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Time to development of macrovascular complications and its predictors among type 2 diabetes mellitus patients at Jimma University Medical Center. 吉马大学医疗中心 2 型糖尿病患者出现大血管并发症的时间及其预测因素。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-21 DOI: 10.1186/s12902-024-01782-3
Abera Feyisa Adare, Firew Tiruneh Tiyare, Buzuneh Tasfa Marine
<p><strong>Background: </strong>Type 2 diabetes mellitus is a serious metabolic disease that is often associated with vascular complications. The increasing prevalence of type 2 diabetes mellitus poses significant public health challenges, particularly in Low and Middle-Income Countries where healthcare resources are often limited. In Africa, the burden of T2DM is rising rapidly, leading to a consequential increase in macrovascular complications such as cardiovascular disease and stroke. These complications not only affect the quality of life but also significantly contribute to morbidity and mortality among affected individuals. The main objective of this study was to assess the time to development of macrovascular complications and identify its predictors among type 2 diabetes mellitus patients in Jimma University medical center from 2018-2022.</p><p><strong>Methods: </strong>Institutional-based retrospective follow-up study was conducted in Jimma University Medical Center among newly diagnosed type 2 diabetes mellitus patient from 2018, to 2022. A systematic sampling technique was used to recruit 452 records of type 2 diabetes mellitus patients. The Kaplan-Meier curve and the log-rank tests were used to determine the time to macro-vascular complications, and evaluate the significant difference in survival probability among predictors respectively. The overall goodness of the Cox proportional hazard model was checked by Cox-Snell residuals. Bivariable and multivariable cox-proportional hazard regression were used to identify the association between the variables and survival time.</p><p><strong>Results: </strong>The median survival time to development of macro vascular complications was 24 months. Urban residence [(Adjusted hazard ratio = 2.02; 95% CI: (1.33, 3.05)], having hypertension at start of diabetic treatment [(AHR = 1.52; 95% CI: (1.06, 2.13)], baseline age ≥ 60 years [(AHR = 4.42; 95% CI: (1.72, 11.29)], having dyslipidemia at baseline [(AHR = 1.82; 95% CI: (1.13, 2.93)], High density lipoprotein cholesterol levels < 40 mg/dl [(AHR = 2.11; (1.16, 3.81)], triglycerides > 150 mg/dl [(AHR = 1.48; 95% CI:( 1.02, 2.13)], Hemoglobin A1C level > 7% [(AHR = 1.49; 95% CI: (1.04, 2.14)], and Oral hypoglycemic agents + insulin [(AHR = 2.73; 95% CI: (1.81, 4.09)] were the significant predictors of the time to development of macro vascular complications.</p><p><strong>Conclusion: </strong>Findings in this study indicated that the median time to development of macro vascular complications among type 2 diabetes mellitus patients was 24 months. Baseline age category in years, residence, presence of hypertension, presence of dyslipidemia, High density lipoprotein-cholesterol level < 40 mg/dl, triglyceride > 150 mg/dl, HgbA1C > 7% at baseline, and medication regimens were identified as independent significant predictors of the time to development of macro vascular complications among type 2 diabetes mellitus patients. The findings call attention to the
背景:2 型糖尿病是一种严重的代谢性疾病,通常伴有血管并发症。2 型糖尿病发病率的不断上升给公共卫生带来了重大挑战,尤其是在医疗资源往往有限的中低收入国家。在非洲,2 型糖尿病的发病率正在迅速上升,导致心血管疾病和中风等大血管并发症随之增加。这些并发症不仅影响了患者的生活质量,还大大增加了患者的发病率和死亡率。本研究的主要目的是评估吉马大学医疗中心 2 型糖尿病患者在 2018-2022 年间出现大血管并发症的时间,并确定其预测因素:在吉马大学医疗中心对2018年至2022年新诊断的2型糖尿病患者进行了基于机构的回顾性随访研究。采用系统抽样技术收集了 452 份 2 型糖尿病患者记录。分别采用卡普兰-梅耶曲线和对数秩检验来确定大血管并发症的发生时间,并评估各预测因子在生存概率上的显著差异。Cox-Snell残差检验了Cox比例危险模型的整体良好性。采用二变量和多变量 Cox 比例危险回归来确定变量与生存时间之间的关系:结果:出现大血管并发症的中位生存时间为24个月。93)]、高密度脂蛋白胆固醇水平为 150 mg/dl [(AHR = 1.48; 95% CI:( 1.02, 2.13)]、血红蛋白 A1C 水平 > 7% [(AHR = 1.49; 95% CI: (1.04, 2.14)]、口服降糖药+胰岛素[(AHR = 2.73; 95% CI: (1.81, 4.09)]是大血管并发症发生时间的显著预测因素:本研究结果表明,2 型糖尿病患者出现大血管并发症的中位时间为 24 个月。基线年龄(岁)、居住地、是否患有高血压、是否患有血脂异常、高密度脂蛋白胆固醇水平(150 mg/dl)、基线 HgbA1C > 7% 和药物治疗方案被确定为 2 型糖尿病患者大血管并发症发生时间的独立重要预测因素。研究结果提醒人们注意治疗方案的作用,尤其是口服降糖药和胰岛素联合疗法的使用与并发症危险的增加有关。在较短的随访期内,大血管并发症的发生率较高,这凸显了在 T2DM 管理中采取积极主动的个体化护理策略的必要性。通过早期识别高危患者并制定相应的治疗方案,医疗服务提供者有可能改善治疗效果并减轻该人群的大血管并发症负担。
{"title":"Time to development of macrovascular complications and its predictors among type 2 diabetes mellitus patients at Jimma University Medical Center.","authors":"Abera Feyisa Adare, Firew Tiruneh Tiyare, Buzuneh Tasfa Marine","doi":"10.1186/s12902-024-01782-3","DOIUrl":"https://doi.org/10.1186/s12902-024-01782-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Type 2 diabetes mellitus is a serious metabolic disease that is often associated with vascular complications. The increasing prevalence of type 2 diabetes mellitus poses significant public health challenges, particularly in Low and Middle-Income Countries where healthcare resources are often limited. In Africa, the burden of T2DM is rising rapidly, leading to a consequential increase in macrovascular complications such as cardiovascular disease and stroke. These complications not only affect the quality of life but also significantly contribute to morbidity and mortality among affected individuals. The main objective of this study was to assess the time to development of macrovascular complications and identify its predictors among type 2 diabetes mellitus patients in Jimma University medical center from 2018-2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Institutional-based retrospective follow-up study was conducted in Jimma University Medical Center among newly diagnosed type 2 diabetes mellitus patient from 2018, to 2022. A systematic sampling technique was used to recruit 452 records of type 2 diabetes mellitus patients. The Kaplan-Meier curve and the log-rank tests were used to determine the time to macro-vascular complications, and evaluate the significant difference in survival probability among predictors respectively. The overall goodness of the Cox proportional hazard model was checked by Cox-Snell residuals. Bivariable and multivariable cox-proportional hazard regression were used to identify the association between the variables and survival time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The median survival time to development of macro vascular complications was 24 months. Urban residence [(Adjusted hazard ratio = 2.02; 95% CI: (1.33, 3.05)], having hypertension at start of diabetic treatment [(AHR = 1.52; 95% CI: (1.06, 2.13)], baseline age ≥ 60 years [(AHR = 4.42; 95% CI: (1.72, 11.29)], having dyslipidemia at baseline [(AHR = 1.82; 95% CI: (1.13, 2.93)], High density lipoprotein cholesterol levels &lt; 40 mg/dl [(AHR = 2.11; (1.16, 3.81)], triglycerides &gt; 150 mg/dl [(AHR = 1.48; 95% CI:( 1.02, 2.13)], Hemoglobin A1C level &gt; 7% [(AHR = 1.49; 95% CI: (1.04, 2.14)], and Oral hypoglycemic agents + insulin [(AHR = 2.73; 95% CI: (1.81, 4.09)] were the significant predictors of the time to development of macro vascular complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Findings in this study indicated that the median time to development of macro vascular complications among type 2 diabetes mellitus patients was 24 months. Baseline age category in years, residence, presence of hypertension, presence of dyslipidemia, High density lipoprotein-cholesterol level &lt; 40 mg/dl, triglyceride &gt; 150 mg/dl, HgbA1C &gt; 7% at baseline, and medication regimens were identified as independent significant predictors of the time to development of macro vascular complications among type 2 diabetes mellitus patients. The findings call attention to the","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"252"},"PeriodicalIF":2.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686015","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
Body composition analysis in women with polycystic ovary syndrome: a cross-sectional study from the Tehran Lipid and Glucose Study (TLGS). 多囊卵巢综合征妇女的身体成分分析:德黑兰血脂和血糖研究(TLGS)的横断面研究。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-19 DOI: 10.1186/s12902-024-01783-2
Anahita Zakeri, Amir Ebadinejad, Maryam Rahmati, Amir Abbas Momenan, Mahtab Niroomand, Majid Valizadeh, Fereidoun Azizi, Fahimeh Ramezani Tehrani, Farhad Hosseinpanah

