J. Endocrinol. Invest. [JOURNAL]
Sun
200 papers
The role of gut microbiota in thyroid cancer: from pathogenesis to diagnosis and treatment.
He LJ, Zhang SC, Cai YC
J Endocrinol Invest · 2026 May · PMID 42101707 · Publisher ↗
In recent years, the key role of the gut microbiota (GM) in the diagnosis, prognosis, and treatment of thyroid cancer (TC) has become increasingly clear. This review examines the complex interactions between gut dysbiosi...
In recent years, the key role of the gut microbiota (GM) in the diagnosis, prognosis, and treatment of thyroid cancer (TC) has become increasingly clear. This review examines the complex interactions between gut dysbiosis and the occurrence and development of TC; focuses on changes in specific microbiotas that are directly related to tumor stage, lymph node metastasis, and drug resistance; and evaluates the potential of these microbiotas as novel biomarkers for treating TC. To elucidate the underlying molecular mechanisms, this review systematically evaluates the pathways through which the GM regulates the host immune response through metabolites (such as short-chain fatty acids and lipopolysaccharides) and reveals the core role of chronic inflammation in the formation of the microenvironment and the immune escape of TC. Furthermore, by exploring the effects of the microbiota on the hypothalamic-pituitary-thyroid axis and the peripheral thyroid hormone conversion, this review elucidates the profound role of the GM in the regulation of thyroid homeostasis. Based on this evidence, this review highlights the clinical applications of intervention strategies targeting the microbiota, including probiotics, dietary adjustments, and fecal microbiota transplantation, as adjuvant approaches for TC management.
From genetic diagnosis to healthy live births: implementing an integrated PGT-M pathway for 21-hydroxylase deficiency.
Chen X, Peng C, Chen H … +6 more , Yang H, Zhao X, Hu T, Wang H, Liu S, Ren J
J Endocrinol Invest · 2026 May · PMID 42096172 · Publisher ↗
PURPOSE: This study aimed to assess the clinical efficacy of a comprehensive reproductive management pathway integrating genetic diagnosis, preimplantation genetic testing for monogenic disorders and aneuploid (PGT-M & P...
PURPOSE: This study aimed to assess the clinical efficacy of a comprehensive reproductive management pathway integrating genetic diagnosis, preimplantation genetic testing for monogenic disorders and aneuploid (PGT-M & PGT-A) and prenatal diagnosis for families affected by CYP21A2 variant related 21-hydroxylase deficiency (21-OHD). METHODS: We performed a retrospective analysis of three families affected by 21-OHD. Definitive genetic diagnosis of the CYP21A2 locus was established using Multiplex Ligation-dependent Probe Amplification (MLPA) and Sanger sequencing. In parallel, whole-exome sequencing (WES) was performed to rule out other causes of congenital adrenal hyperplasia(CAH). The Asian Screening Array (ASA) was employed for PGT-M linkage analysis, while next-generation sequencing (NGS) was used for PGT-A. Prenatal diagnosis was performed to validate the PGT-M and PGT-A results. RESULTS: Pathogenic CYP21A2 variants were confirmed in all families. PGT-M enabled all couples to obtain transferable embryos, which were either genetically normal or carriers. Embryo transfer resulted in two clinical pregnancies and one miscarriage. Prenatal diagnosis in the two ongoing pregnancies showed complete concordance with the PGT-M profiles. Both pregnancies resulted in the delivery of healthy offspring. CONCLUSION: An integrated pathway combining genetic diagnosis, PGT-M, and prenatal diagnosis is a feasible and effective strategy for families with CYP21A2 variant related 21-OHD. This real-world application suggests the potential clinical utility of this multidisciplinary approach. Nevertheless, the conclusions should be interpreted with caution due to the small cohort size, and further studies with larger samples are required to confirm the efficacy and reproducibility of this integrated strategy.
Non-incidentally detected adrenal mass: a paradigm shift beyond incidentaloma?
Di Dalmazi G, Ceccato F
J Endocrinol Invest · 2026 May · PMID 42090116 · Publisher ↗
Abstract loading — click title to view on PubMed.
Comparative analysis of PTH Washout and 99mTc-MIBI SPECT/CT in presurgical localization for patients with primary hyperparathyroidism.
Cieślewicz M, Szczepanek-Parulska E, Witowska A … +4 more , Filipowicz D, Zybek-Kocik A, Czepczyński R, Ruchała M
J Endocrinol Invest · 2026 May · PMID 42090115 · Publisher ↗
PURPOSE: Our study aimed to evaluate the performance and concordance of parathyroid hormone wash-out (PTHw) and Tc-MIBI+SPECT/CT (MIBI) in preoperative localization for patients with primary hyperparathyroidism (PHPT), a...
