BMC Endocrine Disorders最新文献

Objective: This study aimed to determine whether a relationship exist between pre-therapy 25-hydroxyvitamin D levels and the remission/negative conversion rates of thyrotropin receptor antibody (TRAB) during treatment in patients with newly diagnosed Graves' disease (GD).

Methods: 171 patients were included from the Endocrinology Department of the First Affiliated Hospital of Fujian Medical University in March 2013 to April 2016. Ninety-five patients of them were diagnosed at our hospital but transferred to local hospitals for treatment. Seventy-six patients were followed and treated at our hospital with a median follow-up time of 11.03 (range 6-27) months. Patients were divided into 3 groups according to baseline 25-hydroxyvitamin D levels; <20 ng/mL (31,43.05%), 20-29 ng /mL (20,27.78%), and ≥ 30 ng/mL (20,29.17%). The TRAB remission rate and negative conversion rate was assessed among each group.

Results: There was a higher TSH and lower TRAB titer in the 20-29 ng/mL group at initial diagnosis. Cox regression analysis suggested that 20-29 ng/mL group had significantly higher remission rates [RR; 95% CI: 7.505 (1.401-40.201), 8.975 (2.759-29.196),6.853(2.206-21.285), respectively] and negative conversion rates [RR; 95% CI: 7.835 (1.468-41.804),7.189(1.393-37.092), 8.122(1.621-40.688)] at the 6-, 12-, and 24-month follow-up, respectively . The level of 25-hydroxyvitamin D at the time of initial diagnosis was not associated with the re-normal of free Triiodothyronine(FT3), free thyroxineIndex(FT4) or TSH levels during the follow-up.

Conclusion: Newly diagnosed GD patients with appropriate baseline 25-hydroxyvitamin D levels (20-29 ng/mL) are beneficial for the reduction of TRAB during antithyroid therapy.

Background: The etiology of thyroid cancer especially in women in not well recognized in Yazd, at the center of Iran. The aim of present study was to investigate the risk factors of thyroid cancer among women living in this province.

Methods: The present study was carried out as a case-control study, comprising women diagnosed with papillary thyroid cancer (PTC) as the case group, along with two distinct control groups sourced from different origins (i.e., relatives and non-relatives) between 2020 and 2022. Data pertaining to several risk factors including demographic characteristics, reproductive variables, medical history related to thyroid and non-thyroid ailments, exposure to head and neck radiation, as well as familial cancer history, was collected from all participants. Binary logistic regression was utilized to discover risk and protective factors.

Results: In present study, 77 individuals participated in the case group, 76 in the relative control group and 72 in the non-relative control group. The history of OCP use and exposure to head and neck radiation were remained in the model as risk factors in all three case‒relative control (OR = 6.65, 95%CI: 2.53‒17.49; P-value < 0.001), case‒non-relative control (OR = 6.32, 95%CI: 2.14‒18.70; P-value = 0.001) and case‒total control comparisons (OR = 6.66, 95%CI: 2.84‒15.64; P-value < 0.001).

Conclusion: The OCP use as well as exposure to head and neck radiation were determined to be strong or relatively strong risk factors in both case‒relative control and case‒non-relative control comparisons. Consequently, it seems these two factors represent genuine risk factors for papillary thyroid cancer.

Background: Thyroid hormone plays an important role in accumulating bone development and regulating bone metabolism. It is established that hypothyroidism is linked to increased risk of osteoporosis and fracture. However, the effects of levothyroxine (LT4) treatment on bone for hypothyroid patients remain controversial.

Methods: A systematical search was conducted of several databases, from inception until December 9, 2022, and updated the search using the same search strategy on October 30, 2024, for studies evaluating the effects of LT4 treatment on bone in hypothyroidism including subclinical hypothyroidism (SCH) and overt hypothyroidism (OH). The data were reported using a random-effects model with a standardized mean difference (SMD) and 95% conference interval (CI).

Results: Thirteen of the 5996 published articles were included in this meta-analysis. No significance was found in bone mineral density (BMD) at the lumbar spine between SCH patients treated with LT4 and control group either at baseline or after intervention. For OH, BMD at the lumbar spine was statistically lower in LT4 treatment group compared with healthy controls (HCs) (SMD: -0.28, 95%CI: -0.55, -0.02, P = 0.040, I² = 52%). There were no differences in BMD at the femoral neck, trochanter, and Ward's triangle between OH patients treated with LT4 and HCs. In addition, BMD at the lumbar spine was significantly lower in males with OH undergoing LT4 treatment for a duration of less than five years compared to those treated over five years. Nevertheless, no significant differences were found in bone metabolism biomarkers between OH patients treated with LT4 and HCs.

Conclusion: This systematic review and meta-analysis demonstrated that there is a slight adverse effect of LT4 replacement therapy on bone and mineral metabolism in patients with OH, while no observed effect was found in SCH patients.

Background: Studies of the world health organization indicated that Diabetes is on the rise. The occurrence of diabetes is steadily increasing everywhere, most markedly in the world's middle and low-income countries. The aim of this study is to explore the consequence of war on the sugar level of diabetic mellitus patients.

