J. Endocrinol. Invest. [JOURNAL]
Sun
200 papers
Short- and mid-term efficacy of percutaneous ethanol injection in cystic and predominantly cystic thyroid nodules: systematic review and meta-analysis.
Wolde Sellasie S, Deandrea M, Amendola S … +3 more , Piticchio T, Uccioli L, Trimboli P
J Endocrinol Invest · 2026 Jun · PMID 42301547 · Publisher ↗
OBJECTIVE: To evaluate the short- and mid-term volume reduction rate(VRR) after percutaneous ethanol injection(PEI), at 1,3 and 6 months, in patients with cystic or predominantly cystic thyroid nodules(CNs/pCNs, respecti...
OBJECTIVE: To evaluate the short- and mid-term volume reduction rate(VRR) after percutaneous ethanol injection(PEI), at 1,3 and 6 months, in patients with cystic or predominantly cystic thyroid nodules(CNs/pCNs, respectively), conducting a systematic review and meta-analysis of published data on VRR outcomes across these intervals. DESIGN AND METHODS: A systematic search of articles published up to October 30,2025 identified studies reporting PEI treatment for CNs/pCNs.Characteristics of the study design, CNs/pCNs cohorts, and outcomes of interest(VRR at 1,3 and 6 months of follow up)were extracted.Statistical analysis included a random-effects meta-analysis, assessment of heterogeneity with use of the I statistic, and meta-regression and subgroup analyses to explore potential sources of heterogeneity. RESULTS: Six studies comprising 431 CNs/pCNs were included.The pooled VRRs at 1,3 and 6 months post-PEI were 85.18%(95% CI: 80.72-89.64),91.50%(95% CI: 88.88-94.12) and 93.11%(95% CI: 90.91-95.31),respectively. Stratifying by nodule cystic composition, the VRR at consecutive follow-up time points was significantly different between the 1- and 3-month intervals in both subgroups [CN: VRRs at 1, 3 and 6 months were 91.16% (88.38-93.93), 95.69% (94.16-97.22) and 96.02% (94.16-97.87), respectively; pCN: VRRs at 1,3 and 6 months were respectively 80.19% (77.04-83.33), 87.08% (84.95-89.2) and 90.01%(88.83-91.19)].A secondary meta-regression analysis with baseline mean volume as covariate demonstrated a significant inverse association with VRR at 1 and 3 months in pCN(p = 0.02). CONCLUSION: By providing pooled VRRs for the short- and mid-term follow-up, this meta-analysis should be regarded as an initial step, paving the way for larger, high-quality studies aimed at standardizing the PEI procedure and supporting its incorporation into future dedicated guidelines.
Validation of the Italian version of the hypoparathyroidism patient questionnaire-28 (HPQ-28): a multicenter study.
Arcidiacono F, Sesso G, Prinzi A … +8 more , Barca I, Palermo A, Da Re G, Naciu AM, Tabacco G, Sigglekow H, Frasca F, Malandrino P
J Endocrinol Invest · 2026 Jun · PMID 42301546 · Publisher ↗
PURPOSE: Hypoparathyroidism (HypoPT) is a rare endocrine disorder frequently associated with impaired quality of life. Disease-specific patient-reported outcome measures may help to better characterize symptom burden in...
PURPOSE: Hypoparathyroidism (HypoPT) is a rare endocrine disorder frequently associated with impaired quality of life. Disease-specific patient-reported outcome measures may help to better characterize symptom burden in Hypoparathyroid patients. The Hypoparathyroidism Patient Questionnaire-28 (HPQ-28) was originally developed in German and subsequently validated French. The aim of this study was to validate the Italian version of the HPQ-28 in a multicenter cohort. METHODS: In this cross-sectional study, adult participants were recruited from two tertiary referral centres in Italy. The study population were divided in three groups: patients with chronic postsurgical HypoPT (Group 1), patients with hypothyroidism without HypoPT (Group 2), and healthy controls (Group 3). Structural validity was assessed using confirmatory factor analysis with a weighted least squares mean- and varianceadjusted estimator. Internal consistency was evaluated using Cronbach's alpha and McDonald's omega coefficients. Test-retest reliability was assessed using intraclass correlation coefficients in a subgroup of patients. Construct validity was examined by comparing HPQ-28 scores across clinical groups. RESULTS: A total of 163 participants were included (69 HypoPT patients, 60 hypothyroid patients, and 34 controls). Confirmatory factor analysis supported the original six-factor structure of the HPQ-28, with acceptable goodness-of-fit indices (CFI = 0.933, TLI = 0.924, RMSEA = 0.075, SRMR = 0.081). Internal consistency was satisfactory across domains, with Cronbach's alpha ranging from 0.70 to 0.89 and McDonald's omega from 0.75 to 0.93. Test-retest reliability demonstrated good temporal stability. Patients with HypoPT reported significantly higher symptom burden compared with both hypothyroid patients and healthy controls across several domains. CONCLUSIONS: The Italian version of the HPQ-28 demonstrates good psychometric properties and represents a reliable disease-specific instrument for assessing symptom burden in patients with hypoparathyroidism in both clinical practice and research settings.