PURPOSE: Our study aimed to evaluate the performance and concordance of parathyroid hormone wash-out (PTHw) and Tc-MIBI+SPECT/CT (MIBI) in preoperative localization for patients with primary hyperparathyroidism (PHPT), and assess potential factors influencing their diagnostic utility including patient characteristics, lesion size and comorbidities. METHODS: This was a real-life, retrospective study involving 125 participants, who underwent ultrasound-guided fine needle aspiration biopsy with PTHw determined by electrochemiluminescence (Elecsys analyser) and subtraction scintigraphy together with SPECT/CT images. RESULTS: PTHw was positive in 84.8% and MIBI in 84.0% of cases, with concordant findings in 73.6% of patients. In MIBI-negative cases, PTHw accurately localized PA in 70.0%, while MIBI identified lesions in 68.4% of PTHw-negative cases. Larger lesions were associated with improved performance for both techniques, although a significant size-dependent effect (≥10 mm) was observed only for MIBI (χ = 3.92, p = 0.048; φ = -0.18). The right inferior gland was the most frequent lesion location detected by PTHw (28.0%). PTHw correlated positively with serum PTH (r=0.29), PTHw-to-serum PTH ratio (r=0.84), total calcium (r=0.27), ionized calcium (r=0.31) and alkaline phosphatase (r=0.31), and inversely with phosphate (r = -0.22) and vitamin D (r= -0.20). CONCLUSION: Our findings reinforce the complementary role of ultrasound-guided parathyroid hormone washout and Tc-MIBI with SPECT/CT, in the preoperative PHPT imaging diagnostics, particularly when one modality yields negative or inconclusive results. Additionally, our results highlight the need for individualized imaging strategies based on specific patient profiles. Larger prospective studies with histopathological verification are warranted to corroborate these observations and refine preoperative localization protocols.
Quality of life in primary aldosteronism, medical vs surgical treatment: a systematic review and meta-analysis.
Wever M, Basile C, Bobbio E … +4 more , Gkaniatsa E, Biermasz N, Esposito D, Ragnarsson O
J Endocrinol Invest · 2026 May · PMID 42090114 · Publisher ↗
INTRODUCTION: Primary aldosteronism (PA) can be managed either by unilateral adrenalectomy (ADX) or pharmacologically with mineralocorticoid receptor antagonists (MRA). Several recent meta-analyses have examined how thes...
INTRODUCTION: Primary aldosteronism (PA) can be managed either by unilateral adrenalectomy (ADX) or pharmacologically with mineralocorticoid receptor antagonists (MRA). Several recent meta-analyses have examined how these treatment modalities affect cardiovascular outcomes in patients with PA. However, the impact of treatment on quality of life (QoL) remains largely unexplored. OBJECTIVE: To synthesize data from previous studies that have investigated QoL in either medically or surgically treated patients with PA. METHODS: A literature search was conducted in May 2025 in PubMed, Embase and Web of Science. Studies containing data on QoL before and after ADX or MRA were selected. RESULTS: Fifteen studies evaluated QoL after treatment for PA. Most comparative studies reported greater and faster QoL improvement after ADX than with MRA. QoL consistently improved after ADX, whereas results with MRA were variable and less consistent. Patients treated with MRA were older than patients treated with ADX and frequently received low MRA doses. Five studies (259 ADX-treated and 88 MRA-treated patients) were included in a meta-analysis. Baseline QoL did not differ between treatment groups. At 6 months, QoL improved in both groups, with no statistically significant difference between ADX and MRA. CONCLUSION: Treatment of PA is associated with improved QoL following both ADX and MRA therapy. Although several studies suggest superior outcomes after adrenalectomy, the meta-analysis did not show a significant difference at 6 months of follow-up. The limited number of patients, short follow-up duration, and potential undertreatment with MRA represent important limitations.
Mining safety signals of PD-1/PD-L1 inhibitor-related adrenal insufficiency: a study based on the FAERS database.
Pan R, Chen T, Guo G … +5 more , Chang S, Zhou J, Niu P, Zeng X, Zhang J
J Endocrinol Invest · 2026 May · PMID 42090113 · Publisher ↗
PurposeThis study evaluated the potential association between programmed cell death protein-1/ligand-1 (PD-1/PD-L1) inhibitors and adrenal insufficiency (AI) in the Food and Drug Administration Adverse Event Reporting Sy...
PurposeThis study evaluated the potential association between programmed cell death protein-1/ligand-1 (PD-1/PD-L1) inhibitors and adrenal insufficiency (AI) in the Food and Drug Administration Adverse Event Reporting System (FAERS) database to explore drug safety signals. MethodsThis study extracted real-world adverse event reports from the FAERS database spanning 2004 Q1 to 2024 Q4. Multiple disproportionality analysis methods were employed to evaluate the association between PD-1/PD-L1 inhibitors and AI, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN) based on Information Component (IC), and Multi-item Gamma Poisson Shrinker (MGPS) methods. ResultsA total of 164,152 adverse events related to PD-1/PD-L1 inhibitors were identified in the FAERS database, among which 1,023 cases were associated with AI. The top three drugs with the highest signal strength, measured by IC, tislelizumab (IC = 5.53), pembrolizumab (IC = 4.01), and cemiplimab (IC = 3.53). Time-to-onset analysis indicated that durvalumab and pembrolizumab were associated with the highest risk of AI during the initial treatment period (3-6 months), followed by a declining trend. Subgroup analysis showed a higher risk in patients over 65, males at significantly higher risk than females, and a stronger association of gastric cancer with AI risk signals than other cancers. Additionally, combination therapy with paclitaxel or lenvatinib mesylate was associated with an increased risk of AI onset.ConclusionsPD-1/PD-L1 inhibitors carry a potential risk of AI, and emphasis should be placed on early monitoring during clinical use to reduce the occurrence of adverse events.
