BMC Endocrine Disorders最新文献

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, also considered a metabolic syndrome, and is associated with poor prognosis. eGDR (estimated glucose disposal rate) is a new biomarker to assessment insulin resistance (IR). The association between eGDR and MASLD and liver fibrosis is currently unclear.

Objective: The aim of this cross-sectional study is to appraise the association between eGDR and MASLD and liver fibrosis.

Methods: This study have enrolled 3,100 participants from the 2017-2018 National Health and Nutrition Examination Surveys (NHANES). Binary logistic regression analysis was used to assess the association between eGDR and MASLD and liver fibrosis. Receiver operating characteristic (ROC) was applied to estimate the ability of eGDR to identify MASLD.

Results: The mean age of the subjects was 54.59 (17.29) years, and 49.26% were female. The prevalence of MASLD and liver fibrosis was 62.19% and 11.15%, respectively. In the fully adjusted models, there were negative associations of eGDR with the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), with βs of -15.18 and - 0.74 (all p < 0.01), respectively. There were negative associations of eGDR with MASLD and liver fibrosis, with odds ratios (ORs) and 95% confidence intervals of 0.53 (95% CI: 0.48-0.74) and 0.40 (95% CI: 0.28-0.57) (all p < 0.01). The area under the curve (AUC) of the eGDR for identifying MASLD and liver fibrosis is 0.74 and 0.75, respectively.

Conclusion: The study findings suggest a significant association between eGDR and MASLD as well as liver fibrosis. eGDR may serve as a biomarker for identifying MASLD.

Background: We studied the link between adherence to a low carbohydrate diet (LCD) and metabolic syndrome (MetS) and its components in Iranian population.

Methods: In this cross-sectional study, a validated 65-item food frequency questionnaire was used to collect dietary intakes from 3847 Iranian adults aged 35 to 65 years. These intakes were then used to calculate the LCD scores. The definition of metabolic syndrome followed the guidelines provided by the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI). To explore the association between LCD and MetS, multivariate logistic regression was employed in three models.

Results: After accounting for potential confounding factors, individuals in the highest quartile of LCD score demonstrated a lower probability of having MetS compared to those in the lowest quartile (OR: 0.70; 95% CI: 0.56-0.88). When the analyses were performed for components of MetS, we found that compared to individuals in the bottom quartile, those in the top quartile of LCD score had a lower odds of enlarged waist circumference (OR: 0.62; 95% CI: 0.49-0.79), low serum HDL cholesterol (OR: 0.75; 95% CI: 0.62-0.92) and elevated blood pressure (OR: 0.71; 95% CI: 0.57-0.88). Regarding other components of MetS, no significant association was seen between LCD score and high serum triacylglycerol concentrations and abnormal glucose homeostasis.

Conclusions: We found that adherence to a LCD was inversely related to MetS and its components including low serum HDL-C, elevated blood pressure, and enlarged waist circumference.

Clinical trial number: Not applicable.

Background: the metabolic effects of sodium-glucose cotransporter-2 inhibitors (SGLT2i), such as lipolysis and ectopic fat reduction, seem related to the synthesis of fibroblast growth factor-21 (FGF-21), and FGF-21 analogs are now under investigation for the treatment of obesity complications such as metabolic dysfunction-associated steatotic liver disease. However, FGF-21 levels are paradoxically higher in obesity, indicating a hormone-resistant state that may hinder the benefits of SGLT2i.

Methods: To define if a different energy status influences the response to SGLT2i, we evaluated the effects of dapagliflozin administration on nine-week-old C57BL/6J wild-type and B6.V-LEP ob/ob mice as a model of genetic obesity. Blood glucose, body weight and food intake were evaluated, and the FGF-21 expression was determined in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and brown adipose tissue (BAT). In the liver, FGF-21 gene expression, protein concentration and triglyceride content were evaluated.

Results: glucose plasma levels and body weight were higher in ob/ob than in lean mice. After four weeks of treatment, dapagliflozin reduced blood glucose levels and body weight in both animal models, but weight loss was more significant in lean mice. The baseline expression of FGF-21 was higher in both SAT, VAT and the liver of ob/ob mice, whereas it was almost undetectable in BAT in both animal groups. After the treatment period, dapagliflozin was shown to increase FGF-21 expression in VAT only in lean animals, while the expression was unaffected in ob/ob mice. Similar effects were observed in the liver analyses, along with no variation in triglyceride content.

Conclusions: SGLT2i administration results in less pronounced metabolic effects in ob/ob mice than in lean mice. This data suggests a less sensitive response in obesity, probably due to a chronic stimulation leading to abnormalities of the SGLT2i-FGF-21 axis which should be considered in managing patients affected by genetic obesity.

Objectives: To evaluate the frequency of erectile dysfunction in male patients who undergo thyroidectomy using the International Index of Erectile Function (IIEF-5), and explore possible risk factors.

