BMC Endocrine Disorders最新文献

Objective: To analyze the characteristics of pulmonary nodules (PNs) and related influencing factors in patients with type 2 diabetes mellitus (T2DM).

Methods: Retrospectively analyzed the clinical and biochemical characteristics of 224 patients with PNs and 488 patients with non-PNs in patients with T2DM, and compared the clinical data of 72 patients with large nodules (≥ 5 mm) and 152 patients with small nodules (< 5 mm) in the pulmonary nodules (PNs) group.

Results: Compared to the non-PNs group, the PNs Patients in the group had a longer duration of diabetes, higher age, serum creatinine (SCR), blood urea nitrogen (BUN) and the lower albumin (ALB) and body mass index (BMI); women, diabetic retinopathy (DR), diabetic peripheral neuropathy (DPN), and estimated glomerular filtration rate (eGFR) < 60 ml/min1.73m² were more represented in the PNs group; there were fewer patients with overweight in the PNs group. Age and eGFR < 60 ml/min/1.73m² were independent risk factors for PNs in patients with T2DM, and overweight was associated with a reduced risk of PNs. Compared with the small nodule group, patients in the large nodule group had higher fasting blood glucose (FBG) and lower fasting insulin (FINS); meanwhile, patients with decreased homeostasis model assessment-β (HOMA-β) and high smoking index (SI) were higher in the large nodule group; decreased HOMA-β and high SI were independent risk factors for large nodules.

Conclusions: Age and eGFR < 60 ml/min/1.73m² were independent risk factors for pulmonary nodules in patients with T2DM, and overweight may be a protective factor. Moreover, decreased islet B-cell function and smoking may contribute to the presence of PNs with a diameter of over 5 mm.

Obesity and atherosclerosis are significant metabolic diseases characterized by disrupted lipid metabolism. MicroRNAs (miRNAs) are small, conserved, non-coding RNA sequences consisting of approximately 22 nucleotides, playing crucial roles in biological and pathological functions. Among these, miR-33a/b is particularly associated with metabolic diseases, notably obesity and atherosclerosis. In this pilot case-control study, 45 subjects were examined, and serum miR-33b levels were measured in three groups: a control group, hypercholesterolemic (HC) subjects without obesity (HC group), and obese subjects without hypercholesterolemia (obese group). Serum miR-33b levels were determined using the real-time PCR method. The expression of miR-33b was significantly higher in the HC and obese groups compared to the control group (p < 0.001). The Body mass index (BMI) in the obese group was significantly higher than in the control and HC groups (p < 0.001). Additionally, serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-c) levels were higher in the HC group compared to both the control and obese groups. Our study demonstrated a correlation between serum miR-33b levels and HC and obesity. Finally, the ROC analysis demonstrated that miR-33b had an AUC of 0.74 for identifying hypercholesterolemia and an AUC of 0.76 for identifying obesity, indicating its acceptable diagnostic value alongside traditional markers. Therefore, serum miR-33b levels can be considered as a potential biomarker for obesity and hypercholesterolemia, but these finding are preliminary and further investigation is necessary in larger samples to confirm these associations.

Background: Endogenous sex hormones in postmenopausal women have been associated with risk of cardiovascular diseases. The aim of this study was to determine the association between endogenous sex hormones and the revised Framingham Stroke Risk Profile (rFSRP) in postmenopausal women.

Methods: This is an observational cross-sectional study on the Vara-Skövde cohort, a Swedish population-based study for longitudinal surveillance of the development and progress of type 2 diabetes and hypertension. The participants were physically examined in 2002-2005 and sex hormones were analysed with liquid chromatography-tandem mass spectrometry assay (LC-MS/MS). Women who were ≥55 years old, with estradiol levels below 20 pg/mL, not using hormonal therapy, and with no self-reported history of stroke, were included (N = 133). The outcome variable was rFSRP. Regression analyses of log-transformed rFSRP were fitted against levels of sex hormones (17-α-OH-progesterone, estrone, estradiol, progesterone, dihydrotestosterone, dehydroepiandrosterone, testosterone and androstenedione), adjusting for body mass index (BMI) or waist-to-hip ratio (WHR), C-reactive protein (CRP) and cholesterol level.

Results: Levels of estrone and estradiol were positively associated with rFSRP in the crude model (estrone β = 0.208, 95% CI = 0.081;0.336, P = 0.002; estradiol β = 0.170, CI = 0.034;0.305, P = 0.015). Adjustments for BMI revealed significant positive associations between progesterone (β = 0.155 95% CI = 0.025;0.285, P = 0.020), estrone (β = 0.167, 95% CI = 0.037;0.297, P = 0.013) and 17-α-OH-progesterone (β = 0.146, 95% CI = 0.014; 0.277, P = 0.030) and rFSRP, and adjustments for WHR revealed a significant positive association between testosterone and rFSRP (β = 0.152, CI = 0.026;0.278, p = 0.018).

Conclusions: Increase of estrone was associated with higher rFSRP, also in the fully adjusted model, whereas progesterone, 17-α-OH-progesterone and testosterone were significant only in the models adjusting for BMI and WHR respectively. Larger studies studying stroke events are warranted to confirm these findings.

Clinical trial number: Not applicable.

Background: Menopause is a significant phase in women's health, in which the incidence of obstructive sleep apnea (OSA) is significantly increased. Body fat distribution changes with age and hormone levels in postmenopausal women, but the extent to which changes in body fat distribution affect the occurrence of OSA is unclear.

Methods: This research performed a cross-sectional analysis utilizing data from the 2015-2016 National Health and Nutrition Examination Survey (NHANES). Body fat distribution was quantified using dual-energy X-ray absorptiometry in kilograms. Menopausal status and OSA symptoms were determined by questionnaire. Weighted multivariable regression analysis was utilized to investigate the correlation between menopausal status and OSA symptoms and body fat composition. We did a mediation analysis to assess how much of the effect of menopausal status on OSA symptoms was mediated through in body fat composition.

Results: The analysis comprised 1459 individuals from NHANES, consisting of 1188 premenopausal and 271 postmenopausal women. In the weighted sample, 36.01% of premenopausal women and 53.39% of postmenopausal women had OSA symptoms. After adjusting for body mass index (BMI) and other potential confounders, menopausal status was correlated with a higher prevalence of OSA symptoms (OR = 1.57; 95% CI: 1.16,2.13), and increased visceral fat mass (β = 0.12; 95% CI: 0.07, 0.17). In addition, visceral fat mass exhibited a significant correlation with OSA symptoms (OR = 3.79; 95% CI: 1.61, 8.94). Mediation analysis showed that 29.76% of the effect of menopausal status on OSA symptoms was mediated through visceral fat. In age-matched analysis, postmenopausal women had higher visceral fat mass (0.63 kg vs. 0.52 kg, P = 0.02) and a higher prevalence of OSA symptoms (68.3% vs. 45.7%, P = 0.02) compared with premenopausal women; however, there was no significant difference in BMI (P > 0.05).

Conclusion: Our results suggest that menopausal status is associated with increased visceral fat accumulation and OSA symptoms prevalence. Visceral fat accumulation appears to play an important role in the development of OSA in postmenopausal women, independent of BMI; this highlights the importance of further studying this relationship.

Background: The Weight-adjusted-waist index (WWI) has emerged as a predictive factor for a range of metabolic disorders. To date, the predictive value of the WWI in relation to sarcopenia in individuals with diabetics has not been extensively explored. This study aims to investigate the impact of the WWI on the prevalence of sarcopenia among patients with type 2 diabetes mellitus (T2DM).

Method: In this study, we enrolled 417 patients with T2DM from the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between Dec. 2023 and Apr. 2024. The relationship between the WWI and the prevalence of sarcopenia in T2DM patients was evaluated using multivariate logistic regression, subgroup analysis, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curve analysis.

Results: Among the 417 patients with T2DM, 76 (18.22%) were identified as having sarcopenia. The prevalence of sarcopenia across the WWI quartile categories, from the first to the fourth quartile, was 8.65%, 8.57%, 20.19% and 8.65% respectively. Multivariate logistic regression analysis revealed that, after adjusting for covariates, a higher WWI was an independent risk factor for sarcopenia in male T2DM patients (OR = 1.836, 95% CI: 1.216-2.772, P = 0.004). This association was not observed in female patients. Subgroup analysis further revealed a stronger correlation between WWI and sarcopenia among male patients with higher HbA1c levels. In males, RCS regression demonstrated a non-linear positive correlation, with an inflection point at a WWI of 10.42 cm/√kg. Finally, the area under the ROC curve (AUC) for the WWI was 0.612.

Conclusions: WWI emerges as a robust and independent risk factor for sarcopenia in male patients with T2DM. WWI may serve as an accessible and cost-effective tool for identify sarcopenia in patients with diabetes.

Background: This study aimed to evaluate the impact of combined levothyroxine (LT4) and triiodothyronine (LT3) therapy on quality of life in patients with primary hypothyroidism.

Methods: In a randomized, double-blind, parallel-group trial, 151 Iranian patients diagnosed with primary hypothyroidism between 2020 and 2021 were enrolled. One group received LT4 alone (n = 80), while the other received LT4 and LT3 (n = 71) for a minimum of six months. The primary outcome was quality of life assessed using the SF-36V1 questionnaire, and the secondary endpoints included clinical and laboratory measurements.

Results: In the LT4 + LT3 group, a significant reduction in TSH levels (p < 0.05) was observed compared to baseline. While no significant differences emerged between the groups in terms of blood pressure, lipid profiles (except for low-density lipoprotein cholesterol), or body weight, there were notable improvements in physical functioning and bodily pain in the LT4 + LT3 group compared to the LT4 + placebo group. Compared with baseline, combination therapy significantly increased the physical component summary score after six months, but the difference was not significant.

Conclusion: Combination therapy may benefit patients with primary hypothyroidism, particularly those experiencing body pain or physical function issues. However, the overall impact on quality of life remains inconclusive, as evidenced by the scores for the mental component. Further research is needed to determine the broader implications of this therapy. This study provides valuable insights into the potential advantages of combining LT4 and LT3 in the management of primary hypothyroidism.

Trial registration: The study was registered with the Iranian Registry of Clinical Trials (IRCT) and assigned the registration number IRCT20200410047012N1 on 2022-08-07.

Trial registration number: IRCT20200410047012N1. Date of registration: 2020-06-12.

Background: The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation.

Methods: A total of 236 patients were enrolled in this study between August 2019 and December 2020. RIPPT was employed to identify and protect the inferior parathyroid gland (IPG), and its identification rate and the anatomical variations were analyzed. The parathyroid hormone (PTH) and serum calcium levels were compared between patients who underwent IPG orthotopic retention and those who received IPG auto-transplantation, stratified by the anatomical type of the IPG.

Results: In total, the IPG identification rate was 97.88% (231/236), and the auto-transplantation rate was 74.46% (172/231). The anatomical relationship between IPG and thymus was observed in 77.97% of patients (184/236). Additionally, PTH levels were higher in patients with IPG orthotopic retention compared to those with IPG auto-transplantation both on postoperative day 1 (POD1) and at 6 months. PTH levels were also higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention compared to those who underwent both auto-transplantation procedures.

Conclusion: Retrograde inferior parathyroid protection technique (RIPPT) underscores the importance of protecting inferior parathyroid gland (IPG) in thyroid surgery and has been demonstrated to be effective in the rapid identification and functional preservation of IPG, based on short-term outcomes.

Clinical trial number: Not applicable.

Objective: Insulin resistance (IR) is often present in diabetes, which imposes a heavy burden on the prevention and treatment of diabetes. Triglyceride glucose index (TyG) is simple, reliable and reproducible in detecting IR, and has great advantages in predicting the risk of diabetes. The aim of this study was to analyze the potential association between TyG and the risk of diabetes in Chinese middle-aged and older adults using a prospective cohort study design.

Methods: This study used longitudinal data from five waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, 2018, and 2020, involving 5886 participants. We used Cox proportional risk regression modeling to investigate the association between TyG index and the risk of new-onset diabetes, and decision tree analysis to identify high-risk groups for diabetes. Finally, ROC curves were applied in order to construct a predictive model for diabetes.

Results: A total of 1054 (17.9%) participants developed diabetes throughout the 9-year follow-up. Our study utilized a multivariate Cox proportional risk regression model and found a significant correlation between TyG index and diabetes risk. The analysis also revealed a nonlinear relationship between TyG index and diabetes risk.Receiver Operating Characteristic(ROC) curve analysis showed that the Area under the curve(AUC) area of TyG index in predicting the risk of new-onset diabetes was 0.652 (P < 0.05).

Conclusions: TyG index can be used as a risk factor for predicting new-onset diabetes in the middle-aged and elderly population in China. In addition, there was a nonlinear relationship between TyG index and diabetes. Improving insulin resistance by regulating glucose and lipid metabolism plays an important role in the primary prevention of diabetes.

Background: Diabetic foot ulcers (DFUs) are characterized by dynamic wound microbiome, the timely and accurate identification of pathogens in the clinic is required to initiate precise and individualized treatment. Metagenomic next-generation sequencing (mNGS) has been a useful supplement to routine culture method for the etiological diagnosis of DFUs. In this study, we utilized a routine culture method and mNGS to analyze the same DFU wound samples and the results were compared.

Methods: Forty samples from patients with DFUs at a tertiary medical center in South China were collected, the microorganisms were identified with mNGS and routine culture method simultaneously.

Results: The results showed that the positive detection rate of microorganisms in DFUs with mNGS was much higher (95% vs. 60%). Thirteen strains of microorganisms were detected with routine culture method, and seventy-seven strains were detected with mNGS. Staphylococcus aureus was the most common microorganism detected with culture method, while Enterococcus faecalis was the most common microorganism detected with mNGS. The false negative rate of the culture method was 35%, that was, 14 samples with negative results with culture method were found to be positive with mNGS.

Conclusion: The mNGS method had a higher positive detection rate and identified a broader spectrum of microorganisms in DFUs, thus, mNGS provided a more comprehensive understanding of the microbiome of DFUs to facilitate the development of timely and optimal treatment.

Trial registration: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethical Review Committee of the Fujian Medical University Union Hospital (approval number 2021KY054).

Background: Primary hyperparathyroidism (pHPT) is the third most common endocrine system disorder. Parathyroidectomy (PTx) is the gold standard of care in symptomatic patients. Patients who are not surgical candidates may benefit from percutaneous ethanol ablation, which is a minimally invasive procedure. This study aims to evaluate the effectiveness and safety of PTx vs. PEA.

Method: A single-centered randomized, not-blinded parallel clinical trial in consecutive patients with pHPT treated with percutaneous alcohol ablation (PEA) between January 2020 and November 2021. Patients with a confirmed solitary parathyroid adenoma and a biochemically verified pHPT were randomly enrolled in the PTx or PEA groups. Complications and lab data were evaluated 24 h, 2 weeks, 3 months, and 6 months following interventions. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 22.0 was used for statistical analysis.

Result: The final sample comprised 68 patients in each group which 113 of whom were female (83.0%). Complete response was observed in 91.1% (n = 62) of the PEA group and 98.5% (n = 67) of the PTx group. According to repeated-measures analysis, Calcium, PTH, Phosphorus, and Alkaline phosphatase fell significantly and continuously in each intervention group, except for the persistent patients. According to ROC analysis, a cutoff of > 425.5 mm3 for the adenoma volume and > 13.5 mm for its largest diameter showed a sensitivity = 75% and specificity = 69% for partial response in the PEA group (AUC = 0.81 and 0.84, respectively). PTx group experienced statistically significant higher pain according to the Visual Analogue Scale (VAS score) (p < 0.001).

Conclusion: PTH, serum-adjusted Calcium, and adenoma size and volume were all significantly reduced by PTx and PEA, with no significant difference between them. PEA is an effective alternative to PTx, particularly in adenomas with a volume of less than 425.5 mm3 and a maximum diameter of 13.5 mm.

Trial registration number: IRCT20210204050241N1 (04/26/2021).