Functional hypothalamic amenorrhea and anti-Müllerian hormone: insights for fertility assessment.
Notaristefano G, Tropea A, Samasiuk A … +6 more , Ranalli M, Policriti MA, Diterlizzi A, Ghi T, Lanzone A, Apa R
J Endocrinol Invest · 2026 May · PMID 42090112 · Publisher ↗
BACKGROUND: Anti-Müllerian hormone (AMH) is widely used as a marker of ovarian reserve. However, its reliability in functional hypothalamic amenorrhea (FHA) remains debated. FHA is characterized by reduced gonadotropin s...
BACKGROUND: Anti-Müllerian hormone (AMH) is widely used as a marker of ovarian reserve. However, its reliability in functional hypothalamic amenorrhea (FHA) remains debated. FHA is characterized by reduced gonadotropin secretion and impaired folliculogenesis, which may influence AMH expression and lead to an underestimation of reproductive potential. METHODS: We conducted a case-control study including women diagnosed with FHA and age-matched healthy controls. FHA patients were stratified according to the presence or absence of polycystic ovarian morphology (PCOM). Serum gonadotropins, estradiol, androgens, and AMH were measured and compared between groups. Correlation analyses were performed to explore associations among hormonal parameters. RESULTS: Overall, AMH concentrations in FHA patients were comparable to those of controls. However, stratification revealed that FHA without PCOM was associated with significantly reduced AMH, whereas FHA with PCOM displayed increased values. FHA patients also showed reduced gonadotropins, estradiol, and androgens compared with controls. In the non-PCOM FHA subgroup, AMH correlated positively with androgens and negatively with estradiol. These findings suggest that suppression of gonadotropins and consequent androgen deficiency may contribute to reduced AMH levels in FHA. CONCLUSIONS: This pilot study indicates that low AMH in FHA may reflect hypothalamic suppression of gonadotropins rather than true ovarian reserve potentially leading to misinterpretation in fertility counseling. These observations should be interpreted with caution given the small sample size, but they support the hypothesis that AMH levels might recover with restoration of hypothalamic-pituitary activity and menstrual cycles. Larger, longitudinal studies are warranted to confirm the reversibility of AMH and clarify its prognostic value in FHA.
Metabolic dysfunction-associated steatotic liver disease in cushing's syndrome: a case controlled FibroScan study.
Apaydin T, Keklikkiran C, Kani HT … +2 more , Yilmaz Y, Yavuz DG
J Endocrinol Invest · 2026 May · PMID 42090111 · Publisher ↗
PURPOSE: Metabolic dysfunction-associated steatotic liver disease (MASLD) is commonly associated with obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). Cushing's syndrome (CS), defined by chronic hypercor...
PURPOSE: Metabolic dysfunction-associated steatotic liver disease (MASLD) is commonly associated with obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). Cushing's syndrome (CS), defined by chronic hypercortisolism, shares overlapping metabolic features with MASLD. However, the relationship between CS and MASLD remains underexplored. This study aimed to investigate the prevalence of hepatic steatosis and fibrosis in patients with CS using FibroScan and to examine their relationship with clinical and metabolic parameters. METHODS: This cross-sectional study included 44 patients with endogenous CS, along with 52 age-, sex-, and BMI-matched controls and 44 age- and sex-matched controls. Hepatic steatosis and fibrosis were assessed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) using vibration-controlled transient elastography. RESULTS: MASLD was present in 56.8% of CS patients, with moderate-to-severe steatosis in 47.7%. CAP and LSM values were comparable between CS and metabolically matched controls, but CAP was higher than in healthy controls. CAP positively correlated with body mass index (BMI), waist circumference, triglycerides, and 24-hour urine cortisol (UFC), and negatively with growth hormone. LSM was positively correlated with BMI and GGT. No correlations were found with fasting glucose, HbA1c, or serum cortisol. Multivariate analysis identified UFC as an independent predictor of CAP, while BMI and GGT independently predicted LSM. CONCLUSION: Hepatic steatosis was frequent in CS and similar to metabolically matched individuals, but more common than in healthy controls. UFC, BMI, and waist circumference contribute to liver fat accumulation, while diabetes was not an independent predictor of steatosis in CS.
Inhibition of endolysosomal two-pore channel 2 (TPC2) induces osteoblast differentiation and matrix mineralization while targeting autophagy.
Montaseri A, Rossi M, Battafarano G … +15 more , Riccioli A, Palombi F, Giampietri C, Liguoro D, Mancini R, Meucci M, Palmisano B, Riminucci M, Keller M, Bracher F, Grimm C, Umehara K, De-Eknamkul W, Filippini A, Del Fattore A
J Endocrinol Invest · 2026 May · PMID 42090110 · Publisher ↗
PURPOSE: Endolysosomal two-pore channels (TPCs) are non-selective cation channels that control the release of Ca and Na from the endolysosomal lumen. TPCs also reportedly play a role in autophagy. Interestingly, autophag...
