BMC Endocrine Disorders最新文献

Background: Autoimmune thyroid diseases (AITD) and allergic rhinitis (AR) are prevalent conditions; however, limited research has investigated their association. This study aimed to evaluate whether AR can be considered a risk factor for developing AITD.

Methods: A retrospective cohort study analyzed the records of AITD patients who visited Alexandria University Students Hospital between January 2017 and December 2021. The parameters included in the study were thyroid-stimulating hormone (TSH), Free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibodies (TPOAb), thyrotropin receptor antibody (TRAb), eosinophils count, and IgE.

Results: Out of 4,515 eligible patients, 41.7% were diagnosed with AR in addition to AITD. Among the patients with both conditions, 81% were females, their mean age was 45.71 ± 24.14 years, and the mean duration of AITD was 7.32 ± 2.11 years. The Kaplan-Meier analysis revealed that the AR cohort had a higher cumulative incidence of AITD than did the non-AR cohort (log-rank test, p = 0.001). Multivariate-adjusted hazardous ratios showed that patients with AR, female sex, higher white blood cell count, and diagnosis in November had a higher risk of developing AITD.

Conclusions: Screening for AITD should be conducted at the time of diagnosis of AR as it could be a risk factor for AITD.

Background: Hashimoto's thyroiditis (HT) is associated with high cardiovascular risk. Thyroid volume has a notable dispersion of values in these patients. This study aims to clarify the association between thyroid antibodies, thyroid morphology, insulin resistance, and lipid profile in patients with HT.

Methods: Cross-sectional study that includes 409 subjects diagnosed with HT. We assessed thyroid function, markers of autoimmunity, and markers of cardiovascular risk. We also evaluated thyroid ultrasound and studied the correlation between all factors.

Results: Among the study population, 9.8% were male, the mean age was 56.4 ± 17.4 years, 63.7% had dyslipidemia, and 29.5% had diabetes. Patients with hypothyroidism had higher levels of anti-thyroperoxidase antibodies (TPOab), and the decreased thyroid dimensions subgroup had a higher percentage of patients taking levothyroxine (98.7%). Positive correlations were found between TPOab and volume, and negative correlations were observed between thyroid-stimulating hormone (TSH) and volume.

Conclusion: The current study reveals a complex interrelationship between cardiovascular disease risk factors, thyroid function, autoimmunity, and thyroid volume in HT. These associations may be of clinical relevance, and further studies are needed to elucidate how these findings may be used clinically to reduce the cardiovascular risk in patients with HT.

Background: Diabetes mellitus is one of the most common chronic illnesses in children with multiple psychosocial, economic and developmental effects. Psychiatric disorders such as depression, anxiety, psychological distress, and eating disorders are more common in diabetic patients than the non-diabetic once. The main objective of our study was to assess Prevalence and associated factors of psychiatric problems in children aged 6-18 years with type 1 diabetes mellitus in Gondar, Ethiopia.

Methods: An institution-based cross-sectional study was conducted among 206 children aged 6-18 years with type-1 diabetes mellitus having regular follow-ups at the University of Gondar comprehensive and Specialized Hospital (UoGCSH) over three three-month period. Data was collected by trained physicians using interviewer-administered structured questionnaires. Convenient sampling technique was applied and Participants were selected sequentially until the sample size was achieved. Both bivariate and multivariate logistic regression analyses were used for Model fitness and the strength of association was determined using an OR, p-value of < 0.05 and 95% CI.

Results: The prevalence of psychiatric problems was 11.7% and those children living with only either of the parent (AOR = 8.39, 95%: 1.5-46), living with other relatives (AOR = 11.3, 95% CI: 1.97-64.7), more than 5 family size (AOR = 0.3, 95%CI: 0.1-1.2), fathers attended formal education (AOR = 0.3, 95%: 0.04-1.73), a patient having good glycemic control (AOR = 0.2, 95%: 0.04-0.67) and those with a family history of diabetes mellitus(AOR = 5.2, 95% CI: 1.2-22.1) were significantly associated with a psychiatric problem in diabetic aged 6-18 years with p-value < 0.05.

