BMC Endocrine Disorders最新文献

Background: The estimated glucose disposal rate (eGDR), a novel composite indicator for assessing insulin resistance (IR), remains underexplored for its ability to predict the risk of chronic kidney disease (CKD) in individuals with diabetes or prediabetes.

Method: A total of 17,595 patients with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were included. CKD is defined based on the estimated glomerular filtration rate and the urine albumin-to-creatinine ratio. The calculation of eGDR is based on the waist circumference, hypertension status and glycated hemoglobin. Multivariable logistic regression was used to evaluate the association between eGDR and CKD. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Subgroup analysis explores the differences in effects among different populations. Mediating analysis was used to quantify the role of serum uric acid (SUA) in the eGDR-CKD association. Receiver operating characteristic curve (ROC) curves were used to compare the predictive performance of eGDR with that of other IR indices.

Results: After full adjustment, the eGDR showed a significant inverse association with CKD risk. The RCS curves confirmed a linear negative relationship between eGDR and CKD. Subgroup analysis revealed stronger associations in men. Mediation analysis indicated that SUA partially mediated the eGDR-CKD association, accounting for 6.2% of the total effect. ROC analysis revealed that the eGDR shad a moderate predictive ability for CKD in patients with diabetes or prediabetes.

Conclusion: This cross-sectional study confirmed that the eGDR is linearly negatively correlated with CKD in a population with diabetes or prediabetes and that its discriminative power is moderate but superior to that of traditional IR indicators. The statistical overlap of SUA on the total association was approximately 6.2%, but the mediating effect was fragile. This finding should be verified in prospective cohorts in the future.

Objectives: COVID-19 is associated with multiorgan dysfunction, including the endocrine system, and severe illness often involves endocrine-metabolic issues. We investigated hormonal axes in hospitalized COVID-19 patients in Iran and their correlation with disease severity, outcomes, and inflammatory biomarkers.

Methods: We conducted a cross-sectional study with 200 hospitalized COVID-19 patients. An initial endocrinology panel assessed thyroid hormones, gonadal hormones, adrenal hormones, and prolactin levels. Disease severity was evaluated using the COVID-19 Severity Index.

Results: Of 183 patients analyzed, most had severe (21.7%) or critical (63.3%) infections. Abnormal hormone levels were common, with 26.8% having non-thyroidal illness syndrome (NTIS), 30.1% suspected of adrenal insufficiency, and no patient with subacute thyroiditis. Additionally, 95.5% of males had hypogonadism, comprising 20.5% with primary and 75% with secondary disease. However, hormonal levels and diagnoses did not significantly correlate with COVID-19 severity (P > 0.05). Deceased patients had lower T3 levels and a higher NTIS diagnosis rate (P = 0.013 and 0.012, respectively). Moreover, C-reactive protein levels were significantly higher among COVID-19 patients with adrenal insufficiency likelihood (P = 0.005) and primary or secondary hypogonadism (P = 0.018). The ESR levels were significantly higher in COVID-19 patients with NTIS (P = 0.009) and significantly lower in patients with primary or secondary hypogonadism (P = 0.033).

Conclusion: Hospitalized COVID-19 patients exhibit hormonal abnormalities, which were correlated with inflammatory biomarkers, but these do not significantly correlate with disease severity or outcome, except for lower T3 levels and a higher NTIS diagnosis rate in deceased patients.

Background: Insulin resistance (IR) is intricately associated with the reduction or deficiency of testosterone (TD) in males. Estimated glucose disposal rate (eGDR) has emerged as a novel marker for assessing IR. This study aims to examine the association between eGDR and total testosterone, as well as the risk of TD, in male patients diagnosed with type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study evaluated 957 male patients with T2DM admitted to the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between 2019 and 2022. The study explored the association between eGDR and testosterone, as well as the risk of TD, utilizing multivariable linear and logistic regression analyses. Additionally, the study elucidated the mediating roles of AIP and SII in the effect of eGDR on TD through the mediation analysis.

Results: After adjusting for potential confounding variables, eGDR demonstrates a significant negative linear association with the risk of TD (OR = 0.83, 95% CI: 0.77, 0.89) and a significant positive linear association with total testosterone (β = 0.15, 95% CI: 0.10, 0.19). The subgroup analyses showed that this association was stronger in individuals younger than 60. Additionally, AUC for eGDR was significantly higher (AUC = 0.656, 95% CI: 0.618, 0.695) compared to waist circumference, HbA1c, and TyG. Mediation analysis identified that AIP and SII accounted for 14.9% and 8.8% of the association between eGDR and TD, respectively.

