BMC Endocrine Disorders最新文献

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).

Background: Proper planning of reproductive health needs for HIV-infected adolescents requires a clear understanding of the effects of HIV infection on adolescents' pubertal development.

Objective: To assess the effects of HIV infection on the hypothalamic-pituitary-ovarian (HPO) axis, ovarian reserve and pubertal development in adolescent girls at a tertiary hospital in Zimbabwe.

Methods: This was a cross-sectional survey of HIV-infected adolescent girls aged 10-19 years, with available CD4 + count results at a tertiary hospital in Zimbabwe. Consecutive sampling was used to select study participants. Pubertal milestones were assessed using the age of menarche and Tanner stage for breast and pubic hair development. Growth was assessed using World Health Organisation growth charts. The HPO axis was evaluated by measuring serum follicular stimulating hormone (FSH), luteinising hormone (LH) and estradiol. The ovarian reserve was assessed in adolescents above 18 years of age by measuring the serum anti-mullein hormone (AMH) levels. Data were analysed in STATA version 13.0, and the results are presented as mean (SD) or median (quartiles) and proportions, as appropriate.

Results: One hundred and one (101) HIV-infected adolescents were recruited for the study. Menarche, thelarche and pubarche were delayed in 15.9%, 28.6% and 46.8% of the adolescents, respectively. A total of 59.4% had moderate to severe stunting, and 53.5% were either overweight or obese. Most participants had normal serum FSH, LH, and estradiol levels, and there was no association between these hormone levels and growth indicators. The serum AMH levels were reduced in 24.1% of the adolescents. There were no significant differences in the hormonal levels and pubertal development between the WHO CD4 classes.

Conclusion: HIV infection is associated with stunted growth and delayed sexual maturation with an intact HPO axis in the majority of adolescents. There was no association between growth indicators and FSH and LH levels. The degree of HIV immunosuppression had no significant impact on the HPO axis and pubertal development. A larger study is needed to assess the impact of HIV infection on ovarian reserve.

Trial registration: This protocol was approved by the Medical Research Council of Zimbabwe (MRCZ) (reference number MRCZ/A/1730).

Background: Diabetes characterized by chronic hyperglycemia, has become a serious hazard to human health in the recent decades. Previous research suggests that asprosin may contribute to the development of diabetes by regulating glucose homeostasis, appetite, insulin secretion, and insulin sensitivity. Although some studies have shown that asprosin levels are higher in patients with diabetes than in healthy individuals, the association between asprosin levels and diabetes remains controversial.

Aim: This meta-analysis aimed to assess asprosin levels in patients with diabetes and in healthy individuals.

Methods: We searched the following electronic databases: Web of Science, ScienceDirect, PubMed, and Willy. The title or abstract uses the following search term: "diabetes" is used in combination with the term "asprosin." The meta-analysis results are presented as standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs).

Results: Fourteen articles were included in this meta-analysis. In our meta-analysis, the asprosin level in patients with diabetes was significantly higher than that in healthy controls (SMD: 0.95, 95% CI [0.66, 1.24]). Moreover, there was a significant difference in the asprosin levels between patients with diabetes without complication and those with complication (SMD: 0.81, 95% CI [0.33, 1.29]).

Conclusions: This systematic review is the first to evaluate the relationship between asprosin levels and diabetes. The asprosin levels were significantly higher in patients with diabetes.

Clinical trial number: Not applicable.

Background and objective: While the connection between the Triglyceride glucose-waist circumference (TyG-WC) index and the risk of diabetes remains understudied, this particular research delves into the potential predictive value of the TyG-WC index within a significant Japanese population.

Methods: This retrospective cohort study encompassed a comprehensive analysis of 15,413 Japanese adults, all of whom were diabetes-free at the outset of the study period from 2004 to 2015. Comprehensive medical records were obtained for all participants who underwent physical examinations. The study employed Cox proportional-hazards regression, smooth curve fitting, various sensitivity, and subgroup analyses to explore the association between TyG-WC and the development of diabetes. Furthermore, a Receiver Operating Characteristic (ROC) curve was created to detect the predictive capability of TyG-WC for diabetes risk.

Results: After a maximum of 13.0 years of follow-up, 358 people finally developed diabetes. Upon adjusting for covariates, the result showed TyG-WC was positively and independently associated with incident Diabetes Mellitus (DM) (Hazard Ratio (HR): 1.004, 95%C: 1.001-1.006). Furthermore, ROC curve analysis demonstrated that TyG-WC outperformed both the triglycerides-glucose index and triglyceride glucose-body mass index in predicting the onset of diabetes.

Conclusion: High levels of TyG-WC are autonomously linked to a heightened risk of diabetes in the Japanese demographic, indicating its potential as a dependable predictive indicator for diabetes mellitus in individuals at elevated risk.

Objective: The purpose of this investigation is to assess the clinical risk linked to the onset of diabetes in individuals with non-alcoholic fatty liver disease (NAFLD) through the utilization of the cardiac metabolic index (CMI), which is derived from triglycerides, high-density lipoprotein, height, and waist circumference. Research focusing on the application of CMI for evaluating diabetes risk among NAFLD patients remains scarce, and an exploration of the association between CMI and the emergence of diabetes within this demographic has not been conducted. This investigation aims to illuminate this connection, thereby providing novel insights into the prevention of diabetes progression in individuals with NAFLD.

Methods: Data were procured from a cross-sectional study involving 15,435 participants conducted by the Japanese government, resulting in a final cohort of 2,503 adults aged 18 and above who met the eligibility criteria for evaluation. The CMI is determined using the formula: TG (mmol/L) / HDL-C (mmol/L) * WHtR. CMI values were categorized into quartiles (Q1 to Q4) based on their scores, arranged from low to high. The investigation utilized logistic regression models, restricted cubic spline analysis, and subgroup analyses, with adjustments made for continuous models to elucidate the association between CMI and diabetes development among individuals with NAFLD, as well as the non-linear relationship between CMI and this outcome.

Results: The investigation comprised 2,503 subjects with an average age of 44.79 ± 8.33 years, of whom 204 were diagnosed with new-onset diabetes (8.15%). Multivariate logistic regression analysis indicated that within the CMI quartile groupings, individuals with NAFLD in the uppermost quartile (Q4) exhibited the greatest likelihood of new-onset diabetes relative to those in the lowest quartile (Q1) (odds ratio, OR = 3.239, 95% confidence interval [CI]: 1.993-5.264, P < 0.001). Additionally, escalating CMI values corresponded to an increasing probability of new-onset diabetes in NAFLD subjects (OR = 1.705, 95% CI: 1.362-2.133, P < 0.001). Restricted cubic spline analysis demonstrated a non-linear connection between CMI and new-onset diabetes in NAFLD patients (P overall < 0.001, P non-linear = 0.035), with a risk inflection point identified at a CMI of 0.5554. Subgroup analysis revealed no significant interactions between gender, age, physical activity, alcohol consumption, or smoking status and the likelihood of new-onset diabetes in this patient population (P for interaction > 0.05).

Conclusion: Findings from this study indicate a notable positive non-linear connection between elevated CMI scores and the probability of new-onset diabetes in individuals afflicted with NAFLD.

Clinical trial number: Not applicable.