J. Endocrinol. Invest. [JOURNAL]
Sun
200 papers
Microvascular complications and risk of osteoporosis and fractures in type 2 diabetes: a nationwide Asian cohort study.
Yen YH, Wei JC, Ko FS … +6 more , Yen FS, Lin HJ, Li PY, Cho DY, Hwu CM, Hsu CC
J Endocrinol Invest · 2026 Apr · PMID 42002671 · Publisher ↗
PURPOSE: Type 2 diabetes mellitus (T2DM) is associated with elevated risks of osteoporosis and fractures, but the contribution of diabetic microvascular complications remains poorly defined—especially in Asian population...
PURPOSE: Type 2 diabetes mellitus (T2DM) is associated with elevated risks of osteoporosis and fractures, but the contribution of diabetic microvascular complications remains poorly defined—especially in Asian populations. Prior studies have suggested links between diabetes-related complications and skeletal fragility, but most were limited by small sample sizes, cross-sectional designs, or inadequate adjustment for key confounders such as medication use, fall history, and comorbidities. METHODS: Using Taiwan’s National Health Insurance Research Database, we conducted a large-scale, population-based cohort study of individuals newly diagnosed with T2DM (2008–2020) to assess associations between microvascular complications and the risk of new-onset osteoporosis and osteoporotic fractures using multivariable Cox proportional hazards models. RESULTS: In this East Asian cohort, patients with diabetic neuropathy (DN), retinopathy (DR), or kidney disease (DKD) exhibited a graded increase in the risk of both osteoporosis and major osteoporotic fractures, including those of the hip, spine, humerus, and radius/ulna. Compared to patients without microvascular disease, those with DR and DN had significantly higher risks of osteoporosis (adjusted hazard ratio [aHR]: 1.14 [95% CI: 1.09–1.19] and 1.25 [1.22–1.28], respectively; p < 0.001). Furthermore, amongst the microvascular complications, DN showed the strongest and most consistent associations with osteoporosis and spine fractures. CONCLUSIONS: This nationwide cohort focused exclusively on newly diagnosed T2DM patients and comprehensively adjusted for confounders. Our findings suggest that microvascular complications may serve as independent predictors of skeletal fragility and support their incorporation into fracture risk assessment models, particularly for Asian individuals with T2DM.
Effects of physical exercise on menstrual symptoms in polycystic ovary syndrome: a systematic review.
Molinaro M, Greco F, Ingargiola A … +4 more , Raffa A, Greco EA, Emerenziani GP, Aversa A
J Endocrinol Invest · 2026 Apr · PMID 42002670 · Publisher ↗
BACKGROUND: Despite the current guidelines, evidence on the benefits of physical exercise (PE) in PCOS remains limited and heterogeneous. While PE’s positive metabolic effects are established, its impact on menstrual sym...
BACKGROUND: Despite the current guidelines, evidence on the benefits of physical exercise (PE) in PCOS remains limited and heterogeneous. While PE’s positive metabolic effects are established, its impact on menstrual symptoms is poorly understood. This review synthesises evidence on whether PE improves menstrual symptoms in reproductive-aged women with PCOS. METHODS: Three databases (PubMed, Scopus, and Web of Science) were searched for peer-reviewed English articles up until March 25, 2025, without any restrictions on the publication date. The search results were conducted independently by two different reviewers, and the reference lists of the selected papers have been searched. A narrative synthesis of the included studies was conducted. The types of study selected were mainly randomised controlled trials, including High-Intensity Interval Training (HIIT) in three studies, Moderate-Intensity Continuous Training (MICT/aerobic) in seven, and combined aerobic-resistance training in two. PE lasted from 12 weeks to 6 months, primarily at 3 sessions/week. Menstrual Cyclicity/Frequency was measured in all studies via menstrual diaries. RESULTS: Ten studies involving 290 participants with PCOS (BMI ≥ 25 kg/m²; aged 18–40 years) were included. PE improved cycle regularity across interventions. HIIT showed the highest improvement rate (69%), while MICT was effective for the most participants (n = 132). Protocols typically lasted ≥ 3 months at 3 sessions/week. Adding resistance training provided further benefits, particularly for women with hyperandrogenism. DISCUSSION: The findings suggest that PE may lead to significant improvements in menstrual cyclicity. However, due to the high heterogeneity in patients’ enrolment and different intervention protocols applied with limited long-term follow-up, the reproducibility of our investigation remains to be confirmed. REGISTRATION: This systematic review was registered in PROSPERO (CRD420251009235).
