Browse

You are looking at 11 - 20 of 1,402 items for

Jorge Gabriel Ruiz-Sánchez Servicio de Endocrinología y Nutrición. Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Hospital Universitario Fundación Jiménez Díaz, Madrid, España
Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España

Search for other papers by Jorge Gabriel Ruiz-Sánchez in
Google Scholar
PubMed
Close
,
Alfonso Luis Calle-Pascual Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
Servicio de Endocrinología y Nutrición. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, España
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, España

Search for other papers by Alfonso Luis Calle-Pascual in
Google Scholar
PubMed
Close
,
Miguel Ángel Rubio-Herrera Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
Servicio de Endocrinología y Nutrición. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, España

Search for other papers by Miguel Ángel Rubio-Herrera in
Google Scholar
PubMed
Close
,
María Paz De Miguel Novoa Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
Servicio de Endocrinología y Nutrición. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, España

Search for other papers by María Paz De Miguel Novoa in
Google Scholar
PubMed
Close
,
Emilia Gómez-Hoyos Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, España

Search for other papers by Emilia Gómez-Hoyos in
Google Scholar
PubMed
Close
, and
Isabelle Runkle Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
Servicio de Endocrinología y Nutrición. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, España

Search for other papers by Isabelle Runkle in
Google Scholar
PubMed
Close

Introduction

Hypoaldosteronism is characterized by hyperkalemia, and/or hypovolemic hyponatremia (HH), often accompanied by metabolic acidosis. HH is typical of hypoaldosteronism, whereas euvolemic hyponatremia (EH) is not. The purpose of the current study is to describe the characteristics of hyponatremia in hypoaldosteronism and elucidate whether EH can be considered part of the disease’s spectrum.

Methods

In a hypoaldosteronism cohort, we analyzed the factors associated with hyponatremia, comparing the characteristics of EH and HH and their associated factors. Correlation analyses of mineralocorticoid biomarkers, such as the transtubular potassium gradient (TTKG), the urinary Na+/K+ ratio (UNa+/UK+) with serum, and urinary electrolytes were performed in both types of hyponatremia.

Results

Of 112 hypoaldosteronism episodes, 77.7% were ≥65 years old, 44.6% were women, and 80 (71.4%) had hyponatremia. Hyponatremia was negatively associated with the presence of chronic kidney disease, and positively with a hypovolemic state, malnutrition, a prior history of hyponatremia, and glucocorticoid therapy. HH: 61/80 and EH: 19/80 episodes. HH was associated with an age ≥65 years and the use of diuretics, as well as factors related to an aldosterone deficit and/or mineralocorticoid resistance. In HH but not in EH, urinary potassium was correlated with the TTKG, and urinary sodium with both the TTKG and the UNa+/UK+.

Conclusion

Both HH and EH can be observed in hypoaldosteronism. However, only the former would be related to insufficient mineralocorticoid activity.

Significance statement

Isolated hypoaldosteronism is a poorly understood and underdiagnosed endocrinological disorder, classically recognized only when hyperkalemia is present. The development of hypovolemic hyponatremia, however, is also easily explained by the physiopathology of the disorder. The current study addresses the features of hyponatremia when found in the context of mineralocorticoid insufficiency, and confirms an association between hypovolemic hyponatremia and isolated hypoaldosteronism. Thus, the clinical spectrum of hypoaldosteronism is extended to include hypovolemic hyponatremia as a frequent manifestation of the disorder.

Open access
Mireille N M van Poppel Institute of Human Movement Sciences, Sport and Health, University of Graz, Graz, Austria

Search for other papers by Mireille N M van Poppel in
Google Scholar
PubMed
Close
,
Christopher J Nolan Department of Endocrinology at The Canberra Hospital and the Australian National University School of Medicine and Psychology, Canberra, ACT, Australia

Search for other papers by Christopher J Nolan in
Google Scholar
PubMed
Close
, and
Gernot Desoye Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria

Search for other papers by Gernot Desoye in
Google Scholar
PubMed
Close

Pancreas agenesis is a rare condition underlying a variant of permanent neonatal diabetes mellitus. Neonates with this condition are born small for gestational age, but less is known about which components of growth are impacted, the timing of the growth restriction and potential sex differences. Our objective was to assess in which periods in gestation complete pancreas agenesis restricts fetal growth and possible sex differences in susceptibility. Published cases (n = 49) with pancreas agenesis providing relevant data (gestational age, fetal sex, birth weight, birth length, head circumference, placental weight) were identified by MEDLINE and secondary literature search covering the years 1950–January 2023. Semiquantitative analysis of these case reports used centiles based on Intergrowth-21 reference charts. Neonates with pancreas agenesis were severely growth restricted; however, median centiles for birth weight, birth length, and head circumference of those born before week 36 were significantly higher compared to those born from 36 weeks. Similar results were found when data were separated by before and from 38 weeks. Head circumference was less affected than birth weight or birth length. No sex differences were found. In conclusion, pancreas agenesis severely restricts fetal length and head circumference in addition to weight growth, with stronger effects evident from 36 weeks of gestation. In addition to the well-known effects of insulin on growth of fetal fat mass, the pronounced effect on birth length and head circumference indicates effects of insulin on fetal lean body growth as well. Lack of power may account for failure to find sex differences.

Significance statement

Neonates with complete pancreas agenesis are born small, but the details of their growth deviation, timing, and potential sex differences remain uncertain. All neonates with pancreas agenesis in our study had reduced birth weight, length, and head circumference, with milder effects in those born before 36 weeks compared to after 36 weeks. This trend persisted when data were separated into before and after 38 weeks, with no discernible sex differences. The absence of the pancreas, and therefore insulin, significantly reduces fetal growth, especially after 36 weeks of gestation. In addition to insulin’s known role in fetal fat mass, our findings suggest it has a substantial influence on birth length and head circumference, underscoring its impact on fetal lean body growth.

Open access
Bogumila Urgatz Merck Healthcare KGaA, Darmstadt, Germany

Search for other papers by Bogumila Urgatz in
Google Scholar
PubMed
Close
and
Kris G Poppe University Hospital CHU Saint Pierre, Free University of Brussels, Brussels, Belgium

Search for other papers by Kris G Poppe in
Google Scholar
PubMed
Close

Hypothyroidism is a relatively common finding during pregnancy. This may be due either to the presence of existing thyroid disease and/or to the increased demands that pregnancy places the thyroid gland to provide thyroid hormones for the mother and the developing fetus. There is no doubt that overt hypothyroidism is associated strongly with adverse pregnancy outcomes, including miscarriage. Meta-analyses show that thyroid hormone replacement with levothyroxine (LT4) reduces the risk of adverse pregnancy outcomes in the setting of overt hypothyroidism. Accordingly, management guidelines in this area are unanimous in recommending intervention with to control the level of thyrotropin (TSH) to below 2.5 μIU/mL. The evidence for an adverse impact of subclinical hypothyroidism (SCH) on pregnancy outcomes is less clear, although meta-analyses suggest that SCH reduces the chance of a successful pregnancy outcome. Guidelines also support intervention for some patients with SCH, particularly where TSH is high (>10 μIU/mL), or where TSH is above its trimester-specific reference range in a woman with thyroid autoimmunity (giving LT4 to euthyroid women with thyroid autoimmunity is not supported). Real-world evidence suggests that hypothyroidism in pregnancy is often overlooked or that LT4 is not given appropriately to gain tight control of TSH. More research is needed to identify the barriers to optimal thyroid care with LT4 at this crucial time.

Open access
Behnaz Abiri Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Search for other papers by Behnaz Abiri in
Google Scholar
PubMed
Close
,
Majid Valizadeh Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Search for other papers by Majid Valizadeh in
Google Scholar
PubMed
Close
,
Amirhossein Ramezani Ahmadi Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Search for other papers by Amirhossein Ramezani Ahmadi in
Google Scholar
PubMed
Close
,
Shirin Amini Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran

Search for other papers by Shirin Amini in
Google Scholar
PubMed
Close
,
Mohammad Nikoohemmat Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Search for other papers by Mohammad Nikoohemmat in
Google Scholar
PubMed
Close
,
Faeze Abbaspour Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Search for other papers by Faeze Abbaspour in
Google Scholar
PubMed
Close
, and
Farhad Hosseinpanah Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Search for other papers by Farhad Hosseinpanah in
Google Scholar
PubMed
Close

Objectives

It has not been established whether vitamin D deficiency is associated with anthropometric state; therefore, this systematic review examined the relationship between serum vitamin D levels with anthropometrics and adiposity across different ages.

Methods

Studies that examined vitamin D deficiency with adiposity measures in different age groups were searched in the PubMed, Scopus, Embase, and Google Scholar databases until November 2023. Two investigators independently reviewed titles and abstracts, examined full-text articles, extracted data, and rated the quality in accordance with the Newcastle–Ottawa criteria.

Results

Seventy-two studies, with a total of 59,430 subjects, were included. Of these studies, 27 cross-sectional studies and one longitudinal study (with 25,615 participants) evaluated the possible link between 25(OH)D serum concentrations and anthropometric/adiposity indices in the pediatric population. Forty-two cross-sectional studies and two cohort investigations (with 33,815 participants) investigated the relationship between serum 25(OH)D levels and adiposity measures in adults and/or the elderly population. There is evidence supporting links between vitamin D deficiency and obesity, and revealed an inverse association between vitamin D and adiposity indicators, specifically in female subjects. However, the effects of several confounding factors should also be considered.

Conclusion

Most published studies, most of which were cross-sectional, reported a negative association between vitamin D and female adiposity indicators. Therefore, serum vitamin D levels should be monitored in overweight/obese individuals.

Open access
Yunyi Ding Y Ding, Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China

Search for other papers by Yunyi Ding in
Google Scholar
PubMed
Close
,
Siyao Lv S Lv, Department of Gastroenterology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310007, China

Search for other papers by Siyao Lv in
Google Scholar
PubMed
Close
,
Ruijie Xie R Xie, Division of Clinical Epidemiology and Aging Research, Heidelberg University, Heidelberg, Germany

Search for other papers by Ruijie Xie in
Google Scholar
PubMed
Close
,
Wei Ye W Ye, Department of Gastroenterology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China

Search for other papers by Wei Ye in
Google Scholar
PubMed
Close
,
Yichen Luo Y Luo, Zhejiang University, Hangzhou, 310058, China

Search for other papers by Yichen Luo in
Google Scholar
PubMed
Close
, and
Yayu Li Y Li, Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China

Search for other papers by Yayu Li in
Google Scholar
PubMed
Close

Objective: The aim of this study was to investigate the relationship between weight-adjusted-waist index and diabetic kidney disease in individuals afflicted with type 2 diabetes.

Methods: Comprehensive data was ascertained from the National Health and Nutrition Examination Survey in 2013-March 2020. Weighted univariate, multivariate logistic regression models, subgroup analyses and tests for interaction were performed. Additionally, we employed smooth curve fitting to assess linear correlations and the threshold effects were calculated by applying a binary linear regression model. Breakpoints are identified by a model with maximum likelihood ratio and a two-step recursive approach. Receiver operating characteristic curve (ROC) along with the area under the curve (AUC) value predict the capability of weight-adjusted-waist index and body mass index for diabetic kidney disease.

Results: A total of 10,661 individuals diagnosed with type 2 diabetes were included, and the overall prevalence of diabetic kidney disease was 20.74%. WWI exhibited a positive correlation with the likelihood of diabetic kidney disease in type 2 diabetes patients (OR: 1.17, 95% CI: 1.03-1.33). The results of subgroup analysis showed significant interaction for gender (P<0.05). Among female patients, U-shaped correlations were observed with a breakpoint at 11.48. Additionally, weight-adjusted-waist index (AUC=0.664) proved to be a more effective predictor of diabetic kidney disease compared to body mass index (AUC=0.555).

Conclusion: In patients with type 2 diabetes, increased weight-adjusted-waist index is implicated with an increased risk of diabetic kidney disease. Weight-adjusted-waist index can be used as a new anthropometric index to predict diabetic kidney disease, and its predictive ability is stronger than body mass index.

Open access
Sofia Maria Lider Burciulescu S Lider Burciulescu, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania

Search for other papers by Sofia Maria Lider Burciulescu in
Google Scholar
PubMed
Close
,
Monica Livia Gheorghiu M Gheorghiu, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania

Search for other papers by Monica Livia Gheorghiu in
Google Scholar
PubMed
Close
,
Andrei Muresan A Muresan, National Institute of Endocrinology C I Parhon, Bucuresti, Romania

Search for other papers by Andrei Muresan in
Google Scholar
PubMed
Close
,
Iuliana Gherlan I Gherlan, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania

Search for other papers by Iuliana Gherlan in
Google Scholar
PubMed
Close
,
Patocs Attila P Attila, National Institute of Oncology, Budapest, 1122, Hungary

Search for other papers by Patocs Attila in
Google Scholar
PubMed
Close
, and
Corin Badiu C Badiu, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania

Search for other papers by Corin Badiu in
Google Scholar
PubMed
Close

Background: Pheochromocytomas (PHEOs) are rare catecholamine-secreting adrenal tumors. Approximately 60-90% of bilateral PHEOs are hereditary. We retrospectively analyzed the clinical characteristics of patients with bilateral PHEOs and the morbidity rate (malignancy, tumor recurrence and adrenal insufficiency rate) related to surgery technique and genetic status of the patients.

Results: Fourteen patients (12.5%, 9 women, 5 men) had synchronous or metachronous bilateral PHEOs (out of 112 PHEO patients who underwent surgery between 1976-2021). Mean age at diagnosis was 35 ± 18.5 years (3 were children). Nine patients (64.2%) presented synchronous bilateral tumors, 5 (35.7%) contralateral metachronous tumors, 2-12 years after the first surgical intervention; 3 (21.4%) were metastatic. Median follow-up: 5 years (1-41), IQR 19 months. 78.5% had a germline mutation (8 RET gene with MEN2A syndrome, 3 VHL syndrome, 3 not tested). Post surgery recurrence was noted in 16.6% of patients (1 with MEN2A syndrome and metastatic PHEOs, 1 with VHL syndrome), with similar rates after total adrenalectomy or cortical-sparing adrenal surgery. Adrenal insufficiency was avoided in 40% after cortical-sparing surgery.

Conclusion: Bilateral PHEOs are usually associated with genetic syndromes. The surgical technique for patients with hereditary bilateral PHEOs should be chosen based on a personalized approach, as they are at higher risk for developing new adrenal tumors requiring additional surgeries.

Open access
Yi Jia Y Jia, Shanghai, 200438, China

Search for other papers by Yi Jia in
Google Scholar
PubMed
Close
,
Yanan Yang Y Yang, Shanghai University of Sport, Shanghai, China

Search for other papers by Yanan Yang in
Google Scholar
PubMed
Close
,
Jing Qu J Qu, Shanghai University of Sport, Shanghai, China

Search for other papers by Jing Qu in
Google Scholar
PubMed
Close
,
Lijun Yin L Yin, Shanghai University of Sport, Shanghai, China

Search for other papers by Lijun Yin in
Google Scholar
PubMed
Close
, and
Xiaohui Wang X Wang, Shanghai University of Sport, Shanghai, China

Search for other papers by Xiaohui Wang in
Google Scholar
PubMed
Close

Adipokine chemerin plays important roles in disorders of glucose and lipid metabolism of obesity and obesity-related diseases, and exercise-induced improvement of glucose and lipid metabolism is closely related to the decrease of chemerin, but the mechanisms by which chemerin regulates glucose and lipid metabolism remain unclarified. Hypotestosterone induces male obesity and disorders of glucose and lipid metabolism through androgen receptor (AR) and its target genes: glucose and lipid metabolism related molecules (including FOXO1, PEPCK, PGC-1α and SCD1). Recently, the link between them has been reported that chemerin modulated the secretion of androgen. In this study, global chemerin knockout [chemerin(-/-)] mice were established to demonstrate the roles of chemerin in regulating blood glucose and blood lipid of mice under diet (high-fat and normal diet) and exercise interventions, then to explore its mechanisms (AR- glucose and lipid metabolism enzymes). We found that the blood lipid and adipocyte size were lowed accompanied with the improvements of the levels of serum testosterone, gastrocnemius AR, and gastrocnemius FOXO1, SCD1 and PGC-1α in HFD chemerin(-/-) mice, but exercise-induced improvements of the above indicators in HFD WT mice were attenuated or abolished in HFD chemerin(-/-) mice. In conclusion, the decrease of chemerin improved blood lipid of HFD male mice at sedentary and exercise states, mediated partly by the increases of testosterone and AR to regulate glucose and lipid metabolism enzymes. To our knowledge, it is the first report about chemerin’s regulation on glucose and lipid metabolism might be mediated by testosterone and AR in vivo.

Open access
Marianna Viukari Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Search for other papers by Marianna Viukari in
Google Scholar
PubMed
Close
,
Helena Leijon Department of Pathology, University of Helsinki and HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland

Search for other papers by Helena Leijon in
Google Scholar
PubMed
Close
,
Tiina Vesterinen Department of Pathology, University of Helsinki and HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland

Search for other papers by Tiina Vesterinen in
Google Scholar
PubMed
Close
,
Sanni Söderlund Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Search for other papers by Sanni Söderlund in
Google Scholar
PubMed
Close
,
Päivi Hämäläinen Department of Internal Medicine, Tampere University Hospital, Tampere, Finland

Search for other papers by Päivi Hämäläinen in
Google Scholar
PubMed
Close
,
Iina Yliaska Medical Research Center Oulu, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland

Search for other papers by Iina Yliaska in
Google Scholar
PubMed
Close
,
Päivi Rautiainen Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland

Search for other papers by Päivi Rautiainen in
Google Scholar
PubMed
Close
,
Reeta Rintamäki Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland

Search for other papers by Reeta Rintamäki in
Google Scholar
PubMed
Close
,
Minna Soinio Department of Endocrinology, Turku University Hospital, Turku, Finland

Search for other papers by Minna Soinio in
Google Scholar
PubMed
Close
,
Ilkka Pörsti Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland

Search for other papers by Ilkka Pörsti in
Google Scholar
PubMed
Close
,
Pasi I Nevalainen Department of Internal Medicine, Tampere University Hospital, Tampere, Finland

Search for other papers by Pasi I Nevalainen in
Google Scholar
PubMed
Close
, and
Niina Matikainen Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Search for other papers by Niina Matikainen in
Google Scholar
PubMed
Close

Objective

The associations between adrenal histopathology, lateralization studies, and surgical outcomes in primary aldosteronism remain poorly characterized. We examined the value of immunohistochemical analysis of CYP11B2 for evaluation of adrenalectomy outcomes after anatomical versus functional subtyping.

Design

A retrospective multicenter study of 277 patients operated for primary aldosteronism who had an adrenalectomy sample available in the Finnish biobanks from 1 January 2000 to 31 December 2019. Adrenal slides from biobanks were analyzed centrally after CYP11B2 and CYP11B1 staining. Clinical data were obtained from patient registries. Histopathological diagnosis and cure after surgery were assessed as outcome measures.

Results

Re-evaluation with CYP11B2 staining changed the histopathological diagnosis in 91 patients (33%). The presence of a CYP11B2-positive adenoma and the use of functional subtyping independently predicted clinical cure of primary aldosteronism. CYP11B2-positive <7 mm nodules were more frequent in patients without clinical cure, whereas CYP11B2-positive micronodules were common in all patients and had no impact on adrenalectomy outcomes. Small CYP11B2-positive nodules and micronodules were equally prevalent regardless of the subtyping method applied. Clinical cure rates were lower and CYP11B2-negative adenomas more common after adrenalectomy based on anatomical imaging than functional studies.

Conclusions

Incorporating CYP11B2 staining in histopathological diagnosis enhances the prediction of surgical outcomes in primary aldosteronism. A finding of CYP11B2-positive adenoma is indicative of cure of primary aldosteronism, whereas smaller CYP11B2-positive nodules associate with poorer results at postoperative evaluation. Functional subtyping methods decrease the operations of CYP11B2-negative adenomas and are superior to anatomical imaging in identifying unilateral primary aldosteronism.

Open access
Xinge Tao Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

Search for other papers by Xinge Tao in
Google Scholar
PubMed
Close
,
Yanbin Xue Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Search for other papers by Yanbin Xue in
Google Scholar
PubMed
Close
,
Rui Niu Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

Search for other papers by Rui Niu in
Google Scholar
PubMed
Close
,
Wenjing Lu Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

Search for other papers by Wenjing Lu in
Google Scholar
PubMed
Close
,
Huayan Yao Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Search for other papers by Huayan Yao in
Google Scholar
PubMed
Close
,
Chunmei He Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

Search for other papers by Chunmei He in
Google Scholar
PubMed
Close
,
Bin Cui Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Search for other papers by Bin Cui in
Google Scholar
PubMed
Close
, and
Changqin Liu Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Xiamen Key Laboratory for Clinical Efficacy and Evidence-Based Research of Traditional Chinese Medicine, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Fujian Province Key Laboratory of Diabetes Translational Medicine, The First Affiliated Hospital of Xiamen University, School of medicine, Xiamen University, Xiamen, China

Search for other papers by Changqin Liu in
Google Scholar
PubMed
Close

Objective

The aim of this study was to compare the differences in incident population, comorbidities, and glucose-lowering drug prescriptions between newly diagnosed patients with early-onset type 2 diabetes mellitus (T2DM) and those with late-onset T2DM to provide real-world evidence for clinical practice.

Methods

This study was based on the Shanghai Hospital Link Database (SHLD). Anonymized electronic medical record (EHR) data from 2013 to 2021 were included in this study. Newly diagnosed patients with T2DM were defined as those without related diagnostic records or glucose-lowering medicine prescriptions in the past 3 years. Early-onset T2DM was defined as patients who were aged 18–40 years old at the first visit for T2DM to represent those who were born after the 1980s. And late-onset T2DM was defined as those aged 65–80 years old to represent those who were born in a relatively undeveloped period. Descriptive statistical analyses were performed to describe their incidence number, glucose-lowering drug prescriptions, and comorbidities at the first visit to the hospital between two T2DM groups.

Results

There were a total of 35,457 newly diagnosed patients with early-onset T2DM and 149,108 newly diagnosed patients with late-onset T2DM included in this study. Patients with late-onset T2DM constituted the majority and their number increased by 2.5% on average by years, while the number of patients with early-onset T2DM remained stable each year. Compared with late-onset T2DM patients, more early-onset T2DM patients had dyslipidemia at the first visit to hospitals (9.5% vs 7.7%, P < 0.01) despite their significant age differences. Patients with early-onset T2DM were more likely to use metformin (74.8% vs 46.5, P < 0.01), dipeptidyl peptidase-4 inhibitors (DDP-4i) (16.7% vs 11.2%, P < 0.01), thiazolidinediones (TZD) (14.9% vs 8.4%, P < 0.01), sodium glucose cotransporter 2 inhibitors (SGLT2-i) (0.8% vs 0.3%, P < 0.01), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) (3.7% vs 0.5%, P < 0.01) at their first visit to the hospital.

Conclusions

Different characteristics were observed between patients with early-onset T2DM and those with late-onset T2DM. Compared with patients with late-onset T2DM, those with early-onset T2DM were more prone to dyslipidemia and had novel organ-protective drugs prescribed.

Open access
Signe Kirkegaard Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

Search for other papers by Signe Kirkegaard in
Google Scholar
PubMed
Close
,
Nanna Maria Uldall Torp Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

Search for other papers by Nanna Maria Uldall Torp in
Google Scholar
PubMed
Close
,
Stig Andersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark

Search for other papers by Stig Andersen in
Google Scholar
PubMed
Close
, and
Stine Linding Andersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

Search for other papers by Stine Linding Andersen in
Google Scholar
PubMed
Close

Endometriosis and polycystic ovary syndrome (PCOS) are common gynecological disorders that constitute a significant burden of disease in women of fertile age. The disorders share a link to female reproduction and infertility; however, divergent effects on menstrual cycle, related hormones, and body composition have been proposed. Disorders of the thyroid gland including abnormal thyroid dysfunction (hyperthyroidism or hypothyroidism) and/or markers of thyroid autoimmunity similarly show a female predominance and onset in younger age groups. We reviewed the literature on the association between endometriosis, PCOS, and thyroid disease up until July 1, 2023, and identified 8 original studies on endometriosis and thyroid disease and 30 original studies on PCOS and thyroid disease. The studies were observational and heterogeneous regarding the design, sample size, and definitions of exposure and outcome; however, a tendency was seen toward an association between hyperthyroidism and endometriosis. Especially an association between endometriosis and slightly elevated levels of thyroid-stimulating hormone receptor antibodies has been found and corroborated in studies from different populations. On the other hand, the literature review turned a focus toward an association between hypothyroidism and PCOS, however, with uncertainties as to whether the association is caused by hypothyroidism per se and/or the thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies). More evidence is needed to substantiate an association between endometriosis, PCOS, and thyroid disease, and to differentiate between the role of thyroid function and thyroid autoimmunity. Furthermore, studies are warranted to extend knowledge on the different disease characteristics and underlying mechanisms.

Open access