Conclusion: The study demonstrates that, in adult patients with T2DM, an elevated eGDR is positively associated with testosterone and inversely associated with the risk of TD.

Clinical trial: Not applicable.

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder characterized by hyperandrogenism, insulin resistance, and reproductive dysfunction. Accumulating evidence indicates that gut microbiota and their metabolites, particularly short-chain fatty acids (SCFAs), contribute to PCOS pathogenesis. However, subtype-specific alterations, especially in Traditional Chinese Medicine (TCM)-defined phlegm-dampness PCOS, remain insufficiently explored.

Objective: This study aimed to comprehensively compare gut microbial composition, SCFA concentrations, and their associations with anthropometric, clinical, and biochemical indicators in women with phlegm-dampness PCOS, non-phlegm-dampness PCOS, and healthy controls.

Methods: In this cross-sectional analysis, 54 women were recruited and stratified into phlegm-dampness PCOS (n = 17), non-phlegm-dampness PCOS (n = 18), and healthy control (n = 19) groups. Anthropometric measurements, reproductive and metabolic indices, and serum hormones were assessed. Fecal SCFAs were quantified via gas chromatography, and gut microbial profiles were characterized using 16 S rRNA gene sequencing. Bioinformatic and statistical analyses included diversity indices, taxonomic abundance, principal component and clustering analyses, and correlation networks linking microbiota, SCFAs, and host phenotypes.

Results: Phlegm-dampness PCOS exhibited significantly reduced α-diversity compared with controls (p < 0.05) and distinct microbial profiles across multiple taxonomic levels. Key alterations included enrichment of Blautia wexlerae and depletion of Faecalibacterium and Alistipes. Fecal butyrate and propionate levels were markedly reduced in phlegm-dampness PCOS versus controls (p < 0.01). Correlation analyses revealed Blautia wexlerae was positively associated with BMI, waist circumference, hirsutism, and acanthosis nigricans, while Alistipes shahii correlated with serum testosterone and HOMA-IR. Distinct correlation networks highlighted microbiota-metabolite-host interactions specific to phlegm-dampness PCOS. Compared with healthy controls, the non-phlegm PCOS group (Group B) exhibited intermediate values for microbial diversity and SCFAs; however, most Group B vs. control differences were not significant after adjustment for BMI and age with FDR correction.

Conclusion: Women with phlegm-dampness PCOS demonstrate more profound gut dysbiosis, SCFA depletion, and distinct microbiota-clinical correlations than non-phlegm-dampness PCOS and healthy controls. These findings underscore the biological relevance of TCM-based subtype stratification and suggest that precision microbiota-targeted interventions may enhance therapeutic outcomes in PCOS.

Clinical trial number: NA.

Objective: Elevated prolactin levels are considered a potential parameter associated with increased cardiovascular risk. The aim of our study is to investigate the possible role of Endocan levels in the cardiovascular risk associated with hyperprolactinemia by comparing patients with hyperprolactinemia to a healthy control group.

Methods: The study included 39 patients with hyperprolactinemia of various etiologies and 39 healthy controls. In both groups, cardiovascular risk-related parameters-including height, body weight, BMI, waist circumference, CRP, and lipid levels-were evaluated and recorded. Endocan levels were measured using the ELISA method.

Results: The groups were comparable in age, sex, height, body weight, BMI, and waist circumference. No significant differences were found between the patient and control groups in terms of height, body weight, BMI, waist circumference, WBC count, fasting glucose, insulin levels, HOMA-IR, HbA1c, lipid profile, CRP, and 25(OH) vitamin D levels. However, serum Endocan levels were significantly higher in the hyperprolactinemic group (p = 0.028). In this group, Endocan levels showed a significant positive correlation with waist circumference, body weight, and BMI, and a negative correlation with WBC count.

Conclusion: One of the key findings of our study is the elevated Endocan levels in patients with mildly increased prolactin levels (45.90 ± 2.72 ng/mL), indicating a higher cardiovascular risk. This may reflect the association between elevated prolactin and endothelial dysfunction. Further prospective studies with larger sample sizes and longer follow-up are needed to better evaluate Endocan levels in patients with hyperprolactinemia.

Clinical trial number: No applicable.