Ketogenic diet as a therapeutic intervention for biochemical hyperandrogenism in PCOS women with obesity or overweight: a meta-analytic study.
Maseroli E, Alfaroli C, Cirillo M … +5 more , Ravelli SA, Lambrinoudaki I, Focardi M, Virgili G, Vignozzi L
J Endocrinol Invest · 2026 Jun · PMID 42287532 · Publisher ↗
PURPOSE: To assess whether the Ketogenic Diet (KD) is associated with improvements in biochemical markers of hyperandrogenism in women diagnosed with Polycystic Ovary Syndrome (PCOS) with obesity or overweight. METHODS:...
PURPOSE: To assess whether the Ketogenic Diet (KD) is associated with improvements in biochemical markers of hyperandrogenism in women diagnosed with Polycystic Ovary Syndrome (PCOS) with obesity or overweight. METHODS: A systematic search was conducted in five databases: MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science. Both RCTs and pre-post studies providing data for direct extraction or calculation of mean (SD) changes in the investigated outcomes, published until March 1, 2025, were considered. Protocols included "Very Low" and "Low" Calories KD, and modified KD regimens. The primary outcome was the effect of the KD on total testosterone (TT), Free T (FT) and Sex Hormone Binding Globulin (SHBG) compared to baseline. RESULTS: The KD was found to be associated with a statistically significant reduction in TT (n = 290, Mean Difference [MD] -0.35, CI -0.46; -0.24) and a significant increase in SHBG levels (n = 144, MD 19.50, CI 6.90; 32.11), independently of study design. When considering only RCTs (4 studies), the KD showed a moderate, statistically significant benefit on TT levels compared to the control intervention, with a high heterogeneity (n = 115 vs. 117, SMD -0.284, CI -0.543, -0.035; p = 0.031). Neither the duration of the KD protocol, the change in BMI, the change in fasting insulin levels nor the change in LH/FSH ratio were able to significantly affect the change in TT levels observed over time. In addition, the KD associated with a significant reduction in LH levels (n = 275, MD -3.48, CI -4.71; -2.26) and in the LH/FSH ratio (n = 275, MD -0.99, CI -1.44; -0.54). CONCLUSION: Our meta-analysis indicates a reduced biochemical hyperandrogenism-particularly a reduction in TT-and a reduction in the LH/FSH ratio among women with PCOS following a KD. Our findings also suggest a specific effect of ketosis on ovarian function acting alongside metabolic improvements, but a direct causal link cannot be definitively established. Owing to the low quality and heterogeneous nature of the available studies, larger, high-quality RCTs are essential to consolidate this evidence and determine clinical efficacy.
The association of high-sensitivity C-reactive protein levels and their changes with heart failure in Chinese diabetes patients.
Liu P, Chen S, Li M … +2 more , Wang Y, Wang Y
J Endocrinol Invest · 2026 Jun · PMID 42287531 · Publisher ↗
OBJECTIVE: To investigate the associations of baseline high-sensitivity C-reactive protein (hs-CRP), hs-CRP trajectories, and cumulative hs-CRP (CumCRP) exposure with the risk of incident heart failure (HF) in individual...
OBJECTIVE: To investigate the associations of baseline high-sensitivity C-reactive protein (hs-CRP), hs-CRP trajectories, and cumulative hs-CRP (CumCRP) exposure with the risk of incident heart failure (HF) in individuals with diabetes. METHODS: We analyzed 18,269 patients with diabetes from the Kailuan Study who were free of HF and cancer at baseline (2006-2012). Baseline hs-CRP was categorized into quartiles (Q1-Q4), with a separate group for hs-CRP values > 20 mg/L. Repeated measurements were used to identify long-term trajectories via group-based trajectory modelling and calculate time-weighted cumulative hs-CRP after excluding participants with hs-CRP > 20 mg/L. Fine-Gray subdistribution hazard models were employed to estimate adjusted hazard ratios (HRs) for incident HF. RESULTS: Over a mean follow-up of 9.66 ± 2.85 years, 826 HF occurred. Compared with baseline hs-CRP quartile (Q1), the HRs for HF increased across higher quartiles and in the > 20 mg/L group were 1.22 (95% CI 0.98-1.52) for Q2, 1.25 (1.00-1.55) for Q3, 1.42 (1.15-1.76) for Q4, and 1.68 (1.24-2.28) for hs-CRP > 20 mg/L group. In longitudinal analyses, the high-decreased (HR:1.65; 95% CI:1.32-2.06) and moderate-fluctuated (HR:1.48; 95% CI:1.07-2.04) trajectories were associated with significantly higher HF risk than the low-stable pattern. Similarly, the highest CumCRP quartiles were associated with increased HF risk with HR (95% CI) of 1.33 (1.08-1.64) for Q3, and 1.47 (1.19-1.82) for Q4 compared to Q1. CONCLUSIONS: In this large cohort of patients with diabetes, higher baseline hs-CRP, greater cumulative hs-CRP exposure, and hs-CRP trajectories characterized by earlier elevation were independently associated with increased risk of incident HF. These findings highlight the importance of monitoring long-term inflammatory burden for HF risk stratification in diabetes.
Thiazide therapy in chronic hypoparathyroidism: effects on hypercalciuria and renal function-a systematic review and exploratory meta-analysis.