Background: Obesity is associated with the development of polycystic ovarian syndrome (PCOS), a complex endocrine disorder. However, the correlation between body composition and PCOS in women has not been thoroughly investigated. This study aimed to examine body composition using bioelectrical impedance analysis (BIA) in women with and without PCOS in a population-based study within the Tehran Lipid and Glucose Study (TLGS).

Methods: We conducted a cross-sectional study among non-menopausal women aged 18-45 who underwent BIA in phase VII of the TLGS. A total of 150 participants with PCOS and 240 without PCOS were included based on the Rotterdam criteria. Baseline demographic, anthropometric, laboratory, and body composition parameters were compared between the two groups.

Results: The mean age was 33.7 ± 7.45 years in the PCOS group and 35.49 ± 7.05 years in the control group. The mean BMI was 27.0 ± 4.0 kg/m2 in the PCOS group and 27.1 ± 4.4 kg/m2 in the control group. No significant differences were found in body composition parameters between the two groups as assessed by BIA. Additionally, there were no correlations between body composition and hormone parameters in PCOS patients.

Conclusion: In this sample of non-referral patients with PCOS, the use of BIA did not provide added value beyond conventional anthropometric measures for assessing body composition. Further longitudinal research is needed to determine whether body composition analysis can enhance PCOS evaluation.

背景:肥胖与多囊卵巢综合征(PCOS)的发生有关,这是一种复杂的内分泌失调症。然而,对女性身体成分与多囊卵巢综合征之间的相关性尚未进行深入研究。本研究旨在德黑兰血脂和血糖研究(TLGS)范围内的一项人群研究中,使用生物电阻抗分析法(BIA)检测患有和未患有多囊卵巢综合症的女性的身体成分:我们对德黑兰血脂和血糖研究(TLGS)第七阶段中接受 BIA 分析的 18-45 岁非绝经妇女进行了横断面研究。根据鹿特丹标准,共纳入了 150 名患有多囊卵巢综合症的参与者和 240 名未患有多囊卵巢综合症的参与者。对两组的基线人口统计学、人体测量学、实验室和身体成分参数进行了比较:结果:多囊卵巢综合征组的平均年龄为(33.7±7.45)岁,对照组为(35.49±7.05)岁。多囊卵巢综合征组的平均体重指数为 27.0 ± 4.0 kg/m2,对照组为 27.1 ± 4.4 kg/m2。根据 BIA 评估,两组之间的身体成分参数无明显差异。此外,多囊卵巢综合症患者的身体成分与激素参数之间没有相关性:结论:在这个非转诊的多囊卵巢综合症患者样本中,使用 BIA 评估身体成分并没有比传统的人体测量方法更有价值。需要进一步开展纵向研究,以确定身体成分分析是否能加强对多囊卵巢综合症的评估。
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引用次数: 0
Inverted U-shaped association between total testosterone with bone mineral density in men over 60 years old. 60 岁以上男性总睾酮与骨矿物质密度之间的关系呈倒 U 型。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-18 DOI: 10.1186/s12902-024-01780-5
Ji Ma, Jian Zhao, Ning Wu, Minghua Han, Zhuojing Yang, Haoyang Chen, Qian Zhao

Background: Aging often leads to changes in hormone levels, particularly testosterone, which is thought to significantly affect bone health in older males.

Objective: This study aimed to explore the link between testosterone levels and bone mineral density in men aged 60 and above.

Methods: Data from the National Health and Nutrition Examination Survey 2013-2014 were used. Weighted multivariable linear regression models were employed to study the association between testosterone and bone mineral density. Furthermore, a weighted generalized additive model and smooth curve fitting were used to address potential nonlinear patterns in the data.

