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Long-term recombinant human growth hormone therapy in Dent's disease type 1. 长期重组人生长激素治疗1型邓氏病。
Pub Date : 2025-01-01 DOI: 10.5603/ep.105878
Miao Huang, Guoqing Dong, Yongmei Zeng, Fan Wu, Peipei Liu, Xiyan Lu

Not required for Clinical Vignette.

临床小品不需要。
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引用次数: 0
Effectiveness of therapy with recombinant human growth hormone (rhGH) in patients with hypoplastic left heart syndrome (HLHS) and short stature. 重组人生长激素(rhGH)治疗左心发育不全综合征(HLHS)和身材矮小患者的疗效。
Pub Date : 2025-01-01 Epub Date: 2025-09-25 DOI: 10.5603/ep.106211
Aleksandra Furtak, Magdalena Ossowska, Karolina Komorkiewicz, Dominika Januś, Dorota Roztoczyńska, Jerzy B Starzyk, Anna Wędrychowicz

Introduction: Hypoplastic left heart syndrome (HLHS) is among the most severe and complex forms of congenital heart disease. Despite advances in medical and surgical management, patients with HLHS remain at risk for numerous short- and long-term complications, including growth impairment. The aim of this study is to evaluate the effectiveness and safety of recombinant human growth hormone (rhGH) therapy in patients with HLHS and either growth hormone deficiency (GHD) or small for gestational age (SGA) status, treated at a single tertiary pediatric endocrinology center.

Material and methods: We retrospectively studied eight male patients with HLHS and short stature. Patients were qualified for rhGH therapy in accordance with the guidelines of the Polish rhGH treatment program dedicated to children with short stature and GHD or SGA. Five patients with GHD were qualified for rhGH therapy. The median age of the patients was 14.4 years, and the median height standard deviation score (SDS) was -5.82. Patients who did not initiate rhGH therapy had a median age of 13.8 years and a median height SDS of -3.97. To evaluate the effectiveness of rhGH therapy, we assessed patients' height SDS, bone age, and serum insulin-like growth factor 1 (IGF-1) concentrations at baseline (prior to treatment initiation), approximately one year after the start of therapy, and annually thereafter.

Results: During rhGH therapy, the mean height SDS improved from -5.82 to -5.38 at the first follow-up after a mean duration of 1.1 years. Ultimately, the mean height SDS further improved to -4.92 after an average of 2.5 years of treatment. In contrast, patients who did not receive rhGH therapy showed no improvement; their mean height SDS declined from -3.79 to -4.15 over an observation period of 8 to 16 months.

Conclusion: Growth failure in patients with HLHS is likely multifactorial in origin, extending beyond the cardiac defect and its treatment. Short stature in this population warrants thorough evaluation, and in cases of confirmed GHD, rhGH therapy should be considered when feasible. Treatment decisions must be individualized, considering the patient's overall clinical condition and coexisting comorbidities.

左心发育不全综合征(HLHS)是先天性心脏病中最严重和最复杂的形式之一。尽管在医疗和外科治疗方面取得了进展,但HLHS患者仍然面临许多短期和长期并发症的风险,包括生长障碍。本研究的目的是评估重组人生长激素(rhGH)治疗在单一三级儿科内分泌中心治疗的HLHS和生长激素缺乏症(GHD)或小胎龄(SGA)状态患者的有效性和安全性。材料和方法:我们回顾性研究了8例男性HLHS和身材矮小的患者。根据波兰rhGH治疗方案的指导方针,患者有资格接受rhGH治疗,该方案专门用于矮小和GHD或SGA的儿童。5例GHD患者符合rhGH治疗条件。患者年龄中位数为14.4岁,身高标准差(SDS)中位数为-5.82。未开始rhGH治疗的患者中位年龄为13.8岁,中位身高SDS为-3.97。为了评估rhGH治疗的有效性,我们在基线(治疗开始前)、治疗开始后大约一年后和之后每年评估患者的身高SDS、骨龄和血清胰岛素样生长因子1 (IGF-1)浓度。结果:在rhGH治疗期间,平均持续时间1.1年后的第一次随访中,平均身高SDS从-5.82改善到-5.38。最终,平均治疗2.5年后,平均身高SDS进一步改善至-4.92。相比之下,未接受rhGH治疗的患者没有改善;在8 ~ 16个月的观察期内,平均身高SDS从-3.79下降到-4.15。结论:HLHS患者生长衰竭的病因可能是多因素的,超出了心脏缺陷及其治疗范围。这一人群的矮小身材需要进行彻底的评估,在确诊为GHD的情况下,应考虑在可行的情况下进行rhGH治疗。治疗决定必须个体化,考虑患者的整体临床状况和共存的合并症。
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引用次数: 0
Aberrant expression of miR1271-5p in polycystic ovary syndrome and its regulatory effect on granulosa cells via targeting PRKAR1A. miR1271-5p在多囊卵巢综合征中的异常表达及其通过靶向PRKAR1A对颗粒细胞的调控作用
Pub Date : 2025-01-01 DOI: 10.5603/ep.108079
Ke Chen, Yanni Lv, Xuehua Cai, Yanxia Huang, Aizhen Pan

