BMC Endocrine Disorders最新文献

Objectives: Central obesity is a well-known risk factor of numerous disease. Numerous indicators are developed for central obesity measurement, among them, abdominal volume index (AVI), reflecting total volume of the abdomen, precisely estimates the visceral fat volume. As a relatively new health measure and potent prognostic marker of metabolic disturbances, no study is available to investigate its role in cardio-metabolic health and oxidized LDL among obese young adults. In the current study we aimed to evaluate the association between abdominal volume index (AVI) with cardio-metabolic profile including serum lipids, glycemic markers of serum glucose, hemoglobin (Hb) A₁C, insulin, oxidized LDL and blood pressure among young obese adults.

Methods: Two hundred twenty young adults aged 18 to 25 years old with overweight or obesity were enrolled in the current study. Anthropometric measurements were done and AVI were calculated. Biochemical variables including serum total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), triglyceride (TG), glycemic markers, including fasting serum glucose (FBS), insulin, hemoglobin (Hb) A₁C and blood pressure were also measured with an automatic analyzer.

Results: Participants in the third tertiles of AVI had higher body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) (p < 0.001 for all). Among biochemical variables, oxidized LDL, TG and HDL demonstrated significant associations across AVI tertiles in the first and second models, with higher oxidized LDL and TG and lower HDL levels observed in higher AVI tertiles (p < 0.05). Moreover, those at the highest AVI tertiles showed significantly higher odds ratios for elevated cardio-metabolic index and systolic and diastolic blood pressures compared to the first tertiles (p < 0.05).

Conclusions: In the current study, we comprehensively investigated the association between AVI with cardio-metabolic health in young obese adults and accordingly, AVI was unfavorably associated with metabolic health among obese adults. Further studies are needed to elaborate the underlying mechanisms.

Clinical trial number: Not applicable.

Background: Obesity will cause metabolic syndrome (Mets) easily, and its pathogenesis is not completely clear.

Aim: To probe into the predictive value of miR-122-5p and its regulatory mechanism in Mets.

Method: The predictive effect of miR-122-5p on Mets was evaluated by constructing a Receiver Operating Characteristic (ROC) curve. The target genes of miR-122-5p were predicted using the ENCORI/starBase and TargetScanHuman databases, and pyruvate kinase M2 (PKM2), closely related to Mets, was screened by GO and KEGG analysis. The roles of miR-122-5p/PKM2 in insulin resistance (IR) were explored by treating the human normal liver cells (HLCs) with palmitic acid (PA) to induce the IR model. The effects of miR-122-5p/PKM2 on glucose metabolism (GM) of HLCs were evaluated by detecting the production of pyruvic acid, lactic acid, and ATP.

Results: MiR-122-5p was highly expressed in obese people and Mets patients, and its predicted AUC for Mets was 0.876. In HLCs transfected with wild-type PKM2 luciferase vector (PKM2-wt), luciferase activity was attenuated by the miR-122-5p mimic and enhanced by its inhibitor. The expression of PKM2 was inhibited by the miR-122-5p mimic and up-regulated by its inhibitor. The miR-122-5p mimic enhanced PA-induced IR and inhibited the GM of HLCs, which were reversed by overexpression of PKM2. The miR-122-5p inhibitor exerted the opposite effects of its mimic, which were also reversed by silencing of PKM2.

Conclusion: MiR-122-5p, a risk factor for Mets, mediated the IR and abnormal glucose metabolism of HLCs by negatively regulating PKM2.

Clinical trial number: Not applicable.

Background: This research investigated how physical activity (PA) might impact the expression of several microRNAs, specifically miR-126, miR-146a, miR-34a, miR-124a, miR-155, and miR-221, in the blood of elderly individuals with type 2 diabetes (T2D). Additionally, the study examined the relationship between these microRNAs and markers of vascular endothelial dysfunction, including vascular endothelial growth factor (VEGF), apolipoprotein A-I (apoA-I), and apolipoprotein B (apoB), to assess their potential in the prevention, early detection, and treatment of diabetes.

