Archives of Endocrinology Metabolism最新文献

Objective: To investigate the practices of Brazilian endocrinologists in educating patients with adrenal insufficiency about stress-induced glucocorticoid adjustments.

Methods: This was a cross-sectional online survey carried out with 280 endocrinologists across Brazil. The survey included demographic questions and ten clinical vignettes assessing knowledge of appropriate glucocorticoid adjustments during various stressful situations. All participants provided informed consent, and the study protocol was approved by the local Ethics Committee. Statistical analysis compared responses based on physician demographics and practice settings.

Results: The mean percentage of correct answers was 63.3%. A significant proportion of respondents (41.1%) incorrectly believed that patients should not self-administer intramuscular hydrocortisone during an adrenal crisis. Older physicians tended to provide more conservative (and potentially harmful) glucocorticoid dosing recommendations in certain scenarios. Physicians working in both outpatient and hospital settings demonstrated better knowledge of patient education and emergency glucocorticoid administration.

Conclusion: The results of this study revealed moderate adherence to guidelines among Brazilian endocrinologists regarding adrenal insufficiency management and patient education. There is a need for improved education on glucocorticoid self-administration and targeted interventions to address knowledge gaps across different clinical scenarios. Further research is needed to evaluate the impact of these findings on patient outcomes and develop strategies to optimize the management of adrenal insufficiency in Brazil.

Objective: Graves' disease (GD) is the leading cause of hyperthyroidism globally, with 40% of affected individuals developing thyroid eye disease (TED). Treatment options for TED have advanced in recent years. This study aimed to investigate the prevalence of TED at a single center in Brazil, contributing more robust data for cost-analysis studies assessing the financial implications of novel TED treatments. Subjects and.

Methods: This study evaluated the clinical histories of 660 patients diagnosed with GD from 1999 to 2019. The patients were categorized into four groups based on the presence and severity of TED.

Results: The prevalence of TED within the study population, categorized according to severity, was as follows: absent (n = 325; 49%), mild (n = 221; 33%), moderate to severe (n = 107; 16%), and sight-threatening (n = 7; 1%). A significant correlation was observed between older age at diagnosis, smoking, larger goiters, and the presence and severity of TED.

Conclusion: The prevalence of TED identified in this single-center study contributes valuable insights for the design of cost-analysis studies and the assessment of the financial implications of novel treatments for TED within both the public and private healthcare systems in Brazil.

Objective: To identify factors potentially associated with radioiodine-refractory disease among patients treated for differentiated thyroid carcinoma at a referral center in Northeastern Brazil.

Methods: A total of 554 medical records of patients with differentiated thyroid carcinoma treated between January 2010 and August 2024 were evaluated. Radioiodine-refractory disease tumors were detected in 44 (7.9%) patients. Clinical, laboratory, and radiological data were compared between the radioiodine-refractory disease and non-radioiodine-refractory disease groups to determine factors associated with poor differentiated thyroid carcinoma outcomes.

Results: Factors most strongly associated with progression to radioiodine-refractory disease included older age, increased number of surgeries performed, aggressive histological subtypes, larger tumor size, vascular invasion, extrathyroidal extension, compromised margins, lymph node metastasis, distant metastasis at diagnosis and during follow-up, higher malignant tumor classification staging, high risk of recurrence, high thyroglobulin levels prior to radioiodine therapy, higher doses and greater number of radioiodine therapy doses, and higher frequency of incomplete responses within the first year post-treatment.

Conclusion: Identifying possible factors associated with radioiodine-refractory disease development may allow early diagnosis and a more effective treatment.

Objective: This study determined the optimal cutoff point for the triglyceride-glucose (TyG) index for predicting subclinical atherosclerosis (SA). Subjects and.

Methods: Overall, 10,039 participants (5,598 men and 4,441 women) aged > 18 years were recruited from Xiamen Chang Gung Hospital. Demographic information was provided, and the TyG index was calculated. The TyG index was categorized into quartiles, and SA was assessed by measuring brachial-ankle pulse wave velocity (baPWV). The cutoff point for the TyG index was determined via receiver operating characteristic (ROC) curve analysis.