Methods: 163 male patients who undergo partial, unilateral or bilateral thyroidectomy between December 2021 and September 2022 were retrospectively studied. The IIEF-5 questionnaires were completed 6 and 12 months after surgery, and patients who reported erectile dysfunction (ED) before surgery were not included. Sociodemographic factors (age, education status, and employment status) and health behavior (smoking and alcohol consumption) were also recorded. The above factors and clinical data were included for statistical analysis.

Results: Fifty-five patients underwent total thyroidectomy (TT), 67 underwent hemithyroidectomy (HT), and 41 underwent partial thyroidectomy (PT). Six months after surgery, 33 patients (60%) in the TT group, 38 (56.7%) patients in the HT group, and 11(26.8%) patients in the PT group reported ED. The lowest scores were observed in the TT group (TT: 19.22 ± 3.895, HT: 20.67 ± 2.836, PT: 21.98 ± 1.651, P < 0.05). At the 12-month postoperative visit, the mean IIEF-5 scores were better in the HT and PT groups and worse in the TT group (TT: 18.36 ± 4.335, HT: 21.40 ± 2.692, PT: 22.54 ± 1.206, P < 0.05). Binary logistic regression analysis revealed that age and extent of resection significantly affected the onset of postoperative ED.

Conclusions: Thyroidectomy, especially the total thyroidectomy, adversely affects erectile function. In addition to the operative procedure, age was also found to be significantly associated with postoperative ED.

Aim: Numerous studies have revealed the decisive role of serum chloride in the outcome of specific patients. However, the potential role of serum chloride in general populations has been rarely investigated. This study aims to assess the association of serum chloride with MetS risk in the general population.

Methods: A total of 13,290 adult participants were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. The association between serum chloride and MetS was investigated using weighted logistic regression analyses. The weighted restricted cubic spline (RCS) was constructed based on the fully adjusted model to explore its dose-response relationship. Further stratified analyses were also conducted. All data and analyses were conducted using the "Survey" package in R software (Version 4.4.1).

Results: The average age of this population was 48.20 ± 0.35, the average BMI was 29.42 ± 0.12 kg/m², included 48.54% males, and the weighted prevalence of MetS was 37.83%. After adjusting full covariates, serum chloride was negatively associated with MetS risk in overweight or obese participants who did not smoke or heavy drink. Meanwhile, serum chloride was significantly inversely correlated with the raised fast glucose (FG), total cholesterol (TG) and blood pressure (BP), and positively related with the reduced high density lipoprotein cholesterol (HDL-C). Consistent results were observed in the RCS analysis.

Conclusion: This study suggested a potential inverse relationship between serum chloride levels and MetS risk. Understanding this link may offer fresh perspectives on preventing and treating MetS, presenting new therapeutic targets and strategies for public health improvement.

Background: Heterotaxy syndrome is a rare congenital condition characterized by abnormal arrangement of thoracoabdominal organs, often associated with complex cardiac and splenic anomalies. Pheochromocytoma is a rare neuroendocrine tumor that overproduces catecholamines, leading to various complications. The co-occurrence of heterotaxy syndrome and pheochromocytoma has not been previously reported. This case report presents a unique finding of pheochromocytoma in a patient with heterotaxy syndrome and a functioning ectopic spleen, offering novel clinical insights.

Case presentation: A 19-year-old male with congenital heart disease was incidentally found to have a right adrenal mass during abdominal ultrasonography which followed abnormal lab results. Computed tomography (CT) scans confirmed abnormal organ positioning consistent with heterotaxy syndrome, including a midline liver, right-sided colon, and the absence of a spleen in its typical location. Subsequent scintigraphy with Technetium-99 m denatured red blood cells revealed a functioning ectopic spleen in the left subdiaphragmatic space. The right adrenal mass was confirmed to be pheochromocytoma based on elevated urinary catecholamine levels. Despite recommendations for surgery, the patient chose medical management with alpha-blockers and remained stable over a one-year follow-up with no significant events.

Conclusions: This case is notable concurrency of pheochromocytoma and heterotaxy and for the rare occurrence of a functioning ectopic spleen in a patient with heterotaxy syndrome, a condition where splenic anomalies typically manifest as asplenia or polysplenia. The importance of extensive imaging, particularly Tc-99 m labeled denatured erythrocyte scintigraphy imaging, is emphasized, as routine imaging like CT scans may fail to detect ectopic organs. Additionally, the concurrent presence of pheochromocytoma (PCC) and heterotaxy syndrome, although rare, raises intriguing questions about their potential link. While this case does not explore the association in detail, chronic hypoxia caused by congenital cardiovascular anomalies in heterotaxy syndrome could activate hypoxia-inducible factors (HIFs), which may promote tumorigenesis, including the development of PCC. Future studies are warranted to explore these mechanisms further and clarify the pathophysiological connection between heterotaxy syndrome, hypoxia, and PCC.

Background: Low testosterone levels is associated with higher cardiovascular risk in men with diabetes. However, there are few studies on testosterone levels and the factors affecting them in patients with young-onset diabetes (YOD). The objective of this study was to investigate the correlation between waist-to-hip ratio (WHR) and testosterone levels in men diagnosed with YOD.