Introduction: Polycystic ovary syndrome (PCOS) is characterized by ovulation disturbance, hyperandrogenemia, and polycystic ovary, causing infertility. There is a lack of unified conclusions on the pathogenesis of PCOS, resulting in challenges in the clinical management. This study evaluated the potential of miR-1271-5p in diagnosing PCOS and its regulatory effect on granulosa cells, aiming to explore a potential therapeutic target for PCOS.

Material and methods: This study enrolled 189 PCOS patients with 107 healthy women as the control group. Serum miR-1271-5p was assessed by quantitative polymerase chain reaction (qPCR), and its clinical significance was evaluated from the perspectives of diagnosis and correlation with clinical symptoms. In vitro, the regulatory effects of miR-1271-5p on granulosa cell injury (KGN cell induced by lipopolysaccharide, LPS) were evaluated from the perspectives of cell growth, apoptosis, oxidative stress, and inflammation. The regulatory mechanism was estimated through the target prediction.

Results: miR-1271-5p was upregulated in PCOS, discriminating PCOS patients and correlated with obesity, insulin resistance, and hormone disturbance of PCOS patients. miR-1271-5p, and insulin resistance- and hormone-related features, was identified as risk factors for PCOS. In KGN cells, miR-1271-5p targeted PRKAR1A and negatively regulated its expression. Silencing miR-1271-5p could alleviate LPS-induced cell injury, including reduced cell viability, oxidative stress, and inflammation. Knocking down PRKAR1A could reverse the protective effects of miR-1271-5p on KGN cells.

Conclusions: miR-1271-5p served as a biomarker for PCOS, predicting disease risk and diagnosing disease onset. The miR-1271-5p/PRKAR1A axis regulated granulosa cell injury under LPS, which can be considered a potential therapeutic target for PCOS.

简介:多囊卵巢综合征(PCOS)以排卵障碍、高雄激素血症和多囊卵巢为特征,导致不孕。关于多囊卵巢综合征的发病机制尚无统一的结论,给临床管理带来了挑战。本研究评估miR-1271-5p在PCOS诊断中的潜力及其对颗粒细胞的调控作用,旨在探索PCOS的潜在治疗靶点。材料与方法:本研究纳入189例PCOS患者和107名健康女性作为对照组。采用定量聚合酶链反应(quantitative polymerase chain reaction, qPCR)检测血清miR-1271-5p,从诊断及与临床症状的相关性角度评价其临床意义。在体外,从细胞生长、凋亡、氧化应激和炎症等方面评价miR-1271-5p对颗粒细胞损伤(脂多糖诱导的KGN细胞)的调节作用。通过靶标预测,估计其调控机制。结果:miR-1271-5p在PCOS中表达上调,对PCOS患者有鉴别作用,并与PCOS患者的肥胖、胰岛素抵抗、激素紊乱相关。miR-1271-5p以及胰岛素抵抗和激素相关特征被确定为PCOS的危险因素。在KGN细胞中,miR-1271-5p靶向PRKAR1A并负调控其表达。沉默miR-1271-5p可以减轻lps诱导的细胞损伤,包括细胞活力降低、氧化应激和炎症。敲低PRKAR1A可逆转miR-1271-5p对KGN细胞的保护作用。结论:miR-1271-5p可作为PCOS的生物标志物,预测疾病风险,诊断疾病发病。miR-1271-5p/PRKAR1A轴在LPS作用下调控颗粒细胞损伤,可被认为是PCOS的潜在治疗靶点。
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引用次数: 0
Risk factors and prediction of cognitive dysfunction in diabetes-related stroke. 糖尿病相关脑卒中认知功能障碍的危险因素及预测。
Pub Date : 2025-01-01 DOI: 10.5603/ep.103676
Ning Lin Wei, Zhou Su, Hailiang Yan