Methods: This correlational observational study involved 100 male participants, aged between 18 and 65 years, all of whom had been living with type 2 diabetes (T2D) for over six years. The participants were divided into three groups: inactive, moderate, and active, depending on their level of physical activity (PA). Real-time PCR and immunoassays were employed to measure the expression of selected miRNAs, as well as VEGF, apoA-I, apoB, and diabetic management indicators. PA levels were determined using ACTi graph GT1M accelerometer (model WAM 7164; Fort Walton Beach, FL) and energy expenditure was measured in the form of metabolic equivalent (MET) by indirect calorimetry method.

Results: The expression levels of miR-146a, miR-34a, and miR-124a were significantly higher in patients with higher physical activity, while no such increase was observed for the other miRNAs in less active participants. Additionally, PA-active individuals showed a more pronounced decrease in fasting blood sugar (FBS), insulin resistance (IR), fasting insulin (FINS), HOMA-IR, HbA1c (%), and levels of VEGF, apoAI, apoB, and the apoB/apoA-I ratio. The alteration in miRNA expression was positively associated with physical activity, VEGF, apoAI, apoB, the apoB/apoA-I ratio, and diabetes-related metrics, while being inversely related to BMI.

Conclusions: In diabetic patients with higher physical activity levels, circulating miR-146a, miR-34a, and miR-124a showed elevated expression, accompanied by a notable decrease in vascular biomarkers, including apoAI, apoB, and the apoB/apoA-I ratio. The findings revealed a strong correlation between these vascular biomarkers and the physiological responses of miR-146a, miR-34a, and miR-124a, though larger studies are required to validate these results further.

Trial registration: Not applicable.

Background: Metabolic dysfunction associated steatotic liver disease (MASLD) is prevalent in up to 60% of patients with type 2 diabetes mellitus (T2DM). T2DM accelerates the risk of hepatic fibrosis and hepatocellular carcinoma in patients with MASLD. Our goal in this study was to identify patients with suspected MASLD and hepatic fibrosis in a large T2DM clinic by using noninvasive fibrosis scoring systems.

Methods: We conducted a retrospective study of patients with T2DM seen by our endocrinologists at the Medical Faculty Associates (MFA) Diabetes Center in Washington, DC, from November 1, 2021, until November 1, 2022. We included all subjects who were over 18 years old with a hemoglobin A1c (HbA1c) of 6.5 or higher. Patients with a history of significant alcohol consumption, decompensated cirrhosis, previous bariatric surgery, or prior chronic liver disease were excluded from the study. We identified patients at risk for hepatic fibrosis by using the Fibrosis-4 (FIB-4) Index, NAFLD Fibrosis Score (NFS) and AST to Platelet Ratio Index (APRI) when lab values were available.

Results: A total of 1,411 patients were evaluated for T2DM by an endocrinology provider during the one-year period. Out of these, 336 patients met one or more of the exclusion criteria, leaving a total of 1075 patients included in the analysis. The majority were African American (n = 582, 54%), 261 were Caucasian (24.3%), and 85 were Hispanic (7.9%). Most patients were females (n = 675, 62.7%). The mean HbA1c was 8.1 ± 2.3. 643 patients (59.8%) were insulin dependent. Based on FIB-4 scores, we found that 35 (3.9%) patients had a score of > 2.67 associated with advanced fibrosis and 257 (29%) patients with scores of 1.3-2.67 had moderate fibrosis. Using the NFS calculator, there were 281 (28%) patients with values of > 0.675 consistent with F3-F4 disease. 715 (71.8%) patients with values of < 0.675 consistent with F0-F2 fibrosis. A total of 6(< 1%) patients met criteria for advanced fibrosis by APRI scoring.

Conclusion: In our urban Diabetes Center, utilizing the NFS calculator may detect many patients with advanced liver disease. Further research is needed to ensure the internal validity of the non-invasive tests in predicting liver fibrosis and to correlate these findings with transient elastography and other imaging evidence of fatty liver disease.

Clinical trial number: Non-applicable.

Background and objective: The effects of Empagliflozin on liver health in patients with Type 2 Diabetes Mellitus (T2DM) have not been fully elucidated. This study aimed to assess the impact of Empagliflozin on liver steatosis and related biomarkers in T2DM patients.