"One-stop-shop" medical imaging for osteoporosis and obese patients: a narrative review.
Zhang L, Lei H, Li Y … +2 more , Yang H, Zhao H
J Endocrinol Invest · 2026 Jun · PMID 41999439 · Publisher ↗
BACKGROUND: Obesity and osteoporosis frequently coexist. Assessing them separately can miss obesity-related bias in lumbar aBMD and fragility driven by impaired bone quality. To deliver a practical, scenario-based “one-s...
BACKGROUND: Obesity and osteoporosis frequently coexist. Assessing them separately can miss obesity-related bias in lumbar aBMD and fragility driven by impaired bone quality. To deliver a practical, scenario-based “one-stop-shop” that simultaneously characterizes adiposity and bone status. METHODS: Narrative review framed by PICO. We searched the MEDLINE, PubMed, Scopus, and Web of Science databases to evaluate various imaging modalities for obesity and osteoporosis, as well as their feasibility for “one-stop-shop”. RESULTS: Pathophysiologically, expansion of bone-marrow adipose tissue, adipokine/hormonal dysregulation, and mesenchymal stem-cell adipogenic shift, reduces bone mass. Clinically, the feasibility of mainstream imaging techniques for “one-stop-shop” is evaluated: As diagnostic tools, QCT and DXA cater precisely to the requirements of clinical diagnosis, providing reliable evidence for disease confirmation. As screening tools, both perform exceptionally well; among them, DXA, with its distinct advantages of lower radiation exposure and cost-effectiveness, is particularly suited for large-scale preliminary screening of populations. Additionally, DECT, MRI, and ultrasound can serve as effective supplementary tools, enhancing the comprehensive assessment of bone health and obesity. CONCLUSIONS: This review focuses on the field of obesity-osteoporosis comorbidity. It deconstructs the interaction between the two conditions at the pathophysiological and clinical levels, explores the characteristics of high-risk populations, and examines the feasibility of the “one-stop-shop”. Bone mass and fat data acquired through “one-stop-shop” provide a more comprehensive and accurate reflection of adiposity and bone status, enabling clinicians to formulate targeted intervention strategies.
Adverse effect of age on pancreatic islet morphology, islet cell turnover and lineage-labelled hormone expression in mice.
Dubey V, Tanday N, Sridhar A … +4 more , Tarasov AI, Flatt PR, Moffett RC, Irwin N
J Endocrinol Invest · 2026 Apr · PMID 41989513 · Publisher ↗
AIMS: Ageing leads to a gradual decline in the structure and function of many bodily organs, including the endocrine pancreas. The current study examines the impact of ageing on pancreatic islet morphology, and especiall...