Results: The analysis included 621 elderly men. After accounting for various factors, the study uncovered a Inverted U-shaped correlation between testosterone levels and femoral neck density. Notably, a turning point was identified at the testosterone level of 406.4 ng/dL. Further examination, using different models, showed that testosterone levels in the third quartile (group Q3) were positively linked to bone density. However, contrasting trends were observed in the first (group Q1) and fourth quartiles (group Q4), where testosterone levels displayed a negative relationship with bone density.

Conclusion: The results indicate a complex interplay between testosterone levels and bone mineral density in elderly men. The U-shaped trend suggests that both low and high testosterone levels could negatively impact bone health. These findings highlight the importance of maintaining testosterone levels within an optimal range to preserve bone health in aging men.

背景:衰老通常会导致激素水平的变化,尤其是睾酮,而睾酮被认为会严重影响老年男性的骨骼健康:本研究旨在探讨 60 岁及以上男性睾酮水平与骨矿物质密度之间的联系:方法:采用2013-2014年全国健康与营养调查的数据。采用加权多变量线性回归模型研究睾酮与骨矿物质密度之间的关系。此外,还使用了加权广义加法模型和平滑曲线拟合来解决数据中潜在的非线性模式:分析包括 621 名老年男性。在考虑了各种因素后,研究发现睾酮水平与股骨颈密度之间存在倒 U 型相关性。值得注意的是,在睾酮水平达到 406.4 纳克/分升时出现了一个转折点。使用不同模型进行的进一步研究表明,睾酮水平处于第三四分位数(Q3 组)的人群与骨密度呈正相关。然而,在第一四分位数(Q1 组)和第四四分位数(Q4 组)中却出现了相反的趋势,睾酮水平与骨密度呈负相关:结论:研究结果表明,老年男性的睾酮水平与骨质密度之间存在复杂的相互作用。U型趋势表明,睾酮水平过低和过高都会对骨骼健康产生负面影响。这些发现强调了将睾酮水平保持在最佳范围内对维护老年男性骨骼健康的重要性。
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引用次数: 0
Risk of Hepatocellular Carcinoma with Glucagon-like Peptide-1 receptor agonist treatment in patients: a systematic review and meta-analysis. 胰高血糖素样肽-1 受体激动剂治疗患者罹患肝细胞癌的风险:系统回顾和荟萃分析。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-18 DOI: 10.1186/s12902-024-01775-2
Muhammed Shabil, Mahalaqua Nazli Khatib, Suhas Ballal, Pooja Bansal, Balvir S Tomar, Ayash Ashraf, M Ravi Kumar, Aashna Sinha, Pramod Rawat, Abhay M Gaidhane, Sanjit Sah, Afukonyo Shidoiku Daniel, Ambanna Yappalparvi, Ganesh Bushi

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide, with increased prevalence in individuals with chronic liver conditions and type 2 diabetes mellitus (T2DM). Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) have shown promise in diabetes management and may influence liver disease progression. This systematic review and meta-analysis aimed to assess the efficacy of GLP-1 RAs in reducing the risk of HCC in patients with T2DM.

Methods: We conducted a literature search of PubMed, EMBASE, and Web of Science up to August 1, 2024. Studies that evaluated the incidence of HCC in T2DM patients treated with GLP-1 RAs compared to other therapies were included. Meta-analyses were performed using a random-effects model to compute pooled hazard ratios (HRs) and 95% confidence intervals (CIs), and heterogeneity was assessed using the I² statistic. All statistical analyses were performed in R software version 4.3.

Results: Eight studies met the inclusion criteria. The pooled analysis demonstrated that GLP-1 RA treatment was associated with a significant reduction in HCC risk compared to insulin or no GLP-1 RA treatment (pooled HR = 0.41, 95% CI: 0.28 to 0.55), with considerable heterogeneity (I² = 74%). Compared to metformin and DPP-4 inhibitors, GLP-1 RAs did not significantly alter HCC risk (HR = 0.99, 95% CI: 0.79 to 1.27 for metformin; HR = 1.05, 95% CI: 0.80 to 1.39 for DPP-4 inhibitors). However, GLP-1 RAs were associated with a reduced risk compared to sulfonylureas (HR = 0.78, 95% CI: 0.65 to 0.93).

Conclusion: GLP-1 RAs may offer protective benefits against HCC in T2DM patients compared to insulin or no GLP-1 RAs, but not significantly over other antidiabetic medications. This review indicates the need for further randomized controlled trials to clarify the role of GLP-1 RAs in HCC risk mitigation and to explore their mechanistic pathways in liver disease management.

