BMC Endocrine Disorders最新文献

Background: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder influenced by genetic, hormonal, and environmental factors. In the environmental context, phthalate esters, specifically Mono-2-ethylhexyl phthalate (MEHP) and Di-2-ethylhexyl phthalate (DEHP), have emerged as potential endocrine disruptors, demanding a mysterious role in PCOS.

Objective: The study aimed to compare demographic, biochemical parameters, and levels of phthalate esters, specifically MEHP and DEHP, in women with and without PCOS. The association between these phthalate esters and different biochemical markers was also of interest for investigation.

Methods: The study included 160 participants, 90 in the PCOS group and 70 in the control group. Demographic and biochemical parameters were measured and compared for both groups. The levels of MEHP and DEHP in serum were determined using High-Performance Liquid Chromatography (HPLC).

Results: The PCOS group had a significantly higher average age and Body Mass Index (BMI) compared to the control group (p < 0.0001). Testosterone and luteinizing hormone (LH) levels were significantly elevated in the PCOS group (p < 0.05). In contrast, estradiol, follicle-stimulating hormone (FSH), prolactin, LH/FSH ratio, dehydroepiandrosterone sulfate, and thyroid-stimulating hormone (TSH) levels showed no significant difference. Notably, MEHP and DEHP levels were significantly higher in the PCOS group compared to the control group (47.33 ± 27.67 vs. 31.09 ± 18.74, p < 0.0001 and 31.03 ± 25.76 vs. 22.98 ± 19.65, p = 0.03 respectively). DEHP levels in the PCOS group demonstrated significant positive correlations with LH levels, LH/FSH ratio, and estradiol levels. In contrast, MEHP levels showed no significant correlations with the evaluated biochemical parameters. Neither MEHP nor DEHP displayed significant correlations with any examined parameters in the control group.

Conclusion: This study underscores the elevated levels of MEHP and DEHP in women with PCOS, highlighting the potential influence of these environmental toxins in PCOS pathogenesis.

Clinical trial number: Not applicable.

Background: This study was conducted to evaluate the association between the implementation of the WHO 2017 and 2022 classification updates for pituitary tumours and the validity of ICD-10 codes in identifying nonfunctioning and functioning subtypes of pituitary neuroendocrine tumours (PitNETs) in a real-world surgical cohort.

Methods: We analysed data from 1,096 surgically treated PitNET patients at a major Chinese medical centre between January 2020 and April 2024. The validity of the ICD-10 codes for identifying nonfunctioning and functioning PitNET subtypes was assessed using prepathological discharge diagnoses as the reference standard. The performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index, F1 score, and kappa statistic, were calculated for each subtype. These validity measures were then compared between cases classified according to the 2017/2022 WHO criteria and those classified using the pre-2017 criteria in pathological reports.

Results: ICD-10 code sensitivity was lowest for nonfunctioning PitNETs (72.9%; 95% CI: 69.1-76.3), followed by functioning gonadotrophs (83.3%; 95% CI: 36.5-99.1) and corticotrophs (84.0%; 95% CI: 77.4-89.0), while other subtypes maintained high sensitivity (97.9%-100%). Most subtypes had low PPVs (6.3-75.0%), except for nonfunctioning and somatotroph PitNETs. The nonfunctioning PitNET code also had a low NPV (73.8%; 95% CI: 70.1-77.2). When cases were pathologically classified using the updated 2017/2022 WHO criteria, a substantial decrease in sensitivity for nonfunctioning PitNETs was observed (94.7% to 63.0%, p < 0.001), which coincided with a reduced NPV, F1 score, and kappa, despite increased specificity (95.8% vs. 86.8%, p < 0.01). Similarly, under the new classification, corticotroph PitNETs had decreased specificity (100.0% to 92.8%, p < 0.001), PPV (94.8% to 64.6%, p < 0.001), and composite metrics. Notably, low PPVs persisted for lactotroph (59.2%) and gonadotroph (5.1%) PitNETs. Coding discrepancies primarily involved confusion with new pathological terminology and misapplication of endocrine codes for pituitary stalk compression effects.

Conclusion: The updated WHO classifications enhance pathological detail but should not guide clinical ICD coding, as misapplication reduces coding accuracy in surgically managed PitNETs. Future frameworks must align pathological nomenclature with clinical endocrine function in the ICD, maintaining a clear distinction between these domains. Multidisciplinary collaboration and standardized coding protocols are essential for improving accuracy.

Clinical trial number: Not applicable.