Endokrynologia Polska最新文献

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Introduction: No study has specifically investigated the correlation between stress hyperglycemia ratio (SHR) and mortality in critically ill patients across different glucose metabolic status and diabetes mellitus (DM) subtypes.

Material and methods: Analysis was conducted using the Medical Information Mart for Intensive Care-IV 2.2 database.

Result: In this study, a total of 73,181 intensive care unit (ICU) patients were included, among whom 33,683 critically ill patients were included in the final analysis. Logistic model analysis revealed that the SHR was associated with elevated mortality rates in the ICU and in-hospital among patients with type 2 diabetes mellitus (T2DM) and those in the ICU with different glucose metabolism status, particularly in individuals with prediabetes mellitus (Pre-DM) and normal glucose regulation (NGR). In the Cox proportional hazards model, SHR was linked to an increased risk of one-year mortality, particularly among critically ill patients with Pre-DM. Mediation analysis revealed that the high SHR could account for 14.0% and 11.3% of the increased risk of ICU death and in-hospital mortality associated with DM, respectively.

Conclusion: SHR is correlated with both short-term and long-term mortality in critically ill patients across various glucose metabolism status, particularly evident in those with NGR and Pre-DM. Moreover, SHR demonstrates an elevated risk of short-term and long-term mortality in critically ill patients with T2DM. Additionally, SHR plays a mediating role in the association between DM and mortality.

Introduction: Hashimoto's thyroiditis (HT) is the most common organ-specific autoimmune disorder. It is a chronic lymphocytic infiltration into the thyroid gland and is characterized by the production of anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TgAb). HT is a polygenic disease with an incompletely defined etiopathogenesis. It affects 0.3-1.5/1000 subjects/year and is 4-10 times more frequent in women than in men (3.5-5/1000 subjects/year in women versus 0.6-1.0/1000 subjects in men).

Material and methods: The study group included 482 females of childbearing age (18-45 years). The group was divided into 3 subgroups: (147 - healthy individuals, 152 - hypothyreosis, 183 - HT). All patients were recruited in a 24-months period from the Cardiometabolic Center Gierach-Med in Bydgoszcz, Poland, and the Department of Endocrinology and Diabetology Collegium Medicum University of Nicolaus Copernicus in Bydgoszcz, Poland, and provided verbal consent to participate in the study.

Results: We noticed that a lower level of ferritin was connected with a higher level of thyroid-stimulating hormone (TSH) in each of the subgroups. Additionally, we marked the correlation between ferritin and TSH and anti-thyroid antibodies (TPOAb and TgAb). There was a strong, negative correlation between TSH and ferritin level in all the study groups. Moreover, there was a weak, negative correlation between anti-TPO, anti-TG, and ferritin level in females with HT.

Conclusions: To sum up, we believe that hypothyroidism, especially in the course of Hashimoto's disease, leads to an increased risk of iron and ferritin deficiency and requires monitoring of these parameters.

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Obesity, regardless of age, is associated with various metabolic disorders. Amino acids, as essential food ingredients, play a critical role in regulating glucose and energy metabolism. Thus, their plasma concentrations may reflect the metabolic state of the individual. This narrative review aims to find out similarities in plasma amino acid profiles across the selected obese individuals (children, adolescents, and adults). An analysis of 21 original studies revealed similar amino acid alterations regardless of the age group- in particular, elevated levels of branched-chain amino acids (BCAAs: isoleucine, leucine, valine), tyrosine, glutamic acid, alanine, and proline, as well as decreased concentrations of glutamine, serine, glycine, and asparagine. These findings suggest the presence of a common, age-independent metabolic signature of amino acids in obesity. Such changes may reflect impaired amino acid catabolism and have been linked to insulin resistance, increased risk of type 2 diabetes risk, and other metabolic complications. There is a need to establish age- and population-specific reference values for plasma amino acids to use amino acid profiling as a diagnostic and prognostic tool management of obesity. Accurate plasma amino acid profile measurements could support early detection of obesity-related metabolic disturbances and the implementation of targeted nutritional and therapeutic strategies.

Introduction: Radioiodine-refractory differentiated thyroid cancer (RAIR DTC), although rare, constitutes a real clinical challenge due to its prognosis despite a growing number of available treatment modalities. This study aimed to analyze the real-world efficacy and toxicity of lenvatinib therapy in a group of Polish patients with advanced RAIR DTC.

Material and methods: A group of 27 patients was eligible for lenvatinib therapy due to measurable, progressive, RAIR DTC, of whom 21 ultimately received the treatment. Treatment outcomes were assessed in terms of Response Evaluation Criteria in Solid Tumors (RECIST) as well as Kaplan-Meier estimates of overall survival and progression-free survival (PFS) for the whole cohort and for subgroups receiving lenvatinib as the first or subsequent line of targeted therapy. PFS was reported using both intention-to-treat (ITT) and per-protocol (PP) definitions, depending on whether treatment discontinuation was treated as censoring. Treatment toxicity was evaluated according to Common Terminology Criteria for Adverse Events (CTCAE).

Results: Median overall survival (OS) in the whole group was 38.9 months [95% confidence interval (CI): 23.8- not reached (NR)], while one-year and two-year survival rates were 0.85 (95% CI: 0.72-1.00) and 0.63 (95% CI 0.45-0.89), respectively. ITT-PFS was 21.3 months (95% CI: 12.2-NR). One-year ITT-PFS was 0.75 (95% CI: 0.57- .00), while 2-year ITT-PFS was 0.44 (95% CI: 0.22-0.76). Similar estimates were obtained using the PP-PFS definition. All patients reported treatment-related side effects, the most common being proteinuria, weight loss, hypertension, and mucositis.

Conclusion: This retrospective analysis of a Polish RAIR thyroid cancer cohort demonstrated very good efficacy of lenvatinib in the first-line setting, while its activity in the second-line setting, although still present, was reduced. Based on these results, we suggest that lenvatinib should again be available for the treatment of RAIR thyroid cancer in Poland.

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Diabetes is a major metabolic disease that is undergoing a global increase and negatively impacts the body's ability to regulate blood glucose levels. Although currently there are common therapeutic strategies, there is growing interest in alternative treatments, driven by concerns over potential side effects and limited efficacy. This review evaluates the influence of phytochemicals on diabetes treatment, as supported by evidence from recent clinical trials. A wide array of phytochemicals, including polyphenols, flavonoids, and alkaloids, have shown considerable potential in the management of diabetes. Their reported effects include regulation of blood glucose levels, improvement of insulin sensitivity, and modulation of carbohydrate metabolism. In addition, phytochemicals have demonstrated antioxidant activity by reducing oxidative stress and strengthening endogenous defense mechanisms, along with anti-inflammatory effects mediated through cytokine regulation and signaling pathways. Collectively, these actions contribute to improved glycemic control and overall metabolic stability. It has also been hypothesized that phytochemicals may help ameliorate diabetes-related complications such as cardiovascular dysfunction, nephropathy, and neuropathy. Although promising results have been observed in clinical trials, limitations exist due to variability in study design, intervention dose, and treatment duration. Furthermore, most available findings are short-term, leaving the long-term efficacy and safety of phytochemicals less clearly defined. In conclusion, phytochemicals represent a promising adjunctive approach in diabetes management, offering multi-targeted effects on glycemic regulation, oxidative stress, and inflammation. However, further large-scale, well-designed studies are required to clarify their mechanisms of action and establish their long-term clinical implications.