PURPOSE: Endolysosomal two-pore channels (TPCs) are non-selective cation channels that control the release of Ca and Na from the endolysosomal lumen. TPCs also reportedly play a role in autophagy. Interestingly, autophagy regulates bone cell differentiation and function. This study aimed to provide an in-depth insight into TPC2's action in the autophagy pathway to control osteoblast differentiation and function. METHODS: Primary human mesenchymal stem cells (hMSCs) and human osteoblast-like cells (Saos-2) were used to assess osteoblastogenesis and bone mineralization, respectively. MSCs were treated with different pharmacological TPC2 inhibitors including naringenin, tetrandrine, MT-8 and SG-094 during their differentiation process. Finally, formation of osteoblasts and in vitro bone mineralization were evaluated by alkaline phosphatase, alizarin red S and Von Kossa staining. Western blot analysis was performed to investigate the expression of autophagy-related molecules. RESULTS: The inhibition of TPC2 activity stimulates osteoblast differentiation from hMSCs and bone mineralization by Saos-2 cells. Interestingly, TPC2 inhibition reduces beclin-1 and LC3-II expression while that of the mammalian target of rapamycin (mTOR), the master regulator of autophagy, increases. Inhibition of mTOR activity by rapamycin reverses osteoblast differentiation induced by TPC2 inhibitor SG-094. CONCLUSION: Inhibition of TPC2 channel activity increases osteoblast differentiation and bone mineralization in vitro and interferes with the completion of autophagy, upregulating phosphorylated mTOR.
Association of first-trimester inflammatory markers with gestational diabetes mellitus subtypes and patterns: a cohort study.
Wang J, Jing L, Liu B … +3 more , Kong X, Kang S, Wu Y
J Endocrinol Invest · 2026 May · PMID 42082866 · Publisher ↗
PURPOSE: To evaluate the associations between first-trimester inflammatory markers and gestational diabetes mellitus (GDM), including its subtypes and patterns, and to explore the role of these markers in the early ident...
PURPOSE: To evaluate the associations between first-trimester inflammatory markers and gestational diabetes mellitus (GDM), including its subtypes and patterns, and to explore the role of these markers in the early identification of GDM risk. METHODS: This cohort study included pregnant women aged ≥ 18 years and < 16 weeks of gestation, based on their first antenatal registration date, at a tertiary hospital from March to December 2023 retrospectively and from December 2023 to August 2024 prospectively. Inflammatory markers, calculated from peripheral blood cell counts, included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregated immune-inflammation index (AISI). Outcomes were GDM and its subtypes (isolated fasting hyperglycemia [IFH], isolated post-load hyperglycemia [IPH], and combined hyperglycemia [CH]), as well as patterns identified through latent class trajectory modeling based on blood glucose change during the OGTT. RESULTS: Among 4,426 eligible women, 821 developed GDM. Elevated first-trimester NLR, SII, SIRI, and AISI were significantly associated with higher GDM risk. Compared with non-GDM pregnant women, these markers were positively associated with both IPH (ORs range: 1.16-1.22) and CH (ORs range: 1.28-1.54), but not IFH, and with two OGTT glucose trajectories (medium-speed increase-rapid decrease group [ORs range: 1.20-1.25] and rapid increase-slow decrease group [ORs range: 1.31-1.68]), while no significant associations were observed for the other two trajectories. CONCLUSION: First-trimester inflammatory markers are associated with more severe GDM phenotypes and may serve as potential biomarkers to inform the early identification of higher-risk GDM phenotypes.
Shifts in waist-to-height ratio categories within tirzepatide groups: a post-hoc analysis of SURMOUNT-1.
Sattar N, Tchang BG, Vincent RP … +5 more , Wang H, Murphy M, Dunn JP, Dimitriadis GK, Fraseur Brumm J
J Endocrinol Invest · 2026 Jun · PMID 42082865 · Full text
OBJECTIVE: To evaluate shifts in waist-to-height ratio (WHtR) categories among adults with obesity or overweight, with or without prediabetes, treated with tirzepatide in the SURMOUNT-1 study. METHODS: This post hoc anal...
OBJECTIVE: To evaluate shifts in waist-to-height ratio (WHtR) categories among adults with obesity or overweight, with or without prediabetes, treated with tirzepatide in the SURMOUNT-1 study. METHODS: This post hoc analysis included 2,538 participants from the SURMOUNT-1 Phase 3, double-blind, randomized, placebo-controlled trial. Adults with BMI ≥ 30 or ≥ 27 kg/m² and at least one obesity-related complication (ORC), excluding diabetes, were randomized to receive once-weekly tirzepatide (5, 10, or 15 mg) or placebo, alongside a reduced-calorie diet and increased physical activity. Participants were grouped by baseline WHtR (≤ 0.49, > 0.49 to ≤ 0.59, > 0.59) according to the National Institute for Health and Care Excellence (NICE) framework. Participants with prediabetes at baseline had additional follow-up data beyond week 72, and shifts in their WHtR categories at week 176 were also included. Change from baseline in WHtR was analyzed using a mixed model for repeated measures (MMRM). Shift tables were used to summarize changes from baseline to post-baseline WHtR category levels. RESULTS: At baseline, 89.8% of participants had a WHtR > 0.59, 10.1% had > 0.49 to ≤ 0.59, and 0.1% had ≤ 0.49. After 72 weeks of tirzepatide (10/15 mg), 16.7% of participants achieved a WHtR ≤ 0.49, and 54.7% improved their baseline WHtR category compared to 9.6% with placebo. At 176 weeks, among participants with prediabetes, 12.2% achieved WHtR ≤ 0.49, and 46.4% improved their category with tirzepatide versus 9.3% with placebo. CONCLUSIONS: Tirzepatide treatment was associated with sustained improvements in WHtR categories, with a greater proportion of participants shifting to a better WHtR category compared to participants treated with placebo. Improved WHtR may be suggestive of lower future cardiometabolic risk. Further analyses of this nature will enhance the understanding and application of WHtR in obesity management across diverse populations.