AIMS: Ageing leads to a gradual decline in the structure and function of many bodily organs, including the endocrine pancreas. The current study examines the impact of ageing on pancreatic islet morphology, and especially the role of islet cell plasticity in this process. METHODS: Transgenic Ins1Cre/+;Rosa26-eYFP mice, with islet beta-cell tracing capabilities, were employed at 12 and 52 weeks of age, and islet morphology, islet cell turnover as well as changes in beta-cell identity and plasticity assessed. RESULTS: Ageing was associated with elevated body weight and circulating glucose levels. There was also substantial remodelling of pancreatic islet morphology in 52-week-old mice, that included a notable decrease of islet number as well as overall islet, alpha- and beta-cell areas. This was associated with diminished beta-cell proliferation and survival, but interestingly alpha-cell proliferation was increased in older mice, as was the number of islet cells positive for both insulin and glucagon. There was increased loss of insulin expression in original GFP labelled islet cells in older Ins1Cre/+;Rosa26-eYFP mice complemented by augmented glucagon and GFP co-positive cell numbers. Observations in GluCreERT2;ROSA26-eYFP transgenic mice, with alpha-cell tracing technologies, demonstrated reduced numbers of lineage-labelled alpha-cells co-expressing insulin. Furthermore, the ability of pancreatic ductal cells to assume an islet beta-cell phenotype was impaired in older Ins1Cre/+;Rosa26-eYFP mice. CONCLUSION: These findings demonstrate an age-related deterioration of pancreatic islet morphology, linked in part to altered patterns of lineage-labelled hormone expression alongside changes in islet cell turnover.
Supplementation with the probiotic Bifidobacterium lactis BB-12 improves the efficacy of alendronate sodium/vitamin D₃ therapy on skeletal health in stage 3 CKD.
Zhao X, Zhai Q, Jia X … +5 more , Zhu Y, Bao Y, Min X, Du L, Liu Y
J Endocrinol Invest · 2026 Apr · PMID 41989512 · Publisher ↗
BACKGROUND: Chronic kidney disease (CKD) accelerates bone loss and immune dysfunction, with limited treatment efficacy due to altered mineral metabolism. Emerging evidence links gut microbiota to bone and immune health,...
BACKGROUND: Chronic kidney disease (CKD) accelerates bone loss and immune dysfunction, with limited treatment efficacy due to altered mineral metabolism. Emerging evidence links gut microbiota to bone and immune health, yet data in CKD patients remain scarce. AIM: To assess whether adding Bifidobacterium animalis subsp. lactis BB-12 to standard alendronate/vitamin D3 therapy improves bone mineral density (BMD), bone metabolism, and T cell immune function in osteoporotic elderly with CKD stage 3. METHODS: In this 12-month RCT, 128 patients (≥ 65 years) with CKD stage 3 and osteoporosis received alendronate/vitamin D3 plus either B. lactis BB-12 (n = 64) or placebo (n = 64). Outcomes included BMD changes, bone turnover markers, T cell subsets, metabolic parameters, and safety. RESULTS: The intervention group showed greater lumbar spine (5.8% vs. 3.9%) and femoral neck (3.7% vs. 2.4%) BMD gains (p < 0.001). CTX-I reduction was more pronounced (-48.6% vs. -32.4%, p < 0.001). Treg proportions increased (6.8% vs. 5.2%) and Th17/Treg ratio decreased (1.8 vs. 2.6) (p < 0.01). Enhanced T cell mitochondrial respiration (OCR/ECAR: 2.4 vs. 1.8) and reduced inflammatory cytokines (IL-17, TNF-α) were observed (p < 0.01). Adverse events were comparable. CONCLUSIONS: B. lactis BB-12 supplementation enhances standard osteoporosis therapy in elderly CKD stage 3 patients, improving BMD and immune-metabolic profiles via the gut-bone-immune axis.
Association of aryl hydrocarbon receptor gene polymorphisms with hashimoto's thyroiditis.
Ruggeri RM, Donato L, Minuti A … +5 more , Aliquò F, Sidoti A, Campennì A, Cannavò S, D'Ascola A
J Endocrinol Invest · 2026 Apr · PMID 41984408 · Publisher ↗
PURPOSE: The interplay between genetic susceptibility and environmental triggers is critical in autoimmune diseases such as Hashimoto’s thyroiditis (HT). The aryl hydrocarbon receptor (AhR) gene plays a key role in gene-...
