Browse
You are looking at 121 - 130 of 1,467 items for
Clinical Research Center for Metabolic Disease, Gansu Province, Lanzhou, Gansu, China
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
Search for other papers by Feifei Shao in
Google Scholar
PubMed
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
Search for other papers by Xinxin Hu in
Google Scholar
PubMed
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
Search for other papers by Jiayu Li in
Google Scholar
PubMed
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
Search for other papers by Bona Bai in
Google Scholar
PubMed
Clinical Research Center for Metabolic Disease, Gansu Province, Lanzhou, Gansu, China
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
Search for other papers by Limin Tian in
Google Scholar
PubMed
Aims
Aging, obesity, and type 2 diabetes mellitus (T2DM) form a metabolic disease continuum that has a continuously increasing prevalence. Lipidomics explains the complex interactions between lipid metabolism and metabolic diseases. We aimed to systematically investigate the plasma lipidome changes induced by newly diagnosed impaired glucose tolerance (IGT) and T2DM in overweight/obese elderly individuals and to identify potential biomarkers to differentiate between the IGT, T2DM, and control groups.
Methods
Plasma samples from 148 overweight/obese elderly individuals, including 52 patients with IGT, 47 patients with T2DM, and 49 euglycemic controls, were analyzed using a high-coverage nontargeted absolute quantitative lipidomics approach.
Results
We quantified 1840 lipids from thirty-eight classes and seven lipid categories. Among overweight/obese elderly individuals, the lipidomic profiles of IGT and T2DM patients were significantly different from those of controls, while they were similar in the IGT and T2DM groups. The concentrations of diglycerides, triglycerides, phosphatidylcholines, and ceramides were obviously altered in the IGT and T2DM groups. Particularly, IGT and T2DM induced the accumulation of triglycerides with longer carbon atom numbers (C44–50) and saturated or lower double bond numbers (n (C=C) = 0–2). Furthermore, a total of 17 potential lipidic biomarkers were identified to successfully differentiate between the IGT, T2DM, and control groups.
Conclusions
In overweight/obese elderly patients, IGT and T2DM induced apparent lipidome-wide changes. This study’s results may contribute to explaining the complex dysfunctional lipid metabolism in aging, obesity, and diabetes.
Search for other papers by Stefan M Constantinescu in
Google Scholar
PubMed
Search for other papers by Thierry Duprez in
Google Scholar
PubMed
Search for other papers by Edward Fomekong in
Google Scholar
PubMed
Search for other papers by Christian Raftopoulos in
Google Scholar
PubMed
Search for other papers by Orsalia Alexopoulou in
Google Scholar
PubMed
Search for other papers by Dominique Maiter in
Google Scholar
PubMed
Objectives
The incidental diagnosis of nonfunctioning pituitary macroadenomas (NFPMAs) is becoming more prevalent with the spread of modern brain imaging techniques. We sought to uncover new data about their natural history and surgical outcome.
Design
This is a retrospective single-center observational study.
Methods
Among 210 patients seen for a NFPMA between 2010 and 2019, 70 (33%) were discovered incidentally (i-NFPMA). We analyzed outcomes in a total of 65 patients with available follow-up data.
Results
Mean age at diagnosis (± s.d.) was 60 ± 14 years and mean maximal diameter was 20.0 ± 7.3 mm. At diagnosis, 29 patients (45%) had pituitary hormone deficits (LH/FSH 41%, TSH 29%, ACTH 15%) and 12% had visual field deficits. 26 patients underwent initial surgery, while 12 had delayed surgery after initial surveillance. In the surveillance group, the risk of tumor growth was estimated at 10%/year. Patients with hormonal deficits at diagnosis experienced earlier growth at 24 months (P < 0.02). Overall, surgical resection of the i-NFPMA led to stable or improved endocrine function in 91% of patients, with only 6% postoperative permanent diabetes insipidus. Moreover, surgery was more effective in preserving intact endocrine function (10/12) than restoring altered endocrine function to normal (6/22, P = 0.03).
Conclusion
About one-third of NFPMAs are now discovered incidentally and a significant subset may be responsible for unrecognized endocrine and visual deficits. Under surveillance the risk of further tumor growth is significant (10%/year) and seems to occur faster in patients already harboring an endocrine deficit. Early surgical removal before onset of endocrine deficits appears to lead to better endocrine outcome.