Methods: A retrospective longitudinal study with a sample of 67 diabetic mellitus patients was used. As a result, longitudinal different models, which are generalized linear mixed effects and nonlinear mixed effect models were fitted on the continuous response variable, the Sugar Level of the diabetic patients.

Results: The results depicted that Blood Sugar Level of the patients increases over time. Moreover, as age, weight, medication, total cholesterol, high density lipoprotein (HDL), creatinine and linear time effect increase, Blood Sugar Level increases significantly, whereas triglyceride and low density lipoprotein increase, Blood Sugar Level of the adult Diabetes mellitus patients decreases.

Conclusion: The war has significant effect on the poor control of blood glucose level of the adult diabetic patients in Tigray region, Ethiopia. Due to the war, siege or blockages, in return there were rare of medicine, the patients were not taking their medicines on time, and they did not get enough insulin as well.

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) in lower and middle - income countries call for preventive public health interventions. Studies from Africa including those from Ghana, consistently reveal high T2DM-related mortality rates. While previous research in the Ho municipality has primarily examined risk factors, comorbidity, and quality of life of T2DM patients, this study specifically investigated mortality predictors among these patients.

Method: The study was retrospective involving medical records of T2DM patients. Data extracted included mortality outcome (dead or alive), sociodemographic characteristics (age, sex, marital status, educational level, occupation and location), family history of diseases (diabetes, cardiovascular disease (CVD), or asthma), lifestyle (smoking and alcohol intake), comorbidities (such as skin infections, sickle cell disease, urinary tract infections, and pneumonia) and complications of diabetes (CVD, nephropathy, neuropathy, foot ulcers, and diabetic ketoacidosis) were analyzed using Stata version 16.0 and Python 3.6.1 programming language. Both descriptive and inferential statistics were done to describe and build predictive models respectively. The performance of machine learning (ML) techniques such as support vector machine (SVM), decision tree, k nearest neighbor (kNN), eXtreme Gradient Boosting (XGBoost) and logistic regression were evaluated using the best-fitting predictive model for T2DM mortality.

Results: Of the 328 participants, 183 (55.79%) were female, and the percentage of mortality was 11.28%. A 100% mortality was recorded among the T2DM patients with sepsis (p-value = 0.012). T2DM in-patients were 3.83 times as likely to die [AOR = 3.83; 95% CI: (1.53-9.61)] if they had nephropathy compared to T2DM in-patients without nephropathy (p-value = 0.004). The full model which included sociodemographic characteristics, family history, lifestyle variables and complications of T2DM had the best prediction of T2DM mortality outcome (ROC = 72.97%). The accuracy for (test and train datasets) were as follows: (90% and 90%), (100% and 100%), (90% and 90%), (90% and 88%) and (88% and 90%) respectively for the various ML classification techniques: logistic regression, Decision tree classifier, kNN classifier, SVM and XGBoost.

Conclusion: This study found that all in-patients with sepsis died. Nephropathy was the identified significant predictor of T2DM mortality. Decision tree classifier provided the best classifying potential.

Background: As the prevalence of metabolic syndrome (MetS) rises among older adults, the associated risks of cardiovascular diseases and diabetes significantly increase, and it is closely linked to various metabolic processes in the body. Dysregulation of tryptophan (TRP) metabolism, particularly alterations in the kynurenine (KYN) and serotonin pathways, has been linked to the onset of chronic inflammation, oxidative stress, and insulin resistance, key contributors to the development of MetS. We aim to investigate the relationship between the TRP metabolites and the risk of MetS in older adults.

Methods: Ultra-performance liquid chromatography tandem mass spectrometry was used to detect TRP and its seven metabolites in a study involving 986 participants. Physical examination included the following indicators: blood pressure, body mass index, triglyceride levels, and high-density lipoprotein cholesterol (HDL-C) levels. Multiple linear regression, restricted cubic spline curve, binary logistic analysis, and sex-stratified analysis were used to explore the relationship between the metabolites and the risk of MetS in older adults.

Results: The results indicated that, after adjusting for covariates, higher levels of TRP, KYN, kynurenic acid (KA), and xanthurenic acid (XA) were risk factors for MetS (P for trend < 0.05). By contrast, higher ratios of 5-hydroxytryptamine to TRP and indole-3-propionic acid to TRP were protective factors against MetS (P for trend < 0.05).

Conclusions: TRP and its metabolites may serve as potential indicators for assessing and managing MetS in older adults, complementing existing biomarkers.

Clinical trial number: Not applicable.

Background: Despite TSH suppressive therapy improve the prognosis for the patient with differentiated thyroid cancer (DTC), there is an increasing concern regarding the potentially harmful effects of lifelong TSH suppression. Therefore, we aimed to examine the changes in body composition under TSH suppression in postmenopausal women with DTC.

Methods: The body composition was assessed by the volumes as following; fat tissues of the epicardium and abdominal visceral and subcutaneous areas; bilateral psoas muscle or thigh muscle. Each volumetric measurements were performed using computed tomography (CT) scans using baseline and follow-up fluorine-18 fluorodeoxyglucose positron emission tomography/CT (¹⁸F-FDG PET/CT)s for 2-year follow up period in Pusan National University Hospital, South Korea.

Results: The 43 patients' median age was 50.0 years, and median body mass index (BMI) was 23.53 (interquartile range[IQR]: 22.19- 24.92) at the initial ¹⁸F-FDG PET/CT. The median follow-up period was 19.24 months (IQR: 17.24-21.79). No significant change in weight or BMI were observed during follow-up. Volumes of fat and muscles was not changed significantly except epicardial fat volume. The epicardial fat volume significantly increased during the follow-up period. The epicardial fat volumes were correlated with visceral fat volume, respectively, however, the changing ratio was only correlated with TSH suppression on multiple regression analysis.

Conclusion: Both skeletal muscle and abdominal fat volumes did not change, whereas epicardial fat volume increased over less than 2 years of observation under TSH suppressive therapy. Further research is needed for the harmonization of benefits or losses with the optimal TSH concentration in postmenopausal women.

Background: Considering, the changes in lifestyle during the last decade the main aim of this study was to investigate the pooled prevalence of metabolic syndrome (MetS) and its components in Iran.

Methods: For implementing a comprehensive search strategy related to the objectives of the present meta-analysis, all international databases like PubMed (Medline), Scopus, Embase, Web of Sciences (Elsevier), and CINHAL were searched up to January 2024. The quality of the final selected studies was evaluated according to the Joanna Briggs Institute Critical Appraisal (JBI) tool for analytical cross-sectional studies. The subgroup analysis was performed based on gender, province, area, criteria of diagnosis, and components of metabolic syndrome. All of the analyses were carried out in STATA version 17.

Results: Among 2,034 relevant primary studies, 194 articles were entered into the meta-analysis. the prevalence of MetS in Iran was assessed using various criteria. The overall pooled prevalence was (31%, 95% CI: 28-34%), with a higher occurrence in females and individuals aged over 65 years. The central region, particularly Qom, reported the highest prevalence, while Tehran had the lowest. Low HDL cholesterol and waist circumference were the most common MetS components. The study provides critical data for health policy and intervention strategies in Iran.

Conclusion: Higher rates in females and the elderly and the predominance of low HDL cholesterol and waist circumference as MetS components call for targeted public health interventions. These insights are pivotal for formulating strategic health policies to mitigate MetS and its impact on the Iranian population.

Background: Microwave ablation is a new, minimally invasive technique for the treatment of thyroid nodules. Hyperthyroidism due to destructive thyroiditis is a known risk of microwave ablation, though it occurs in only a minority of cases. We report a rare case of a patient diagnosed with Graves' disease nearly six months after undergoing microwave ablation of a thyroid nodule.

Case presentation: On July 31, 2022, a 43-year-old male patient presented to our hospital with symptoms of pyrexia, excessive sweating, and palpitations lasting for 15 days. History inquiry revealed that the patient had undergone microwave ablation of right-sided thyroid nodule nearly five months ago at another hospital. The patient's thyroid ultrasound suggested bilateral diffuse thyroid lesions, with a moderately echogenic mass observed on the right side of the thyroid gland, potentially indicative of thyroid nodule ablation. The patient had elevated serum thyroid hormone levels, decreased thyroid-stimulating hormone levels and positive associated thyroid antibodies. To control the symptoms of hyperthyroidism, the patient opted for oral antithyroid medication, and thyroid hormonal levels returned to normal after 3 months of treatment. The patient is now under regular follow-up.

Conclusions: In this case, we presented the onset of Graves' disease following microwave ablation in a patient with subclinical thyroid autoimmunity. While the causal relationship between microwave ablation and Graves' disease remains unproven, this case suggests that preexisting autoimmune thyroid conditions may increase susceptibility to postoperative thyroid dysfunction. Procedural factors, such as thermal injury to surrounding tissues and potential involvement of the autonomic nervous system, are also potential contributors to the development of Graves' disease following microwave ablation.

Background: The present study aimed to explore the threshold-effect association of serum ferritin levels with type 2 diabetes mellitus (T2DM) and prediabetes mellitus in Chinese adults.

Methods: A total of 8365 people from CHNS a cross-sectional survey in 2009 were finally included. The biomarker data, including major cardiovascular biomarkers and important nutrition biomarkers were collected. The association of serum ferritin levels with T2DM and prediabetes mellitus were assessed by using restricted cubic spline function combined with multivariate logistic regression model.

Results: The mean age of the study subjects was 50.3 years, and 46.5% were men. The risk of T2DM and prediabetes mellitus increased when the ferritin level was greater than 140 ng/ml. The OR(OR = 0.59, 95% CI, 0.35-0.98)was lowest between 40 to < 60 ng/ml in men with prediabetes mellitus. The OR(OR = 0.61, 95% CI, 0.41-0.90)was lowest between 20 to < 40 ng/ml in women with prediabetes mellitus. Serum ferritin levels and OR value of women younger than 50 years old are lower than those of other participants.

Conclusions: There is a correlation between ferritin levels and pathoglycemia, with women under 50 years old having a lower risk for the same ferritin level, and maintaining low levels of ferritin can reduce the risk of developing diabetes mellitus.