PURPOSE: The interplay between genetic susceptibility and environmental triggers is critical in autoimmune diseases such as Hashimoto’s thyroiditis (HT). The aryl hydrocarbon receptor (AhR) gene plays a key role in gene-environment interaction and in modulation of immune responses. Given that environmental changes shape the selection of genetic variants, we hypothesized that polymorphisms in AhR may contribute to HT susceptibility. PATIENTS AND METHODS: Two AhR single nucleotide polymorphisms (SNPs), rs2066853 (exon 10) and rs10249788 (promoter region), were analyzed in 200 unrelated subjects (100 HT patients and 100 matched healthy controls, HC). Genotyping was performed using restriction fragment length polymorphism analysis and nucleotide sequencing. All genotype distributions were in Hardy–Weinberg equilibrium. RESULTS: The rs10249788 (C > T) variant was detected in 20/100 HT patients and 7/100 HCs. Genotype frequencies differed significantly between groups (P < 0.05), with the heterozygous C/T genotype showing an odds ratio > 3 and a significant association with HT. Multivariate analysis demonstrated that rs10249788 was independently associated with family history of HT and thyroid function (P < 0.05). TSH levels increased progressively from C/C to variant genotypes, suggesting an influence of the T allele on thyroid functional expression. The rs2066853 (G > A) variant was rare and showed no disease-specific relevance. CONCLUSIONS: The AhR polymorphism rs10249788 (C > T) is associated with Hashimoto’s thyroiditis, emerging as a potential genetic contributor to disease susceptibility and clinical expression.
Atherogenic index of plasma predicts gestational diabetes mellitus and correlates with disease severity and adverse pregnancy outcomes.
Xiao S, Wang X, Zhang H … +1 more , Liu R
J Endocrinol Invest · 2026 Apr · PMID 41984407 · Publisher ↗
BACKGROUND: Early identification of gestational diabetes mellitus (GDM) is essential for timely intervention. The atherogenic index of plasma (AIP) may reflect early lipid dysregulation preceding GDM onset. METHODS: This...
BACKGROUND: Early identification of gestational diabetes mellitus (GDM) is essential for timely intervention. The atherogenic index of plasma (AIP) may reflect early lipid dysregulation preceding GDM onset. METHODS: This retrospective cohort included 660 pregnant women who underwent first-trimester (11-13⁺⁶ weeks) lipid testing and GDM screening at 24-28 weeks based on IADPSG criteria. Demographic and biochemical data were extracted from medical records. Logistic regression identified independent predictors of GDM, and receiver operating characteristic (ROC) analysis evaluated predictive performance. Correlation and subgroup analyses examined associations between AIP, glucose parameters, and pregnancy outcomes. RESULTS: Women who developed GDM had higher first-trimester AIP levels than those without GDM (0.29 ± 0.17 vs. 0.11 ± 0.11, P < 0.001). AIP independently predicted GDM (OR = 14.37, 95% CI: 3.05-85.35; P < 0.001) and demonstrated higher diagnostic accuracy (AUC = 0.81) compared with TG and HDL-C. Higher AIP correlated with fasting, 1-hour, and 2-hour OGTT glucose levels (all P < 0.001) and was associated with greater risks of prematurity, neonatal asphyxia, and overall adverse outcomes. CONCLUSION: First-trimester AIP is a robust biomarker for early prediction of GDM and adverse perinatal outcomes, offering a practical tool for early risk assessment.
Thyroid function and ultrasound surveillance in childhood cancer survivors (CCS): a position paper of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED).
Tuli G, Calcaterra V, Di Mase R … +24 more , Vigone MC, Gastaldi R, Ferrigno R, Improda N, Klain A, Licenziati MR, Pellino V, Aversa T, Pepe G, Ortolano R, Capalbo D, Urbano F, Di Frenna M, Cavarzere P, Penta L, Munarin J, Vincenzi G, Molinari S, Faienza MF, Street ME, Salerno M, Wasniewska M, Cherubini V, Cassio A
J Endocrinol Invest · 2026 Apr · PMID 41984406 · Publisher ↗
PURPOSE: Thyroid sequelae are the most frequent endocrine late effects of cancer treatment in childhood cancer survivors (CCS), making periodic life-long surveillance essential for the prompt diagnosis and management of...