背景:肝细胞癌(HCC)是全球癌症相关死亡的主要原因,在患有慢性肝病和 2 型糖尿病(T2DM)的人中发病率更高。胰高血糖素样肽-1受体激动剂(GLP-1 RAs)在糖尿病治疗中显示出良好的前景,并可能影响肝病的进展。本系统综述和荟萃分析旨在评估 GLP-1 RAs 在降低 T2DM 患者 HCC 风险方面的疗效:我们对截至 2024 年 8 月 1 日的 PubMed、EMBASE 和 Web of Science 进行了文献检索。方法:我们检索了截至 2024 年 8 月 1 日的 PubMed、EMBASE 和 Web Science 文献,纳入了评估 T2DM 患者接受 GLP-1 RAs 治疗后与其他疗法相比 HCC 发生率的研究。采用随机效应模型进行 Meta 分析,计算汇总的危险比 (HR) 和 95% 置信区间 (CI),并使用 I² 统计量评估异质性。所有统计分析均在 R 软件 4.3 版本中进行:八项研究符合纳入标准。汇总分析表明,与胰岛素或无 GLP-1 RA 治疗相比,GLP-1 RA 治疗可显著降低 HCC 风险(汇总 HR = 0.41,95% CI:0.28 至 0.55),但存在相当大的异质性(I² = 74%)。与二甲双胍和 DPP-4 抑制剂相比,GLP-1 RAs 并未显著改变 HCC 风险(二甲双胍的 HR = 0.99,95% CI:0.79 至 1.27;DPP-4 抑制剂的 HR = 1.05,95% CI:0.80 至 1.39)。然而,与磺脲类药物相比,GLP-1 RAs 可降低风险(HR = 0.78,95% CI:0.65 至 0.93):结论:与胰岛素或无 GLP-1 RAs 相比,GLP-1 RAs 可为 T2DM 患者提供预防 HCC 的保护性益处,但与其他抗糖尿病药物相比效果并不明显。本综述表明,有必要进一步开展随机对照试验,以明确 GLP-1 RAs 在降低 HCC 风险中的作用,并探索其在肝病管理中的机制途径。
{"title":"Risk of Hepatocellular Carcinoma with Glucagon-like Peptide-1 receptor agonist treatment in patients: a systematic review and meta-analysis.","authors":"Muhammed Shabil, Mahalaqua Nazli Khatib, Suhas Ballal, Pooja Bansal, Balvir S Tomar, Ayash Ashraf, M Ravi Kumar, Aashna Sinha, Pramod Rawat, Abhay M Gaidhane, Sanjit Sah, Afukonyo Shidoiku Daniel, Ambanna Yappalparvi, Ganesh Bushi","doi":"10.1186/s12902-024-01775-2","DOIUrl":"10.1186/s12902-024-01775-2","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide, with increased prevalence in individuals with chronic liver conditions and type 2 diabetes mellitus (T2DM). Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) have shown promise in diabetes management and may influence liver disease progression. This systematic review and meta-analysis aimed to assess the efficacy of GLP-1 RAs in reducing the risk of HCC in patients with T2DM.</p><p><strong>Methods: </strong>We conducted a literature search of PubMed, EMBASE, and Web of Science up to August 1, 2024. Studies that evaluated the incidence of HCC in T2DM patients treated with GLP-1 RAs compared to other therapies were included. Meta-analyses were performed using a random-effects model to compute pooled hazard ratios (HRs) and 95% confidence intervals (CIs), and heterogeneity was assessed using the I² statistic. All statistical analyses were performed in R software version 4.3.</p><p><strong>Results: </strong>Eight studies met the inclusion criteria. The pooled analysis demonstrated that GLP-1 RA treatment was associated with a significant reduction in HCC risk compared to insulin or no GLP-1 RA treatment (pooled HR = 0.41, 95% CI: 0.28 to 0.55), with considerable heterogeneity (I² = 74%). Compared to metformin and DPP-4 inhibitors, GLP-1 RAs did not significantly alter HCC risk (HR = 0.99, 95% CI: 0.79 to 1.27 for metformin; HR = 1.05, 95% CI: 0.80 to 1.39 for DPP-4 inhibitors). However, GLP-1 RAs were associated with a reduced risk compared to sulfonylureas (HR = 0.78, 95% CI: 0.65 to 0.93).</p><p><strong>Conclusion: </strong>GLP-1 RAs may offer protective benefits against HCC in T2DM patients compared to insulin or no GLP-1 RAs, but not significantly over other antidiabetic medications. This review indicates the need for further randomized controlled trials to clarify the role of GLP-1 RAs in HCC risk mitigation and to explore their mechanistic pathways in liver disease management.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"246"},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mediating effect of fasting blood glucose and peripheral arterial disease on the relationship between sexual functioning and health-related quality of life among Nigerians with type 2 diabetes. 空腹血糖和外周动脉疾病对尼日利亚 2 型糖尿病患者性功能与健康相关生活质量之间关系的中介效应。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-18 DOI: 10.1186/s12902-024-01784-1
Olufemi O Oyewole, Ayotunde O Ale, Ayanbola I Adepoju, Grace M Emmanuel, Michael O Ogunlana, Olufunmilayo O Oyewole, Olatunde Odusan

Background: Poor glycemic control and sexual dysfunction have been shown to impair health-related quality of life (HRQoL) of individuals with diabetes. However, mediators underlying this relationship have not been evaluated. This study aimed/sought to assess the effect of fasting blood glucose (FBG) and peripheral arterial disease (PAD) on the relationship between sexual functioning (SeF) and HRQoL among Nigerians with type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study consecutively recruited 210 participants diagnosed with T2DM. The recent FBG and lipid profiles were gleaned from the medical records of the participants. We assessed the ankle-brachial index by 8 MHz handheld vascular Doppler. Participants completed the Changes in Sexual Functioning Questionnaire and Short Form 12 (SF-12) questionnaire to assess SeF and HRQoL, respectively.

Results: Significant differences exist in HRQoL of participants with good and poor glycemic control (mean rank = 111.02 vs. 93.64, p = 0.035) but none between participants with and without PAD (mean rank = 101.39 vs. 107.60, p = 0.483). There was a significant correlation between SeF and HRQoL (r = 0.181, CI = 0.043-0.313, p = 0.008), and a significant negative correlation between HRQoL and FBG (r = -0.149, CI = -0.284 - -0.008, p = 0.033). There is a significant indirect effect of impact of SeF on HRQoL through FBG (b = -0.027, t = -0.899) and PAD (b = 0.034, t = 1.246). Furthermore, the direct effect of SeF on HRQoL in the presence of the mediators was also significant (b = 0.483, p = 0.001). This shows that PAD and FBG mediates the relationship between SeF and HRQoL.

Conclusion: Good glycemic control and the absence of PAD mediate the relationship between SeF and HRQoL in Nigerians with T2DM.

Clinical trial number: Not applicable.

背景:血糖控制不佳和性功能障碍已被证明会损害糖尿病患者的健康相关生活质量(HRQoL)。然而,这种关系的中介因素尚未得到评估。本研究旨在评估空腹血糖(FBG)和外周动脉疾病(PAD)对尼日利亚 2 型糖尿病(T2DM)患者性功能(SeF)和 HRQoL 之间关系的影响:这项横断面研究连续招募了 210 名确诊为 T2DM 患者。我们从参与者的医疗记录中收集了他们近期的血糖和血脂情况。我们用 8 兆赫手持血管多普勒仪评估了踝肱指数。参与者填写了性功能变化问卷和简表 12 (SF-12) 问卷,以分别评估 SeF 和 HRQoL:结果:血糖控制良好和血糖控制不佳的参与者在 HRQoL 方面存在显著差异(平均等级 = 111.02 vs. 93.64,p = 0.035),但有 PAD 和没有 PAD 的参与者之间没有差异(平均等级 = 101.39 vs. 107.60,p = 0.483)。SeF 与 HRQoL 之间存在明显的相关性(r = 0.181,CI = 0.043-0.313,p = 0.008),HRQoL 与 FBG 之间存在明显的负相关(r = -0.149,CI = -0.284 -0.008,p = 0.033)。SeF 通过 FBG(b = -0.027,t = -0.899)和 PAD(b = 0.034,t = 1.246)对 HRQoL 有明显的间接影响。此外,在存在中介因子的情况下,SeF 对 HRQoL 的直接影响也是显著的(b = 0.483,p = 0.001)。这表明,PAD 和 FBG 是 SeF 与 HRQoL 之间关系的中介:结论:良好的血糖控制和无 PAD 可调节尼日利亚 T2DM 患者 SeF 与 HRQoL 之间的关系:临床试验编号:不适用。
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引用次数: 0
Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis. 双相情感障碍患者的甲状腺激素水平:系统综述和荟萃分析。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-18 DOI: 10.1186/s12902-024-01776-1
Shanshan Liu, Xiaoai Chen, Xiaotao Li, Limin Tian

Purpose: To investigate the difference in blood (serum/plasma) thyroid hormone (TH) levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3), in bipolar disorder (BD) during different mood episodes (depression and mania) compared with healthy control (HC) and between manic episodes (BD-M) and depressive episodes (BD-D).

