BMC Endocrine Disorders最新文献

Objectives: To determine the relationship between serum Ism-1 levels and the progression of renal function decline in patients with T2DM.

Methods: This prospective longitudinal study included 223 patients with T2DM. Patients were divided into quartiles according to serum Ism-1 levels. A Cox proportional hazards ratio model was applied to analyze the relationship between CKD progression and serum Ism-1 levels.

Results: A total of 197 patients were finally analyzed, and the mean length of follow-up was 40.86 months. The serum Ism-1 levels were associated with eGFR decline and an increased risk of composite renal outcomes after adjusting for age, gender, body mass index, diabetes duration, history of hypertension, fasting blood glucose, fasting C-peptide, total cholesterol, triglycerides, drinking, smoking and follow-up period (all p < 0.05). However, the predictive ability of Ism-1 for composite renal outcomes disappeared after adjusting for baseline eGFR in Cox regression analysis and receiver operating characteristic (ROC) curve analysis.

Conclusions: High serum Ism-1 may be a biomarker for the progression of renal function decline in patients with T2DM.

Clinical trial number: Not applicable.

Background: We aimed to evaluate the relationships between the pan immune-inflammation value (PIV), the systemic immune-inflammation index (SII), and hormonal levels in patients with polycystic ovary syndrome (PCOS).

Methods: 160 patients with PCOS and 142 healthy participants took part in the study. Demographic characteristics, lymphocytes, monocytes, neutrophils, white blood cells (WBC), platelets, fasting glucose levels, hormonal parameters as insulin, dehydroepiandrosterone sulfate (DHEASO₄), prolactin, free and total testosterone, estradiol, luteinizing hormone (LH), 17-OH-progesterone, follicle-stimulating hormone (FSH), and 11-deoxycorticosterone were examined. Hematological indices, SII and PIV, were calculated. Receiver operating characteristic (ROC) analysis showed the diagnostic potential of the research parameters.

Results: The median WBC, SII and PIV values (7.63, 605.5, 312.69, respectively) were significantly higher in patients (p = 0.023; p < 0.001; p = 0.002; respectively). The median free testosterone, 17-OH progesterone, and LH values were also significantly higher in PCOS group (p = 0.009, p = 0.017, p = 0.012, respectively). Statistically significant and positive correlations were found between SII and insulin, SII and DHEA-SO₄, PIV and insulin, and PIV and DHEA-SO₄ levels (p = 0.006, p = 0.003, p = 0.037, p = 0.042, respectively). A statistically significant and positive correlation was also observed between PIV and free testosterone levels (p = 0.008). We found that a baseline serum SII > 520.0 and PIV > 262.4 were associated with PCOS with 65% specificity and 61% sensitivity for the SII (area under the curve [AUC], 0.669; 95% CI 0.584-0.755; p < 0.001) and 58% specificity and 60% sensitivity for the PIV ([AUC], 0.642; 95% CI 0.555-0.729; p = 0.002).

Conclusions: Monitoring SII and PIV may assist clinicians in evaluating inflammation and treatment needs in patients with PCOS.

Clinical trial number: Not applicable.

Background: Polycystic ovary syndrome (PCOS) is linked to hyperandrogenism and gut microbiota dysbiosis. Dietary fibers (DFs), such as resistant starch type 2 (RS2) and arabinoxylan (AX), modulate the gut microbiota and produce short-chain fatty acid (SCFA), potentially ameliorating PCOS symptoms. This study investigated the therapeutic potential of RS2 and AX in a mouse model of letrozole-induced PCOS and explored the underlying mechanisms involving the gut microbiota-SCFA-liver signaling pathways.

Methods: Letrozole-induced PCOS mice were divided into six groups: control (C), RS2 (R), AX (A), PCOS model (M), RS2-treated PCOS (RM), and AX-treated PCOS (AM) groups. The interventions lasted 35 days. Body weight, glucose tolerance, insulin resistance, ovarian morphology, estrous cycles, the gut microbiota (16 S rRNA sequencing), serum SCFA levels, fecal bile acids, and hepatic proteomics (DIA-MS) were analyzed.

Results: RS2 and AX reduced body weight, improved insulin sensitivity (lower HOMA-IR, p < 0.05), restored regular estrous cycles, and mitigated ovarian cystic follicles in PCOS mice. Gut microbiota analysis revealed an increased prevalence of Ligilactobacillus in the RM and AM groups (p < 0.05), which was correlated with elevated SCFA (acetic acid, butyrate) levels. Hepatic proteomics revealed increased expression of AMPK signaling proteins (Prkag2 and Pck1) in treated PCOS mice (p < 0.05), which was linked to the SCFA-mediated activation of GPRs (GPR41/43). AX also modulated pathways associated with nonalcoholic fatty liver disease. Bile acid metabolism showed no significant intervention-related changes.

Conclusion: RS2 and AX alleviated PCOS phenotypes by enriching Ligilactobacillus, increasing SCFA production, and activating hepatic AMPK signaling. These findings highlight gut microbiota modulation and SCFA-driven metabolic pathways as therapeutic targets for PCOS. This study provides mechanistic insights into dietary fiber interventions for endocrine disorders.

Background: Immune checkpoint inhibitors (ICIs) represent the most significant therapeutic advancement in oncology over the past decade, with sintilimab demonstrating efficacy as a programmed cell death-1 (PD-1) inhibitor. While these agents have markedly improved tumor response rates and overall survival across multiple malignancies, their use is complicated by a growing incidence of immune-related adverse events (irAEs), particularly endocrine toxicities. To our knowledge, this is the first case report of adrenal crisis during levothyroxine supplementation for ICI-induced hypothyroidism and undiagnosed adrenal insufficiency.

Case presentation: A 71-year-old male patient was admitted to our hospital with complaints of anorexia, fatigue, and weight loss. He had a confirmed diagnosis of esophageal squamous cell carcinoma 18 months prior and received systemic therapy, including sintilimab and esophagectomy (with normal thyroid and renal function at baseline). Sintilimab was administered for 10 treatment cycles. 4 months after completion of chemotherapy, the patient developed macular rash on the trunk and extremities and was treated with high-dose topical corticosteroids, and 1 month later, he began to suffer from anorexia and weight loss of 4.0 kg until this admission. At the same time, hypothyroidism and hyponatremia were detected, and levothyroxine (100 µg/day) was commenced. However, he worsened, with two episodes of fever, hypotension, and somnolence, as well as hyponatremia, hypoglycemia, anemia, and elevated serum creatinine. Cortisol and adrenocorticotrophic hormone (ACTH) levels decreased in the morning, and concurrent pericardial effusion and diffuse T-wave inversions were detected via electrocardiogram. He was diagnosed with secondary adrenal insufficiency and took prednisone (5 mg twice a day), and the symptoms improved rapidly. 1 week later, the serum electrolytes were normal, his weight increased by 3.5 kg, his physical activity improved, and the T wave on the electrocardiogram normalized. After taking prednisone for 18 days, his condition improved further. The morning cortisol level still decreased, while ACTH levels normalized, and pericardial effusion disappeared.

Conclusion: This is a typical case of endocrine irAEs caused by ICIs, and the patient's macular rash may also be related to ICIs. For patients treated with ICIs, preventive monitoring of symptoms of irAEs and related hormones is crucial for timely diagnosis, treatment, and even prevention of endocrine crisis.