PURPOSE: Thyroid sequelae are the most frequent endocrine late effects of cancer treatment in childhood cancer survivors (CCS), making periodic life-long surveillance essential for the prompt diagnosis and management of hypothyroidism, hyperthyroidism, and thyroid nodules. METHODS: Considering the large CCS population and the high relevance of thyroid sequelae in pediatric age (< 18 years), eight clinical questions (CQ) were addressed to provide a practical, tailored framework. RESULTS: Although conclusive evidence is lacking, the significant morbidity associated with hypothyroidism in children and adolescents—including adverse effects on metabolism, growth, neurocognitive development, and quality of life—supports regular thyroid function monitoring in all CCS, regardless of treatment type. Assessment is recommended at baseline and subsequently according to the treatment protocol for all patients receiving chemotherapy, radiation to the head, neck, or mediastinum, sellar/suprasellar surgery, or iodinated contrast agents. In children treated with tyrosine kinase inhibitors or immune checkpoint inhibitors, thyroid function and antibody titers should be assessed at baseline, monthly during treatment, every six months during the first year after discontinuation, and annually thereafter. Ultrasound surveillance protocol may start at baseline, in order to evaluate also thyroid volume changes, and then every 2-3years after the radiation exposure or 131−IMIBG treatment or annually if nodules are present. CONCLUSION: Given the high prevalence of thyroid sequelae requiring life-long follow-up, pediatric endocrinologists play a pivotal role in the multidisciplinary management of CCS.
Disease-related burden and treatment experience in patients with acromegaly: a gender perspective.
Laflör LP, Siegel S, Giese S … +7 more , Honegger J, Friedel AL, Unger N, van Baal L, Wrede KH, Kreitschmann-Andermahr I, Schock L
J Endocrinol Invest · 2026 Apr · PMID 41984405 · Publisher ↗
OBJECTIVES: Acromegaly, a rare endocrine disorder caused by excess growth hormone secretion, affects men and women similarly in prevalence, with women reporting a greater disease burden and a more impaired quality of lif...
OBJECTIVES: Acromegaly, a rare endocrine disorder caused by excess growth hormone secretion, affects men and women similarly in prevalence, with women reporting a greater disease burden and a more impaired quality of life (QoL). It was the aim of the present study to investigate gender differences in subjective disease burden, comorbidities, treatment experience, satisfaction, and QoL in acromegaly, and assess whether QoL differences are mediated by comorbidities and/or gender-specific treatment experiences. METHODS: In a multicenter cross-sectional study, 63 patients with biochemically confirmed acromegaly were surveyed using validated short scales (SF-12, WPAI, MK-HAI, ASKU, PDRQ-9) and self-developed questionnaires assessing sociodemographic data, disease status, subjective symptom load, comorbidities, and patient experiences. Statistical comparisons between men and women were conducted using nonparametric tests. RESULTS: Women reported significantly higher symptom burden, musculoskeletal comorbidities, and health anxiety, alongside lower physical and mental QoL scores, compared to men. Women expressed lower satisfaction with therapy success and greater perceived treatment need, despite similar patient–doctor relationship quality ratings. CONCLUSIONS: Women with acromegaly experience a disproportionate physical and psychological burden relative to men. Our findings, including the subjective treatment experiences, point to the role of comorbidities and differences in treatment outcome in shaping this disparity and underscore the need for patient-centered, gender-sensitive approaches to acromegaly care.
Higher osteocalcin levels are associated with preserved β-cell function in early-established type 1 diabetes.
Zhuang T, Yang Q, Yang D … +3 more , Qian L, Bi Y, Lu J
J Endocrinol Invest · 2026 Apr · PMID 41964785 · Publisher ↗
PURPOSE: Bone-derived cytokines have been implicated in glucose metabolism, but their role in type 1 diabetes mellitus (T1DM) is unclear. We investigated alterations in bone turnover markers (BTMs) and their associations...