Fetuin-A: a potential molecular link between obesity, diabetes (type 2 and type 1) and metabolic steatotic liver disease (MASLD).
Milani I, Ciasca G, Chinucci M … +4 more , Carnazzo V, Leonetti F, Basile U, Capoccia D
J Endocrinol Invest · 2026 May · PMID 42082864 · Publisher ↗
PURPOSE: Fetuin-A represents a novel molecular target involved in the complex pathogenesis of metabolic disorders. This study aimed to evaluate its association with obesity, type 2 (T2DM) and type 1 (T1DM) diabetes and i...
PURPOSE: Fetuin-A represents a novel molecular target involved in the complex pathogenesis of metabolic disorders. This study aimed to evaluate its association with obesity, type 2 (T2DM) and type 1 (T1DM) diabetes and its correlation with non-invasive liver assessment. METHODS: 105 patients (38 with obesity without T2DM, 30 with T2DM, and 37 with T1DM) and 13 controls were included. All participants underwent transient elastography (TE) with controlled attenuation parameter (CAP), and liver stiffness measurement (LSM), clinical and biochemical data (including fetuin-A). RESULTS: Fetuin-A was significantly higher in all clinical groups than controls, with the greatest increase observed in obesity without T2DM. Fetuin-A correlated positively with measures of adiposity (BMI, waist circumference, waist to height ratio), triglycerides, and non-invasive indicators of liver steatosis (Fatty Liver Index and CAP), while showing no association with fibrosis (defined by LSM ≥ 7.9 kPa). In age- and sex-adjusted models, fetuin-A remained independently associated with obesity and T1DM, whereas T2DM showed a negative but not significant association. Fetuin-A was significantly higher in steatosis, with good discriminatory ability (AUC 0.84, 95% CI 0.77-0.91) and a sensitivity of 0.75 and specificity of 0.74 at the optimal Youden threshold. Negative association with male sex and positive association with age was also observed. CONCLUSIONS: Results confirm fetuin-A as a molecular signature of metabolic disorders, mediating the cross-talk between liver and adipose tissue. Further studies are needed to validate it as a useful biomarker for the early diagnosis and monitoring of liver and metabolic disease, including obesity, T2DM, T1DM, and MASLD, and to reach a consensus on reference values definition.
Association of composite inflammatory indicators with osteoporosis and sarcopenia in type 2 diabetes mellitus: the mediating role of inflammation.
Cao H, Zhong L, Zhong F … +4 more , Lin R, Chen H, Huang J, Wei W
J Endocrinol Invest · 2026 May · PMID 42081166 · Publisher ↗
OBJECTIVE: This study aimed to investigate the associations between composite inflammatory indicators and the presence of osteoporosis (OP) and sarcopenia in patients with type 2 diabetes mellitus (T2DM), and to explore...