Methods: As of September 1, 2024, the electronic databases PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, and Clinical Trials. Gov were systematically searched with no language limitations. Standardized mean differences (SMD) with 95% confidence interval (CI) were summarized using a random effects model. The chi-squared-based Q test and the I2 test assessed the size of heterogeneity.

Results: The 21 studies included a total of 3696 participants, Of the 2942 BD patients, 1583 were in depressive episodes 1359 were in manic episodes. The status of measuring blood TH levels included 2 studies in plasma and 19 in serum. Combined with the results of the sensitivity analyses, we obtained the following relatively reliable results: serum T3 (SMD: -0.63, 95%CI: -1.09 to -0.17) and FT3 (SMD: -0.42, 95%CI: -0.83 to -0.00) levels decreased significantly in BD-D compared to HC; serum T3 (SMD: -0.91, 95%CI: -1.49 to -0.32) levels decreased significantly and serum FT4 (SMD: 0.37, 95%CI: 0.14 to 0.60) levels increased significantly in BD-M than in HC; serum T3 (SMD: 0.87, 95%CI: 0.24 to 1.49) and FT3 (SMD: 0.27, 95%CI: 0.13 to 0.42) levels demonstrated a significant elevation in BD-M compared to BD-D. In the group of euthyroidism, apart from serum FT4 (SMD: 0.21, 95%CI: -0.15 to 0.58) levels showed no significant difference between BD-M and HC, other results above remained consistent.

Conclusion: Serum T3 and FT3 levels decreased significantly in BD-D compared to HC. Serum T3 levels decreased significantly and serum FT4 levels increased significantly in BD-M compared to HC. Serum T3 and FT3 levels increased significantly in BD-M than in BD-D. The temporality of changes in TH levels and BD progression demands further longitudinal studies to illustrate.

Trial registration: Number and date of registration for prospectively registered trials No. CRD42022378530.

目的研究双相情感障碍患者在不同情绪发作期(抑郁和躁狂)的血液(血清/血浆)甲状腺激素(TH)水平,包括促甲状腺激素(TSH)、甲状腺素(T4)、三碘甲状腺原氨酸(T3)、游离甲状腺素(FT4)和游离三碘甲状腺原氨酸(FT3)与健康对照组(HC)的差异、和游离三碘甲状腺原氨酸(FT3),与健康对照组(HC)相比,以及与躁狂发作(BD-M)和抑郁发作(BD-D)之间的比较。研究方法截至 2024 年 9 月 1 日,系统检索了 PubMed、Embase、Cochrane Library、Web of Science、中国国家知识基础设施、中国生物医学文献数据库、中国科技期刊数据库、万方数据库和 Clinical Trials.在没有语言限制的情况下,对所有文献进行了系统检索。采用随机效应模型总结了标准化平均差(SMD)及 95% 置信区间(CI)。基于卡方的Q检验和I2检验评估了异质性的大小:21 项研究共纳入 3696 名参与者,在 2942 名 BD 患者中,1583 人处于抑郁发作期,1359 人处于躁狂发作期。血液中 TH 水平的测量情况包括 2 项血浆研究和 19 项血清研究。结合敏感性分析的结果,我们得出了以下相对可靠的结果:与 HC 相比,BD-D 患者的血清 T3(SMD:-0.63,95%CI:-1.09 至 -0.17)和 FT3(SMD:-0.42,95%CI:-0.83 至 -0.00)水平显著下降;与 HC 相比,BD-D 患者的血清 T3(SMD:-0.91,95%CI:-1.49至-0.32)水平显著下降,血清FT4(SMD:0.37,95%CI:0.14至0.60)水平显著升高;与HC相比,BD-M的血清T3(SMD:0.87,95%CI:0.24至1.49)和FT3(SMD:0.27,95%CI:0.13至0.42)水平显著升高。在甲状腺功能正常组中,除了血清FT4(SMD:0.21,95%CI:-0.15至0.58)水平在BD-M和HC之间无明显差异外,上述其他结果保持一致:结论:与 HC 相比,BD-D 的血清 T3 和 FT3 水平明显下降。结论:与 HC 相比,BD-D 的血清 T3 和 FT3 水平明显下降;与 HC 相比,BD-M 的血清 T3 水平明显下降,血清 FT4 水平明显上升。与 BD-D 相比,BD-M 的血清 T3 和 FT3 水平明显升高。TH水平变化与BD进展的时间性需要进一步的纵向研究来说明:前瞻性注册试验的编号和注册日期 编号:CRD42022378530。
{"title":"Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis.","authors":"Shanshan Liu, Xiaoai Chen, Xiaotao Li, Limin Tian","doi":"10.1186/s12902-024-01776-1","DOIUrl":"10.1186/s12902-024-01776-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the difference in blood (serum/plasma) thyroid hormone (TH) levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3), in bipolar disorder (BD) during different mood episodes (depression and mania) compared with healthy control (HC) and between manic episodes (BD-M) and depressive episodes (BD-D).</p><p><strong>Methods: </strong>As of September 1, 2024, the electronic databases PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, and Clinical Trials. Gov were systematically searched with no language limitations. Standardized mean differences (SMD) with 95% confidence interval (CI) were summarized using a random effects model. The chi-squared-based Q test and the I<sup>2</sup> test assessed the size of heterogeneity.</p><p><strong>Results: </strong>The 21 studies included a total of 3696 participants, Of the 2942 BD patients, 1583 were in depressive episodes 1359 were in manic episodes. The status of measuring blood TH levels included 2 studies in plasma and 19 in serum. Combined with the results of the sensitivity analyses, we obtained the following relatively reliable results: serum T3 (SMD: -0.63, 95%CI: -1.09 to -0.17) and FT3 (SMD: -0.42, 95%CI: -0.83 to -0.00) levels decreased significantly in BD-D compared to HC; serum T3 (SMD: -0.91, 95%CI: -1.49 to -0.32) levels decreased significantly and serum FT4 (SMD: 0.37, 95%CI: 0.14 to 0.60) levels increased significantly in BD-M than in HC; serum T3 (SMD: 0.87, 95%CI: 0.24 to 1.49) and FT3 (SMD: 0.27, 95%CI: 0.13 to 0.42) levels demonstrated a significant elevation in BD-M compared to BD-D. In the group of euthyroidism, apart from serum FT4 (SMD: 0.21, 95%CI: -0.15 to 0.58) levels showed no significant difference between BD-M and HC, other results above remained consistent.</p><p><strong>Conclusion: </strong>Serum T3 and FT3 levels decreased significantly in BD-D compared to HC. Serum T3 levels decreased significantly and serum FT4 levels increased significantly in BD-M compared to HC. Serum T3 and FT3 levels increased significantly in BD-M than in BD-D. The temporality of changes in TH levels and BD progression demands further longitudinal studies to illustrate.</p><p><strong>Trial registration: </strong>Number and date of registration for prospectively registered trials No. CRD42022378530.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"248"},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does higher serum 25-hydroxyvitamin D levels will harm bone mineral density?: a cross-sectional study. 较高的血清 25- 羟维生素 D 水平是否会损害骨矿物质密度:一项横断面研究。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-18 DOI: 10.1186/s12902-024-01760-9
Bingcheng Xu, Qiai Li, Bo Luo, Hao Liu