PURPOSE: Bone-derived cytokines have been implicated in glucose metabolism, but their role in type 1 diabetes mellitus (T1DM) is unclear. We investigated alterations in bone turnover markers (BTMs) and their associations with β-cell function and autoimmunity in T1DM. METHODS: This cross-sectional study enrolled 369 T1DM individuals and 150 matched controls. Serum BTMs, fasting C-peptide (FCP), HbA1c, glucose, and islet-autoimmune profile were measured. Analyses included group comparisons, linear regression, and Locally Estimated Scatterplot Smoothing (LOESS) to visualize the relationships of FCP and osteocalcin (OC) with disease duration. A logistic-regression model incorporating OC was developed to assess β-cell failure in participants at early stage of established T1DM. RESULTS: Serum BTMs were significantly lower in T1DM versus controls, and lowest in the low-FCP subgroup. Only log-transformed OC (ln[OC]) remained independently associated with log-transformed FCP (ln[FCP]) after adjustment (β = 0.38, P = 0.036). LOESS modelling revealed biphasic FCP decline (rapid within 2 years, then slow), while OC rose initially, peaking at 2 years before declining. The positive ln[OC]-ln[FCP] association was significant only within 5 years post-diagnosis. In this early stage, OC also correlated with regulatory T cells frequency (r = 0.319, P = 0.009). A model combining OC, body mass index, duration, insulin dose, age, and glucose discriminated severe β-cell failure with an AUC of 0.83 (95% confidence interval: 0.77-0.89). CONCLUSION: In early-established T1DM, OC independently associates with preserved β-cell function. Higher OC levels were accompanied by better β-cell function and an expanded regulatory T-cell pool, suggesting a potential role in the islet immune microenvironment.
Lipocalin 2 promotes papillary thyroid cancer progression through activation of glycolysis via Hippo/YAP1/HIF1α axis.
Qian X, Tang J, Jiang L … +3 more , Li L, Shen C, Teng L
J Endocrinol Invest · 2026 Apr · PMID 41964784 · Publisher ↗
BACKGROUND: Lipocalin-2 (LCN2), a secreted glycoprotein implicated in inflammation, metabolism, and tumor progression, has emerged as a critical regulator of cancer cell proliferation and metastasis. However, its role in...
BACKGROUND: Lipocalin-2 (LCN2), a secreted glycoprotein implicated in inflammation, metabolism, and tumor progression, has emerged as a critical regulator of cancer cell proliferation and metastasis. However, its role in papillary thyroid carcinoma (PTC) remains poorly understood. METHODS: The expression of LCN2 in PTC and adjacent normal tissues was assessed by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry (IHC). After LCN2 knockdown or overexpression, cell proliferation, migration, and invasion were evaluated using Cell Counting Kit-8 (CCK-8), colony formation, Transwell, wound-healing, and flow cytometry assays. Glycolytic capacity was assessed via Seahorse extracellular flux analysis, and expression of glycolysis-related genes was determined by RT-qPCR. Differentially expressed genes (DEGs) following LCN2 knockdown were identified via high-throughput sequencing, with Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses used to explore potential mechanisms. Co-immunoprecipitation, luciferase reporter assays, and chromatin immunoprecipitation (ChIP) were employed to examine the involvement of the Hippo/YAP1/HIF1α axis in LCN2-mediated glycolytic activation. In vivo, BCPAP cells with stable LCN2 knockdown were injected into nude mice, and tumor growth was monitored. RESULTS: LCN2 was significantly upregulated in PTC tissues and cells compared to controls, and its high expression was closely correlated with extrathyroidal extension and lymph node metastasis. In vitro, LCN2 knockdown significantly inhibited PTC cell proliferation, migration, invasion, and glycolysis, while overexpression exerted the opposite effects. These effects were reversed by 2-deoxyglucose (2-DG), a glycolysis inhibitor. In vivo, silencing of LCN2 markedly suppressed tumor growth. GO and KEGG analyses indicated that LCN2 may regulate glycolysis in PTC through the Hippo signaling pathway. Mechanistically, LCN2 directly targeted YAP1, which in turn modulated the transcriptional activity of HIF1α to enhance glycolysis. CONCLUSIONS: LCN2 is highly expressed in PTC and promotes glycolysis, proliferation, invasion, and migration by activating the Hippo/YAP1/HIF1α axis. This study elucidates the oncogenic mechanism of the LCN2/YAP1/HIF1α axis in PTC and provides a potential target for molecular therapy.