Division of Epidemiology and Biometry, Carl von Ossietzky University, Oldenburg, Germany
Search for other papers by Julia Beckhaus in
Google Scholar
PubMed
Search for other papers by Svenja Boekhoff in
Google Scholar
PubMed
Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, Ontario, Canada
Search for other papers by Katrin Scheinemann in
Google Scholar
PubMed
Search for other papers by Freimut H Schilling in
Google Scholar
PubMed
Search for other papers by Gudrun Fleischhack in
Google Scholar
PubMed
Search for other papers by Gerhard Binder in
Google Scholar
PubMed
Search for other papers by Brigitte Bison in
Google Scholar
PubMed
Search for other papers by Torsten Pietsch in
Google Scholar
PubMed
Search for other papers by Carsten Friedrich in
Google Scholar
PubMed
Search for other papers by Hermann L Müller in
Google Scholar
PubMed
Background
Craniopharyngiomas (CPs) are rare embryonic tumors. Clinical presentation and outcome of patients perinatally diagnosed with congenital CP (cCP) are not clear and refer mainly to a few case reports in the literature. The aim of this study was to analyze clinical presentation and outcome in patients with cCP.
Study design
Three hundred and sixty-one patients diagnosed with adamantinomatous CP were recruited 2007–2022 in KRANIOPHARYNGEOM 2007/Registry 2019 and prospectively observed. In two cases, cCP was diagnosed prenatally and in one case on the second day of life. Pre- and perinatal diagnostic findings, postnatal evaluation, and therapeutic interventions and outcome in these three cases of cCP were analyzed.
Results
All patients survived. One patient developed psychomotor retardation and a mild hemiparesis. Prenatal routine ultrasound examination led to the diagnosis of cCP. Tumor resection was performed during the early postnatal period (range: 11–51 days of age). Functional capacity, measured by Fertigkeitenskala-Münster-Heidelberg (FMH) was reduced in three and behavioral parameters, measured by the Strength and Difficulties Questionnaire (SDQ) were abnormal in two cases.
Conclusion
cCP is a rare diagnosis with a prevalence of 0.83% in our study group. Compared to cases reported in the literature, the presented cases were treated immediately and had a better prognosis. Based on improvements of diagnostic and therapeutic techniques, prenatal diagnosis of cCP should lead to transfer prior to delivery of cCP patients to a specialized center for delivery and postnatal treatment of newborns with sellar masses by a multidisciplinary team to secure the improved prognosis of these patients.
Significance statement
We previously reported that lower event-free survival rates after craniopharyngioma are associated with younger age at diagnosis. Perinatally diagnosed congenital craniopharyngiomas are very rare. This article presents three unique cases with congenital craniopharyngioma, comparing their diagnostics, therapy, and development. All three cases had surgery during the early postnatal period with sparing of the posterior hypothalamus. In each case, endocrinopathy was present at follow-up. Low functional capacity was reported in all cases and an abnormal total difficulties score in two cases. Compared to the literature, the presented cases had better prognosis in morbidity and mortality. This report and the review of the literature confirm the importance of a multidisciplinary approach in the diagnostic and treatment of the very rare condition of congenital craniopharyngioma.
Alfred Health, Melbourne, Victoria, Australia
Search for other papers by Pravik Solanki in
Google Scholar
PubMed
Department of General Practice, Melbourne Medical School, The University of Melbourne, Victoria, Australia
Search for other papers by Beng Eu in
Google Scholar
PubMed
Search for other papers by Jeremy Smith in
Google Scholar
PubMed
Search for other papers by Carolyn Allan in
Google Scholar
PubMed
Search for other papers by Kevin Lee in
Google Scholar
PubMed
Hypogonadism can result following anabolic steroid abuse. The duration and degree of recovery from anabolic steroid-induced hypogonadism (ASIH) is immensely variable, and there is a paucity of prospective controlled data characterising the trajectory of natural recovery following cessation. This poses difficulties for users trying to stop androgen abuse, and clinicians wanting to assist them. The objective of this paper was to synthesise evidence on the physical, psychological and biochemical patterns of ASIH recovery. We present the pathophysiology of ASIH through a literature review of hypothalamic–pituitary–testosterone axis recovery in supraphysiological testosterone exposure. This is followed by a scoping review of relevant observational and interventional studies published on PubMed and finally, a conclusion that is an easy reference for clinicians helping patients that are recovering from AAS abuse. Results indicate that ASIH recovery depends on age and degree of androgen abuse, with physical changes like testicular atrophy expected to have near full recovery over months to years; spermatogenesis expected to achieve full recovery over months to years; libido returning to baseline over several months (typically less potent than during AAS use); and recovery from gynaecomastia being unlikely. For psychological recovery, data are insufficient and conflicting, indicating a transient withdrawal period which may be followed by persisting longer-term milder symptoms. For biochemical recovery, near complete recovery of testosterone is seen over months, and complete gonadotropin recovery is expected over 3–6 months. Further prospective studies are indicated to more closely describe patterns of recovery.
Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Search for other papers by Supitcha Patjamontri in
Google Scholar
PubMed
NIHR Health Protection Research Unit on Chemical Radiation Threats and Hazards, Imperial College London, London, UK
Search for other papers by Alexander Spiers in
Google Scholar
PubMed
NIHR Health Protection Research Unit on Chemical Radiation Threats and Hazards, Imperial College London, London, UK
National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
Mohn Centre for Children’s Health and Wellbeing, Imperial College London, London, UK
Search for other papers by Rachel B Smith in
Google Scholar
PubMed
NIHR Health Protection Research Unit on Chemical Radiation Threats and Hazards, Imperial College London, London, UK
Search for other papers by Chen Shen in
Google Scholar
PubMed
Search for other papers by Jo Adaway in
Google Scholar
PubMed
Search for other papers by Brian G Keevil in
Google Scholar
PubMed
NIHR Health Protection Research Unit on Chemical Radiation Threats and Hazards, Imperial College London, London, UK
National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
Mohn Centre for Children’s Health and Wellbeing, Imperial College London, London, UK
Search for other papers by Mireille B Toledano in
Google Scholar
PubMed
Search for other papers by S Faisal Ahmed in
Google Scholar
PubMed
Context
Salivary androgens represent non-invasive biomarkers of puberty that may have utility in clinical and population studies.
Objective
To understand normal age-related variation in salivary sex steroids and demonstrate their correlation to pubertal development in young adolescents.
Design, setting and participants
School-based cohort study of 1495 adolescents at two time points for collecting saliva samples approximately 2 years apart.
Outcome measures
The saliva samples were analyzed for five androgens (testosterone, androstenedione (A4), 17-hydroxyprogesterone, 11-ketotestosterone and 11β-hydroxyandrostenedione) using liquid chromatography-mass spectrometry; in addition, salivary dehydroepiandrosterone (DHEA) and oestradiol (OE2) were analysed by ELISA. The pubertal staging was self-reported using the Pubertal Development Scale (PDS).
Results
In 1236 saliva samples from 903 boys aged between 11 and 16 years, salivary androgens except DHEA exhibited an increasing trend with an advancing age (ANOVA, P < 0.001), with salivary testosterone and A4 concentration showing the strongest correlation (r = 0.55, P < 0.001 and r = 0.48, P < 0.001, respectively). In a subgroup analysis of 155 and 63 saliva samples in boys and girls, respectively, morning salivary testosterone concentrations showed the highest correlation with composite PDS scores and voice-breaking category from PDS self-report in boys (r = 0.75, r = 0.67, respectively). In girls, salivary DHEA and OE2 had negligible correlations with age or composite PDS scores.
Conclusion
In boys aged 11–16 years, an increase in salivary testosterone and A4 is associated with self-reported pubertal progress and represents valid non-invasive biomarkers of puberty in boys.
Search for other papers by Lingjuan Li in
Google Scholar
PubMed
Search for other papers by Jing Qin in
Google Scholar
PubMed
Search for other papers by Lin Ren in
Google Scholar
PubMed
Search for other papers by Shiyuan Xiang in
Google Scholar
PubMed
National Center for Neurological Disorders, Shanghai, China
Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
Neurosurgical Institute of Fudan University, Shanghai, China
Shanghai Key Laboratory of Medical Brain Function and Restoration and Neural Regeneration, Fudan University, Shanghai, China
Search for other papers by Xiaoyun Cao in
Google Scholar
PubMed
Search for other papers by Xianglan Zheng in
Google Scholar
PubMed
Search for other papers by Zhiwen Yin in
Google Scholar
PubMed
National Center for Neurological Disorders, Shanghai, China
Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
Neurosurgical Institute of Fudan University, Shanghai, China
Shanghai Key Laboratory of Medical Brain Function and Restoration and Neural Regeneration, Fudan University, Shanghai, China
Search for other papers by Nidan Qiao in
Google Scholar
PubMed
Purpose
We aimed to describe and predict the risk of severe hypernatremia after surgical resection of craniopharyngioma and to identify the association of water intake, urine output, and sodium level change in the patients.