OBJECTIVE: This study aimed to investigate the associations between composite inflammatory indicators and the presence of osteoporosis (OP) and sarcopenia in patients with type 2 diabetes mellitus (T2DM), and to explore the potential mediating role of inflammation in the relationship between sarcopenia and OP. METHODS: In this cross-sectional study, 756 adults with T2DM were enrolled. Osteoporosis was defined as a Bone Mineral Density (BMD) T-score ≤ -2.5 at the hip or lumbar spine. Sarcopenia was diagnosed according to Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Composite inflammatory indicators, including systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), pan-immune inflammation value (PIV), platelet-to-lymphocyte ratio (PLR), advanced lung cancer inflammation index (ALI), neutrophil-to-albumin percentage ratio (NPAR), platelet-to-neutrophil ratio (PNR), and neutrophil-lymphocyte-platelet ratio (NLPR) were calculated from routine blood parameters. Associations between composite inflammatory indicators and OP as well as sarcopenia were assessed using restricted cubic splines (RCS) and multivariate logistic regression analysis. The ability of composite inflammatory indicators to identify sarcopenia was evaluated using receiver operating characteristic (ROC) curves. Mediation analysis to assess the indirect effect of inflammation on the sarcopenia and osteoporosis relationship. RESULTS: In this study, the prevalence of osteoporosis was 31.1%, and the prevalence of sarcopenia was 34.0%. RCS analysis revealed that ALI exhibited a linear negative correlation with osteoporosis, and SII, SIRI, NLR, PIV, PLR, NLPR, NPAR exhibited linear positive correlations with sarcopenia (all P for nonlinearity > 0.05). PNR and ALI demonstrated a negative nonlinear association with sarcopenia (all P for nonlinearity < 0.05). Logistic regression analysis indicated that sarcopenia was positively associated with osteoporosis (P< 0.05). However, ALI (aOR 0.99, 95% CI 0.98-1.00) showed inverse association with osteoporosis (P < 0.05). Logistic regression analysis also indicated that osteoporosis was positively associated with sarcopenia (P < 0.05). The multivariable regression analysis showed hs-CRR (aOR 1.03, 95% CI 1.01-1.05), SII (aOR 1.00, 95% CI 1.00-1.00), SIRI (aOR 1.46, 95% CI 1.13-1.93), PIV (aOR 1.00, 95% CI 1.00-1.00), NPAR (aOR 1.11, 95% CI 1.04-1.19), and NLR (aOR 1.20, 95% CI 1.05-1.38) showed positive associations with sarcopenia. Conversely, ALI (aOR 0.98, 95% CI 0.97-0.99) exhibited a inverse association with sarcopenia (P < 0.05). The area under the ROC curve (AUC) for ALI in identifying sarcopenia was 0.68. Mediation analysis showed that ALI mediated the statistical association between sarcopenia and osteoporosis with proportions (%) of 19.58. CONCLUSION: Sarcopenia is positively associated with osteoporosis in patients with T2DM, and this relationship is partially mediated by systemic inflammation, as captured by the ALI. The ALI may serve as a useful and accessible clinical indicator to identify T2DM patients at higher risk for sarcopenia and osteoporosis, who may benefit from targeted screening and multimodal interventions.
Predictive parameters of semen outcome improvement after varicocele treatment by scleroembolization: a retrospective study.
De Toni L, Ferraioli G, Todisco M … +10 more , Congiu S, Palego P, Graziani A, Caretta N, Grande G, De Conti G, Lafrate M, Moro FD, Ferlin A, Garolla A
J Endocrinol Invest · 2026 Apr · PMID 42053703 · Publisher ↗
PURPOSE: Varicocele is a recognized male factor of infertility. Surgical/microsurgical correction represents a therapeutical option to improve fertility outcomes but predictive parameters for the identification who can a...
PURPOSE: Varicocele is a recognized male factor of infertility. Surgical/microsurgical correction represents a therapeutical option to improve fertility outcomes but predictive parameters for the identification who can actually benefit from varicocele correction are under investigated. Here we aimed to identify baseline predictors of semen outcome improvement after varicocele treatment by scleroembolization approach. METHODS: 85 patients receiving varicocele treatment by anterograde scleroembolization (ASE, N = 42) or retrograde scleroembolization (RSE, N = 43) were retrospectively recruited. Basal and 6-months follow-up evaluation of semen, hormonal and ultrasound parameters (US) were performed to address the respective effect of varicocele treatment. In addition, basal parameters were assessed as clinical outcome predictors. RESULTS: Varicocele grade reduction was observed in more than 90% of patients (P < 0.001). Compared to basal, significant increase of sperm concentration (10.0 ± 9.2 × 10cells/mL vs. 23.4 ± 26.9 × 10cells/mL; P < 0.001), total sperm count (TSC 39.0 ± 54.5 × 10cells vs. 70.3 ± 90.6 × 10cells, P < 0.001) and total motile sperm count (TMS, 9.8 ± 12.8 × 10cells vs. 36.7 ± 58.1 × 10cells, P < 0.001), was observed, with no differences between RSE or ASE. All US parameters were also improved (all P < 0.001). Logistic regression analysis of basal semen and ultrasound parameters showed that basal sperm motility and left testis-mean transit time (L-MTT) were associated with TSC and TMS doubling at follow-up. However, Receiver Operating Characteristic curve analysis showed that only basal L-MTT basal sperm was consistently associated with TSC and TMS doubling at follow-up (respectively: AUC = 0.834, CI: 0.747-0.921 and AUC = 0.805, CI: 0.708-0.901; both P < 0.001). CONCLUSION: Baseline sperm count and US parameters represent useful clinical descriptors to address those subjects eligible for varicocele correction.
Correction: Impact of estroprogestin therapies on bone health from adolescence to postmenopause.
Gregorio G, Silvia F, Silvia C … +6 more , Elena R, Antonio R, Jacopo B, Marco B, Giovanni G, S C
J Endocrinol Invest · 2026 Apr · PMID 42048046 · Publisher ↗
Abstract loading — click title to view on PubMed.
Correction: Understanding the burden of endocrine and metabolic disorders in Prader-Willi syndrome: data from the Italian registry.
Grugni G, Rocchetti A, Bucolo C … +32 more , Buganza R, Buoncuore G, Colao A, Corica D, Crinò A, Dassie F, de Sanctis L, Delvecchio M, Di Candia F, Faienza MF, Fintini D, Greco D, Guazzarotti L, Lo Preiato V, Maffei P, Mariani M, Mozzillo E, Pagotto U, Pajno R, Patti G, Rutigliano I, Salvatore M, Sartorio A, Scarano E, Siena S, Tamaro G, Tornese G, Vitale R, Wasniewska M, Zampino G, Torreri P, Maghnie M
J Endocrinol Invest · 2026 Apr · PMID 42048045 · Publisher ↗
Abstract loading — click title to view on PubMed.
