BMC Endocrine Disorders最新文献

Background: Lingual thyroid is a rare congenital anomaly resulting from the aberrant migration of thyroid tissue during embryonic development. Although frequently asymptomatic, its identification in military aircrew poses particular challenges given the rigorous standards of aeromedical certification.

Case presentation: A 37-year-old male military helicopter pilot was incidentally diagnosed with lingual thyroid during routine health screening. The patient remained asymptomatic throughout the clinical course. Comprehensive evaluations-including thyroid function tests, biochemical profiling, cervical magnetic resonance imaging, electronic laryngoscopy, radionuclide scanning, and portable sleep monitoring-confirmed the presence of a lingual thyroid with subclinical hypothyroidism. Imaging demonstrated the ectopic tissue at the tongue base to be the sole functioning thyroid gland. Levothyroxine therapy was initiated, resulting in normalization of thyroid hormone levels. Polysomnography was performed due to the anatomical location of the lesion and excluded obstructive sleep apnea or ventilatory compromise. Given the patient's strong motivation to resume flight duties, a multidisciplinary aeromedical evaluation was conducted. Based on clinical stability, absence of symptoms, and treatment response, the pilot was deemed aeromedically fit. Since June 2021, he has accumulated over 900 flight hours, with preserved thyroid function and no evidence of disease progression on longitudinal follow-up.

Conclusions: To the best of our knowledge, this represents the first documented case in China of a military pilot with lingual thyroid successfully certified for continued flying duties. This case suggests that congenital endocrine anomalies may be compatible with high-demand occupational roles in select cases, pending comprehensive individual evaluation and risk-based aeromedical assessment. It further supports the adoption of a risk-stratified, non-invasive management paradigm in aviation medicine, with implications for enhancing both flight safety and personnel retention.

Background: Hashimoto's thyroiditis is a common autoimmune thyroid disorder and a leading cause of subclinical hypothyroidism. Tumor markers such as CA 19 - 9 and CA 72 - 4 may also be elevated in certain benign inflammatory conditions. This study aimed to investigate the levels of CA 19 - 9 and CA 72 - 4 in patients with subclinical hypothyroidism due to Hashimoto's thyroiditis and to evaluate the effects of levothyroxine treatment.

Methods: This prospective case-control study included 30 patients with subclinical hypothyroidism due to Hashimoto's thyroiditis and 30 healthy controls matched by age and sex. Serum levels of CA 19 - 9, CA 72 - 4, TSH, free T4, TPOAb, and TgAb were measured at baseline and after 6 weeks of levothyroxine therapy. Additionally, correlations between tumor markers and thyroid function parameters were analyzed.

Results: Initially, there were no significant differences in CA 19 - 9 and CA 72 - 4 levels between the patient and control groups. Following treatment, a significant decrease in CA 19 - 9 levels was observed in patients who achieved euthyroidism (p = 0.020), whereas no significant change was detected in CA 72 - 4 levels.

Conclusions: CA 19 - 9 and CA 72 - 4 levels do not appear to differ significantly between patients with subclinical hypothyroidism due to Hashimoto's thyroiditis and healthy individuals. However, CA 19 - 9 levels may decrease upon restoration of euthyroidism, potentially reflecting a reduction in thyroid-related inflammation. Further studies with larger cohorts and longer follow-up periods are warranted to confirm and clarify these observations.

Background: The relationship between the TyG index and MASLD in lean young populations remains unclear.

Methods: In this retrospective study, we analyzed data from individuals aged 18 to 35 Years old who underwent abdominal ultrasound examinations at a healthcare management center from January 2019 to December 2023. First, we categorized the TyG index into quartiles and used logistic regression models to examine the relationship between MASLD and TyG. Next, we applied restricted cubic splines (RCS) to assess whether the relationship between TyG and MASLD followed a nonlinear pattern. Additionally, we stratified the analysis by sex to explore whether the association between MASLD and TyG differed between males and females.

