Endocrine Practice

OBJECTIVE: To describe clinical characteristics, hormonal profile and body composition of obese men in preoperative of bariatric surgery. METHODS: Cross-sectional, population-based study. Patients evaluated from June 2019 to December 2021 in two obesity referral centers. Patients underwent clinical evaluation, androgen deficiency screening using ADAM (Androgen Deficiency in the Aging Male questionnaire), hormonal profile and body composition assessment through body mass index (BMI), body fat percentage (FM-%) and mass (FM-kg) measured by electrical bioimpedance and dual energy X-ray absorptiometry...

Skeletal modeling in childhood and adolescence and continuous remodeling throughout the lifespan are designed to adapt to a changing environment and resist external forces and fractures. The flux of sex steroids in men and women, beginning from fetal development and evolving through infancy, childhood, puberty, young adulthood, peri/menopause transition, and post-menopause, is critical for bone size, peak bone mass, and the risk for fractures. The contributions of estrogen and testosterone on skeletal development have been difficult to study due to the reciprocal and intertwining contributions of one on the other...

No abstract text is available yet for this article.

BACKGROUND: Recent advancements in diabetes technology have significantly improved Type 1 diabetes (T1D) management, but disparities persist, particularly in the adoption of automated insulin delivery (AID) systems within minoritized communities. We aimed to improve patient access to AID system training and overcome clinical inertia to referral. METHODS: We report on a transformative program implemented at Boston Medical Center, the largest safety-net hospital in New England, aimed at reducing disparities in AID system utilization...

BACKGROUND: The management of secondary hyperparathyroidism in patients undergoing dialysis is debated, with uncontrolled parathyroid hormone (PTH) levels becoming more common despite the expanded use of medical treatments like cinacalcet. This study examines the clinical benefits of parathyroidectomy versus medical treatment in reducing mortality and managing key laboratory parameters in patients undergoing dialysis. METHODS: PubMed, Embase, Cochrane, Scopus, and Web of Science databases were searched for cohort studies or randomized controlled trials published before August 18, 2023...

BACKGROUND: Individuals with hyperthyroidism are at an increased risk of atrial fibrillation (AF), but the association between autoantibodies and AF or cardiovascular mortality in individuals who have returned to normal thyroid function remains unclear. METHODS: The study utilized electronic medical records from National Taiwan University Hospital between 2000 and 2022. Each hyperthyroidism patient had at least one thyrotropin binding inhibiting immunoglobulin (TBII) measurement...

BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) has evolved since it was first introduced in 2009 to become a worldwide accepted cytologic analysis reference, due to its simplicity and reproducibility. To date, the consistency of BSRTC throughout time has yet to be investigated. METHODS: Retrospective single institution case series with chart review of all patients who underwent FNAs for a thyroid nodule in our institution between the years 2010 to 2018 with a documented BSRTC classification...

BACKGROUND: In contrast to adults Primary hyperparathyroidism (PHPT) in children and adolescents, is a rare endocrine disorder. METHODS: A retrospective review of PHPT cases between 2005-2022 from a single tertiary university medical center, including clinical signs and symptoms, laboratory findings, radiological evaluation, treatment, and post-operative complications. RESULTS: Ten children (Mean age at diagnosis 16.3±1.3 years) were diagnosed with PHPT...

Advances in monitoring and treatment of people living with Type 1 Diabetes (T1D) have led to longer life expectancy, but with it an ageing population of T1D patients with age-associated conditions. While diabetic macrovascular, brain, eye, nerve and kidney complications are widely recognized, bone fragility with concomitant fracture has received considerably less attention, even though bone fractures lead to very high morbidity and mortality. Hip fracture risk is up to 6-fold higher in T1D compared to age- and sex-matched non-diabetic controls and is significantly higher than in type 2 diabetes...

OBJECTIVE: To provide a clinical approach towards immune checkpoint inhibitor (ICI)-associated endocrinopathies, their link with cancer outcomes, factors which differentiate them from other immune related adverse events (irAEs), and health systems innovation to improve care for these patients. METHODS: A literature search for articles pertaining to ICIs and endocrinopathies was performed and supplemented by expert opinions of the authors. RESULTS: While irAEs can affect almost any organ, they frequently target the endocrine glands, most commonly thyroid...

OBJECTIVE: This study evaluates the impact of a representative Proton Pump Inhibitor (PPI) (omeprazole), administered simultaneously or staggered, on the pharmacokinetics (PK) of levothyroxine (LT4) solution (Tirosint®-SOL). METHODS: This was a randomized, 3-way crossover, comparative bioavailability study in 36 healthy adults under fasting conditions. Omeprazole 40 mg delayed-release capsule was administered once daily from Day 1 to 6 (mornings, Treatment-A; evenings, Treatment-B; none, Treatment-C) to increase and stabilize gastric pH...

OBJECTIVE: The evidence of thyroid dysfunction in the post-acute phase of SARS-CoV-2 infection is limited. This study aimed to evaluate the risk of incident thyroid dysfunction in the post-acute phase of COVID-19. METHODS: This retrospective, propensity-score matched, population-based study included COVID-19 patients and non-COVID-19 individuals between January 2020 and March 2022, identified from the electronic medical records of the Hong Kong Hospital Authority...

OBJECTIVE: Despite improvements in glucose monitoring technologies, insulin formulations and insulin delivery systems, too many patients with type 1 diabetes continue to struggle to meet their glycemic goals. As a result, they suffer from high rates of microvascular and macrovascular disease. Titration of insulin therapy, while essential to the care of these patients, is often limited by undesirable side effects of hypoglycemia and weight gain. SGLT inhibitors have been proposed as a potential adjunctive therapy to insulin that may offset some of these effects, while simultaneously enabling patients with type 1 diabetes to potentially reap the cardiovascular and renal benefits afforded by these agents in those with type 2 diabetes...

INTRODUCTION: High-resolution ultrasonography devices have led to the increased detection of thyroid nodules and the need for fine-needle aspiration biopsy (FNAB). However, FNAB is an invasive procedure that can cause discomfort and pain. Music therapy has been used for centuries to alleviate pain, and our clinical trial was conducted to investigate its impact on pain scores during thyroid FNAB. MATERIALS AND METHODS: We conducted a randomized, controlled clinical trial, including adult patients undergoing thyroid FNAB...

No abstract text is available yet for this article.

BACKGROUND: Teplizumab has emerged as a potential disease-modifying drug in type 1 diabetes (T1D). This meta-analysis sought to summarize the therapeutic effect of teplizumab in newly diagnosed patients with T1D. METHODS: Randomized controlled trials (RCTs) involving patients with T1D receiving teplizumab in the intervention arm and placebo (or no active intervention) in the control arm were searched throughout the electronic databases. The primary outcome was the change in area under the curve (AUC) of C-peptide levels from baseline...

OBJECTIVE: Malabsorption of levothyroxine (LT4) is often seen in patients with hypothyroidism and gastrointestinal (GI) conditions. Our study was designed to establish the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with hypothyroidism and irritable bowel syndrome (IBS), and to demonstrate that liquid LT4 is more consistently absorbed vs. tablet, leading to improvement in thyroid and GI symptoms. METHODS: This was a single-center, open label, prospective cohort study of liquid LT4 in 75 adult patients with hypothyroidism and IBS...

Incidental radiographic findings of an empty sella are prevalent in up to 35% of the general population. While empty sella was initially considered clinically insignificant, a subset of patients exhibits endocrine or neuro-ophthalmologic manifestations which are diagnostic of empty sella syndrome (ESS). Recent studies suggest that more patients are affected by ESS than previously recognized, necessitating a deeper understanding of this condition and an approach to evaluating and managing these patients. This comprehensive review addresses the etiologies and risk factors associated with primary and secondary empty sella, the radiological features that differentiate empty sella from other sellar lesions, and the role of clinical history and hormone testing in identifying patients with ESS...

BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for type 2 diabetes treatment, have shown potential benefits beyond glycemic control, including a positive impact on blood pressure. This meta-analysis aims to evaluate their effects on patients with type 2 diabetes and hypertension. METHODS: We searched PubMed, Google Scholar, and Cochrane databases for relevant randomized controlled trials (RCTs) published until May 31, 2023. Ten RCTs involving participants with confirmed Type 2 diabetes mellitus were selected...

OBJECTIVE: An alterable risk factor for hyperuricemia is obesity. Additionally, obese persons may have a moderate form of acquired resistance to thyroid hormones. Thyrotropin (TSH), thyroid hormones, and obesity all interact subtly. However, the connection between thyroid hormone sensitivity and hyperuricaemia in obese patients both before and after laparoscopic sleeve gastrectomy (LSG) has not yet been clarified. The objective of our study was to investigate the connection between impaired thyroid hormone sensitivity and elevated uric acid (UA) levels before and after LSG...