Gender differences in long-term complications of chronic hypoparathyroidism: a systematic review.
Cetani F, Pierotti L, Bodini I … +8 more , Bongermino C, Cagnina S, Carrara S, De Michelis V, Gianotti L, Pusterla A, Corbetta S, Italian Study Group on Gender Difference in Endocrine Diseases
J Endocrinol Invest · 2026 Apr · PMID 42029970 · Publisher ↗
BACKGROUND: Chronic hypoparathyroidism (HypoPT) is a rare endocrine disorder associated with lifelong treatment and a wide spectrum of long-term complications. Potential gender differences in disease-related complication...
BACKGROUND: Chronic hypoparathyroidism (HypoPT) is a rare endocrine disorder associated with lifelong treatment and a wide spectrum of long-term complications. Potential gender differences in disease-related complications remain poorly defined. This systematic review aimed to evaluate sex-related differences in long-term complications of chronic HypoPT and to explore the impact of disease etiology on these outcomes. METHODS: A systematic search of PubMed, Scopus, EMBASE, and the Cochrane Library was conducted for English-language studies published from January 1980 to July 2025. Eligible studies included randomized controlled trials, cohort studies, case-control studies, and case series involving both women and men with chronic HypoPT and reporting long-term complications. Study selection and data extraction were performed independently by two reviewers according to PRISMA guidelines. Outcomes of interest included renal, skeletal, neurological, cardiovascular, neuropsychiatric complications, and quality of life. RESULTS: Forty-two studies were included. Renal complications showed sex-related patterns, with hypercalciuria more frequently reported in women and chronic kidney disease more commonly observed in men. Skeletal complications, particularly vertebral fractures, were more prevalent in postmenopausal women, while bone mineral density and turnover markers showed minimal sex differences. Neurological complications, including basal ganglia calcifications, did not consistently differ by sex, although women more frequently reported cognitive and neuropsychiatric symptoms. Cardiovascular risk appeared higher in women in some cohorts. Quality of life impairment and symptom burden were consistently greater in women, especially when assessed using disease-specific instruments. CONCLUSIONS: Available evidence suggests gender-related trends in long-term complications of chronic HypoPT, but data are limited by heterogeneity and lack of sex-stratified analyses. Gender-informed research is needed to support personalized management strategies.
Novel biomarkers to guide glucocorticoid replacement in primary adrenal insufficiency: a proof-of-concept study using copeptin-derived ratios.
Bima C, Campioni L, Berton AM … +8 more , Sola C, Bergoglio B, Di Carlo MC, Ponzetto F, Settanni F, Ceccato F, Parasiliti-Caprino M, Giordano R
J Endocrinol Invest · 2026 Apr · PMID 42026386 · Publisher ↗
BACKGROUND: Optimising glucocorticoid (GC) replacement in primary adrenal insufficiency (PAI) remains challenging, as clinical and biochemical markers do not reliably mirror tissue cortisol exposure. OBJECTIVE: To evalua...
BACKGROUND: Optimising glucocorticoid (GC) replacement in primary adrenal insufficiency (PAI) remains challenging, as clinical and biochemical markers do not reliably mirror tissue cortisol exposure. OBJECTIVE: To evaluate salivary cortisone exposure and copeptin-derived ratios as candidate biomarkers of GC replacement adequacy in PAI. DESIGN: Cross-sectional case-control study with 12-month follow-up including nineteen adults with autoimmune or idiopathic PAI on stable hydrocortisone (HC; immediate- or dual-release) plus fludrocortisone, and forty-three healthy controls. METHODS: Six daytime saliva samples were collected for cortisol and cortisone quantification by LC-MS/MS. The area-under-the-curve (AUC) of cortisone was computed, and patients were classified as GC excess (AUC above the 90th percentile of controls; Group A) or adequate replacement (10th-90th percentile; Group B). Plasma ACTH, copeptin, renin, electrolytes and osmolarity were measured fasting and 120 min post-dose. RESULTS: At baseline, 31.6% of patients showed GC excess, increasing to 36.8% at follow-up. Compared with Group B, Group A exhibited higher HbA1c (46.5 vs. 34.0 mmol/mol, p < 0.05) and diastolic blood pressure (84.5 ± 8.7 vs. 77.0 ± 9.6 mmHg, p < 0.05) with lower pulse pressure. ACTH and ACTH/copeptin ratios were markedly reduced in Group A both fasting (median 38.1 vs. 132.4) and post-dose (12.9 vs. 41.6), while renin/copeptin ratios declined at T1. ACTH/copeptin correlated inversely with cortisone AUC (r = - 0.59, p < 0.01). CONCLUSIONS: Salivary cortisone AUC, together with ACTH/copeptin and renin/copeptin ratios, identifies physiologically distinct GC exposure profiles linked to metabolic and haemodynamic alterations. These biomarkers may refine personalised GC replacement in PAI.