Results: A total of 20,242 participants (14763 women [72.9%]; [mean ± SD] age, 29.07 [3.60]) were included in the study. The overall incidence of MASLD was 5.1%. The median (IQR) TyG index was 8.0 (7.6, 8.2). The association between TyG index and the incidence of MASLD followed a reverse L-shaped, with a cut-off value of 8.3. For each 1-unit increase in the TyG index, the association was significant both below 8.3 (HR = 2.1; 95%CI: 1.4-3.4 ) and above this threshold (HR = 12.1; 95%CI: 8.2-17.8). A significant interaction between sex and the TyG index was observed (P < 0.001). Both males and females showing an increase in MASLD risk after the TyG index exceeded 8.3.

Conclusion: In young populations, higher TyG index is associated with an increased risk of MASLD, with distinct patterns observed between sexes. The risk of MASLD rises sharply once the TyG index exceeds 8.3.

Background and aim: This study aimed to investigate the relationship between atherogenic index of plasma (AIP) and incident type 2 diabetes mellitus (T2DM) in non-alcoholic fatty liver disease (NAFLD) patients.

Methods and results: In this retrospective study, 2,370 NAFLD patients were stratified into tertiles based on AIP levels. Baseline demographic, anthropometric, and biochemical characteristics were compared across tertiles. Multivariable logistic regression models were employed to assess the association between AIP and incident T2DM, adjusting for potential confounders, including age, sex, body mass index (BMI), hemoglobin A1c (HbA1c), smoking status, high blood pressure (HBP), and liver enzymes. Restricted cubic splines (RCS) evaluated dose-response relationships, and receiver operating characteristic (ROC) curves compared the predictive performance of AIP against individual parameters. In the fully adjusted model (Model 3), the highest tertile (Q3) demonstrated a 1.99-fold increased T2DM risk (OR = 1.99, 95% CI: 1.29-3.08, P = 0.002) versus Q1. A linear dose-response relationship was observed (P for non-linearity = 0.663), with each 1-unit AiP increase corresponding to a 2.76-fold higher T2DM risk (OR = 2.76, 95% CI: 1.54-4.93, P < 0.001). AIP demonstrated superior predictive performance for incident T2DM compared to traditional markers, as evidenced by higher area under the receiver operating characteristic curve (AUC) values. The relationship between AIP and incident T2DM remained consistent across various population subgroups (all interaction P-values>0.05).

Conclusions: Elevated AIP is independently associated with an increased risk of incident T2DM in NAFLD patients, highlighting its potential as a predictive biomarker for diabetes in this high-risk population.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia, represents a growing global health burden. Natural menopause in women is defined as continuous cessation of menstruation for more than twelve consecutive months, and it is an important determinant of their future health. The average age at natural menopause is around 51 years. Early menopause is defined as the onset of menopause between the ages of 40 and 45 years, while genetic and environmental factors influence menopause timing, evidence suggests T2DM may accelerate ovarian aging. The aim of this study is to explore the existence of a relationship between T2DM and the natural age of menopause in Syrian women-a population with unique genetic and lifestyle factors underrepresented in existing literature.

Methods: A cross-sectional study was conducted at Al-Mouwasat and National University Hospitals in Damascus, from 2022 to 2024. 175 naturally postmenopausal women aged over 45 years were included in the study, with participants stratified by T2DM status, which was confirmed either by an HbA1c level of ≥ 6.5% or a physician's diagnosis. The age at menopause was ascertained based on self-reported cessation of menses for at least 12 months, exclusion of surgical or iatrogenic menopause cases, and validation against medical records. Data were analyzed using SPSS 25.0 with multivariable linear regression (α = 0.05).

Results: The mean age at natural menopause did not differ significantly between women with and without T2DM (p = 0.099); key differences emerged in subgroup analyses. Women with T2DM demonstrated a 2.3-fold higher prevalence of early menopause (< 45 years) compared to non-diabetic counterparts (20.2% vs. 10.5%; p = 0.023). Notably, those with long-standing diabetes (> 10 years duration) experienced menopause ~ 2 years earlier than controls (p = 0.040). Furthermore, women with T2DM microvascular complications- specifically retinopathy (p = 0.044) and nephropathy (p = 0.000) - showed significantly earlier menopause compared to diabetes-free women.