Methods: A before-after clinical trial was conducted with 119 T2DM patients aged 20 to 70 with fatty liver, recruited from Laghman Hakim Hospital, Tehran, Iran. Participants were administered Empagliflozin for 6 months, with clinical and laboratory assessments conducted at baseline, 3 months, and 6 months. Liver function was evaluated through blood tests and imaging, including ultrasound and Magnetic resonance imaging (MRI), to assess hepatic steatosis. Biomarkers such as HbA1c, fasting blood glucose, insulin, lipid profile, and liver enzymes were measured. Insulin resistance was estimated using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) formula. Data were analyzed using SPSS 26 and STATA 14.

Results: A total of 119 patients (Intervention (N = 69), Control (N = 50)) were participated. The intervention group demonstrated a significant reduction in liver fat grade compared to the control group, with 17.5% of patients showing a reduction from grade 3 to grade 1 on MRI and 6% in the control group. The odds of worsening fatty liver in the control group were 48 times higher (95% CI: 15.5, 148.5) on MRI and 52 times higher (95% CI: 15.2, 178.1) on ultrasound, compared to the intervention group (NNT = 2). After 6 months, the intervention group showed significantly lower risks for ALT (RR: 0.72, 95% CI: 0.62-0.84), AST, and alkaline phosphatase (Alkp) abnormalities. Liver enzyme levels (ALT, AST, GGT) and systolic blood pressure (SBP) decreased significantly in the Empagliflozin group, with mean differences of -15.33 (95% CI: -18.8, -11.88) for ALT, -12.82 (95% CI: -15.5, -10.13) for AST, and - 6.31 (95% CI: -8.65, -3.97) for systolic blood pressure (SBP).

Conclusion: These findings suggest that Empagliflozin could be an effective adjunctive therapy for managing liver dysfunction in T2DM patients with NAFLD.

Trial registration: Registered retrospectively in the Iranian Registry of Clinical Trials (IRCT20210811052150N1) on April 16,2023 Access at https://irct.behdasht.gov.ir/search/result?query=IRCT20210811052150N1 .

Background: Hypothyroidism is a common thyroid disease affecting the health of the global population and oxidative stress and inflammation are involved in the pathophysiological process of hypothyroidism. Comprehensive dietary antioxidant index (CDAI), representing the overall dietary antioxidant capacity, has been proved to be associated with a variety of diseases. However, association between CDAI and hypothyroidism risk remains unclear. This study aims to evaluate the association of CDAI and hypothyroidism risk.

Methods: Data of this study were extracted from the National Health and Nutrition Examination Surveys (NHANES) database 2007-2012. CDAI, represents the overall dietary nutrients capacity, was calculated by selenium, zinc, magnesium, vitamin A, C and E. Thyroid stimulating hormone (TSH) > 5.6 mIU/L was defined as hypothyroidism. The weighted multivariate logistic regression models and propensity score matching (PSM) analysis were utilized to evaluate the relationship between CDAI and hypothyroidism, with odds ratio (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analysis were further evaluated the relationship between CDAI and hypothyroidism. Moreover, the association between the components of CDAI and hypothyroidism was also explored.

Results: Totally, 7,959 subjects with information of complete dietary intake and thyroid function measurement were included. Of whom, 213 (2.68%) subjects had hypothyroidism. After adjusted all covariates, we observed high CDAI was related to low hypothyroidism risk (OR = 0.44, 95%CI: 0.27-0.71). This relationship was prominent in subjects with aged < 65 years old (OR = 0.32, 95%CI: 0.16-0.62), male (OR = 0.39, 95%CI: 0.15-0.99) and BMI ≥ 25 kg/m² (OR = 0.38, 95%CI: 0.19-0.76). The association between high CDAI and low hypothyroidism risk remained significant when subjects using thyroid hormones were excluded (OR = 0.47, 95%CI: 0.27-0.81).

Conclusion: High CDAI was related to low hypothyroidism risk among U.S. adults. Our finding showed that the intake of an antioxidant-rich dietary is a potential method to reduce the risk of hypothyroidism.

Background: Selenium is a key regulator of metabolic homeostasis. It has been proposed that exposure to selenium might be associated with metabolic syndrome (MetS). However, the results are contradictory. This meta-analysis was carried out to analyze the relationships between selenium levels in biological samples and odds of Mets.

Methods: We searched Scopus and PubMed databases up until September 2024 to identify relevant studies. Odds ratio (OR) and 95% confidence interval was used to pool the data using a random effects model.

