Hormones-International Journal of Endocrinology and Metabolism最新文献

Theodoros Aretaios (1829-1893), having pursued advanced studies at home and abroad and possessing a wide range of competences and interests, was among the first Greek physicians to produce educational treatises for both students and doctors of medicine. Among these is his medical treatise Surgery which deals with thyroid operations and goiter symptoms as well as post-operative lesions which included a record of his extensive experience, learned recommendations, deep insights, and advanced techniques. In this medical archive, which is preserved in the National Library of Greece, there is, for example, the physician's vivid description of a thyroidectomy that he performed which illustrates his expertise as a surgeon as well as the surgical knowledge of his times. Aretaios was not the first to perform this operation in Greece: he was, however, the first to document it, which he did for the benefit of his fellow Greeks and of surgeons worldwide.

Purpose: Primary aldosteronism (PA), which is the commonest cause of secondary hypertension, can be cured by unilateral adrenalectomy. We report the short-and long-term outcomes after adrenalectomy performed at a single UK center over a period of 24 years.

Methods: Retrospective analysis of biochemical (potassium, aldosterone, renin, and ARR) radiological (CT/MRI, AVS, and nuclear scans), and clinical (surgical complications, blood pressure, and number of antihypertensive medications) short-and long-terms outcomes in patients who underwent adrenalectomy for PA between 1998 and 2021. Standardized PASO and Clavien-Dindo criteria to assess biochemical, clinical, and surgical outcomes were used.

Results: A total of 82 patients were treated via adrenalectomy for PA over a 24-year period. Short-term follow-up data (within 3 months after surgery) was available for all 82 patients (M45, F37, mean age 51.7 years): 24 of them were followed up for at least 60 months (range 60 to 72 months) and 77 (93.9%) patients had laparoscopic surgery (one conversion). Seven patients had postoperative complications classified as Clavien-Dindo II (4), IIIa(1) and IVa(2). Median LOS was 2.5 days (1-12). Complete and partial clinical success was achieved in 29 and 58.3% and 41.7 and 45.8% of patients in the short and the long term, respectively. Clinical benefit was observed in 88% of patients. Complete biochemical success was achieved in 95.8% of patients in the short and the long term.

Conclusion: Unilateral adrenalectomy in patients with PA showed clinical benefit in 88% and achieved biochemical cure in almost all of them. Our data suggest that these benefits persisted for at least 5 years.

Peroxisome proliferator-activated receptors (PPARs) belong to the nuclear hormone receptor family of ligand-activated receptors and are known for their roles as key factors in the regulation of lipid metabolism. In the more than three decades since their discovery, most reports on PPARs have focused on their roles in lipid metabolism, and a portion of the new research has also focused on the relationship between PPARs and fibrosis. Interestingly, lipid metabolism disorders and fibrosis are also inextricably linked. This implies that PPARs, lipid metabolism and fibrosis are interrelated. On this basis, we have summarized the molecular mechanisms of PPARs regulating fibrosis through lipid metabolism and PPARγ directly regulating fibrosis, and pointed out the contradictions and enigmas that need to be further explored in the processes of PPARs regulating lipid metabolism and fibrosis. The aim of the present review is to provide new ideas for PPARs for the treatment of lipid metabolism disorders and fibrosis.

Purpose: Anxiety is a common mental health issue during pregnancy. Moreover, women with gestational diabetes mellitus (GDM) seem to have to cope with higher levels of anxiety, being at higher risk for several health and mental complications. Women with GDM are recommended to undertake regular physical exercise to improve metabolic and reproductive outcomes. However, there are no specific guidelines for exercise in women with GDM and data on its relationship with mental health are scarce. The aim of this study was to investigate the effect of exercise on anxiety symptoms in pregnant women with GDM.

