BMC Endocrine Disorders最新文献

Background: Diabetes characterized by chronic hyperglycemia, has become a serious hazard to human health in the recent decades. Previous research suggests that asprosin may contribute to the development of diabetes by regulating glucose homeostasis, appetite, insulin secretion, and insulin sensitivity. Although some studies have shown that asprosin levels are higher in patients with diabetes than in healthy individuals, the association between asprosin levels and diabetes remains controversial.

Aim: This meta-analysis aimed to assess asprosin levels in patients with diabetes and in healthy individuals.

Methods: We searched the following electronic databases: Web of Science, ScienceDirect, PubMed, and Willy. The title or abstract uses the following search term: "diabetes" is used in combination with the term "asprosin." The meta-analysis results are presented as standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs).

Results: Fourteen articles were included in this meta-analysis. In our meta-analysis, the asprosin level in patients with diabetes was significantly higher than that in healthy controls (SMD: 0.95, 95% CI [0.66, 1.24]). Moreover, there was a significant difference in the asprosin levels between patients with diabetes without complication and those with complication (SMD: 0.81, 95% CI [0.33, 1.29]).

Conclusions: This systematic review is the first to evaluate the relationship between asprosin levels and diabetes. The asprosin levels were significantly higher in patients with diabetes.

Clinical trial number: Not applicable.

Background and objective: While the connection between the Triglyceride glucose-waist circumference (TyG-WC) index and the risk of diabetes remains understudied, this particular research delves into the potential predictive value of the TyG-WC index within a significant Japanese population.

Methods: This retrospective cohort study encompassed a comprehensive analysis of 15,413 Japanese adults, all of whom were diabetes-free at the outset of the study period from 2004 to 2015. Comprehensive medical records were obtained for all participants who underwent physical examinations. The study employed Cox proportional-hazards regression, smooth curve fitting, various sensitivity, and subgroup analyses to explore the association between TyG-WC and the development of diabetes. Furthermore, a Receiver Operating Characteristic (ROC) curve was created to detect the predictive capability of TyG-WC for diabetes risk.

Results: After a maximum of 13.0 years of follow-up, 358 people finally developed diabetes. Upon adjusting for covariates, the result showed TyG-WC was positively and independently associated with incident Diabetes Mellitus (DM) (Hazard Ratio (HR): 1.004, 95%C: 1.001-1.006). Furthermore, ROC curve analysis demonstrated that TyG-WC outperformed both the triglycerides-glucose index and triglyceride glucose-body mass index in predicting the onset of diabetes.

Conclusion: High levels of TyG-WC are autonomously linked to a heightened risk of diabetes in the Japanese demographic, indicating its potential as a dependable predictive indicator for diabetes mellitus in individuals at elevated risk.

Objective: The purpose of this investigation is to assess the clinical risk linked to the onset of diabetes in individuals with non-alcoholic fatty liver disease (NAFLD) through the utilization of the cardiac metabolic index (CMI), which is derived from triglycerides, high-density lipoprotein, height, and waist circumference. Research focusing on the application of CMI for evaluating diabetes risk among NAFLD patients remains scarce, and an exploration of the association between CMI and the emergence of diabetes within this demographic has not been conducted. This investigation aims to illuminate this connection, thereby providing novel insights into the prevention of diabetes progression in individuals with NAFLD.

Methods: Data were procured from a cross-sectional study involving 15,435 participants conducted by the Japanese government, resulting in a final cohort of 2,503 adults aged 18 and above who met the eligibility criteria for evaluation. The CMI is determined using the formula: TG (mmol/L) / HDL-C (mmol/L) * WHtR. CMI values were categorized into quartiles (Q1 to Q4) based on their scores, arranged from low to high. The investigation utilized logistic regression models, restricted cubic spline analysis, and subgroup analyses, with adjustments made for continuous models to elucidate the association between CMI and diabetes development among individuals with NAFLD, as well as the non-linear relationship between CMI and this outcome.