Research design and methods: This cross-sectional study involved 547 male patients with type 2 diabetes mellitus (T2DM) from the Endocrinology Department of the Affiliated Hospital of Jining Medical University. The participants were divided into two groups: a young-onset diabetes (YOD) group and a late-onset diabetes (LOD) group. Anthropometric measurements, including height, weight, waist circumference, and hip circumference, were recorded. Additionally, fasting blood samples were collected to assess various parameters, such as sex hormone levels and lipid profiles. The association between WHR and testosterone levels was analyzed by univariate linear regression and multivariable linear regression analysis.

Results: Five hundred forty-seven patients with type 2 diabetes and aged 50.3 ± 12.1 years were enrolled in the study. One hundred ninety-three patients were assigned to the YOD group based on a diagnosis age of 40 years or younger, while the remaining 354 patients were assigned to the LOD group. The testosterone was significantly lower in the YOD group compare to the LOD group (P = 0.049), and the WHR had an independent effect on testosterone in men with the YOD group (β=-4.67, P = 0.0251), but there was no evidence of such an association in the LOD group (β =-1.13, P = 0.4608).

Conclusions: According to our results, male patients with YOD exhibited lower testosterone levels compared to those with LOD. Furthermore, their testosterone levels were significantly negatively correlated with WHR. These findings indicate that it is more necessary to screen for testosterone in obese patients with YOD and that improving obesity, especially abdominal obesity, may help to interrupt the vicious cycle of low testosterone-obesity-insulin resistance-hyperglycemia-low testosterone.

Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome caused by the secretion of high molecular weight insulin-like growth factor II (IGF-II) from tumors, particularly those of mesenchymal and epithelial origin. This case report describes a 71-year-old male with pelvic sarcoma who presented with severe hypoglycemia, with blood glucose levels dropping below 40 mg/dL and exhibiting neuroglycopenic symptoms. The diagnosis of NICTH was confirmed through biochemical analysis showing hypoinsulinemic hypoglycemia alongside low C-peptide and IGF-1 levels. Initial management with dextrose infusions and glucocorticoids proved ineffective until recombinant human growth hormone (rhGH) therapy was initiated, resulting in a decreased requirement for dextrose. Following angioembolization of the tumor, the patient's blood glucose levels stabilized sufficiently to allow for the complete cessation of dextrose administration. This case highlights the critical role of rhGH in reducing dextrose dependency and the effectiveness of angioembolization in managing NICTH when surgical options are limited.

Introduction: The global increase of prediabetes and diabetes in adolescents raises the issue of early prediction of this metabolic disorder via anthropometric parameters, especially in limited resources settings such as Sudan. However, the reliability of these anthropometric predictors is inconclusive. This study aimed to examine the association between anthropometric measures, including body mass index (BMI), hip circumference (HC), waist circumference (WC), waist-to-hip ratio (WHR), body roundness index (BRI), and a body shape index (ABSI), and prediabetes in adolescents in eastern Sudan.

Methods: This community-based cross-sectional study was conducted among adolescents in Gadarif City, Eastern Sudan. A questionnaire was used to collect sociodemographic information. Anthropometric and glycated hemoglobin (HbA1c) were performed following the standard procedures. The Receiver Operating Characteristic (ROC) curve was generated. Multivariate binary regression analysis was performed.

Results: Among the 401 adolescents, 186 (46.4%) were female, and 215 (53.6%) were male. The median (IQR) age was 14.1 (12.1-16.3) years. There was no correlation between BMI, WC, HC, WHR, BRI, ABSI, and HbA1c levels. Ninety-five (23.7%) adolescents were identified with prediabetes and 10 (2.5%) with diabetes. In univariate analysis, BRI (OR = 1.24, 95.0% CI = 1.01‒1.52) and BMI (OR = 1.05, 95.0% CI = 1.01‒1.10) were associated with prediabetes. The other anthropometrics and sociodemographic parameters were not associated with prediabetes. In multivariate analysis, BRI and BMI were not associated with prediabetes. All the tested anthropometric parameters, WHR (AUC = 0.51, cutoff = 0.80, sensitivity = 0.69, specificity = 0.44), BRI (AUC = 0.57, cutoff = 1.77, sensitivity = 0.77, specificity = 0.42), ABSI (AUC = 0.51, cutoff = 0.14, sensitivity = 0.77, specificity = 0.31), BMI (AUC = 0.55, cutoff = 18.30 kg/m², sensitivity = 0.45, specificity = 0.67), HC (AUC = 0.54, cutoff = 75.75 cm, sensitivity = 0.73, specificity = 0.36), and WC (AUC = 0.55, cutoff = 66.63 cm, sensitivity = 0.49, specificity = 0.63), had poor reliability in detecting prediabetes in adolescents.

Conclusion: This study demonstrated a lack of reliability of anthropometric parameters in predicting prediabetes among adolescents in eastern Sudan. Further extensive research is recommended in various regions of Sudan.