Objective: Vitamin D plays a critical role in the prevention and management of osteoporosis. However, there is an ongoing debate regarding the most effective vitamin D supplementation strategies for maintaining optimal bone mineral density (BMD) levels in adults. This study sought to establish the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and total BMD in a substantial population sample.

Methods: Data from the National Health and Nutrition Examination Survey (NHANES) for the 2011-2018 cycles, encompassing 11,375 adult participants, were analyzed. The primary variables of interest were serum 25(OH)D levels and BMD. A multivariable logistic regression model was utilized to account for relevant variables associated with these correlations.

Results: A U-shaped relationship between serum 25(OH)D levels and BMD was observed. In males, a significant positive association was identified for 25(OH)D levels below 84.8 nmol/L (p < 0.0001), while levels above this threshold showed no significant correlation (p = 0.3377). In females, those with 25(OH)D levels below 31.4 nmol/L exhibited a significant positive association with BMD (p = 0.0010), but this association weakened and became marginally significant above this threshold (p = 0.0650).

Conclusions: For adult males, the optimal serum 25(OH)D level is 84.8 nmol/L, beyond which higher levels do not lead to increased BMD. A deficiency threshold for adult females should be above 31.4 nmol/L, as lower 25(OH)D levels are not conducive to BMD. These findings underscore the importance of maintaining appropriate vitamin D levels for bone health in both genders.

目的:维生素 D 在预防和治疗骨质疏松症方面发挥着至关重要的作用。然而,关于维持成人最佳骨矿物质密度(BMD)水平的最有效维生素 D 补充策略,目前仍存在争议。本研究试图在大量人口样本中建立血清 25- 羟维生素 D [25(OH)D] 水平与总 BMD 之间的相关性:本研究分析了美国国家健康与营养调查(NHANES)2011-2018 年期间的数据,其中包括 11,375 名成年参与者。主要研究变量为血清 25(OH)D 水平和 BMD。利用多变量逻辑回归模型来解释与这些相关性有关的相关变量:血清 25(OH)D 水平与 BMD 之间呈 U 型关系。在男性中,25(OH)D 水平低于 84.8 nmol/L(p 结论:血清 25(OH)D 水平与 BMD 呈显著正相关:对于成年男性来说,血清 25(OH)D 的最佳水平是 84.8 nmol/L,超过这一水平不会导致 BMD 增加。成年女性的缺乏阈值应高于 31.4 nmol/L,因为较低的 25(OH)D 水平不利于 BMD。这些发现强调了保持适当的维生素 D 水平对两性骨骼健康的重要性。
{"title":"Does higher serum 25-hydroxyvitamin D levels will harm bone mineral density?: a cross-sectional study.","authors":"Bingcheng Xu, Qiai Li, Bo Luo, Hao Liu","doi":"10.1186/s12902-024-01760-9","DOIUrl":"10.1186/s12902-024-01760-9","url":null,"abstract":"<p><strong>Objective: </strong>Vitamin D plays a critical role in the prevention and management of osteoporosis. However, there is an ongoing debate regarding the most effective vitamin D supplementation strategies for maintaining optimal bone mineral density (BMD) levels in adults. This study sought to establish the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and total BMD in a substantial population sample.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) for the 2011-2018 cycles, encompassing 11,375 adult participants, were analyzed. The primary variables of interest were serum 25(OH)D levels and BMD. A multivariable logistic regression model was utilized to account for relevant variables associated with these correlations.</p><p><strong>Results: </strong>A U-shaped relationship between serum 25(OH)D levels and BMD was observed. In males, a significant positive association was identified for 25(OH)D levels below 84.8 nmol/L (p < 0.0001), while levels above this threshold showed no significant correlation (p = 0.3377). In females, those with 25(OH)D levels below 31.4 nmol/L exhibited a significant positive association with BMD (p = 0.0010), but this association weakened and became marginally significant above this threshold (p = 0.0650).</p><p><strong>Conclusions: </strong>For adult males, the optimal serum 25(OH)D level is 84.8 nmol/L, beyond which higher levels do not lead to increased BMD. A deficiency threshold for adult females should be above 31.4 nmol/L, as lower 25(OH)D levels are not conducive to BMD. These findings underscore the importance of maintaining appropriate vitamin D levels for bone health in both genders.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"250"},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of gestational diabetes mellitus on women's sexual function: a systematic review and meta-analysis. 妊娠糖尿病对女性性功能的影响:系统回顾和荟萃分析。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-15 DOI: 10.1186/s12902-024-01781-4
Mahsa Maghalian, Mojgan Mirghafourvand

Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap.

Methods: This systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis.

Results: The systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD - 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD - 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD - 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD - 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function.

Conclusion: Compared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs.

