area under the curve (AUC) 0.819 and 0.769] and clinical benefits. High PS was a PFI risk factor (HR = 2.156, 95% CI 1.047-4.440, P = 0.037). Patients with high PS potentially exhibited enriched pathways, increased TIGIT gene expression, Tregs infiltration (P < 0.0001), and higher rates of gene mutations (BRAF, TTN, TG).

Conclusions: The GBM Pathomics model constructed based on the pathohistological features of H&E-stained sections well predicted the expression level of TNFRSF9 molecules in THCA.

背景:TNFRSF9分子在甲状腺癌(THCA)的发生发展中起着关键作用。本研究利用病理组学技术预测TNFRSF9在THCA组织中的表达,并探索其分子机制:方法:分析癌症基因组图谱(TCGA)中的转录组数据、病理图像和临床信息。使用 OTSU 算法和 Pyradiomics 软件包进行图像分割和特征提取。数据集分为训练集和验证集。使用最大相关性最小冗余递归特征消除(mRMR_RFE)选择特征,并使用梯度提升机(GBM)算法进行建模。模型评估包括接收者操作特征曲线(ROC)分析。病理组学模型为基因表达预测输出概率病理组学评分(PS),并在 TNFRSF9 表达组中评估其预后价值。随后的分析包括基因组变异分析(GSVA)、免疫基因表达、细胞丰度、免疫疗法易感性和基因突变分析:结果:TNFRSF9高表达与无进展间期(PFI)恶化相关,是一个独立的风险因素[危险比(HR)=2.178,95%置信区间(CI)1.045-4.538,P=0.038]。确定了九种病理组织学特征。GBM 病理组学模型显示出良好的预测效果[曲线下面积 (AUC) 0.819 和 0.769]和临床效益。高 PS 是 PFI 风险因素(HR = 2.156,95% CI 1.047-4.440,P = 0.037)。高PS患者可能表现出丰富的通路、TIGIT基因表达增加、Tregs浸润(P 结论:高PS患者可能表现出丰富的通路、TIGIT基因表达增加、Tregs浸润):根据H&E染色切片的病理组织学特征构建的GBM病理组学模型很好地预测了THCA中TNFRSF9分子的表达水平。
{"title":"Prediction of TNFRSF9 expression and molecular pathological features in thyroid cancer using machine learning to construct Pathomics models.","authors":"Ying Liu, Junping Zhang, Shanshan Li, Wen Chen, Rongqian Wu, Zejin Hao, Jixiong Xu","doi":"10.1007/s12020-024-03862-9","DOIUrl":"10.1007/s12020-024-03862-9","url":null,"abstract":"<p><strong>Background: </strong>The TNFRSF9 molecule is pivotal in thyroid carcinoma (THCA) development. This study utilizes Pathomics techniques to predict TNFRSF9 expression in THCA tissue and explore its molecular mechanisms.</p><p><strong>Methods: </strong>Transcriptome data, pathology images, and clinical information from the cancer genome atlas (TCGA) were analyzed. Image segmentation and feature extraction were performed using the OTSU's algorithm and pyradiomics package. The dataset was split for training and validation. Features were selected using maximum relevance minimum redundancy recursive feature elimination (mRMR_RFE) and modeling conducted with the gradient boosting machine (GBM) algorithm. Model evaluation included receiver operating characteristic curve (ROC) analysis. The Pathomics model output a probabilistic pathomics score (PS) for gene expression prediction, with its prognostic value assessed in TNFRSF9 expression groups. Subsequent analysis involved gene set variation analysis (GSVA), immune gene expression, cell abundance, immunotherapy susceptibility, and gene mutation analysis.</p><p><strong>Results: </strong>High TNFRSF9 expression correlated with worsened progression-free interval (PFI) and acted as an independent risk factor [hazard ratio (HR) = 2.178, 95% confidence interval (CI) 1.045-4.538, P = 0.038]. Nine pathohistological features were identified. The GBM Pathomics model demonstrated good prediction efficacy [area under the curve (AUC) 0.819 and 0.769] and clinical benefits. High PS was a PFI risk factor (HR = 2.156, 95% CI 1.047-4.440, P = 0.037). Patients with high PS potentially exhibited enriched pathways, increased TIGIT gene expression, Tregs infiltration (P < 0.0001), and higher rates of gene mutations (BRAF, TTN, TG).</p><p><strong>Conclusions: </strong>The GBM Pathomics model constructed based on the pathohistological features of H&E-stained sections well predicted the expression level of TNFRSF9 molecules in THCA.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944288","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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