Acta Endocrinologica-Bucharest最新文献

Background: The aim of this study was to assess the awareness of the USA and world population about osteoporosis, taking into account seasonal variations and economic conditions.

Methods: The term "osteoporosis" was searched using Google Trends between January 1, 2004 and September 12, 2024. Cosinor analysis was used to test the effect of seasonality on relative search volumes (RSV) for osteoporosis searches in the USA and worldwide. LOESS (Locally Estimated Scatterplot Smoothing) was used to decompose a time series into its seasonal component, trend component, and residual component. We also analysed RSV values in US states according to income levels.

Results: It is seen that RSV values in the USA and the world have been in a decreasing trend from 2004 to 2014, but after 2015, they have been in an increasing trend. According to the results of the cosinor analysis, RSV values in the US and worldwide are highest in the fall months and lowest in the summer months. Significant differences were found in search trends between seasons in both the US and the world (p<0.05). There is no statistically significant difference in RSV values by income level worldwide and in the USA (p>0.05).

Conclusion: Osteoporosis appears to be a global health problem and a major focus of attention, both in the US and around the world. Health strategies to increase osteoporosis awareness can be planned to address different income groups, taking into account regional and seasonal effects.

Obesity epidemic, developed in recent decades with global dissemination, brings scientific interest in causes and consequences for mankind. It is of interest whether obesity existed under different, non-obesogenic environments in ancient time. There is evidence for particular obesity existence in artefacts and pictures from caves, originated in ancient times. Human female figurines from Stone Age that represent obesity were discovered in different countries indicating that some form of obesity existed 30.000 years ago. It is supposed that most of these figures represent in some way "Mother of Goddess " connected with fertility. Records from Ancient Egyptian and Biblical eras through Greco-Roman to Medieval times indicate that obesity was present throughout peoples of previous centuries in history, although peoples of previous centuries would probably have experienced overweight and obesity as exceptional rather than normal.

Context: Previous studies have demonstrated a correlation between creatinine and cystatin levels and thyroid disorders.

Objective: To further investigate the diagnostic value of serum creatinine to cystatin C ratio in the diagnosis of thyrotoxicosis.

Design: One hundred eighty four thyrotoxicosis patients and 406 healthy controls were enrolled.

Subjects and methods: We assessed at baseline characteristics, serum Cr:Cyc in thyrotoxicosis group, control group and subgroups and analyzed the relationship between the indicator and the etiology of thyroid gland toxicity.

Results: Subgroup analysis indicated that the Cr:Cyc ratio in the Graves' disease (GD) group was lower than those in the Hashimoto's thyroiditis (HT) and subacute thyroiditis (SAT) groups (P<0.001). Correlation analysis demonstrated that the Cr:Cyc ratio was positively correlated with thyroid stimulating hormone (TSH) and thyrotropin receptor antibody (TRAb) but negatively correlated with free triiodothyronine (FT3) and free thyroxine (FT4) in the GD group. Receiver operating characteristic (ROC) curve analysis indicated that the area under the curve (AUC) value of the Cr:Cyc ratio for the diagnosis of thyrotoxicosis was 0.933 (P<0.001), and the AUC value for the diagnosis of GD was 0.778 (P<0.001).

Conclusion: The Cr:Cyc ratio has clinical significance in the diagnosis of thyrotoxicosis and the identification of thyrotoxicosis etiology.

Context: Understanding factors delaying recovery in thyrotoxicosis patients is crucial for optimizing treatment plan.

Objective: This study aimed to identify predictive factors for the delayed thyroid function recovery in thyrotoxicosis patients.

Design: The study is a retrospective review of medical records of adult thyrotoxicosis patients diagnosed at Kaohsiung Veterans General Hospital, Taiwan, from January 2014 to December 2021. The duration of follow-up for the main outcome was at least 18 months.

Subjects and methods: Patients newly diagnosed with thyrotoxicosis who were age > 18 years old, had a TSH level <0.1 μIU/mL, received CBZ or PTU treatment, and demonstrated a subsequent TSH increase to above 0.4 μIU/mL, were included.

Results: The study included 443 patients. The average time to achieve normalized TSH levels was 6.9 months. Key factors associated with delayed TSH normalization included higher body mass index (BMI) [odds ratio (OR) = 1.06, confidence interval (CI): 1.01-1.12], elevated serum free T4 levels (OR = 1.97; CI, 1.44-2.69), and treatment with propylthiouracil (OR = 2.66; CI, 1.33-5.32). In contrast, factors such as sex, age, season of diagnosis, and comorbidities did not significantly impact the rate of TSH normalization.

Conclusion: The study highlights the importance of considering individual patient characteristics, such as BMI and initial free T4 levels, in thyrotoxicosis management. The findings suggest a potential preference for carbimazole over PTU in achieving faster TSH normalization. This research contributes to the understanding of thyrotoxicosis recovery and supports the need for personalized treatment approaches in clinical practice.

Introduction: Wolfram Syndrome (WS) is a rare autosomal recessively inherited disorder characterized by juvenile-onset diabetes mellitus (DM), diabetes insipidus, optic atrophy (OA), hearing loss and neurodegeneration. This report describes three cases with WS.