Reversion to normoglycemia with tirzepatide vs semaglutide in participants with obesity and prediabetes: a post hoc analysis of SURMOUNT-5.
Galindo RJ, Aronne LJ, Horn DB … +8 more , Miras AD, Dunn JP, Cao D, Lee CJ, Karanikas CA, Heine RJ, Falcon BL, Dimitriadis GK
J Endocrinol Invest · 2026 Apr · PMID 42002673 · Publisher ↗
BACKGROUND: Prevention of progression into type 2 diabetes (T2D) in patients with prediabetes is a key goal of obesity management. In SURMOUNT-5, once weekly tirzepatide at the maximum tolerated dose (MTD 10 mg or 15 mg)...
BACKGROUND: Prevention of progression into type 2 diabetes (T2D) in patients with prediabetes is a key goal of obesity management. In SURMOUNT-5, once weekly tirzepatide at the maximum tolerated dose (MTD 10 mg or 15 mg) compared with semaglutide (MTD 1.7 mg or 2.4 mg) resulted in significantly greater body weight reduction in adults living with obesity without T2D. PURPOSE: Assess changes in glycemia outcomes with tirzepatide (MTD 10 mg or 15 mg) compared with semaglutide (MTD 1.7 mg or 2.4 mg) in participants with obesity and prediabetes from SURMOUNT-5. METHODS: Participants (N = 425) with baseline prediabetes, defined as having ≥ 1 fasting lab-based value of either FSG 100–125 mg/dL or HbA1c 5.7–6.4%, were included in this analysis. Change from baseline in HbA1c, proportion of participants achieving normoglycemia (i.e., HbA1c < 5.7% and FSG < 100 mg/dL), percent change from baseline in body weight, fasting insulin, estimates of insulin sensitivity (HOMA2-IR), and proportion of participants achieving body weight reduction thresholds (≥ 10% to ≥ 30%) at Week 72 were assessed using MMRM or logistic regression for categorical measures using the efficacy analysis set. RESULTS: Mean baseline age was 47 years, 63% were female, BMI was 40 kg/m2, and HbA1c was 5.86%. At Week 72, mean HbA1c reduction was significantly greater with tirzepatide vs semaglutide (-0.60% vs -0.48%; estimated treatment difference [ETD; 95% CI] -0.12% [−0.18, −0.06]; p < 0.001). A greater proportion of tirzepatide-treated participants reverted to normoglycemia (89.9%) vs semaglutide (76.2%). Mean percent body weight reduction was significantly greater with tirzepatide (−21.5% vs -14.5%; ETD −7.1% [−9.1, −5.0]; p < 0.001). Greater improvements in fasting insulin and HOMA2-IR were observed with tirzepatide vs semaglutide (p < 0.001). CONCLUSION: In this post hoc analysis of SURMOUNT-5, a greater proportion of tirzepatide-treated participants with obesity and prediabetes at baseline reverted to normoglycemia compared with semaglutide. Greater improvements in glycemia, estimates of insulin sensitivity and body weight were also observed with tirzepatide.
Leucine supplementation modulates body composition and early weight rebound during GLP-1 receptor agonist therapy in diet-induced obese mice.
Zhao ZW
J Endocrinol Invest · 2026 Apr · PMID 42002672 · Publisher ↗
PURPOSE: GLP-1 receptor agonists (GLP-1RAs) like semaglutide are effective for obesity treatment but may cause lean mass loss and post-discontinuation weight rebound. This study aimed to explore whether leucine supplemen...
PURPOSE: GLP-1 receptor agonists (GLP-1RAs) like semaglutide are effective for obesity treatment but may cause lean mass loss and post-discontinuation weight rebound. This study aimed to explore whether leucine supplementation alone or combined with semaglutide optimizes body composition in diet-induced obese (DIO) mice. METHODS: Male C57BL/6J mice were fed a high-fat diet for 12 weeks to induce obesity. Obese mice were then treated for 14 days with daily subcutaneous injections of semaglutide (120 µg/kg) or vehicle, along with either 1.5% leucine in drinking water or control water, and received the muscle-targeted mTORC1 inhibitor MTP-mTORC1i (1.5 mg/kg) or vehicle three times per week. Body weight, food intake, and body composition (assessed by EchoMRI) were monitored throughout this period. Following semaglutide withdrawal, leucine supplementation and MTP-mTORC1i administration were continued to evaluate their effects on weight rebound. RESULTS: Semaglutide combined with leucine induced greater fat mass loss and higher lean mass retention compared to semaglutide alone, without further suppressing appetite. Following semaglutide discontinuation, leucine supplementation significantly attenuated weight rebound, reduced fat rebound, and preserved lean mass. These beneficial effects were completely abrogated upon mTORC1 inhibition, underscoring the critical dependence on this signaling pathway. CONCLUSIONS: Leucine supplementation may refine GLP-1RA-induced weight loss by favoring fat reduction and preserving lean mass, and could potentially alleviate post-discontinuation weight rebound through muscle mTORC1 activation. Given the relatively short 14-day intervention and limited post-withdrawal follow-up period, these findings should be regarded as preliminary. Leucine may represent a promising adjuvant strategy to improve obesity management, pending validation in longer-term clinical investigations.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe