BMC Endocrine Disorders最新文献

Context: Bilateral inferior petrosal sinus sampling (BIPSS) is widely used to differentially diagnose ectopic ACTH syndrome (EAS) and Cushing's disease (CD) with pituitary lesions less than 6 mm detected on MRI.

Purpose: This study aimed to investigate the diagnostic accuracy of BIPSS and prognosis of low-lateralization [lateralization ratio of bilateral inferior petrosal sampling (IPS) ≤ 1.4] CD with microadenoma (≤ 6 mm).

Methods: This single-centre retrospective study (2011-2019) included 25 EAS and 179 CD (microadenoma ≤ 6 mm) patients whose diagnoses were confirmed by pathology. All CD patients received two to ten years of follow-up.

Results: According to the multivariable regression results, a false-negative diagnosis at baseline might be associated with a lateralization ratio ≤ 1.4 (adjusted OR = 12.69, 95% CI 4.14-38.86; P < 0.001). CD patients were divided into a low-lateralization group (lateralization ratio ≤ 1.4) and a high-lateralization group (> 1.4). An inferior petrosal sinus-to-peripheral ACTH ratio (IPS: P-ACTH) ≥ 2.0 had a sensitivity of 55.0% (95% CI 39.8%-69.3%) for the low-lateralization group (n = 40), which was lower than the sensitivity of 93.5% (95% CI 88.2%-96.6%) for the high-lateralization group (n = 139) (P < 0.001).

Conclusion: Lower diagnostic accuracy and poorer surgical outcomes were found for the low-lateralization group, with a lesser likelihood of remission and more impaired pituitary function after pituitary surgery.

Clinical trial number: Not applicable.

Objectives: To determine the relationship between serum Ism-1 levels and the progression of renal function decline in patients with T2DM.

Methods: This prospective longitudinal study included 223 patients with T2DM. Patients were divided into quartiles according to serum Ism-1 levels. A Cox proportional hazards ratio model was applied to analyze the relationship between CKD progression and serum Ism-1 levels.

Results: A total of 197 patients were finally analyzed, and the mean length of follow-up was 40.86 months. The serum Ism-1 levels were associated with eGFR decline and an increased risk of composite renal outcomes after adjusting for age, gender, body mass index, diabetes duration, history of hypertension, fasting blood glucose, fasting C-peptide, total cholesterol, triglycerides, drinking, smoking and follow-up period (all p < 0.05). However, the predictive ability of Ism-1 for composite renal outcomes disappeared after adjusting for baseline eGFR in Cox regression analysis and receiver operating characteristic (ROC) curve analysis.

Conclusions: High serum Ism-1 may be a biomarker for the progression of renal function decline in patients with T2DM.

Clinical trial number: Not applicable.

Background: We aimed to evaluate the relationships between the pan immune-inflammation value (PIV), the systemic immune-inflammation index (SII), and hormonal levels in patients with polycystic ovary syndrome (PCOS).

Methods: 160 patients with PCOS and 142 healthy participants took part in the study. Demographic characteristics, lymphocytes, monocytes, neutrophils, white blood cells (WBC), platelets, fasting glucose levels, hormonal parameters as insulin, dehydroepiandrosterone sulfate (DHEASO₄), prolactin, free and total testosterone, estradiol, luteinizing hormone (LH), 17-OH-progesterone, follicle-stimulating hormone (FSH), and 11-deoxycorticosterone were examined. Hematological indices, SII and PIV, were calculated. Receiver operating characteristic (ROC) analysis showed the diagnostic potential of the research parameters.

Results: The median WBC, SII and PIV values (7.63, 605.5, 312.69, respectively) were significantly higher in patients (p = 0.023; p < 0.001; p = 0.002; respectively). The median free testosterone, 17-OH progesterone, and LH values were also significantly higher in PCOS group (p = 0.009, p = 0.017, p = 0.012, respectively). Statistically significant and positive correlations were found between SII and insulin, SII and DHEA-SO₄, PIV and insulin, and PIV and DHEA-SO₄ levels (p = 0.006, p = 0.003, p = 0.037, p = 0.042, respectively). A statistically significant and positive correlation was also observed between PIV and free testosterone levels (p = 0.008). We found that a baseline serum SII > 520.0 and PIV > 262.4 were associated with PCOS with 65% specificity and 61% sensitivity for the SII (area under the curve [AUC], 0.669; 95% CI 0.584-0.755; p < 0.001) and 58% specificity and 60% sensitivity for the PIV ([AUC], 0.642; 95% CI 0.555-0.729; p = 0.002).

Conclusions: Monitoring SII and PIV may assist clinicians in evaluating inflammation and treatment needs in patients with PCOS.

Clinical trial number: Not applicable.