Jha V, Venkateswarlu M, Shaharyar A … +3 more , Bhadada SK, Mukherjee S, Dutta P
J Endocrinol Invest · 2026 Jun · PMID 42287530 · Publisher ↗
PURPOSE: Chronic hypoparathyroidism is associated with impaired renal calcium reabsorption, resulting in persistent hypercalciuria and increased risk of nephrolithiasis, nephrocalcinosis, and chronic kidney disease. Thia...
PURPOSE: Chronic hypoparathyroidism is associated with impaired renal calcium reabsorption, resulting in persistent hypercalciuria and increased risk of nephrolithiasis, nephrocalcinosis, and chronic kidney disease. Thiazide diuretics are commonly used to reduce urinary calcium excretion; however, evidence regarding their efficacy and renal safety remains limited. This study aimed to evaluate the effects of thiazide therapy on hypercalciuria and renal outcomes in patients with chronic hypoparathyroidism. METHODS: A systematic search of PubMed/MEDLINE, Embase, Scopus, and Cochrane CENTRAL was conducted from inception to January 2026. Randomized and observational studies assessing thiazide therapy in adults with chronic hypoparathyroidism were included. Meta-analysis was performed using a random-effects model, with outcomes expressed as standardized mean differences (SMDs). RESULTS: Four studies involving 64 participants were included, comprising three physiological interventional studies and one randomized crossover trial. Two studies (n = 26) were eligible for quantitative synthesis. Meta-analysis showed no statistically significant reduction in urinary calcium excretion (SMD - 0.42; 95% CI - 4.64 to 3.80), with substantial imprecision. Qualitative evidence, including one randomized crossover trial, suggested reductions in urinary calcium excretion with thiazide therapy; however, pooled quantitative estimates remained inconclusive, and overall certainty of evidence was limited by small sample sizes, methodological heterogeneity, and short follow-up durations. Renal function remained stable across studies. CONCLUSION: Current evidence suggests a possible reduction in urinary calcium excretion with thiazide therapy in chronic hypoparathyroidism; however, certainty remains low due to limited heterogeneous data and reliance on predominantly small physiological studies with only one randomized crossover trial. Quantitative pooled estimates were inconclusive, and definitive efficacy or long-term renal benefit remain unproven. Larger, well-designed prospective studies are needed to confirm efficacy and establish long-term renal safety. TRIAL REGISTRATION NUMBER: PROSPERO: CRD420261323680.
Impact of concordance between basal LH/FSH ratio and testosterone levels on pregnancy outcomes in patients with PCOS undergoing IVF-ET cycle: a retrospective cohort study.
Xu H, Li J, Yin SQ … +7 more , Chen Q, Tian J, Chen X, Zhang X, Li X, Diao H, Zhang Y
J Endocrinol Invest · 2026 Jun · PMID 42287529 · Publisher ↗
OBJECTIVE: To investigate the association of testosterone levels on ovarian stimulation response in PCOS patients-stratified by serum LH/FSH ratio-undergoing IVF-ET. METHODS: A total of 1,354 PCOS patients who underwent...
OBJECTIVE: To investigate the association of testosterone levels on ovarian stimulation response in PCOS patients-stratified by serum LH/FSH ratio-undergoing IVF-ET. METHODS: A total of 1,354 PCOS patients who underwent fresh embryo transfer were ultimately included in the study. we analyzed and classified it according to the basal LH/FSH ratio values into the following groups: the LH/FSH ≥ 2 group (412 cases) and the LH/FSH < 2 group (942 cases). According to the value of basal serum T level, there were 488 cases in the high T group (> 0.75 ng/ml) and 866 cases in the non-high T group (≤ 0.75 ng/ml), and the outcomes of embryo transfer cycles were compared among the patients in each group. RESULTS: Based on the LH/FSH ratio and testosterone (T) levels, patients were divided into four groups: Group A (LH/FSH < 2, T ≤ 0.75 ng/ml), Group B (LH/FSH < 2, T > 0.75 ng/ml), Group C (LH/FSH ≥ 2, T ≤ 0.75 ng/ml), and Group D (LH/FSH ≥ 2, T > 0.75 ng/ml). There were no statistically significant differences in embryo quality among the four groups (P > 0.05). Regarding pregnancy outcomes, Group B had the lowest live birth rate (51.56%), which was significantly lower than those of Group A (61.87%), Group C (59.79%), and Group D (68.10%)(P ≤ 0.05). Meanwhile, Group B had the highest miscarriage rate (22.38%), significantly higher than the other three groups (10.98%, 12.43%, and 12.90%) (P ≤ 0.05). After adjusting for confounding factors, logistic regression analysis using Group A as the reference showed that Group B had a significantly increased risk of miscarriage (OR = 2.200, 95% CI = 1.325-3.653, P = 0.002) and a significantly lower live birth rate (OR = 0.719, 95% CI = 0.520-0.994, P = 0.046). CONCLUSION: In patients with PCOS, a high LH/FSH ratio accompanied by elevated testosterone levels was not strongly associated with the likelihood of achieving a live birth. However, in the subgroup with an LH/FSH ratio ≤ 2, elevated testosterone levels may be associated with a reduced likelihood of live birth and an increased risk of miscarriage.