Conclusion: The prevalence of psychiatric problems in diabetic children was significantly high and children living with single parent, paternal educational status, glycemic control, family history of diabetes, and family size were found to have significant association with the occurrence of psychiatric problems in diabetic children.

Background: Thyroid disorders are common endocrine conditions impacting multiple organs, including the reproductive system and often lead to sexual dysfunction. These effects can vary by gender; for example, women with hypothyroidism frequently experience reduced libido. Low thyroid hormone levels are also linked to vaginal dryness, causing discomfort, especially during intercourse. This study aims to assess the global prevalence of sexual dysfunction in women with thyroid disorders.

Methods: Systematic searches were performed across electronic databases, including PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar, to retrieve studies reporting the prevalence of sexual dysfunction in patients with thyroid disorders up to February 8, 2024. Inclusion criteria comprised studies that reported on the prevalence of female sexual dysfunction (FSD) in patients with thyroid disorders and studies published in English available full text. Exclusion criteria included case studies, intervention studies, studies with incomplete information, repeated studies and those not written in English. Cross-sectional studies were the primary study design included. Data were analyzed using the Comprehensive Meta-Analysis software (Version 2).

Results: Analysis of nine studies, involving a total sample size of 1013, found an overall prevalence of sexual dysfunction in women with thyroid disorders to be 44.8% (95% CI: 33.8-56.2). Given the substantial reporting of sexual dysfunction among women with either hypothyroidism or hyperthyroidism, subgroup analyses were conducted. The prevalence of sexual dysfunction was 41.8% (95% CI: 26.3-59) among women with hypothyroidism and 59.6% (95% CI: 50.5-68.1) among those with hyperthyroidism.

Conclusion: The notable prevalence of sexual dysfunction in women with thyroid disorders highlights the for increased awareness among this population. Targeted awareness initiatives may help mitigate the occurrence of sexual dysfunction and its adverse effects, improving overall quality of life for affected women.

Clinical trial number: Not applicable.

Background: Obesity is a global issue, with over 1.9 billion adults overweight. Disruption of circadian rhythms (CR) leads to obesity and metabolic disorders. Dietary nutrition significantly impacts sleep disorders and disruption in CR, influencing hormones and inflammation, which can contribute to insomnia. The dietary insulin index (DII) and dietary insulin load (DIL) are important factors in determining sleep quality. The current study aims to investigate the association between DII and DIL with CR and sleep quality among with overweight and obesity women.

Methods: A case-control study involved 280 overweight/obese women aged 25-40 from Tehran University Medical Science. They were assessed for dietary intake, physical activity, and sleep using validated questionnaires. The study also assessed body composition, bioelectrical impedance analysis, biochemical components, anthropometric components, and blood pressure. Socio-demographic and lifestyle characteristics, such as age, educational level, physical activity, and smoking habits, were also assessed through questionnaires.

Result: In the crude and adjustment models, high adherence of DII compared with lower adherence increased the odds of poor sleep quality index among participants. This significant association remained even after adjustment for confounding variables (P < 0.05), such that the odds of poor sleep quality index was 1.92 times higher.

Conclusion: This study showed high adherence to DII and DIL may cause CR disruption. Furthermore, higher adherence to DII lead to poor sleep quality in women.

Objective: The objective is to assess the effectiveness and safety of tirzepatide, liraglutide, and SGLT2i in individuals diagnosed with type 2 diabetes.

Methods: An inquiry was undertaken within the electronic database spanning from its inception to February 11th, 2024, aimed at identifying randomized controlled trials that assess the efficacy and safety of tirzepatide, liraglutide, canagliflozin, ertugliflozin, empagliflozin, dapagliflozin, and henagliflozin. Perform a network meta-analysis to examine the distinctions among them (PROSPERO registration number: CRD42024537006).