Conclusions: T2DM itself was not associated with a significantly earlier average age at natural menopause in Syrian women, but specific aspects of T2DM were significantly linked to earlier menopause, which are longer disease duration (> 10 years), and presence of microvascular complications (retinopathy or nephropathy). Critically, women with T2DM had a significantly higher prevalence of early menopause, indicating a doubled risk compared to non-diabetic women.

Background: Abnormal amino acid metabolic pathways, especially those of glutamine, serine and proline, are crucial to tumourigenesis and the development of papillary thyroid carcinoma (PTC). However, genetic variants in key genes regulating these metabolic pathways remain poorly characterized in PTC.

Methods: Seven SNPs in the SLC1A5, SLC1A3, SHMT1, and PRODH genes were genotyped in 620 patients with PTC and 620 controls using a flight mass spectrometry platform.

Results: The frequency of the minor allele A of SLC1A5-rs2070246 was significantly greater in the PTC group than in the control group, thereby increasing the risk of PTC by 1.587 times (p < 0.0001). Similarly, the minor alleles C, T and A of SLC1A3-rs16903247, SHMT1-rs4925166 and PRODH-rs372055 increased susceptibility to PTC by 2.584, 1.346 and 1.349 times, respectively (p_rs16903247 < 0.0001, p_rs4925166 = 0.00024, and p_rs372055= 0.001, respectively). Moreover, carriers of the rs2070246-GA/AA genotype had a 1.77- and 2.35-fold increased risk of PTC, and the rs16903247-PTC/CC genotype was associated with a 2.42- and 9.46-fold increased risk of PTC (p < 0.0001). In addition, carriers of the TG or TT genotypes of rs4925166 and the AA genotype of rs372055 all presented a greater risk of PTC (p_rs4925166 = 0.0005, p_rs372055= 0.0021). Genetic model data further confirmed that the above four SNPs indeed increased the individual's sensitivity to PTC, as these SNPs were all associated with an elevated disease risk under different models (Bonferroni p < 0.0014).

Conclusion: Our results revealed significant associations between amino acid metabolism gene polymorphisms and PTC risk, suggesting potential biomarkers for PTC susceptibility.

Introduction: Gestational diabetes mellitus (GDM) is a common complication in pregnancy, linked to adverse outcomes for mothers and infants. Elevated levels of non-traditional lipid parameters have been associated with metabolic disorders. This study explores the predictive value of first-trimester non-traditional lipid parameters for GDM diagnosis at 24-28 weeks.

Methods: A retrospective study involving 1197 patients from The Third Affiliated Hospital of Wenzhou Medical University (January 2019 - August 2023) examined the correlation between non-traditional lipid parameters and GDM using logistic regression and stratified analyses. The diagnostic performance of the lipid parameters was evaluated using the area under the curve (AUC) method. Pearson correlation analysis clarified the relationship between non-traditional lipid parameters and neonatal birth weight, as well as their association with oral glucose tolerance test (OGTT) glycemic measures.

Results: Among 1197 participants, 201 were diagnosed with GDM. The GDM group exhibited significantly higher levels of non-traditional lipid parameters. Multivariate analysis identified these lipid measures, particularly Non-HDL-C with an AUC of 64.0% (95% CI: 59.6%-68.4%), as independent predictors of GDM across all models (P < 0.05), except for RC/HDL-C in model3. Most non-traditional lipid parameters demonstrated a linear relationship with GDM, with the exception of Non-HDL-C. Strong positive correlations were observed between fasting blood glucose levels and lipid ratios such as Non-HDL-C/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C, and RC/HDL-C in patients with GDM. No significant differences were found in non-traditional lipid parameters among the single, double, and triple positive groups.

Conclusion: First-trimester non-traditional lipid parameters are significant predictors of GDM, particularly when considering fasting blood glucose levels. These parameters offer potential value for early diagnosis.

Background: PCOS is a complex endocrine-metabolic disorder that is closely associated with oxidative stress. GEN, a naturally occurring isoflavone, has demonstrated beneficial effects in addressing hormonal imbalances and metabolic disturbances, primarily due to its potent antioxidant properties. While accumulating evidence supports its potential in managing PCOS, the full extent of GEN's therapeutic efficacy in alleviating PCOS-related symptoms remains inadequately defined, warranting further detailed investigation.