Introduction: Type 2 diabetes mellitus (T2DM) with secondary cerebral infarction often leads to cognitive dysfunction (CD), impacting patients' quality of life and prognosis. The aim of the study was to explore factors influencing CD in T2DM patients with cerebral infarction and develop a prediction model.

Material and methods: This was a retrospective analysis of 244 T2DM patients with cerebral infarction treated from January 2020 to December 2023. Patients were split into a training set (n = 170) and a test set (n = 74). Logistic regression and random forest models were developed using RStudio.

Results: Logistic regression analysis indicated that age, 25-hydroxyvitamin D [25(OH)D], and triglyceride (TG) were independent influencing factors for CD in patients. In the random forest model, the variables were prioritized based on their importance, with 25(OH)D ranked highest, followed by age, TG, National Institute of Health stroke scale (NIHSS) score, duration of T2DM, and diabetic neuropathy. The area under the receiver operating characteristic curve (AUC) for the Logistic model was 0.799 in the training set and 0.793 in the test set, while the AUC values for the random forest model were recorded at 0.875 and 0.804, respectively. The predicted probabilities of both models in the training and test sets aligned well with the actual incidence of CD.

Conclusion: Age, 25(OH)D, and TG are key factors for CD in T2DM patients with cerebral infarction. The random forest model showed superior predictive performance, making it a promising tool for clinical use.

2型糖尿病(T2DM)合并继发性脑梗死常导致认知功能障碍(CD),影响患者的生活质量和预后。本研究旨在探讨T2DM合并脑梗死患者CD的影响因素,并建立预测模型。材料和方法:对2020年1月至2023年12月期间接受治疗的244例T2DM脑梗死患者进行回顾性分析。患者被分为训练组(n = 170)和测试组(n = 74)。使用RStudio开发逻辑回归和随机森林模型。结果:Logistic回归分析显示,年龄、25-羟基维生素D [25(OH)D]和甘油三酯(TG)是患者CD的独立影响因素。在随机森林模型中,根据变量的重要性对其进行优先排序,25(OH)D排名最高,其次是年龄、TG、美国国立卫生研究院卒中量表(NIHSS)评分、T2DM持续时间和糖尿病神经病变。Logistic模型在训练集和测试集的接收者工作特征曲线下面积(AUC)分别为0.799和0.793,而随机森林模型的AUC分别为0.875和0.804。两种模型在训练集和测试集的预测概率与CD的实际发病率吻合较好。结论:年龄、25(OH)D和TG是T2DM合并脑梗死患者CD的关键因素。随机森林模型显示出优越的预测性能,使其成为临床应用的有前途的工具。
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引用次数: 0
The effects of intragastric balloons on metabolic and inflammatory parameters in obese patients. 胃内气球对肥胖患者代谢和炎症参数的影响。
Pub Date : 2025-01-01 DOI: 10.5603/ep.102955
Maciej Wiewiora, Andrzej Kozłowski, Elżbieta Świętochowska, Hanna Wiewiora, Jerzy Piecuch, Jerzy Piecuch

Introduction: The prevalence of obesity worldwide has rapidly increased. One of the methods for treating obesity is endoscopic intragastric balloon (IGB) implantation. The aim of this study was to evaluate the effects of carbohydrate homeostasis and select cytokines in obese patients with a body mass index (BMI) ≥ 40 kg/m².

