Endokrynologia Polska最新文献

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Introduction: A densitometric diagnosis of osteoporosis qualifies patients to a diagnostic-therapeutic process, but densitometric evaluation may not be sufficient for osteopaenic patients. Therefore, it is essential to assess osteoporosis risk factors, fracture history, and 10-year fracture risk, and classify patients into low-, medium-, high-, or very high-risk categories. In our study, we aimed to assess the risk of fractures in patients with newly diagnosed osteopaenia and determine the percentage of patients at high and very high risk of fracture.

Material and methods: The study included 89 postmenopausal women with newly diagnosed osteopaenia as determined by a T-score of the femoral neck and/or lumbar spine from dual-energy X-ray absorptiometry (DXA) scans between -1.0 and -2.5 standard deviations (SD). Demographic data and laboratory tests were collected. Additionally, based on the Fracture Risk Assessment Tool (FRAX-PL) calculator including bone mineral density (BMD), 10-year fracture risk was calculated for major osteoporotic fractures (FRAX MOF) and hip fractures (FRAX HF). Each patient was then classified into particular risk groups based on FRAX and modified fracture risk assessment criteria.

Results: Our study found the most common risk factors to be glucocorticoid intake (47.19%), parental hip fracture (46.07%), and smoking (39.33%). In the general population, 56.6% of subjects had at least one fracture in adulthood. The FRAX calculator showed that 39.33% of the patients had a very high risk of HF and 34.83% had a very high risk of major osteoporotic fractures (MOF). A high fracture risk for hip fractures (HF) and MOF was noted in 11.24% and 40.45% of the patients, whereas a medium and low risk of MOF was seen in 17.98% and 6.74%, respectively. Significantly more subjects (53.93%) had been classified as being at very high risk of fracture, based on the expanded criteria than on the basis of FRAX alone. Of these, 48.31% met the criteria of FRAX > 15% for MOF or > 4.5% for HF, and 7.87% had multiple (≥ 2) major fractures. Women aged 70-75 years were at the highest risk of fracture.

Conclusions: Our findings highlight the importance of categorising fracture risk in osteopaenic patients, and show that the number of patients at very high fracture risk increases when the expanded criteria from the latest Polish guidelines are applied.

Introduction: The relationship between changes in metabolic score for insulin resistance (METS-IR) and diabetes mellitus (DM) remains to be elucidated. The present study sought to explore whether changes in METS-IR were associated with incident DM.

Material and methods: This study included 4031 individuals aged over 45 years from the China Health and Retirement Longitudinal Study. Utilizing the K-Means clustering method, participants were divided into four groups. Cumulative METS-IR was employed as a quantitative indicator reflecting changes in METS-IR. Multivariable logistic regression models and restricted cubic splines (RCS) were employed to assess the relationship between changes in METS-IR and DM.

Results: During the five-year follow-up, 338 (8.4%) incident DM cases were identified. After adjusting for potential confounders, compared to class 1, the incident DM was significantly higher in class 4 [odds ratio (OR): 2.731, 95% confidence interval (CI): 1.411-5.527, p = 0.003]. When cumulative METS-IR (per SD increase) was introduced as a continuous variable into the multivariate regression model, the association remained significant in Model 3 (OR: 1.393, 95% CI: 1.125-1.715, p = 0.003). Additionally, when cumulative METS-IR was categorized into quartiles, compared to the first quartile, the incident DM was significantly higher in the fourth quartile (OR: 2.022, 95% CI: 1.171-3.501, p = 0.011). In addition, cumulative METS-IR exhibited a nonlinear association with DM (poverall = 0.001, pnon linear = 0.038).

Conclusions: Substantial changes in METS-IR were independently associated with the risk of DM in middle-aged and elderly Chinese people. Long-term METS-IR monitoring is significant for early identification and prevention of DM, with significant implications for clinical practice.

Non-alcoholic fatty liver disease (NAFLD) is a globally prevalent chronic liver condition, primarily characterized by excessive accumulation of fat within the liver. A pivotal factor in the progression of NAFLD is cholesterol deposition, which significantly exacerbates liver cell damage through the induction of endoplasmic reticulum (ER) stress. At the heart of this process is sterol regulatory element-binding protein 2 (SREBP2), a crucial transcription factor in cholesterol synthesis. The expression levels of SREBP2 are closely associated with the severity of NAFLD, marking it as a potential therapeutic target. In mouse liver, FOXO3a, a member of the forkhead box protein family, inhibits the expression of SREBP2. This regulation is further influenced by its phosphorylation by mammalian STE20-related kinase 1 (MST1). Our research has uncovered a novel pathway in a NAFLD model where MST1-induced phosphorylation facilitates the nuclear translocation of FOXO3a, leading to a subsequent inhibition of SREBP2 expression. This critical modulation not only curtails cholesterol synthesis but also mitigates cholesterol deposition, alleviates ER stress, and repairs liver cell damage. These findings highlight the MST1-FOXO3a-SREBP2 axis as a promising new target for NAFLD treatment strategies, offering potential pathways to ameliorate a disease that affects millions worldwide.