Results: Twenty-eight RCTs were included, involving 8499 participants. Compared with placebo, all treatments improved HbA1c levels: tirzepatide 15 mg reduced HbA1c the most (MD [95% CI], -2.24% [-2.52, -1.96]%), followed by tirzepatide 10 mg (MD [95% CI], -1.99% [-2.29, -1.69]%), tirzepatide 5 mg (MD [95% CI], -1.82% [-2.11, -1.53]%), and liraglutide 1.2 mg (MD [95% CI], -1.23% [-1.41, -1.05]%). Canagliflozin 300 mg also showed a significant reduction in HbA1c (MD [95% CI], -1.00% [-1.18, -0.82]). Tirzepatide was also the most effective in promoting weight loss, with the following results compared with placebo: tirzepatide 15 mg (MD [95% CI], -8.74 kg [-9.83, -7.66] kg), tirzepatide 10 mg (MD [95% CI], -7.13 kg [-8.40, -5.88] kg), tirzepatide 5 mg (MD [95% CI], -5.38 kg [-6.65, -4.11] kg), canagliflozin 300 mg (MD [95% CI], -2.31 kg [-2.79, -1.83] kg), and empagliflozin 10 mg (MD [95% CI], -2.00 kg [-2.44, -1.55] kg). In reducing systolic blood pressure (SBP), canagliflozin 300 mg showed the greatest effect (MD [95% CI], -5.96% [-7.96, -3.96] %). For diastolic blood pressure (DBP), henagliflozin 5 mg demonstrated the most significant reduction compared to placebo (MD [95% CI], -2.46% [-3.82, -1.10] %). Liraglutide 1.8 mg was most likely to cause adverse events (AE) (OR [95% CI], 2.57 [1.78, 3.70]), but there was no significant difference in serious adverse events (SAEs) between the interventions (including placebo).

Conclusion: Out of the seven medications examined in this study, tirzepatide demonstrates the most effective antidiabetic and weight-reducing effects. Furthermore, the dosage of Liraglutide at 1.2 mg and above demonstrates a more pronounced hypoglycemic effect in comparison to SGLT2 inhibitors. SGLT2 inhibitors exhibit a distinct hypotensive effect and are suitable for diabetic individuals experiencing hypertension.

Purpose: To evaluate the utility of apparent diffusion coefficient (ADC) values of extraocular muscles (EOMs) in differentiating activity of thyroid eye disease (TED).

Method: Forty-two TED patients who underwent diffusion tensor imaging(DTI) were retrospectively enrolled in this study, including 29 patients in analysis group and 13 patients in validation group. The mean, maximum and minimum ADC value of each EOM were regarded as ADCmean, ADCmax and ADCmin. The difference between ADCmax and ADCmin was regarded as △ADC. The correlations between ADCmean or △ADC of each EOM and clinical activity score (CAS) were assessed.

Results: In analysis group, ADCmean differed between active and inactive eyes and positively correlated with CAS in IR (P < 0.05), not in SR,LR and MR(all p > 0.05). While △ADC differed between two groups and negatively correlated with CAS in all EOMs (all P < 0.05). ADCmean predicted active disease at cut-off value of 1259.3 × 10^-6mm²s^-1 with sensitivity of 66.7% and specificity of 71.4% in IR[area under curve = 0.667, P < 0.05]. △ADC predicted disease activity in all EOMs [area under curve 0.658-0.746,all P < 0.05]. The cut-off values of △ADC were 382, 823,520 and 572 × 10^-6mm²s^-1 with sensitivity of 80.0%, 50.0%, 43.3%, 83.3% and specificity of 67.9%, 85.7%, 89.3%, 60.7% in SR, IR, MR, and LR respectively. There were no significant differences in the predictive efficacy among all cut-off values.

Conclusions: Our results showed that DTI is a valuable tool in the assessment of disease activity of TED. Both ADCmean of IR and △ADC of all four EOMs can be used in discriminating disease activity with the same predictive power.