Material and methods: We analysed 68 obese subjects who underwent IGB. There were 19 females and 49 males in the study, their ages ranged from 23-65 years, their weights were 169.04 ± 33 kg, and their BMIs were 54.81 ± 7.8 kg/m². We measured carbohydrate parameters, including glucose, insulin and Homeostatic Model Assessment - Insulin Resistance (HOMA-IR), and cytokines, such as growth differentiation factor 15 (GDF15), human zinc-alpha-2-glycoprotein (ZAGa2), tumour necrosis factor alpha (TNF-α), and tumour necrosis factor weak inducer of apoptosis (TNFSF12/TWEAK). All parameters were measured before and at 6 months after the IGB was removed.

Results: Anthropometric parameters and carbohydrate homeostasis significantly changed 6 months after IGB implantation. We found significant decreases in body weight (p < 0.0001), BMI (p < 0.0001), glucose levels (p < 0.0001), insulin concentration (p < 0.0001), and HOMA-IR (p < 0.0001), regardless of sex. After 6 months, GDF15 (p < 0.0001), ZAGa2 (p < 0.0001) and TNFα (p < 0.0001) levels decreased. In contrast, the TNFSF12/TWEAK concentration increased (p < 0.0001). There was no difference between women and men in any of the parameters.

Conclusions: The results of this study indicate that IGB-induced weight loss leads to the normalization of metabolic parameters and inflammatory cytokines in obese individuals, regardless of sex.

导读:肥胖症在世界范围内的患病率迅速上升。治疗肥胖的方法之一是内镜下胃内球囊植入术。本研究的目的是评估体重指数(BMI)≥40 kg/m²的肥胖患者体内碳水化合物稳态和细胞因子的影响。材料和方法:我们分析了68例接受IGB治疗的肥胖患者。女性19例,男性49例,年龄23 ~ 65岁,体重169.04±33 kg, bmi为54.81±7.8 kg/m²。我们测量了碳水化合物参数,包括葡萄糖、胰岛素和稳态模型评估-胰岛素抵抗(HOMA-IR),以及细胞因子,如生长分化因子15 (GDF15)、人锌-α -2糖蛋白(ZAGa2)、肿瘤坏死因子α (TNF-α)和肿瘤坏死因子弱诱导细胞凋亡(TNFSF12/TWEAK)。在移除IGB前和移除IGB后6个月测量所有参数。结果:IGB植入6个月后,人体测量参数和碳水化合物稳态发生了显著变化。我们发现,无论性别,体重(p < 0.0001)、BMI (p < 0.0001)、血糖水平(p < 0.0001)、胰岛素浓度(p < 0.0001)和HOMA-IR (p < 0.0001)均显著降低。6个月后,GDF15 (p < 0.0001)、ZAGa2 (p < 0.0001)和TNFα (p < 0.0001)水平下降。TNFSF12/TWEAK浓度升高(p < 0.0001)。女性和男性在任何参数上都没有差异。结论:本研究结果表明,igb诱导的体重减轻导致肥胖个体代谢参数和炎症细胞因子的正常化,无论性别如何。
{"title":"The effects of intragastric balloons on metabolic and inflammatory parameters in obese patients.","authors":"Maciej Wiewiora, Andrzej Kozłowski, Elżbieta Świętochowska, Hanna Wiewiora, Jerzy Piecuch, Jerzy Piecuch","doi":"10.5603/ep.102955","DOIUrl":"10.5603/ep.102955","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of obesity worldwide has rapidly increased. One of the methods for treating obesity is endoscopic intragastric balloon (IGB) implantation. The aim of this study was to evaluate the effects of carbohydrate homeostasis and select cytokines in obese patients with a body mass index (BMI) ≥ 40 kg/m².</p><p><strong>Material and methods: </strong>We analysed 68 obese subjects who underwent IGB. There were 19 females and 49 males in the study, their ages ranged from 23-65 years, their weights were 169.04 ± 33 kg, and their BMIs were 54.81 ± 7.8 kg/m². We measured carbohydrate parameters, including glucose, insulin and Homeostatic Model Assessment - Insulin Resistance (HOMA-IR), and cytokines, such as growth differentiation factor 15 (GDF15), human zinc-alpha-2-glycoprotein (ZAGa2), tumour necrosis factor alpha (TNF-α), and tumour necrosis factor weak inducer of apoptosis (TNFSF12/TWEAK). All parameters were measured before and at 6 months after the IGB was removed.</p><p><strong>Results: </strong>Anthropometric parameters and carbohydrate homeostasis significantly changed 6 months after IGB implantation. We found significant decreases in body weight (p < 0.0001), BMI (p < 0.0001), glucose levels (p < 0.0001), insulin concentration (p < 0.0001), and HOMA-IR (p < 0.0001), regardless of sex. After 6 months, GDF15 (p < 0.0001), ZAGa2 (p < 0.0001) and TNFα (p < 0.0001) levels decreased. In contrast, the TNFSF12/TWEAK concentration increased (p < 0.0001). There was no difference between women and men in any of the parameters.</p><p><strong>Conclusions: </strong>The results of this study indicate that IGB-induced weight loss leads to the normalization of metabolic parameters and inflammatory cytokines in obese individuals, regardless of sex.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 1","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An update on biochemical findings for stages of nutritional rickets. 营养性佝偻病各阶段的最新生化结果。
Pub Date : 2025-01-01 Epub Date: 2025-07-29 DOI: 10.5603/ep.102137
Hüseyin Anıl Korkmaz