背景:妊娠糖尿病(GDM)是一种常见的妊娠并发症,对母体和胎儿健康的不利影响已得到公认。然而,有关其对性健康影响的研究却并不一致。目前,还没有关于 GDM 孕妇性功能的全面综述。本研究的目的是系统地收集和综合现有证据,填补这一重要的研究空白:本系统综述和荟萃分析采用了全面的文献检索策略,并纳入了以下数据库:Cochrane Library、Scopus、PubMed、Web of Science、SID 和 Google Scholar。检索截止到 2024 年 2 月 21 日。本研究中纳入的横断面研究和病例对照研究的质量通过修改后的标准纽卡斯尔-渥太华量表进行评估。证据的确定性通过建议、评估、发展和评价分级(GRADE)框架进行评估。进行了元回归以研究影响总体性功能的变量。此外,还进行了序列分析,以确定荟萃分析所需的信息量:结果:系统性搜索过程共获得了 370 项研究。最终分析包括六项研究。与对照组妇女相比,确诊为 GDM 的孕妇性功能较低。鉴于证据的确定性较低,有必要进行样本量更大的进一步研究,以增强证据的稳健性。医疗保健提供者应关注 GDM 妇女的性健康,并针对她们的特殊需求制定有针对性的干预措施。
{"title":"Impact of gestational diabetes mellitus on women's sexual function: a systematic review and meta-analysis.","authors":"Mahsa Maghalian, Mojgan Mirghafourvand","doi":"10.1186/s12902-024-01781-4","DOIUrl":"10.1186/s12902-024-01781-4","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap.</p><p><strong>Methods: </strong>This systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis.</p><p><strong>Results: </strong>The systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD - 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD - 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD - 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD - 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function.</p><p><strong>Conclusion: </strong>Compared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"245"},"PeriodicalIF":2.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Renovascular hypertension following by juxtaglomerular cell tumor: a challenging case with 12-year history of resistant hypertension and hypokalemia. 并肾小球细胞瘤引起的肾血管性高血压:一个具有 12 年抵抗性高血压和低钾血症病史的棘手病例。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-14 DOI: 10.1186/s12902-024-01770-7
Guangshu Chen, Yang Zhang, Xiaoqing Xiong, Zhengming Li, Xing Hua, Zhenhui Li, Meizheng Lai, Ping Zhu, Jianmin Ran

Background: Adolescents with secondary hyperaldosteronism often present with severe and treatment-resistant hypertension, along with hypokalemia. Renovascular hypertension is frequently caused by renal artery stenosis, primarily due to atherosclerosis and fibromuscular dysplasia (FMD). The presence of an accessory renal artery (ARA) is a common anatomical variation that can contribute to secondary renal vascular hypertension. However, FMD occurring in the ARA is a rare cause of renal vascular hypertension. Juxtaglomerular cell tumor (JGCT) represents a rare etiology of renal hypertension. The co-occurrence of the pathogenic ARA with JGCT is infrequently reported in the existing literature.

Case presentations: This case study presents a young individual with a 12-year history of resistant hypertension, initially diagnosed with pathogenic ARA but later confirmed as JGCT 4 years later. Following surgery for JGCT, the patient experienced only temporary stabilization of blood pressure without anti-hypertensive medication. Stenosis of the ARA was definitively diagnosed one and a half years post-surgery, with FMD occurring on the ARA strongly suspected. The patient underwent balloon dilatation angioplasty 3 years later, leading to sustained blood pressure stability with the use of two medications.

Conclusions: The case study discussed herein involves a patient with resistant hypertension initially diagnosed with ARA but later determined to have late-onset JGCT and renal artery stenosis. It is imperative to consider atypical JGCT in young patients exhibiting resistant hypertension, hypokalemia, and hyperreninemia. Adequate management of renal artery stenosis is crucial in the management of hyperreninemic hypertension.

背景:患有继发性高醛固酮血症的青少年通常会出现严重的耐药性高血压,并伴有低钾血症。肾血管性高血压常由肾动脉狭窄引起,主要是由于动脉粥样硬化和纤维肌发育不良(FMD)。肾动脉分支(ARA)的存在是一种常见的解剖变异,可导致继发性肾血管性高血压。然而,发生在 ARA 上的 FMD 是肾血管性高血压的罕见病因。并肾小球细胞瘤(JGCT)是肾血管性高血压的一种罕见病因。在现有文献中,同时出现致病性 ARA 和 JGCT 的报道并不多见:本病例研究介绍了一名有 12 年抵抗性高血压病史的年轻人,他最初被诊断为致病性 ARA,但 4 年后被确诊为 JGCT。在接受 JGCT 手术治疗后,患者在没有服用降压药的情况下血压仅暂时稳定。术后一年半,患者被明确诊断为 ARA 狭窄,并强烈怀疑 ARA 上发生了 FMD。3 年后,患者接受了球囊扩张血管成形术,使用两种药物后血压持续稳定:本文讨论的病例研究涉及一名最初被诊断为 ARA 的抵抗性高血压患者,但后来被确定为晚发性 JGCT 和肾动脉狭窄。对于表现出抵抗性高血压、低钾血症和高肾素血症的年轻患者,必须考虑非典型 JGCT。在高肾素血症高血压的治疗过程中,适当处理肾动脉狭窄至关重要。
{"title":"Renovascular hypertension following by juxtaglomerular cell tumor: a challenging case with 12-year history of resistant hypertension and hypokalemia.","authors":"Guangshu Chen, Yang Zhang, Xiaoqing Xiong, Zhengming Li, Xing Hua, Zhenhui Li, Meizheng Lai, Ping Zhu, Jianmin Ran","doi":"10.1186/s12902-024-01770-7","DOIUrl":"10.1186/s12902-024-01770-7","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with secondary hyperaldosteronism often present with severe and treatment-resistant hypertension, along with hypokalemia. Renovascular hypertension is frequently caused by renal artery stenosis, primarily due to atherosclerosis and fibromuscular dysplasia (FMD). The presence of an accessory renal artery (ARA) is a common anatomical variation that can contribute to secondary renal vascular hypertension. However, FMD occurring in the ARA is a rare cause of renal vascular hypertension. Juxtaglomerular cell tumor (JGCT) represents a rare etiology of renal hypertension. The co-occurrence of the pathogenic ARA with JGCT is infrequently reported in the existing literature.</p><p><strong>Case presentations: </strong>This case study presents a young individual with a 12-year history of resistant hypertension, initially diagnosed with pathogenic ARA but later confirmed as JGCT 4 years later. Following surgery for JGCT, the patient experienced only temporary stabilization of blood pressure without anti-hypertensive medication. Stenosis of the ARA was definitively diagnosed one and a half years post-surgery, with FMD occurring on the ARA strongly suspected. The patient underwent balloon dilatation angioplasty 3 years later, leading to sustained blood pressure stability with the use of two medications.</p><p><strong>Conclusions: </strong>The case study discussed herein involves a patient with resistant hypertension initially diagnosed with ARA but later determined to have late-onset JGCT and renal artery stenosis. It is imperative to consider atypical JGCT in young patients exhibiting resistant hypertension, hypokalemia, and hyperreninemia. Adequate management of renal artery stenosis is crucial in the management of hyperreninemic hypertension.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"244"},"PeriodicalIF":2.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ectopic adrenocorticotrophic hormone syndrome in a 10-year-old girl with a thymic neuroendocrine tumor: a case report. 一名患有胸腺神经内分泌肿瘤的 10 岁女孩的异位肾上腺皮质激素综合征:病例报告。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-13 DOI: 10.1186/s12902-024-01756-5
Irena Aldhoon-Hainerová, Mikuláš Kosák, Michal Kršek, David Zogala, Karel Pacak