Method
The outcome was postoperative severe hypernatremia. We identified risk factors associated with hypernatremia using multivariable regression. We trained machine learning models to predict the outcome. We compared serum sodium change, intravenous input, oral input, total input, urine output, and net fluid balance according to different nurse shifts.
Results
Among 234 included patients, 125 developed severe hypernatremia after surgery. The peak incidence occurred during day 0 and day 6 after surgery. The risk was increased in patients with gross total resection (odds ratio (OR) 2.41, P < 0.001), high Puget classification (OR 4.44, P = 0.026), preoperative adrenal insufficiency (OR 2.01, P = 0.040), and preoperative hypernatremia (OR 5.55, P < 0.001). The random forest algorithm had the highest area under the receiver operating characteristic curve (0.770, 95% CI, 0.727–0.813) in predicting the outcome and was validated in the prospective validation cohort. Overnight shifts were associated with the highest serum sodium increase (P = 0.010), less intravenous input (P < 0.001), and less desmopressin use (P < 0.001).
Conclusion
The overall incidence of severe hypernatremia after surgical resection of craniopharyngioma was significant, especially in patients with gross total resection, hypothalamus distortion, preoperative adrenal insufficiency, and preoperative severe hypernatremia. Less intravenous input and less desmopressin use were associated with serum sodium increases, especially during overnight shifts.
Search for other papers by Hyunjae Lee in
Google Scholar
PubMed
Search for other papers by Tae-Shin Kim in
Google Scholar
PubMed
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for other papers by Ja-Yoon Gu in
Google Scholar
PubMed
Search for other papers by Mi Ran Yu in
Google Scholar
PubMed
Search for other papers by Seung-Eun Lee in
Google Scholar
PubMed
Search for other papers by Eun Sook Kim in
Google Scholar
PubMed
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for other papers by Hyun Kyung Kim in
Google Scholar
PubMed
Objective
The inflammatory microenvironment has been implicated in differentiated thyroid cancer (DTC). Inflammatory stimuli induce the release of components of neutrophils into extracellular space, leading to formation of neutrophil extracellular trap (NET), which can stimulate growth and progression of cancer. Generation of activated factor XII and thrombin is also involved in cancer progression. This study attempted to determine whether the level of circulating markers of NET, activated factor XII, and endogenous thrombin potential may be useful for detecting the recurrence of DTC.
Methods
A total of 122 patients with DTC were recruited during the postoperative follow-up period. Measurement of the levels of circulating markers of NET (neutrophil elastase, histone–DNA complex, cell-free dsDNA), activated factor XII, and endogenous thrombin potential was performed.
Results
A significantly elevated level of neutrophil elastase was detected in patients with recurrence (n = 12) compared to those without recurrence (n = 110), while significant elevation of the levels of other markers was not observed. The value for area under the curve (0.717, P = 0.018) of neutrophil elastase for detecting recurrence of DTC was superior to that (0.661, P = 0.051) of serum thyroglobulin. An elevated level of neutrophil elastase was significantly associated with recurrence of DTC independent of serum thyroglobulin.
Conclusions
Because an elevated level of neutrophil elastase was detected in patients with recurrence of DTC and showed a significant association with recurrence of DTC, it can be proposed as a novel biomarker for use in detecting recurrence of DTC along with other tests.
Search for other papers by A Bergougnoux in
Google Scholar
PubMed
INSERM Unité 1203 (DEFE), Université de Montpellier, Montpellier, France
Search for other papers by L Gaspari in
Google Scholar
PubMed
Search for other papers by M Soleirol in
Google Scholar
PubMed
Search for other papers by N Servant in
Google Scholar
PubMed
Search for other papers by S Soskin in
Google Scholar
PubMed
Search for other papers by S Rossignol in
Google Scholar
PubMed
Search for other papers by K Wagner-Mahler in
Google Scholar
PubMed
Search for other papers by J Bertherat in
Google Scholar
PubMed
Search for other papers by C Sultan in
Google Scholar
PubMed
Search for other papers by N Kalfa in
Google Scholar
PubMed
Département d'Endocrinologie et de Gynécologie Pédiatrique, Hôpital Arnaud de Villeneuve, Université de Montpellier, Montpellier, France
INSERM Unité 1203 (DEFE), Université de Montpellier, Montpellier, France
Search for other papers by F Paris in
Google Scholar
PubMed
Although hyperandrogenism is a frequent cause of consultation in adolescent girls, more severe forms with virilization must lead to suspicion of an adrenal or ovarian tumor. However, they may also reveal a 46,XY disorder of sexual development (DSD). Here, we describe four adolescent girls referred for pubertal virilization and in whom we diagnosed a 46,XY DSD. We performed gene mutation screening by Sanger sequencing (all patients) and by next-generation sequencing (NGS) in patient #4. We identified new heterozygous NR5A1 gene variants in patients #1 and #2 and a homozygous SRD5A2 gene deletion in patient #3. Patient #4 received a diagnosis of complete androgen insensitivity in childhood; however, due the unusual pubertal virilization, we completed the gene analysis by NGS that revealed two heterozygous HSD17B3 variants. This work underlines the importance of considering the hypothesis of 46,XY DSD in adolescent girls with unexplained virilization at puberty.
Search for other papers by Kathryn Lingen in
Google Scholar
PubMed
Search for other papers by Talia Pikounis in
Google Scholar
PubMed
Search for other papers by Natalie Bellini in
Google Scholar
PubMed
Search for other papers by Diana Isaacs in
Google Scholar
PubMed
Insulin administration remains vital to the treatment of diabetes and although there have been advances in insulin delivery, evidence suggests that many people with diabetes on insulin therapy have suboptimal glycemic management. Recent advancements in insulin administration techniques include connected insulin devices, such as connected insulin pens and pen caps. In this review, we provide an overview of the literature on the use of connected insulin pens and pen caps to further elucidate the clinical benefits and drawbacks of these devices. We discuss the development of these devices, outlining the characteristics of insulin pens and pen caps with regulatory approvals. These devices have different features that can ease the burden of diabetes management, including automatic recording of insulin dose information, tracking of insulin-on-board, bolus calculators, and missed dose alerts. Despite the advantages of connected pens and pen caps, a small percentage of insulin users are currently using these devices, due to many factors, including lack of health-care professional awareness, initial training for prescribers, and setup of the device. Overcoming these barriers and publishing more data demonstrating the glycemic outcomes associated with these systems could improve diabetes management for people living with diabetes. As health-care systems become increasingly digital, connected insulin pens have the potential to allow a data-driven approach to diabetes management for people who are not interested in, cannot afford, or do not have intensive insulin regimens that might warrant use of insulin pumps or automated insulin delivery systems.
Search for other papers by Jelena Stankovic in
Google Scholar
PubMed
Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
Search for other papers by Kurt Kristensen in
Google Scholar
PubMed
Search for other papers by Niels Birkebæk in
Google Scholar
PubMed
Search for other papers by Jens Otto Lunde Jørgensen in
Google Scholar
PubMed
Steno Diabetes Center Aarhus (SDCA), Aarhus University Hospital, Aarhus, Denmark
Search for other papers by Esben Søndergaard in
Google Scholar
PubMed
Background
The diagnosis of the polyuria–polydipsia syndrome is challenging. Copeptin is a robust biomarker of arginine vasopressin (AVP) secretion. Arginine, which stimulates growth hormone (GH), has been shown also to stimulate copeptin secretion via unknown mechanisms.
Aim
The aim was to investigate copeptin levels in response to three different GH stimulation tests in patients suspected of GH deficiency.
Methods
In this cross-sectional study, we measured plasma copeptin levels at baseline and at 60, 105, and 150 min in patients undergoing a stimulation test for growth hormone deficiency with either arginine (n = 16), clonidine (n = 8) or the insulin tolerance test (ITT) (n = 10).
Results
In patients undergoing the arginine test, the mean age was 9 years, and 10 years for clonidine. The ITT was only performed in adult patients (>18 years) with a mean age of 49 years. Copeptin level increased significantly from baseline to 60 min after arginine (P <0.01) and ITT (P < 0.01). By contrast, copeptin level tended to decrease after clonidine stimulation (P = 0.14).
Conclusion
These data support that infusion of arginine increases plasma copeptin levels and reveal a comparable response after an ITT. We hypothesize that the underlying mechanism is abrogation of somatostatin-induced AVP suppression.