Rickets is a disease of the growing skeleton resulting from impaired hypertrophic chondrocyte apoptosis and growth plate mineralization. According to the present data on children with nutritional rickets, there are three stages of biochemical findings. Using these biochemical findings, we aimed to update the stages of nutritional rickets in this review.

佝偻病是一种由肥大软骨细胞凋亡和生长板矿化受损引起的生长骨骼疾病。根据目前关于营养性佝偻病儿童的数据,生化结果有三个阶段。利用这些生化发现,我们旨在更新营养性佝偻病的分期。
{"title":"An update on biochemical findings for stages of nutritional rickets.","authors":"Hüseyin Anıl Korkmaz","doi":"10.5603/ep.102137","DOIUrl":"10.5603/ep.102137","url":null,"abstract":"<p><p>Rickets is a disease of the growing skeleton resulting from impaired hypertrophic chondrocyte apoptosis and growth plate mineralization. According to the present data on children with nutritional rickets, there are three stages of biochemical findings. Using these biochemical findings, we aimed to update the stages of nutritional rickets in this review.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"370-373"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paraganglioma-induced catecholamine cardiomyopathy. 副神经节瘤诱导的儿茶酚胺性心肌病。
Pub Date : 2025-01-01 DOI: 10.5603/ep.102856
Yujie Yang, Yunfei An, Yangjuan Bai, Lei Zhang, Yamei Li, Yuangao Zou, Xinhua Dai

Not required for Clinical Vignette.

临床小品不需要。
{"title":"Paraganglioma-induced catecholamine cardiomyopathy.","authors":"Yujie Yang, Yunfei An, Yangjuan Bai, Lei Zhang, Yamei Li, Yuangao Zou, Xinhua Dai","doi":"10.5603/ep.102856","DOIUrl":"10.5603/ep.102856","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 2","pages":"222-223"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surprising diagnosis of Paget's disease of bone during malignancy diagnosis. 恶性肿瘤诊断中对骨佩吉特病的惊人诊断。
Pub Date : 2025-01-01 Epub Date: 2025-05-07 DOI: 10.5603/ep.102636
Katarzyna Wandzilak, Marcin Renke, Łukasz Obołończyk

Not required for Clinical Vignette.