Altered serum amylin and preptin levels in women with polycystic ovary syndrome: a comparative analysis based on obesity status.
Nasralddin LM, Ahmad SM
J Endocrinol Invest · 2026 Jun · PMID 42287528 · Publisher ↗
BACKGROUND: Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder frequently associated with insulin resistance. Amylin and preptin, peptides secreted by pancreatic β cells, are major contributors to insuli...
BACKGROUND: Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder frequently associated with insulin resistance. Amylin and preptin, peptides secreted by pancreatic β cells, are major contributors to insulin secretion and glucose homeostasis. This study assessed serum amylin and preptin concentrations in women with PCOS and evaluated their associations with anthropometric, metabolic, and reproductive parameters. MATERIALS AND METHODS: This prospective, case-control study included females of reproductive age with PCOS and age-matched healthy controls. Participants were classified as obese and non-obese. Serum amylin and preptin were measured using ELISA, whereas hormonal and biochemical parameters were assessed using standard automated laboratory assays. RESULTS: Women with PCOS exhibited markedly reduced circulating concentrations of amylin and preptin compared with the control group. Amylin levels were consistently lower regardless of obesity status, whereas the reduction in preptin was more pronounced in non-obese individuals. A positive correlation between the two peptides was observed across all groups, with stronger associations in the control subjects. In women with PCOS, both peptides demonstrated only modest correlations with fasting glucose, insulin, HOMA-IR, and QUICKI. Despite these reductions, HOMA-β values were significantly elevated in PCOS, suggesting preserved or compensatory β-cell activity. In addition, women with PCOS showed adverse anthropometric and lipid profiles, along with increased luteinizing hormone, testosterone, and LH/FSH ratio. CONCLUSION: The combined assessment of amylin and preptin suggests alterations in β-cell-derived peptide secretion in PCOS that are not solely explained by adiposity. Notably, these changes occurred despite significantly elevated HOMA-β values, indicating preserved or compensatory β-cell activity. Together, these findings suggest differential regulation of β-cell peptides in PCOS, although the underlying mechanisms require further investigation.
Changes overtime in primary and secondary empty sella: a comparative real-world study.
Bacchi N, Paglia F, Caccin V … +7 more , Madeo B, Margiotta G, Decaroli MC, Monzani ML, Diazzi C, De Vincentis S, Rochira V
J Endocrinol Invest · 2026 Jun · PMID 42258025 · Publisher ↗
PURPOSE: Primary (PES) and Secondary (SES) Empty Sella (ES) show similar radiological appearances, but they may be associated with variable degrees of pituitary dysfunction. Long-term comparative data are limited. This s...
PURPOSE: Primary (PES) and Secondary (SES) Empty Sella (ES) show similar radiological appearances, but they may be associated with variable degrees of pituitary dysfunction. Long-term comparative data are limited. This study aimed to compare baseline and longitudinal endocrine outcomes of PES and SES in a large single-center cohort. METHODS: We conducted a retrospective, longitudinal study including adults with ES followed at a tertiary endocrinology center between 2007 and 2025. ES was classified as PES or SES based on clinical history. Clinical and neuroradiological features, comorbidities, and pituitary hormonal assessments were collected at baseline and during follow-up. RESULTS: A total of 258 participants were included (64.3% women; median age 51.5 years; median follow-up 58.5 months). PES was more prevalent than SES (61.6% vs. 38.4%). At baseline, 41.1% of patients had at least one pituitary hormone deficiency, significantly more frequent in SES than PES (62.6% vs. 27.7%), with gonadotropic deficiency the most common alteration. During follow-up, pituitary function remained stable in most PES patients (83.3%), with a very low incidence of new deficiencies. In contrast, SES showed a significantly higher risk of developing new corticotropic, thyrotropic, and gonadotropic deficiencies. Arginine vasopressin deficiency occurred exclusively in SES. CONCLUSION: In this large longitudinal cohort, PES and SES showed distinct clinical and endocrine evolution. While PES was generally stable course over time, SES was associated with a higher risk of progressive pituitary dysfunction. These findings support systematic baseline endocrine evaluation in all ES patients and a tailored follow-up strategy, with closer surveillance for SES.
Prevalence of osteosarcopenia in postmenopausal women: a systematic review and meta-analysis.
Yu KQ, Ye TT, Zhao WQ
J Endocrinol Invest · 2026 Jun · PMID 42258024 · Publisher ↗
BACKGROUND: Osteosarcopenia (OSP) is defined as the coexistence of osteoporosis (OP) and sarcopenia (SP), and is associated with increased risks of falls, fractures, and frailty. Postmenopausal women are particularly sus...