Results: The meta-analysis encompassed 18 observational studies involving 21,481 participants. It found that higher selenium exposure was related to an elevated likelihood of MetS (OR = 1.30, 95% CI = 1.12-1.51), even after controlling for covariates, such as smoking, age, alcohol consumption, and physical activity. Heterogeneity was significant among the studies (I² = 88.9%, P = 0.001). While elevated serum selenium levels linked to a higher odds of MetS, no such relationship was observed for selenium in urine or toenails. Subgroup analyses indicated that this association was evident only in females (OR = 2.0, 95% CI = 1.17-1.43) and particularly pronounced in individuals aged ≥ 50 years. A dose-response relationship was identified, showing a 6% increase in MetS odds for each additional 10 µg/L of serum selenium, with the odds rising non-linearly when serum levels surpassed 80 µg/L.

Conclusions: This study suggests that selenium may associated with the odds of MetS, following a dose-response relationship.

Objective: This study investigates the comparative short-term and long-term efficacy of endoscopic lipolysis and liposuction versus traditional open excision in the treatment of gynecomastia.

Methods: A total of 140 male patients diagnosed with gynecomastia and admitted to our hospital from April 2021 to May 2022 were enrolled in this study. Patients were randomly assigned to two groups based on the surgical treatment method: the control group (traditional open excision, n = 70) and the observation group (liposuction under endoscope, n = 70). Comprehensive demographic and clinical data were collected for both groups. Surgical indicators, postoperative complication rates, and pain levels measured using the Visual Analog Scale (VAS) one month post-surgery were observed and compared. Additionally, recurrence rates and patient satisfaction scores were evaluated one year after the procedure.

Results: There were no significant differences in demographic and clinical characteristics between the two groups (P > 0.05). The observation group exhibited shorter incision lengths, reduced operation times, and decreased hospital stays compared to the control group (P < 0.05), alongside less intraoperative bleeding (P < 0.05). The incidence of postoperative complications was significantly lower in the observation group (P < 0.05). At one and three weeks post-surgery, the observation group reported lower VAS scores for pain compared to the control group (P < 0.05). There were no significant differences in recurrence rates between the groups one year post-surgery (P > 0.05). However, the observation group achieved higher scores in terms of chest appearance, wound scarring, nipple and areola aesthetics, and overall satisfaction (P < 0.05).

Conclusion: Endoscopic lipolysis and liposuction not only demonstrate advantages such as lower complication rates and expedited recovery in the treatment of gynecomastia but also provide long-term efficacy comparable to traditional surgical methods. This approach significantly enhances patient satisfaction, establishing it as a preferred treatment option due to its safety profile and ability to deliver superior cosmetic outcomes.

Background: Thyroid diseases are the most common endocrine disorders worldwide. Thyroid hormones are essential for lipid synthesis, metabolism, and mobilization. Lipid levels in the blood may be altered when there is thyroid dysfunction. Lipid changes are linked to hyperthyroidism and primarily involve total and low-density lipoprotein cholesterol. The serum lipid profile is negatively impacted by hypothyroidism, which may increase the risk of atherosclerotic disease development. Thus, hypothyroidism constitutes a significant cause of secondary dyslipidemia. However, the results obtained from different studies are inconsistent, and there are few data regarding lipid profiles in thyroid dysfunction patients in the study area. Therefore, this study aimed to assess the lipid profile of thyroid dysfunction patients at Wolaita Sodo University Comprehensive Specialized Hospital from May 1 to June 15, 2021.

Methods: A comparative cross-sectional study was conducted involving 200 participants (100 thyroid dysfunction patients and 100 age- and sex-matched controls). Socio-demographic and related data were collected from the study participants via a pretested structured questionnaire through face-to-face interviews. Independent sample T tests and Mann‒Whitney U tests were used for data analysis. P < 0.05 indicated statistical significance.

Results: Out of 200 study participants 40 (20%) hyperthyroid, 60 (30%) hypothyroidism, and 100 (50%) controls. In individuals with hyperthyroidism, the levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol were significantly lower than those in the control group. Compared to the control group, the hypothyroidism patients had significantly higher levels of triglycerides, low-density lipoprotein cholesterol, total cholesterol, and high-density lipoprotein cholesterol.

Conclusion: The lipid profile can change significantly as a result of thyroid dysfunction. Biochemical screening of lipid profiles is essential for improving patients with thyroid dysfunction with dyslipidemia.