临床小品不需要。
{"title":"Surprising diagnosis of Paget's disease of bone during malignancy diagnosis.","authors":"Katarzyna Wandzilak, Marcin Renke, Łukasz Obołończyk","doi":"10.5603/ep.102636","DOIUrl":"10.5603/ep.102636","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"347-348"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Triglyceride-glucose index and remnant cholesterol in acute ischemic stroke - a cross-sectional study. 急性缺血性中风的甘油三酯-葡萄糖指数和残余胆固醇-横断面研究。
Pub Date : 2025-01-01 DOI: 10.5603/ep.104158
Chen Chen, Weichao Zhu, Tianshuo Sun, Haixu Zhao, Hui Liu, Cui Zhang, Mengyuan Hao, Qian Liang, Guodong Tian, Donglai Jing, Kangbo Li

Introduction: The association between insulin resistance and lipid metabolism in acute ischemic stroke (AIS) remains unclear. To explore their relationship and elucidate potential biomarkers for stroke management, we investigated the association between the triglyceride-glucose index (TyG index) and remnant cholesterol (RC) in patients with AIS.

Material and methods: A total of 116 patients diagnosed with acute ischemic stroke (AIS) and admitted to the Xiong'an New District Rongcheng People's Hospital between December 2022 and June 2023 were randomly chosen for this study. Patients were categorized into three groups based on either the TyG index or RC tertiles. To assess the association between the TyG index and RC, Spearman's rank correlation analysis was conducted. Additionally, ANOVA was utilized to compare the levels of RC across different TyG index tertiles. To determine if RC could serve as a potential explanatory variable of the TyG index and vice versa, multiple linear regression analysis was employed. Furthermore, ordinal logistic regression analysis was carried out to explore the relationships among the TyG index, RC, and AIS severity.

Results: Spearman's rank correlation analysis showed that the TyG index was positively correlated with RC (r = 0.645, p < 0.0001). Multiple linear regression analysis showed that RC was associated with the TyG index (β = 0.695, p < 0.001) and vice versa (β = 0.212,p = 0.008). Ordinal logistic regression analysis indicated that RC was positively associated with AIS severity (estimate = 0.713, p = 0.038).

Conclusions: There is a strong correlation between the TyG index and RC in patients with AIS. In addition, RC was positively associated with the severity of AIS. The results of this study may promote a more comprehensive understanding of the association between insulin resistance and lipid metabolism in AIS.

急性缺血性卒中(AIS)患者胰岛素抵抗与脂质代谢之间的关系尚不清楚。为了探讨它们之间的关系并阐明潜在的脑卒中管理生物标志物,我们研究了AIS患者甘油三酯-葡萄糖指数(TyG指数)和残余胆固醇(RC)之间的关系。材料与方法:随机选取2022年12月至2023年6月雄安新区荣城人民医院收治的急性缺血性脑卒中(AIS)患者116例。根据TyG指数或RC指数将患者分为三组。为了评估TyG指数与RC之间的相关性,我们进行了Spearman等级相关分析。此外,采用方差分析(ANOVA)比较不同类型的TyG指数中RC的水平。为了确定RC是否可以作为TyG指数的潜在解释变量,反之亦然,我们采用多元线性回归分析。此外,通过有序逻辑回归分析探讨TyG指数、RC和AIS严重程度之间的关系。结果:Spearman秩相关分析显示,TyG指数与RC呈正相关(r = 0.645, p < 0.0001)。多元线性回归分析显示,RC与TyG指数呈正相关(β = 0.695, p < 0.001),反之亦然(β = 0.212,p = 0.008)。有序逻辑回归分析显示,RC与AIS严重程度呈正相关(估计值= 0.713,p = 0.038)。结论:AIS患者TyG指数与RC有较强相关性。此外,RC与AIS的严重程度呈正相关。本研究结果可促进对AIS患者胰岛素抵抗与脂质代谢关系的更全面认识。
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引用次数: 0
Assessment of fracture risk based on FRAX score and Polish guidelines in patients with newly diagnosed osteoporosis. 基于FRAX评分和波兰指南的新诊断骨质疏松患者骨折风险评估
Pub Date : 2025-01-01 DOI: 10.5603/ep.102879
Wioletta Stępień-Kłos, Marta Michalska-Kasiczak, Katarzyna Płoszka, Michał Stuss, Ewa Sewerynek

Introduction: The authors of the latest recommendations state that osteoporosis diagnosis should not rely solely on densitometric (DXA) criteria. Fracture risk assessment is crucial for determining diagnosis and intervention thresholds. Comprehensive assessment of fracture risk requires consideration of bone mineral density (BMD) results, use of risk calculators like Fracture Risk Assessment Tool (FRAXTM), and analysis of clinical and lifestyle factors. Experts highlight the need to identify patients at very high fracture risk to justify starting anabolic therapy. This retrospective study assessed fracture risk in newly diagnosed osteoporosis patients, identifying those at high and very high risk.