BACKGROUND: Osteosarcopenia (OSP) is defined as the coexistence of osteoporosis (OP) and sarcopenia (SP), and is associated with increased risks of falls, fractures, and frailty. Postmenopausal women are particularly susceptible due to estrogen deficiency, however, its overall prevalence in this population remains unclear. METHODS: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251142908). PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to 15 October 2025. Eligible studies reported OSP prevalence (or data enabling its calculation) in postmenopausal women, with OP and SP defined by recognized criteria (WHO, EWGSOP, AWGS or equivalents). Two reviewers independently performed study selection, data extraction, and quality assessment using the JBI checklist. Pooled prevalence was estimated using generalized linear mixed models and random-effects meta-analysis with Hartung-Knapp-Sidik-Jonkman adjustment. Heterogeneity, influence analyses, publication bias, and exploratory subgroup analyses by diagnostic criteria, economic level, geographic region, and population source were conducted. Meta-regression evaluated the effect of mean age. RESULTS: Sixteen studies involving 7,631 postmenopausal women and 1,421 OSP cases were included. The pooled prevalence of OSP was 15.6% (95% CI: 9.6-24.3%; I²=97.1%). Using consistent criteria, prevalence was 20.1% (95% CI: 10.7-34.4%) for WHO + AWGS 2019 and 12.7% (95% CI: 2.3-47.5%) for WHO + EWGSOP 2018. Exploratory subgroup analyses showed higher prevalence estimates in developing versus developed regions (18.0% vs. 12.7%), Asian versus non-Asian countries (18.7% vs. 8.2%), and hospital-based versus community-based populations (26.4% vs. 8.7%). No significant study-level association between mean age and OSP prevalence was observed in meta-regression analyses based on the 14 studies with available mean age data. Most studies were of high quality, and no significant publication bias was detected. CONCLUSION: This meta-analysis found a pooled OSP prevalence of 15.6% among postmenopausal women across included studies. Given high heterogeneity, this estimate should be interpreted with caution, as it reflects diverse settings and diagnostic approaches. Exploratory subgroup analyses suggested higher prevalence in developing regions, Asian populations, and hospital‑based settings. Standardized criteria and integrated bone‑muscle assessment may improve early identification and management of OSP in this high-risk population.
Management of gynecomastia in adolescence and adults: the clinical practice guidelines from the Italian Society of Andrology and Sexual Medicine (SIAMS).
Pozza C, Selice R, Barbonetti A … +7 more , Hasenmajer V, Lotti F, Menafra D, Pasquali D, Sansone A, Isidori AM, Rochira V
J Endocrinol Invest · 2026 Jun · PMID 42258023 · Publisher ↗
PURPOSE: Gynecomastia, defined as thebenign proliferation of male breast glandular tissue, is a common condition in both adolescence and adulthood, often associated with physical discomfort and psychological distress. De...
PURPOSE: Gynecomastia, defined as thebenign proliferation of male breast glandular tissue, is a common condition in both adolescence and adulthood, often associated with physical discomfort and psychological distress. Despite its high prevalence, clinical management is frequently inconsistent and lacks standardized, evidence-based recommendations. METHODS: The Italian Society of Andrology and Sexual Medicine (SIAMS) convened a multidisciplinary expert panel to develop updated clinical practice guidelines for the evaluation and management of gynecomastia. Recommendations were formulated based on a systematic review of the available literature and developed through expert consensus according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. The document was critically reviewed and approved by the SIAMS Executive Committee. RESULTS: The guidelines address physiological, pharmacological, pathological, congenital, and genetic forms of gynecomastia, providing a structured diagnostic and therapeutic approach. Clinical assessment, including detailed history and examination, is the cornerstone of diagnosis, and should be complemented by targeted hormonal and imaging investigations when appropriate. Observation is recommended for physiological or recent-onset cases. Pharmacological therapy may be considered in selected idiopathic or painful forms, whereas testosterone replacement should be restricted to men with proven hypogonadism. Surgery is indicated for long-standing fibrotic gynecomastia or significant psychological distress. Psychological support is also advised, especially for adolescents. CONCLUSIONS: These SIAMS Guidelines provide an evidence-based, standardized framework for the diagnosis and management of gynecomastia, promoting individualized, multidisciplinary care and identifying priorities for future research.
Liver steatosis and fibrosis in acromegaly patients with active and controlled disease: a scoping review.
Sagan KP, Lipiec-Rzepecka Z, Patalong-Wójcik M … +3 more , Wasilewicz MP, Andrysiak-Mamos E, Syrenicz A
J Endocrinol Invest · 2026 Jun · PMID 42240753 · Publisher ↗
PURPOSE: Excess growth hormone, as encountered in acromegaly, promotes insulin resistance and enhances adipose tissue lipolysis. This study aimed to summarize the currently available data on the prevalence of hepatic ste...
PURPOSE: Excess growth hormone, as encountered in acromegaly, promotes insulin resistance and enhances adipose tissue lipolysis. This study aimed to summarize the currently available data on the prevalence of hepatic steatosis and liver fibrosis in patients with acromegaly. The secondary objective was to map the studies on the influence of treatment modalities on hepatic outcomes in this population. METHODS: This scoping review was conducted following the PRISMA-ScR guidelines. We performed a systematic literature search across two electronic databases: PubMed and Web of Science from their inception to the 4th of April 2026. In addition, articles were identified through manual searches using Google Scholar and citation tracking. Peer-reviewed original journal articles evaluating hepatic steatosis, fibrosis, and intracellular hepatic lipid (IHL) content in patients with acromegaly were included. Studies that did not utilize radiological methods and case reports were excluded. Results were synthesized narratively and summarized in tables. RESULTS: Twenty-one original studies were included. High heterogeneity was observed among the studies, including study models, imaging methods, patient populations, and outcomes. The data presented in this literature review reveal a pattern of lower IHL content in active acromegaly patients but a higher likelihood of liver fibrosis compared with controls. Control of acromegaly may be associated with a rise in IHL content. CONCLUSIONS: IHL content and hepatic fibrosis in patients with acromegaly may be influenced by disease control status and treatment modalities. Further high-quality studies are required to assess the risk of liver steatosis and fibrosis in this patient population.