Results: The investigation comprised 2,503 subjects with an average age of 44.79 ± 8.33 years, of whom 204 were diagnosed with new-onset diabetes (8.15%). Multivariate logistic regression analysis indicated that within the CMI quartile groupings, individuals with NAFLD in the uppermost quartile (Q4) exhibited the greatest likelihood of new-onset diabetes relative to those in the lowest quartile (Q1) (odds ratio, OR = 3.239, 95% confidence interval [CI]: 1.993-5.264, P < 0.001). Additionally, escalating CMI values corresponded to an increasing probability of new-onset diabetes in NAFLD subjects (OR = 1.705, 95% CI: 1.362-2.133, P < 0.001). Restricted cubic spline analysis demonstrated a non-linear connection between CMI and new-onset diabetes in NAFLD patients (P overall < 0.001, P non-linear = 0.035), with a risk inflection point identified at a CMI of 0.5554. Subgroup analysis revealed no significant interactions between gender, age, physical activity, alcohol consumption, or smoking status and the likelihood of new-onset diabetes in this patient population (P for interaction > 0.05).

Conclusion: Findings from this study indicate a notable positive non-linear connection between elevated CMI scores and the probability of new-onset diabetes in individuals afflicted with NAFLD.

Clinical trial number: Not applicable.

Objective: This study aimed to determine whether a relationship exist between pre-therapy 25-hydroxyvitamin D levels and the remission/negative conversion rates of thyrotropin receptor antibody (TRAB) during treatment in patients with newly diagnosed Graves' disease (GD).

Methods: 171 patients were included from the Endocrinology Department of the First Affiliated Hospital of Fujian Medical University in March 2013 to April 2016. Ninety-five patients of them were diagnosed at our hospital but transferred to local hospitals for treatment. Seventy-six patients were followed and treated at our hospital with a median follow-up time of 11.03 (range 6-27) months. Patients were divided into 3 groups according to baseline 25-hydroxyvitamin D levels; <20 ng/mL (31,43.05%), 20-29 ng /mL (20,27.78%), and ≥ 30 ng/mL (20,29.17%). The TRAB remission rate and negative conversion rate was assessed among each group.

Results: There was a higher TSH and lower TRAB titer in the 20-29 ng/mL group at initial diagnosis. Cox regression analysis suggested that 20-29 ng/mL group had significantly higher remission rates [RR; 95% CI: 7.505 (1.401-40.201), 8.975 (2.759-29.196),6.853(2.206-21.285), respectively] and negative conversion rates [RR; 95% CI: 7.835 (1.468-41.804),7.189(1.393-37.092), 8.122(1.621-40.688)] at the 6-, 12-, and 24-month follow-up, respectively . The level of 25-hydroxyvitamin D at the time of initial diagnosis was not associated with the re-normal of free Triiodothyronine(FT3), free thyroxineIndex(FT4) or TSH levels during the follow-up.

Conclusion: Newly diagnosed GD patients with appropriate baseline 25-hydroxyvitamin D levels (20-29 ng/mL) are beneficial for the reduction of TRAB during antithyroid therapy.

Background: The etiology of thyroid cancer especially in women in not well recognized in Yazd, at the center of Iran. The aim of present study was to investigate the risk factors of thyroid cancer among women living in this province.

Methods: The present study was carried out as a case-control study, comprising women diagnosed with papillary thyroid cancer (PTC) as the case group, along with two distinct control groups sourced from different origins (i.e., relatives and non-relatives) between 2020 and 2022. Data pertaining to several risk factors including demographic characteristics, reproductive variables, medical history related to thyroid and non-thyroid ailments, exposure to head and neck radiation, as well as familial cancer history, was collected from all participants. Binary logistic regression was utilized to discover risk and protective factors.

Results: In present study, 77 individuals participated in the case group, 76 in the relative control group and 72 in the non-relative control group. The history of OCP use and exposure to head and neck radiation were remained in the model as risk factors in all three case‒relative control (OR = 6.65, 95%CI: 2.53‒17.49; P-value < 0.001), case‒non-relative control (OR = 6.32, 95%CI: 2.14‒18.70; P-value = 0.001) and case‒total control comparisons (OR = 6.66, 95%CI: 2.84‒15.64; P-value < 0.001).