Material and methods: The study included 159 postmenopausal women with newly diagnosed osteoporosis, identified by a T-score of ≤ -2.5 standard deviations (SD) from DXA scans of the femoral neck and/or lumbar spine. Demographic data and laboratory tests were collected, and the 10-year fracture risk for major osteoporotic fractures (FRAX MOF) and hip fractures (FRAX HF) was calculated using the FRAX-PL calculator, which included femoral neck BMD. Each patient was then classified into a risk group based on modified fracture risk assessment criteria.

Results: The study found that the most common risk factor for osteoporosis was a previous fracture (56.6%). Other common risk factors included smoking (21.38%), parental hip fracture (13.21%), and glucocorticoid use (10.70%). The FRAX calculator showed that 47.80% of patients were at very high risk for HF and 23.90% for MOF. A high HF risk was present in 10.06% of patients, and high MOF risk in 34.59%, whereas a medium and low MOF risk concerned 25.79% and 15.72% of the subjects, respectively. With expanded criteria, 72.33% of patients were classified at very high risk, compared to 23.90% for MOF and 47.80% for HF based solely on FRAX. Most patients met the T-score ≤ -3.0 SD criterion (52.20%) and FRAX > 15% for MOF or FRAX > 4.5% for HF (52.20%). Women aged 65-70 and 70-75 years are at the highest risk and qualify for anabolic therapy.

Conclusions: Our study highlights the importance of stratifying patients by fracture risk, showing that more individuals are identified at very high risk when using the expanded assessment criteria from the latest Polish guidelines.

介绍:最新建议的作者指出,骨质疏松症的诊断不应该仅仅依赖于密度测量(DXA)标准。骨折风险评估对于确定诊断和干预阈值至关重要。综合评估骨折风险需要考虑骨矿物质密度(BMD)结果,使用骨折风险评估工具(FRAXTM)等风险计算器,并分析临床和生活方式因素。专家强调,需要识别骨折风险非常高的患者,以证明开始合成代谢治疗的合理性。这项回顾性研究评估了新诊断的骨质疏松症患者的骨折风险,确定了那些高风险和非常高风险的患者。材料和方法:该研究纳入159名新近诊断为骨质疏松症的绝经后妇女,通过股骨颈和/或腰椎DXA扫描的t评分≤-2.5标准差(SD)确定。收集人口统计学数据和实验室测试,使用FRAX- pl计算器计算包括股骨颈骨密度在内的主要骨质疏松性骨折(FRAX MOF)和髋部骨折(FRAX HF)的10年骨折风险。然后根据修改后的骨折风险评估标准将每位患者分为风险组。结果:研究发现骨质疏松最常见的危险因素是既往骨折(56.6%)。其他常见的危险因素包括吸烟(21.38%)、父母髋部骨折(13.21%)和使用糖皮质激素(10.70%)。FRAX计算器显示,47.80%的患者HF风险极高,23.90%的患者MOF风险极高。10.06%的患者存在高HF风险,34.59%的患者存在高MOF风险,而中度和低MOF风险分别为25.79%和15.72%。扩大标准后,72.33%的患者被归为非常高风险,而仅基于FRAX的MOF和HF分别为23.90%和47.80%。大多数患者符合t评分≤-3.0 SD标准(52.20%),MOF的FRAX >为15%,HF的FRAX >为4.5%(52.20%)。65-70岁和70-75岁的女性风险最高,适合进行合成代谢治疗。结论:我们的研究强调了根据骨折风险对患者进行分层的重要性,表明当使用最新波兰指南的扩展评估标准时,更多的个体被确定为高危人群。
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引用次数: 0
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Endokrynologia Polska
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