Diagnostic classification and medical decision of idiopathic asthenozoospermia based on metabolomics analysis of seminal plasma.
Zhang C, Zhou X, Zhu L … +1 more , Shi L
J Endocrinol Invest · 2026 Jun · PMID 42240752 · Publisher ↗
BACKGROUND: Idiopathic asthenozoospermia(IA) is diagnosed when decreased or absent sperm motility is observed without an identifiable cause through standard clinical evaluations. So far, there have been no reports on the...
BACKGROUND: Idiopathic asthenozoospermia(IA) is diagnosed when decreased or absent sperm motility is observed without an identifiable cause through standard clinical evaluations. So far, there have been no reports on the metabolomic classification of IA. METHODS: Seminal plasma metabolites were profiled using gas chromatography-mass spectrometry (GC-MS) in 52 healthy controls and 50 patients with IA. Non-negative matrix factorization (NMF) was applied to 62 identified metabolites to classify IA cases into metabolic subtypes, followed by multivariate analyses to characterize the metabolic dysregulation patterns across clusters. RESULTS: NMF identified three distinct IA subtypes with progressively dysregulated metabolic profiles. Eight core metabolites, including citric acid and cholesterol, were consistently altered across all clusters, suggesting shared pathophysiological mechanisms. Cluster 1 showed 10 unique differential metabolites, particularly reduced inositol levels. Cluster 2 was characterized by significantly higher glucose levels compared with other asthenozoospermia cases. Cluster 3 displayed markedly elevated pyruvate levels as a key metabolic feature. CONCLUSION: This study provides the first NMF-based metabolomic classification of IA, revealing heterogeneous metabolic signatures among patients. These findings may support refined diagnostic classification and more rational clinical drug use for IA.
Aldosterone-related biochemical phenotypes in adrenal incidentalomas: clinical relevance in a cohort including normotensive patients.
Idrobo C, Reincke M, Aguilar-Monserrate G … +1 more , Araujo-Castro M
J Endocrinol Invest · 2026 Jun · PMID 42234347 · Publisher ↗
BACKGROUND: Current guidelines recommend screening for primary aldosteronism (PA) only in patients with hypertension and/or hypokalemia. However, recent evidence raises the question of whether normotensive patients with...
BACKGROUND: Current guidelines recommend screening for primary aldosteronism (PA) only in patients with hypertension and/or hypokalemia. However, recent evidence raises the question of whether normotensive patients with adrenal incidentalomas (AIs) might also exhibit biochemical features of aldosterone dysregulation. This study aimed to evaluate the prevalence and clinical significance of aldosterone-related abnormalities in normotensive patients with AIs. METHODS: We retrospectively analyzed 452 patients with AIs, of whom 202 were normotensive. Hormonal evaluation included plasma aldosterone concentration (PAC) and either plasma renin activity or concentration. The aldosterone-to-renin ratio (ARR) was considered elevated if > 20 when calculated with plasma renin activity or > 1.8 when using direct renin concentration. We performed comparative analyses according to blood pressure (BP) status, PAC, ARR, and combined aldosterone phenotypes (PAC > 10 ng/dL with elevated ARR, PAC > 10 ng/dL with normal ARR, and PAC ≤ 10 ng/dL with elevated ARR). Median follow-up was 3 years. RESULTS: Normotensive patients had a median age of 57 years (IQR 14), and 46.3% were male. Among them, 44.8% had PAC > 10 ng/dL and 33.3% had an elevated ARR. Serum potassium levels were within the normal range (median 4.3 mmol/L, IQR 0.5). In normotensive patients, no significant differences in systolic or diastolic BP were observed according to PAC or ARR alone. In the overall cohort, diastolic BP was higher in patients with elevated ARR. Importantly, diastolic BP differed significantly across combined aldosterone phenotypes (p = 0.015), with higher values observed in patients with PAC > 10 ng/dL and elevated ARR compared with those with PAC > 10 ng/dL and normal ARR (adjusted p = 0.048). During follow-up, incident hypertension was numerically higher among ARR-positive normotensive patients (18.4% vs. 11.0%), although this difference did not reach statistical significance (p = 0.215). A total of 10 patients were diagnosed with confirmed PA, including two normotensive individuals. CONCLUSION: Biochemical evidence of aldosterone dysregulation is common in patients with AIs, including normotensive individuals. While isolated elevations in PAC or ARR were not associated with significant BP differences, the coexistence of elevated PAC and ARR identified a subgroup with a more pronounced hemodynamic profile. These findings support the concept of a continuum of aldosterone excess and suggest that combined biochemical phenotypes may be more informative than isolated markers. Further prospective studies are needed to clarify the clinical implications of these findings and to define optimal screening strategies in this population.