Results: SA incidence increased with increasing TyG index in both men (from 5.929% in Group I to 10.579% in Group IV; P < 0.001) and women (from 2.074% in Group I to 14.955% in Group IV; P < 0.001). Multivariate linear regression analysis revealed that a higher TyG index was associated with an elevated risk of SA in men (odds ratio [OR] 4.028, 95% confidence interval [CI] 2.811-5.711) and women (OR 2.599, 95% CI 1.86-5.543). ROC curve analysis revealed that the area under the curve was 0.572 (95% CI = 0.541-0.602; P < 0.001) for men and 0.694 (95% CI = 0.668-0.721; P < 0.001) for women. The optimal TyG index cutoff points for predicting subclinical atherosclerosis were 8.961 for men (sensitivity, 46.5%; specificity, 67.9%) and 8.254 for women (sensitivity, 79.7%; specificity, 49.9%).

Conclusion: The TyG index is a composite indicator of dyslipidemia and hyperglycemia. In clinical practice, women with TyG index values above the cutoff should be further evaluated for the underlying pulse wave velocity.

Objective: Thyroid carcinoma (TC) is the most common cancer of the endocrine system. Dysregulation of microRNA-590-5p (miR-590-5p) has been associated with various malignancies. Targeting mitochondrial respiration is beneficial in treating TC. This study aims to evaluate the role of miR-590-5p in the proliferation and apoptosis of TC cells via mediating mitochondrial respiration.

Materials and methods: Reverse transcription quantitative polymerase chain reaction (qRT-PCR) was used to analyze differential expression of miR-590-5p in TC and para-cancerous tissues, normal thyrocytes, and TC cell lines. TC cells were transfected with agomiRNA negative control (agomiR-NC) or agomiRNA-590-5p (agomiR-590-5p). Cell counting kit 8 (CCK-8) assays, JC-1 staining, reactive oxygen species (ROS) measurements, and flow cytometry were used to detect cell proliferation, mitochondrial membrane potential (MMP), ROS levels, and apoptosis, respectively. The targeting relationship between miR-590-5p and fibroblast growth factor receptor substrate 2 (FRS2) was verified using dual-luciferase reporter assay. The role of miR-590-5p in tumor growth was analyzed in mouse xenograft tumors.

Results: miR-590-5p was expressed at low levels in TC tissues and cells relative to normal tissues. Overexpression of miR-590-5p reduced TC cell proliferation, enhanced apoptosis, and inhibited mitochondrial respiration. miR-590-5p suppressed FRS2 transcription in TC cells. Overexpression of FRS2 reversed the effects of miR-590-5p overexpression, limiting mitochondrial respiration and proliferation, and promoting apoptosis. In vivo, overexpression of miR-590-5p suppressed xenograft tumor growth in mice by reducing the transcription of FRS2.

Conclusion: miR-590-5p was poorly expressed in TC. Overexpression of miR-590-5p limited TC cell proliferation and promoted apoptosis by reducing mitochondrial respiration via decreased transcription of FRS2.

Objective: To identify early manifestations of Graves' disease in young patients and its treatment outcomes.

Subjects and methods: This was a hospital-based review of case records of 47 children (aged 1 month to 18 years) with Graves' disease from 2011 to 2022. Data were summarized and statistically analyzed.

Results: This study included 47 patients with Graves' disease, of whom 31 (66%) were girls. The average age at the initial diagnosis was 12.79 ± 3.75 years. Common presenting complaints included heat intolerance (76.6%), excessive sweating (74.5%), palpitations (68.1%), tremors (48.9%), weight loss (38.3%), increased appetite (34%), diarrhea (31.9%), and constipation (4.3%). The mean thyrotropin receptor antibody titer was 16.93 ± 13.47 IU/L. Remission was achieved in two (4.3%) patients treated with antithyroid drugs.

Conclusion: Graves' disease is the most common cause of juvenile hyperthyroidism, and treating physicians should be aware of its signs and symptoms to avoid treatment delays.

Objective: To investigated how miR-195-5p affects oxidative stress and modulates aerobic metabolism.

Materials and methods: MiR-195-5p plus GLS2 mRNA was identified by conducting real-time quantitative polymerase chain reaction. Western blotting was conducted to determine GLS2 protein expression. Corresponding kits were used to determine the concentrations of glutamate, reduced glutathione, oxidized glutathione, a-ketoglutarate, and adenosine triphosphate. The cell counting Kit-8 assay was performed to determine viability. Flow cytometry assay was performed to measure the reactive oxygen species content. Finally, a dual-luciferase reporter assay was conducted to confirm the interaction of miR-195-5p with GLS2 mRNA in the 3'UTR.