Purpose: This study aims to systematically evaluate the pharmacological efficacy of GEN in the management of PCOS through a meta-analytic synthesis of preclinical data.

Methods: A comprehensive literature search was conducted across six major databases-CNKI, Wanfang Data, VIP, PubMed, and Web of Science-covering publications from database inception until May 2025. The methodological quality of eligible studies was assessed using SYRCLE's risk of bias tool. Data synthesis and meta-analysis were performed using Rev Man 5.3 and Stata 17 software to ensure statistical analysis of the pooled outcomes.

Results: A total of ten studies were included in the meta-analysis. Compared to the control group, GEN exhibited significant therapeutic effects in the treatment of PCOS, including a reduction in body weight (P < 0.00001) and ovarian weight (P < 0.00001) in PCOS rats, as well as a reversal of elevated serum levels of T (P = 0.003) and LH (P < 0.00001). GEN also significantly reduced FBG (P = 0.007), INS (P = 0.0006), and HOMA-IR indices (P = 0.01), decreased MDA content (P = 0.0002) in ovarian tissue, and enhanced antioxidant activity, as indicated by increases in TAC (P < 0.00001), SOD (P < 0.00001), and GPx (P = 0.02). Furthermore, GEN lowered serum levels of LDL-C (P < 0.00001).

Conclusion: GEN demonstrates considerable therapeutic potential in managing PCOS through multiple mechanisms. These include modulation of body and ovarian weight, restoration of endocrine balance by reducing hyperandrogenism and normalizing reproductive hormone profiles, improvement of metabolic parameters through enhanced insulin sensitivity and glycemic control, and attenuation of oxidative stress via increased antioxidant enzyme activity and reduction of lipid peroxidation markers. These findings emphasize GEN's promise as a multifaceted intervention for PCOS, underscoring the need for further translational research to confirm its clinical efficacy.

Background: Recent studies reveal that obesity and reduced muscle mass are key factors implicated in insulin resistance (IR) and abnormal glycemic metabolism. Nonetheless, it remains ambiguous which demographic, particularly those with obesity or diminished muscle mass, exhibits a greater vulnerability to insulin resistance.

Objective: The aim of this study is to investigate the relationship between insulin resistance assessed by the triglyceride and glucose index (TyG index) and abnormal blood glucose metabolism in individuals with both reduced muscle mass and obesity. Furthermore, we assess the efficacy of the TyG index in forecasting occurrences of atypical blood glucose metabolism within this particular demographic.

Methods: This cross-sectional study utilized data collected from adults who underwent a health assessment at our institution between December 2022 and September 2024. The evaluation of insulin sensitivity was conducted utilizing the TyG index, whereas muscle mass was quantified through bioelectrical impedance analysis (BIA). Logistic regression, Receiver Operating Characteristic (ROC) curve analysis, subgroup analysis, and interaction effect analysis were employed to evaluate the association between triglyceride-glucose index levels with subgroups based on different body masses.

Results: This study comprised 1278 people with diminished muscle mass. We found a positive association between TyG index (OR = 7.73; 95% CI: 4.62-13.51; P < 0.001) and the risk of abnormal glucose metabolism among those who were overweight/obese. The analysis of the ROC curve revealed that the TyG index possesses a significant predictive capability for identifying abnormal glucose metabolism in individuals exhibiting diminished muscle mass (AUC = 0.906). This predictive value is particularly pronounced in those who do not present with overweight or obesity (AUC = 0.915), in contrast to its effectiveness in individuals who have both reduced muscle mass and overweight or obesity. Subgroup analyses confirmed the positive association of TyG index with abnormal blood glucose incidence.

Conclusion: This study assessed the link between TyG and abnormal blood glucose metabolism events risk in people with sarcopenia and compared its predictive power for abnormal blood glucose metabolism events onset in those with low muscle mass but not overweight or obese. We recommend using the TyG index as the best predictive marker for assessing abnormal blood glucose metabolism events risk in individuals without concurrent overweight or obesity, regardless of their body mass index.