Correction: Evaluation of sex hormone profile and semen parameters in acromegalic male patients.
Yilmaz MK, Sulu C, Ozkaya HM … +3 more , Kadioglu A, Ortac M, Kadioglu P
J Endocrinol Invest · 2026 Jun · PMID 42223911 · Publisher ↗
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The Goiter of Nan: Historical iodine deficiency through Lanna mural art.
Sriphrapradang C
J Endocrinol Invest · 2026 Jun · PMID 42223910 · Publisher ↗
Abstract loading — click title to view on PubMed.
Clinical and genetic insights into Autosomal Dominant Hypocalcemia type 1: a single-center case series including genotype-phenotype correlations, pregnancy outcomes, and novel CASR variants.
Della Valentina S, Pierotti L, Sardella C … +7 more , Dal Lago A, Pardi E, Michelucci A, Caligo MA, Piaggi P, Rossi P, Cetani F
J Endocrinol Invest · 2026 Jun · PMID 42223909 · Publisher ↗
PURPOSE: The main purpose of this study was to provide a comprehensive characterization of adult patients with Autosomal Dominant Hypocalcemia type 1 (ADH1), focusing on clinical and biochemical features, with particular...
PURPOSE: The main purpose of this study was to provide a comprehensive characterization of adult patients with Autosomal Dominant Hypocalcemia type 1 (ADH1), focusing on clinical and biochemical features, with particular attention to renal involvement, skeletal features and ectopic calcifications. The secondary aims were to explore potential genotype-phenotype correlations, describe two previously unreported CASR variants, and report pregnancy outcomes in affected women. METHODS: We conducted a retrospective, single-centre study of 11 adults with genetically confirmed ADH1 followed at a tertiary Endocrinology Unit between March 2012 and May 2025. Clinical presentation, biochemical data, renal and cerebral involvement, skeletal status and treatment history were collected at first evaluation and during follow-up. CASR variants were identified by next-generation sequencing with Sanger confirmation, and genotype-phenotype relationships were explored. RESULTS: At diagnosis, 64% of patients reported hypocalcemia-related symptoms, while 36% were asymptomatic. Nephrolithiasis, nephrocalcinosis and basal ganglia calcifications were frequent, in patients exposed to long-term calcium and active vitamin D therapy, although causal relationships cannot be established. Axial BMD was normal or increased, whereas radial BMD was often reduced and bone turnover markers were low-normal; no fragility fractures were documented. We identified two novels CASR missense variants and observed marked intra- and interfamilial variability. Four pregnancies in three women with ADH1 resulted in favourable maternal and neonatal outcomes. CONCLUSIONS: In our ADH1 patients we found a wide clinical variability, from asymptomatic hypocalcemia to severe early-onset disease, with a high burden of renal complications and ectopic calcifications. Genotype alone does not fully predict clinical severity, even for the same CASR variant. Pregnancies can have good outcomes under close biochemical monitoring and tailored therapy but should be managed as high-risk.
Portrait of Lili Elbe born Einer Wegener.
Trimarchi F, Martino E, Bartalena L
J Endocrinol Invest · 2026 Jun · PMID 42223908 · Publisher ↗
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Differential associations of traditional and shape-based adiposity indices with steatosis and fibrosis risk in metabolic dysfunction-associated steatotic liver disease.
Geraci G, Paternò V, Vitello A … +13 more , Maida M, Bonomo F, Sanfilippo S, Argento S, Maida C, Cassataro G, Baratta R, Costanzo G, Pallotti F, Geraci C, Esposito R, Polosa R, Ferrara P
J Endocrinol Invest · 2026 Jun · PMID 42223907 · Publisher ↗
BACKGROUND: Traditional anthropometric indices reflect total body adiposity, whereas novel shape-based indices capture fat distribution and unfavorable adiposity. How these measures relate to hepatic steatosis and fibros...
BACKGROUND: Traditional anthropometric indices reflect total body adiposity, whereas novel shape-based indices capture fat distribution and unfavorable adiposity. How these measures relate to hepatic steatosis and fibrosis risk across the spectrum of metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. METHODS: In this cross-sectional study, 222 patients with MASLD were included. Body mass index (BMI), waist circumference (WC), a body shape index (ABSI) and body roundness index (BRI) were evaluated. Hepatic steatosis was assessed by ultrasonography using the Bright Liver Echo Pattern (BLEP), while fibrosis risk was estimated using the Fibrosis-4 (FIB-4) index. RESULTS: BMI, WC, and BRI were higher in individuals with moderate-to-severe hepatic steatosis (BLEP ≥ 2), whereas ABSI did not differ according to steatosis severity. In multivariable logistic regression, BMI was independently associated with BLEP ≥ 2 (OR 1.19; 95% CI 1.05-1.35; p = 0.006), together with fasting glucose. ABSI showed a positive correlation with FIB-4 (r = 0.248; p < 0.001), whereas BMI did not. In multivariable linear regression, ABSI remained independently associated with FIB-4 (β = 0.145; p = 0.017), while BMI and BRI were not. Receiver operating characteristic analyses showed that BMI and WC best discriminated moderate-to-severe steatosis, whereas ABSI demonstrated the highest accuracy for identifying advanced fibrosis risk (FIB-4 ≥ 2.67; AUC 0.714; p = 0.004). CONCLUSIONS: Traditional and shape-based anthropometric indices capture complementary aspects of MASLD. Integrating measures of total adiposity and body shape may improve risk stratification in MASLD, although findings require confirmation using direct measures of liver fibrosis.