Conclusion: The OCP use as well as exposure to head and neck radiation were determined to be strong or relatively strong risk factors in both case‒relative control and case‒non-relative control comparisons. Consequently, it seems these two factors represent genuine risk factors for papillary thyroid cancer.

Background: Thyroid hormone plays an important role in accumulating bone development and regulating bone metabolism. It is established that hypothyroidism is linked to increased risk of osteoporosis and fracture. However, the effects of levothyroxine (LT4) treatment on bone for hypothyroid patients remain controversial.

Methods: A systematical search was conducted of several databases, from inception until December 9, 2022, and updated the search using the same search strategy on October 30, 2024, for studies evaluating the effects of LT4 treatment on bone in hypothyroidism including subclinical hypothyroidism (SCH) and overt hypothyroidism (OH). The data were reported using a random-effects model with a standardized mean difference (SMD) and 95% conference interval (CI).

Results: Thirteen of the 5996 published articles were included in this meta-analysis. No significance was found in bone mineral density (BMD) at the lumbar spine between SCH patients treated with LT4 and control group either at baseline or after intervention. For OH, BMD at the lumbar spine was statistically lower in LT4 treatment group compared with healthy controls (HCs) (SMD: -0.28, 95%CI: -0.55, -0.02, P = 0.040, I² = 52%). There were no differences in BMD at the femoral neck, trochanter, and Ward's triangle between OH patients treated with LT4 and HCs. In addition, BMD at the lumbar spine was significantly lower in males with OH undergoing LT4 treatment for a duration of less than five years compared to those treated over five years. Nevertheless, no significant differences were found in bone metabolism biomarkers between OH patients treated with LT4 and HCs.

Conclusion: This systematic review and meta-analysis demonstrated that there is a slight adverse effect of LT4 replacement therapy on bone and mineral metabolism in patients with OH, while no observed effect was found in SCH patients.

Background: Studies of the world health organization indicated that Diabetes is on the rise. The occurrence of diabetes is steadily increasing everywhere, most markedly in the world's middle and low-income countries. The aim of this study is to explore the consequence of war on the sugar level of diabetic mellitus patients.

Methods: A retrospective longitudinal study with a sample of 67 diabetic mellitus patients was used. As a result, longitudinal different models, which are generalized linear mixed effects and nonlinear mixed effect models were fitted on the continuous response variable, the Sugar Level of the diabetic patients.

Results: The results depicted that Blood Sugar Level of the patients increases over time. Moreover, as age, weight, medication, total cholesterol, high density lipoprotein (HDL), creatinine and linear time effect increase, Blood Sugar Level increases significantly, whereas triglyceride and low density lipoprotein increase, Blood Sugar Level of the adult Diabetes mellitus patients decreases.

Conclusion: The war has significant effect on the poor control of blood glucose level of the adult diabetic patients in Tigray region, Ethiopia. Due to the war, siege or blockages, in return there were rare of medicine, the patients were not taking their medicines on time, and they did not get enough insulin as well.

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) in lower and middle - income countries call for preventive public health interventions. Studies from Africa including those from Ghana, consistently reveal high T2DM-related mortality rates. While previous research in the Ho municipality has primarily examined risk factors, comorbidity, and quality of life of T2DM patients, this study specifically investigated mortality predictors among these patients.

Method: The study was retrospective involving medical records of T2DM patients. Data extracted included mortality outcome (dead or alive), sociodemographic characteristics (age, sex, marital status, educational level, occupation and location), family history of diseases (diabetes, cardiovascular disease (CVD), or asthma), lifestyle (smoking and alcohol intake), comorbidities (such as skin infections, sickle cell disease, urinary tract infections, and pneumonia) and complications of diabetes (CVD, nephropathy, neuropathy, foot ulcers, and diabetic ketoacidosis) were analyzed using Stata version 16.0 and Python 3.6.1 programming language. Both descriptive and inferential statistics were done to describe and build predictive models respectively. The performance of machine learning (ML) techniques such as support vector machine (SVM), decision tree, k nearest neighbor (kNN), eXtreme Gradient Boosting (XGBoost) and logistic regression were evaluated using the best-fitting predictive model for T2DM mortality.