Background: Erectile dysfunction is a common problem among patients with diabetes, often going undiagnosed and having a significant negative impact on their health. This condition necessitates accurate evaluation and early intervention. However, there is an inconsistent explanation of factors and limited evidence on the prevalence of erectile dysfunction among patients with diabetes in eastern Ethiopia. Thus, this study aimed to determine the prevalence of erectile dysfunction and its associated factors among patients with diabetes in public hospitals in the Harari Region, eastern Ethiopia.

Methods: A cross-sectional study was conducted involving 339 randomly selected participants. Data were collected using the Kobo Toolbox with standardized questionnaires administered by interviewers, along with a review of the patients' medical records. Data analysis was performed using Stata version 14. The Poisson regression model with robust variance estimate was fitted to examine the association of the independent variables and erectile dysfunction. An adjusted prevalence ratio (APR) with 95% confidence intervals was reported. Statistical significance was declared at the p-value < 0.05.

Result: The prevalence of erectile dysfunction was 78.28% (95% CI 73-83). Age 35-45 years [APR = 1.38; 95% CI: 1.03-1.84], and > 45 years [APR = 1.58; 95% CI 1.17-2.13], depression [APR = 1.41; 95% CI 1.06-1.86], current khat use [APR = 1.14; 95% CI 1.00-1.28], low social support [APR = 1.70; 95% CI 1.09-2.65] and medium social support [APR = 1.79; 95% CI 1.16-2.78] were factors significantly associated with erectile dysfunction.

Conclusions: More than three-fourths of the participants had erectile dysfunction. Significant factors associated with erectile dysfunction included age 35 years and above, depression, current hat use, and low and medium social support level. The management of erectile dysfunction should be integrated into routine medical care in diabetic follow-up clinics, with special attention for those participants aged 35 years and above, who have depression, currently use Khat, and have low-level social support.

Graves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory thyroid panel. Establishment of elevated serum levels of TRAbs by competitive binding assay or cell-binding assay has its unique role in diagnosis and management of GD, especially in the differential diagnosis, therapy selection, prognostication, evaluation of thyroid function during pregnancy, peri-conceptional and neonatal thyroid workup, and in certain special situation. Inclusion of TRAbs in GD diagnostic algorithm can improve cost-effectiveness of GD management. The current best practice guidelines were developed to provide evidence-based recommendations in the use of TRABs in GD management for healthcare providers in South Asia. A panel of endocrinologists with minimum 10 years of clinical experience in thyroid disorders reviewed existing literature and their quality, and after deliberation and discussion, developed 21 recommendations surrounding the best practices surrounding the role of TRAbs in GD management.

Background: Thyroid metastases from uterine cervical carcinoma are exceedingly rare. Imaging examination and pathological detection exert a pivotal function in distinguishing between benign and malignant thyroid tumors, as well as differentiating metastases from primary thyroid cancer.

Case presentation: Here, we present two cases of uterine cervical cancer metastasizing to the thyroid gland, confirmed by postoperative histopathology at our hospital. Furthermore, we conduct a comprehensive analysis of the imaging appearances, pathological characteristics, diagnosis, prognosis and treatment of the disease through a review of relevant literature. The two cases do not exhibit specific laboratory indicators, making imaging examinations important auxiliary tools, while pathology remains the gold standard for diagnosis.

Conclusions: Although thyroid malignancies predominantly arise as primary tumors, it's crucial to consider the possibility of metastases in patients with a history of cancer. Metastases to the thyroid are relatively uncommon but can occur, particularly in advanced stages of other cancers. Poor outcomes of thyroid metastases from cervical carcinoma have presented significant hurdles for clinicians. Surgical excision of metastatic thyroid cancer may serve as an alternative, offering relief from compression symptoms and prolonging survival to some extent. Further studies are crucially needed to optimize clinical outcomes of the disease.