Background: Thymic neuroendocrine tumor as a cause of Cushing syndrome is extremely rare in children.

Case presentation: We report a case of a 10-year-old girl who presented with typical symptoms and signs of hypercortisolemia, including bone fractures, growth retardation, and kidney stones. The patient was managed with oral ketoconazole, during which she experienced adrenal insufficiency, possibly due to either cyclic adrenocorticotropic hormone (ACTH) secretion or concurrent COVID-19 infection. The patient underwent a diagnostic work-up which indicated the possibility of an ACTH-secreting pituitary neuroendocrine tumor. However, after a transsphenoidal surgery, the diagnosis was not confirmed on histopathological examination. Subsequent bilateral inferior petrosal sinus sampling showed strong indications of the presence of ectopic ACTH syndrome. Detailed rereading of functional imaging studies, including 18F-FDG PET/MRI and 68Ga DOTATOC PET/CT, ultimately identified a small lesion in the thymus. The patient underwent videothoracoscopic thymectomy that confirmed a neuroendocrine tumor with ACTH positivity on histopathological examination.

Conclusion: This case presents some unique challenges related to the diagnosis, management, and treatment of thymic neuroendocrine tumor in a child. We can conclude that ketoconazole treatment was effective in managing hypercortisolemia in our patient. Further, a combination of functional imaging studies can be a useful tool in locating the source of ectopic ACTH secretion. Lastly, in cases of discrepancy in the results of stimulation tests, bilateral inferior petrosal sinus sampling is highly recommended to differentiate between Cushing disease and ectopic ACTH syndrome.

背景:作为库欣综合征病因的胸腺神经内分泌肿瘤极为罕见:胸腺神经内分泌肿瘤导致库欣综合征的病例在儿童中极为罕见:我们报告了一例 10 岁女孩的病例,她出现了高皮质醇血症的典型症状和体征,包括骨折、生长迟缓和肾结石。患者在口服酮康唑治疗期间出现肾上腺功能不全,这可能是由于促肾上腺皮质激素(ACTH)周期性分泌或同时感染 COVID-19。患者接受了诊断性检查,结果显示可能患有分泌促肾上腺皮质激素的垂体神经内分泌肿瘤。然而,经蝶窦手术后,组织病理学检查并未确诊。随后的双侧下蝶窦取样显示,存在异位 ACTH 综合征的强烈迹象。详细重读功能成像检查,包括 18F-FDG PET/MRI 和 68Ga DOTATOC PET/CT,最终确定胸腺有一个小病灶。患者接受了视频胸腔镜胸腺切除术,组织病理学检查证实为ACTH阳性的神经内分泌肿瘤:本病例为儿童胸腺神经内分泌肿瘤的诊断、管理和治疗提出了一些独特的挑战。我们可以得出结论,酮康唑治疗能有效控制患者的高皮质醇血症。此外,结合功能成像研究也是找到异位促肾上腺皮质激素分泌源的有效工具。最后,在刺激试验结果不一致的情况下,强烈建议进行双侧下额窦取样,以区分库欣病和异位 ACTH 综合征。
{"title":"Ectopic adrenocorticotrophic hormone syndrome in a 10-year-old girl with a thymic neuroendocrine tumor: a case report.","authors":"Irena Aldhoon-Hainerová, Mikuláš Kosák, Michal Kršek, David Zogala, Karel Pacak","doi":"10.1186/s12902-024-01756-5","DOIUrl":"10.1186/s12902-024-01756-5","url":null,"abstract":"<p><strong>Background: </strong>Thymic neuroendocrine tumor as a cause of Cushing syndrome is extremely rare in children.</p><p><strong>Case presentation: </strong>We report a case of a 10-year-old girl who presented with typical symptoms and signs of hypercortisolemia, including bone fractures, growth retardation, and kidney stones. The patient was managed with oral ketoconazole, during which she experienced adrenal insufficiency, possibly due to either cyclic adrenocorticotropic hormone (ACTH) secretion or concurrent COVID-19 infection. The patient underwent a diagnostic work-up which indicated the possibility of an ACTH-secreting pituitary neuroendocrine tumor. However, after a transsphenoidal surgery, the diagnosis was not confirmed on histopathological examination. Subsequent bilateral inferior petrosal sinus sampling showed strong indications of the presence of ectopic ACTH syndrome. Detailed rereading of functional imaging studies, including <sup>18</sup>F-FDG PET/MRI and <sup>68</sup>Ga DOTATOC PET/CT, ultimately identified a small lesion in the thymus. The patient underwent videothoracoscopic thymectomy that confirmed a neuroendocrine tumor with ACTH positivity on histopathological examination.</p><p><strong>Conclusion: </strong>This case presents some unique challenges related to the diagnosis, management, and treatment of thymic neuroendocrine tumor in a child. We can conclude that ketoconazole treatment was effective in managing hypercortisolemia in our patient. Further, a combination of functional imaging studies can be a useful tool in locating the source of ectopic ACTH secretion. Lastly, in cases of discrepancy in the results of stimulation tests, bilateral inferior petrosal sinus sampling is highly recommended to differentiate between Cushing disease and ectopic ACTH syndrome.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"24 1","pages":"243"},"PeriodicalIF":2.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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