Results: Of the 328 participants, 183 (55.79%) were female, and the percentage of mortality was 11.28%. A 100% mortality was recorded among the T2DM patients with sepsis (p-value = 0.012). T2DM in-patients were 3.83 times as likely to die [AOR = 3.83; 95% CI: (1.53-9.61)] if they had nephropathy compared to T2DM in-patients without nephropathy (p-value = 0.004). The full model which included sociodemographic characteristics, family history, lifestyle variables and complications of T2DM had the best prediction of T2DM mortality outcome (ROC = 72.97%). The accuracy for (test and train datasets) were as follows: (90% and 90%), (100% and 100%), (90% and 90%), (90% and 88%) and (88% and 90%) respectively for the various ML classification techniques: logistic regression, Decision tree classifier, kNN classifier, SVM and XGBoost.

Conclusion: This study found that all in-patients with sepsis died. Nephropathy was the identified significant predictor of T2DM mortality. Decision tree classifier provided the best classifying potential.

Background: As the prevalence of metabolic syndrome (MetS) rises among older adults, the associated risks of cardiovascular diseases and diabetes significantly increase, and it is closely linked to various metabolic processes in the body. Dysregulation of tryptophan (TRP) metabolism, particularly alterations in the kynurenine (KYN) and serotonin pathways, has been linked to the onset of chronic inflammation, oxidative stress, and insulin resistance, key contributors to the development of MetS. We aim to investigate the relationship between the TRP metabolites and the risk of MetS in older adults.

Methods: Ultra-performance liquid chromatography tandem mass spectrometry was used to detect TRP and its seven metabolites in a study involving 986 participants. Physical examination included the following indicators: blood pressure, body mass index, triglyceride levels, and high-density lipoprotein cholesterol (HDL-C) levels. Multiple linear regression, restricted cubic spline curve, binary logistic analysis, and sex-stratified analysis were used to explore the relationship between the metabolites and the risk of MetS in older adults.

Results: The results indicated that, after adjusting for covariates, higher levels of TRP, KYN, kynurenic acid (KA), and xanthurenic acid (XA) were risk factors for MetS (P for trend < 0.05). By contrast, higher ratios of 5-hydroxytryptamine to TRP and indole-3-propionic acid to TRP were protective factors against MetS (P for trend < 0.05).

Conclusions: TRP and its metabolites may serve as potential indicators for assessing and managing MetS in older adults, complementing existing biomarkers.

Clinical trial number: Not applicable.

Background: Despite TSH suppressive therapy improve the prognosis for the patient with differentiated thyroid cancer (DTC), there is an increasing concern regarding the potentially harmful effects of lifelong TSH suppression. Therefore, we aimed to examine the changes in body composition under TSH suppression in postmenopausal women with DTC.

Methods: The body composition was assessed by the volumes as following; fat tissues of the epicardium and abdominal visceral and subcutaneous areas; bilateral psoas muscle or thigh muscle. Each volumetric measurements were performed using computed tomography (CT) scans using baseline and follow-up fluorine-18 fluorodeoxyglucose positron emission tomography/CT (¹⁸F-FDG PET/CT)s for 2-year follow up period in Pusan National University Hospital, South Korea.

Results: The 43 patients' median age was 50.0 years, and median body mass index (BMI) was 23.53 (interquartile range[IQR]: 22.19- 24.92) at the initial ¹⁸F-FDG PET/CT. The median follow-up period was 19.24 months (IQR: 17.24-21.79). No significant change in weight or BMI were observed during follow-up. Volumes of fat and muscles was not changed significantly except epicardial fat volume. The epicardial fat volume significantly increased during the follow-up period. The epicardial fat volumes were correlated with visceral fat volume, respectively, however, the changing ratio was only correlated with TSH suppression on multiple regression analysis.

Conclusion: Both skeletal muscle and abdominal fat volumes did not change, whereas epicardial fat volume increased over less than 2 years of observation under TSH suppressive therapy. Further research is needed for the harmonization of benefits or losses with the optimal TSH concentration in postmenopausal women.