Results: In high glucose-induced SRA01/04 cells, miR-195-5p was overexpressed, and GLS2 was downregulated. When miR-195-5p was upregulated, the levels of glutamate, reduced glutathione, a-ketoglutarate, and adenosine triphosphate, along with the reduced glutathione-to-oxidized glutathione ratio decreased, whereas the reactive oxygen species levels increased. Oxidative stress was ameliorated after miR-195-5p was downregulated. MiR-195-5p adversely controls the expression of GLS2 mRNA and protein. MiR-195-5p exacerbates oxidative damage and hinders aerobic metabolism by downregulating GLS2.

Conclusion: Oxidative stress and aerobic metabolism in human lens epithelial cells were found to be regulated by miR-195-5p after the downregulation of GLS2.

Objective: To validate the psychometric properties of the Eating Behavior Phenotypes Scale (EFCA) and to analyze the stability of the construct and its external validity in Brazilian Portuguese.

Subjects and methods: A total of 206 adult participants completed a self-administered survey designed to identify eating behavior phenotypes. Confirmatory factor analysis was performed, and internal consistency was assessed using Cronbach's alpha coefficient. Concurrent validity was evaluated through Pearson's correlation between EFCA scores and body mass index. Translation involved independent forward translation from Argentinian Spanish to Brazilian Portuguese, followed by back-translation from Brazilian Portuguese to Spanish. The Brazilian Portuguese version was administered following 100% agreement between the versions.

Results: The EFCA and its subscales in Brazilian Portuguese showed acceptable internal consistency (α = 0.83).

Conclusion: Confirmatory factor analysis indicated a good fit of the data to the proposed structure. No statistically significant correlation was found between the body mass index and each subscale or the total scale score. The translation and back-translation process yielded less than a 5% discrepancy between the versions.

Objective: To quantify moderate-to-vigorous physical activity (MVPA) at postpartum in women with recent gestational diabetes mellitus, using an accelerometer and self-reported measurements from participants of the LINDA-Brasil study.

Materials and methods: In a cross-sectional sample (n = 391), MVPA was assessed via a waist-worn accelerometer and the international physical activity questionnaire (IPAQ), focusing on leisure time and commuting domains.

Results: The median postpartum period was 7.3 months (interquartile range [IQR]: 4.0-14.0). When restricted to 10-minute bouts, device-measured MVPA was 22.31 minutes/week (IQR: 0-65.8), whereas total time spent on MVPA was 213.8 minutes/week (IQR: 137.7-320.0). Higher education and pregnancy complications were associated with lower device-based MVPA. Self-reported leisure-time MVPA in 10-minute bouts was 0 minutes/week (IQR: 0-0). However, including commuting time, it increased to 90 minutes/week (IQR: 10.0-210.0). Based on total device-measured MVPA, 71.6% (CI 66.9-76.0) met the recommended 150 minutes/week. This proportion decreased to 8.4% (95% CI: 5.9-11.7) in 10-minute bouts MVPA. Based on the IPAQ, 7.4% (95% CI: 5.0-10.5) reached the guideline through leisure-time activity and 26.8% (95% CI: 22.5-31.5) through combined leisure and commuting.

Conclusion: Women with gestational diabetes mellitus at postpartum were highly active based on device-measured MVPA. Nevertheless, applying the 10-minute bout reduced these estimates across devices and self-reported measurements. These findings provide crucial information for public policies addressing this high-risk population.

Objective: To evaluate whether inflammatory markers and carotid intima-media thickness are increased in patients with Sheehan syndrome.

Methods: This study included 37 patients diagnosed with Sheehan syndrome who met the eligibility criteria, along with 37 healthy controls matched for age, body mass index, and parity. All participants underwent a detailed clinical evaluation, along with measurement of biochemical and hormonal parameters, as well as inflammatory markers, specifically tumor necrosis factor alpha and interleukin-6. Both patients and controls were assessed for carotid intima-media thickness using a high-resolution color Doppler system.

Results: Patients with Sheehan syndrome had significantly higher mean levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol, along with lower levels of high-density lipoprotein cholesterol compared with controls. They also exhibited higher levels of tumor necrosis factor alpha (23.41 ± 10.97 pg/mL versus 20.05 ± 2.76 pg/mL; p = 0.041) and interleukin-6 (37.19 ± 5.38 pg/mL versus 32.08 ± 1.18 pg/mL; p = 0.004), as well as an increased mean carotid intima-media thickness value (0.71 ± 0.07 mm versus 0.59 ± 0.05 mm; p = 0.001).

Conclusion: Patients with Sheehan syndrome exhibited risk factors that may elevate their likelihood of developing atherosclerosis.