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Introduction: Metabolic syndrome (MS) is a significant cause of morbidity and mortality worldwide, often remaining asymptomatic until complications arise. The prevalence of MS in apparently healthy populations in western Mexico is unknown. This study aimed to determine the prevalence of MS and its components in apparently healthy individuals from western Mexico.

Material and methods: A cross-sectional study involving 947 individuals self-appointed as healthy during a screening program of MS was conducted. All participants underwent anthropometric measurements, blood pressure assessment, and laboratory tests to determine glucose, high-density lipoprotein cholesterol (HDL-C), and triglycerides levels. The diagnosis of MS was established based on the criteria outlined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Participants were categorized into three groups: healthy individuals (HS) (no components of HS), those bordering (with one or two components of MS), and those with metabolic syndrome (≥ 3 components of MS). Group comparisons were performed using ANOVA. The chi-squared test was used to assess associations between categorical variables. Student's t-test was used to compare means between the HS and MS groups. A statistical difference was considered significant when p < 0.05.

Results: The assessment identified 124 (13%) healthy individuals, 520 (55%) individuals bordering on MS, and 303 (32%) individuals with MS. The prevalence of MS was higher as age increased; women had a higher prevalence of hypoalphalipoproteinemia and elevated waist circumference, whereas men had a higher prevalence of hypertriglyceridemia. In general, men had a more impaired glycometabolic and lipidic profile.

Conclusions: The prevalence of MS is high among self-appointed healthy individuals from Western Mexico, underscoring the need for personalized interventions focused on prevention, early detection, and treatment of MS.

Introduction: As a new index of obesity and metabolism, the cardiometabolic index (CMI) has been shown to play an important role in the prediction and diagnosis of metabolic diseases. However, the relationship between CMI and osteoporosis (OP) in type 2 diabetes mellitus (T2DM) patients with metabolism-associated fatty liver disease (MAFLD) remains unclear. The present study aims to explore the relationship between them and provide new insights for the clinical management of OP in patients with T2DM.

Material and methods: A total of 429 T2DM patients with MAFLD were selected. Characteristics of the participants were compared across the quartiles of CMI. Spearman correlation analysis was conducted to examine the correlation between CMI and BMD. Regression models were utilized to investigate the relationship between CMI and bone mineral density (BMD) as well as OP. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic efficacy of CMI for identifying OP in T2DM patients with MAFLD.

Results: The present study found that after adjustment for multivariate analysis, CMI was negatively correlated with lumbar spine (LS) BMD (β = -0.158, p < 0.001), femoral neck (FN) BMD (β = -0.129, p = 0.004), and hip BMD (β = -0.350, p < 0.001) in T2DM patientswith MAFLD. Furthermore, CMI was significantly associated with OP [odds ratio (OR) = 2.297, 95% confidence interval (CI): 1.198-4.424, p = 0.012]. The receiver operating characteristic curve (ROC) curve revealed that the area under the curve (AUC) of CMI for predicting OP in T2DM patients with MAFLD was 0.755 (95% CI: 0.676-0.833, p < 0.001), with an optimal threshold of 1.948. The predictive accuracy for OP was higher in female patients (AUC: 0.863, p < 0.001) compared to male patients (AUC: 0.716, p < 0.001).

Conclusion: CMI shows a significant negative correlation with BMD in T2DM patients with MAFLD. It is an independent risk factor for OP in this patient population, offering a new direction for the prevention and screening of OP in individuals with T2DM. Moreover, CMI demonstrated greater diagnostic efficiency in postmenopausal female patients over the age of 50 years compared to male patients of the same age group.

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Introduction: To determine the trimester-specific reference range of thyroid function in a single centre in Beijing.

Material and methods: A total of 361 healthy pregnant women and 122 normal non-pregnant women tested for thyroid function in the outpatient clinic of our hospital were selected as the research subjects. After being grouped according to the inclusion criteria, the test values of thyroid function indicators thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were recorded, respectively. According to the method of establishing reference value standards given in the guide, using the 2.5 percentile of the data distribution as the lower limit of the reference value and the 97.5 percentile as the upper limit of the reference value, we established the laboratory thyroid function indicators TSH and FT4 pregnancy-specific reference value range.

Results: The values of pregnancy-specific thyroid function indexes in the first, second, and third trimesters were as follows: TSH (0.02-3.39 mIU/L, 0.03-3.43 mIU/L, 0.27-3.88 mIU/L); FT4 (12.24-20.77 pmol/L, 10.78-20.75 pmol/L, 9.54-16.02 pmol/L). Serum TSH and FT4 levels showed a weak negative correlation throughout pregnancy. The established reference value range was used to evaluate the thyroid function of pregnant women in this study. The overall screening found subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and the prevalence of hyperthyroidism to be 3.5%, 0%, 2.5%, and 0.3%, respectively.

Conclusions: The reference range specific to pregnancy differs from that recommended by the American Thyroid Association (ATA), affecting the diagnosis and treatment of thyroid disease in pregnant women. To correctly detect and control these diseases, the pregnancy-specific reference must be set up clinically to avoid clinical over-diagnosis and missed diagnosis.