Establishment of a reference range for hair cortisol using a HPLC-MS/MS method in a Northern Italian population.
Fortuna F, Lanno A, Magrin D … +7 more , Locatelli A, Gonzalez D, Jacobsen D, Jamardo J, Fabre B, Passoni A, Bagnati R
J Endocrinol Invest · 2026 May · PMID 42189485 · Publisher ↗
PURPOSE: Hair cortisol concentration (HCC) represents a promising biomarker for long-term hypothalamic-pituitary-adrenal (HPA) axis activity. However, its routine clinical application is currently limited by the lack of...
PURPOSE: Hair cortisol concentration (HCC) represents a promising biomarker for long-term hypothalamic-pituitary-adrenal (HPA) axis activity. However, its routine clinical application is currently limited by the lack of well-established reference ranges. We aimed to establish population-based reference intervals for HCC in healthy adults from Northern Italy, using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method following the Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. METHODS: Hair samples were collected from 256 healthy volunteers selected using strict inclusion and exclusion criteria. Cortisol quantification was performed by LC-MS/MS using a deuterated internal standard, guaranteeing high sensitivity and specificity. The method was validated for linearity, limit of detection, extraction efficiency, matrix effect, robustness across different sample weights, and inter-batch reproducibility using an internal quality control sample. Reference intervals were defined nonparametrically (2.5th-97.5th percentiles). Associations with demographic, clinical, and lifestyle variables were assessed. RESULTS: The established reference interval was 0.84 to 8.07 pg/mg, with a median of 2.41 pg/mg. HCC was significantly associated with body mass index (ρ = 0.160, p = 0.010) and weakly correlated with perceived stress (ρ = 0.137, p = 0.028). However, no significant associations were observed with sex, age, smoking status, alcohol consumption, physical activity, hair dyeing, or hair washing frequency. CONCLUSION: This study provides, for the first time, a population-based reference interval for hair cortisol concentrations using LC-MS/MS in healthy adults. These findings offer a benchmark for future research, supporting the use of HCC as a biomarker in epidemiological and translational research contexts.
fNIRS estimates prefrontal cortex activation following glucose load in youths with obesity.
Scozia G, Menghini D, Lasaponara S … +9 more , Aureli A, Carducci C, Quaresima V, Isabella R, Doricchi F, Vicari S, Cianfarani S, Fintini D, Manco M
J Endocrinol Invest · 2026 May · PMID 42189484 · Publisher ↗
PURPOSE: The prefrontal cortex [PFC] is crucial in controlling food-related impulses. Functional near-infrared spectroscopy [fNIRS] represents a wearable functional neuroimaging technology for measuring PFC activation in...
PURPOSE: The prefrontal cortex [PFC] is crucial in controlling food-related impulses. Functional near-infrared spectroscopy [fNIRS] represents a wearable functional neuroimaging technology for measuring PFC activation in real life. Aims of the study were to examine PFC activation in fasting conditions and after an oral glucose tolerance test [OGTT] in resting- state [R], cognitive tasks [Ts] conditions and explore the PFC activation relationship with insulin sensitivity index [ISI] in youths with obesity. METHODS: 28 patients' cross-sectional study [age 7-15 y]. ISI was quantified by Matsuda's Index and PFC activation as oxygenated [OHb, mol/L] and total [tHb, mol/L] hemoglobin concentration changes, in fasting and during the first 60 min of the OGTT; in resting-state condition and during cognitive tasks [Ts: Verbal Fluency, Digit Span, Non-Verbal Stroop] administered before [Fasting-Ts], and 15 min after OGTT [OGTT-Ts]. 15 min OGTT-R was divided into 5 time periods [P1-P2-P3-P4-P5], and cognitive tasks [OGTT-Ts] were then administered again. RESULTS: Dorsolateral PFC [DLPFC] and right frontal pole were over-activated in OGTT compared to the fasting state. Significant differences [p < 0.005, false discovery rate corrected] were observed: P2 [OHb Left DLPFC Fasting-R: 1.4710 vs OGTT-R: 4.1310 mol/L], P3 [tHb Right DLPFC Fasting-R: 1.1510 vs OGTT-R: 3.3610 mol/L], and P5 [ OHb Left DLPFC Fasting-R: 1.4710 vs OGTT-R: 4.3410 mol/L, tHb Right DLPFC Fasting-R: 1.1510 vs OGTT-R: 3.0710 mol/L]. The change of left DLPFC activity correlated significantly with ISI [r = 0.61, p < 0.001]. CONCLUSION: fNIRS enabled the non-invasive examination of the PFC hemodynamic response associated with participants' insulin sensitivity in an ecological context. Bilateral DLPFC activation following OGTT in youths with obesity was associated with peripheral ISI. This association suggests that peripheral insulin sensitivity might reflect the PFC's ability to control food-related behaviours.
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