Methods: The present non-randomized, open-label clinical trial was a pilot study intended to provide initial data on the effect of exercise on anxiety symptoms of pregnant women with GDM. Forty-three women were assigned to three the following three study groups, (a) Advice Group (n = 17), Walking Group (n = 14), and Mixed Exercise Group (n = 12), from GDM diagnosis to delivery.

Results: Based on the Beck Anxiety Inventory (BAI) scores, all groups showed normal anxiety changes or mild anxiety levels pre- and post-intervention, ranging between 9.00 (1.00-32.00) (pre-intervention) and 7.5 (1.00-26.00) (post-intervention), but none experienced severe anxiety.

Conclusion: In the present study, a trend of self-selected pace walking to reduce the BAI scores was identified since the Walking Groups had lower scores after the intervention. However, this trend did not reach statistical significance. Brisk walking (30-45 min) three times per week may produce positive changes in both the treatment plan and the anxiety state of women with GDM. Moreover, the study confirms that routine medical care, counseling, and support by an interdisciplinary team are protective against anxiety in women with GDM.

In this case report, we present a 43-year-old man (XY) with azoospermia and typical male appearance, at Tanner stage 5 of sexual development, who presented with severe colicky abdominal pain accompanied by nausea. A pelvic CT scan revealed a pear-shaped structure in the pelvic cavity, located entirely behind the bladder, measuring 106*44 cm with fluid accumulation inside it, extending into the right inguinal canal. There was also evidence suggesting the formation of the upper and mid-third part of a vagina, terminating in the prostatic gland. The patient underwent laparoscopic surgery for the removal of the uterus and the left gonad. The patient had a uterus with hematometra and a blind vaginal pouch measuring 4 centimeters at the end of the uterus, extending posteriorly behind the bladder to the apex of the prostate, containing old blood. Hormonal analysis showed serum estradiol < 5.0 pmol/L (11-44pg/mL), free testosterone at 1.57 ng/ mL(male reference range: 2.5-20 ng/mL), testosterone at 0.56 ng/mL (2.27-10.30),FSH at 44.8 mIU/L (0.95-11.95 mIU/L), LH at 20.4 mIU/L(0.57-12.07), and DHEA-SO4 at 199.0 µg/mL (139.7-484.4 µg/mL). Currently, the patient is under the care of a urologist and is receiving weekly treatment with hCG medication. He reports normal sexual function, including intercourse, orgasm, erection, and ejaculation.

Anti-Müllerian hormone (AMH) is a dimeric glycoprotein that belongs to the transforming growth factor beta superfamily and plays essential roles in sexual differentiation and folliculogenesis. In the male embryo, AMH is produced by the Sertoli cells and induces the involution of the Müllerian ducts. In females, AMH is predominately produced by the granulosa cells of growing preantral and small antral follicles and regulates follicular maturation. Many recent studies have highlighted the significant role of this hormone in the diagnostic approach to female children and adolescents with various disorders that affect ovarian development and function. AMH is considered a valuable diagnostic tool in the management of female pediatric patients with conditions such as polycystic ovary syndrome, precocious puberty, ovarian tumors, differences in sex development, and premature ovarian insufficiency. Standardization of AMH assays, internationally approved reference values based on age and pubertal stage, and widespread availability of the test could further upgrade the clinical utility of AMH, rendering it a valuable tool in the armamentarium of physicians involved in the care of female children and adolescents, and promote future research.

Purpose: Mobile applications (apps) have proven to be highly effective tools to empower patients with type 1 diabetes mellitus (T1DM) and enable them to achieve better self-care, quality of life (QOL), and glycemic control. The aim of the study is to examine whether mySugr^®, an app for diabetes management, together with teleconsultations, can have a positive impact on these factors and, thereby, replace current clinical care.

Methods: This study concerns an exploratory randomized clinical trial of 12 months' duration. People with T1DM using multiple daily injections were randomized to usual care (bolus calculator, five face-to-face visits) or intervention (mySugr^® app, three face-to-face visits, and two teleconsultations). The main outcome was increase in empowerment assessed with the Diabetes Empowerment Scale Short Form questionnaire (DES-SF-S). Secondary outcomes were change in additional glucose-related (blood glucose monitoring, mean blood glucose, standard deviation, coefficient of variation (CV), and high and low blood glucose index) and patient-reported outcome measures (PROMs) (self-management, QOL, and distress).

Results: A total of 25 out of 28 participants completed the study (52% men, age 44.52 years, diabetes duration 21.28 years). At 12 months, no significant differences were identified in the change of DES-SF-S and additional PROMs between arms. Similarly, no differences were observed in glucose-related outcomes except for the change in CV at 9 (control - 1.87 ± 4.98 vs. intervention 5.89 ± 11.33, p = 0.008) and 12 months (control - 2.33 ± 3.54 vs. intervention 5.12 ± 11.32, p = 0.018). Adherence to and satisfaction with the app were high.

Conclusion: Patients with diabetes using the mySugr^® app and teleconsultation achieved similar results to those following usual care in empowerment, other PROMs, and most glucose-related outcomes, thus supporting its use in combination with face-to-face visits. The RCT was registered with ClinicalTrials.gov (NCT03819335, first registration 28/01/2019).

Purpose: Data on the prevalence of obesity among hospitalized patients are limited. Our objective was to capture the rates of overweight and obesity among people admitted to an internal medicine department and to explore a potential association between body mass index (BMI) and causes of hospitalization.

Methods: Demographic and anthropometric parameters and cause of admission were recorded in all patients admitted to our department over a 30-day period.

Results: One hundred and eighteen patients with a mean age of 71.84 years and a mean BMI of 26.85 kg/m² were included in the analysis. Among study participants, 53.25% were living with overweight and obesity. Patients admitted for hepatobiliary disease had a higher BMI compared to those admitted for other diseases of the gastrointestinal tract (P < 0.001).

Conclusions: More than half of patients admitted to an internal medicine department live with obesity or overweight, the specific reasons for admission being associated with a higher BMI.

Purpose: This study explored the clinical value of long non-coding RNA small nucleolar RNA host gene 14 (SNHG14) in diabetic kidney disease (DKD) and the mechanism of renal tubular injury.

Methods: Patients with DKD, type 2 diabetes mellitus (T2DM) and healthy individuals (HVs) were included, as well as the human proximal tubular epithelial cell line (HK-2) induced by high glucose was also included. The mRNA levels of SNHG14 in the serum and cells were detected using RT-qPCR. Diagnostic significance was examined using receiver operating characteristic (ROC) analysis. A commercial test kit, flow cytometry, and enzyme-linked immunosorbent assays were employed to assess reactive oxygen species (ROS) production, apoptosis, inflammatory factor secretion, and extracellular matrix protein levels in HK-2 cells. The dual-luciferase reporter assay and RNA immunoprecipitation were used to validate miR-483-5p concerning SNHG14 or histone deacetylase 4 (HDAC4).

Results: SNHG14 and HDAC4 levels were elevated in the serum of DKD patients and HG-induced HK-2 cells, while miR-483-5p levels were decreased (P < 0.001). SNHG14 increased HDAC4 levels by sponging miR-483-5p. Elevated SNHG14 levels significantly differentiated DKD patients from HVs (AUC = 0.944) and T2DM (AUC = 0.867). Silencing of SNHG14 alleviated HG-induced ROS production and apoptosis as well as the over-secretion of inflammatory factors and extracellular matrix proteins; however, this alleviation was typically suppressed by low expression of miR-483-5p (P < 0.001). Elevated miR-483-5p alleviates HG-induced renal tubular injury, but this alleviation is suppressed by HDAC4 overexpression.

Conclusion: In summary, suppression of SNHG14 has been shown in our study to mitigate renal tubular injury in DKD by regulating apoptosis, oxidative stress, inflammation, and fibrosis through the miR-483-5p/HDAC4 axis.