Case report: The first case was diagnosed with DM and OA at the age of 6 and 11 years, respectively. Second patient was the sibling of the first patient, also had DM and was investigated for WS after his brothers' diagnosis. The third patient was diagnosed with DM at the age of 5 years and developed bilateral sensorineural hearing loss and OA at the ages of 7 and 12 years, respectively. Preliminary diagnoses of all patients were confirmed by Sanger sequencing of the WFS1 gene. Two previously reported and a novel mutation were detected. While our first patient was diagnosed with attention deficit hyperactivity disorder previously described in WS patients, obsessive compulsive disorder observed in case 2, was not previously reported in WS to the best of our knowledge. Puberty delay was detected in our first patient and was diagnosed as constitutional delay of puberty and growth.

Conclusion: Early diagnosis of WS can lead to early detection of associated pathologies and to decrease complications, morbidity and mortality.

Background: Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are associated with disturbed mineral homeostasis and serum bone biomarkers. The interplay between T2DM and CKD on serum bone turnover markers (BTM) is unclear. Our aim was to describe the BTM in patients with T2DM, CKD or both.

Methods: In this observational, single-centre, prospective study, we included 320 patients over 40 years, divided into four groups: T2DM and normal kidney function (n=142), T2DM and CKD (n=36), CKD and normal glucose metabolism (n=29) and healthy controls (n=113). We excluded patients treated for osteoporosis and with secondary osteoporosis. Patients were compared by age, levels of glycated hemoglobin, PTH, alkaline phosphatase, osteocalcin (OC), CTx and 25 OH vitamin D.

Results: Univariate analysis showed that GFR correlated significantly with PTH (r=0.37), OC (r=0.43) and CTX (r=0.45) in the diabetes group but only with PTH (r=0.34) in the non-T2DM group. Multivariate analysis showed that GFR remained significantly correlated with the same bone markers even after adjustment for age, sex or 25(OH)D levels. Diabetics seem to have lower levels of alkaline phosphatase (68±22.1 U/L) and CTX (0.37±0.24 ng/mL) than those without diabetes (76.7±29.6. U/L and 0.5±0.19 ng/mL, respectively). There was no correlation between BTM and glycated hemoglobin.

Conclusions: Bone turnover markers correlate with GFR, particularly in patients with T2DM. However, alkaline phosphatase is lower in T2DM than in non-T2DM.

Introduction: Surgery has lost a lot of ground as the main therapy of most prolactinomas as it is clear from the current guidelines in most prolactin secreting adenomas, even in the setting of optic compression. However, we believe that surgery is still an important part in the treatment of this type of adenomas. This study is aimed to define what is the role of pituitary surgery in the current setup of prolactinoma management.

Material and methods: In this retrospective, single-center study we analyzed 12 consecutive patients who underwent primary endoscopic transsphenoidal surgery for prolactinomas, between 2013 and 2022. Surgical indication, previous dopamine agonist (DA) treatment, remission rates, surgical complications, pituitary function and imagistic appearance are presented.

Results: Of the 12 patients included, 4 had giant PRL and 8 macroadenomas, while 9 of them had previous DA treatment. The main surgical indication was pituitary apoplexy in 5 patients followed by CSF leak after DA treatment, 3 cases, and DA resistance in 3 cases. The main surgical complications were transitory diabetes insipidus in 7 cases. Normalization of prolactin levels was achieved in 2 patients.

Conclusions: Surgical intervention should be strongly considered in all patients with neurologic symptoms referable to the lesion, resistance to medical therapy, other treatment failure or with complications after DA treatment. The endoscopic endonasal surgery offers good surgical outcomes with low rates of surgical complications and should remain an open option for specific cases.

COVID-19 primarily affects the respiratory system. What comes after the disease is now a greater concern for the scientific world. It is remarkable for causing endocrine organ involvement, particularly in the adrenal glands. However, its effect on the adrenal gland has not been fully elucidated. A case of primary adrenal insufficiency after COVID-19. A 31-year-old female patient who presented with complaints of weakness, anorexia, nausea, recent onset of vomiting, dizziness, and low blood pressure for two months was admitted to the outpatient Department of Endocrinology and Metabolism. After discharge, the patient had routine follow-ups, and here we present the information on the first and seventh month after discharge. The patient was diagnosed with primary adrenal insufficiency with cortisol <0.054 µg/dL and adrenocorticotropic hormone >1200 pg/mL in the laboratory. In the non-contrast computed tomography taken in the adrenal protocol, the stem and leaves of both adrenal glands are significantly thinned and appear atrophic, the right adrenal gland is hardly distinguished. Hydrocortisone was started. All complaints were resolved within a week, except hyperpigmentation, which was resolved six months later after treatment. Our study support adrenal gland involvement due to COVID-19, further research is needed to obtain data on damage mechanisms.

The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is widely used for the standardized reporting of thyroid fine-needle aspiration (FNA) cytology. The 2023 revision of TBSRTC introduced specific subcategories for the classification of atypia of undetermined significance (AUS). This study tests the association between AUS subtypes and malignant diagnoses, namely AUS-nuclear atypia and AUS-other, in archived thyroid - FNA specimens with atypia from 2018-2022 at King Abdulaziz University Hospital. A total of 104 thyroid - FNA specimens with AUS were re-evaluated cytologically and correlated with subsequent surgical outcomes, along with a discussion of discrepant cases.