Early in, early out: reproductive lifespan timing and cardiometabolic risk in women.
Calcaterra V, Nappi RE, Cucinella L … +3 more , Scavone IAM, Parrotta GE, Zuccotti G
J Endocrinol Invest · 2026 Apr · PMID 41961372 · Publisher ↗
PURPOSE: The timing of the biological reproductive span, defined by age at menarche and age at menopause which mark overall reproductive lifespan, has emerged as a clinically relevant red flag of cardio-metabolic vulnera...
PURPOSE: The timing of the biological reproductive span, defined by age at menarche and age at menopause which mark overall reproductive lifespan, has emerged as a clinically relevant red flag of cardio-metabolic vulnerability in women. Beyond reproductive function, these milestones reflect interconnected trajectories of ovarian, metabolic, and vascular ageing, offering a life-course framework for cardiovascular risk identification. METHODS: The present narrative review synthesized evidence from PubMed, Scopus, and Web of Science through December 2025 using terms related to reproductive timing, ovarian aging, cardiovascular disease, and metabolic risk. Observational studies, meta-analyses, mechanistic investigations, and clinical guidelines were included. Evidence was critically appraised to integrate epidemiological associations with biological mechanisms and clinical implications. RESULTS: Early menarche is consistently associated with insulin resistance, dyslipidemia, hypertension, type 2 diabetes, coronary heart disease, stroke, and increased mortality. A U-shaped relationship has also been reported, with very late menarche conferring excess risk. Early menopause and primary ovarian insufficiency (POI) increase cardiovascular risk through early estrogen deprivation, endothelial dysfunction, inflammation, and accelerated vascular aging. A shortened reproductive lifespan independently predicts higher cardiovascular events and mortality. These associations reflect not only cumulative estrogen exposure but also shared genetic susceptibility, adiposity-related pathways, early-life programming, and chronic metabolic stress. CONCLUSION: Reproductive timing represents a key sex-specific dimension of cardiovascular risk. Although POI is recognized in guidelines, systematic consideration of age at menarche and reproductive lifespan may improve early detection, risk stratification, and personalized prevention across the female life course. Recognizing reproductive history as a determinant of cardiovascular ageing is essential to advancing truly sex-specific prevention.
Pituitary involvement in ANCA-associated vasculitis: a retrospective single-center experience and literature review.
Xu T, Zhai X, Duan L … +6 more , Yao Y, Deng K, Feng F, You H, Zhang W, Zhu H
J Endocrinol Invest · 2026 Apr · PMID 41961371 · Publisher ↗
PURPOSE: To describe the clinical manifestations and outcomes of pituitary involvement in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: This study evaluated pituitary horm...
PURPOSE: To describe the clinical manifestations and outcomes of pituitary involvement in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: This study evaluated pituitary hormone and imaging in patients with AAV involving pituitary treated at a tertiary hospital from October 2004 to June 2024. RESULTS: Eighteen patients were enrolled, with a mean age of 46.7 ± 15.6 years and a female predominance (13/18). Headache was the most frequent initial symptom (10/18). The predominant pituitary dysfunction included secondary hypogonadism (10/17) and central diabetes insipidus (CDI, 10/18), with the most common MRI finding being loss of posterior pituitary hyperintensity on T1-weighted imaging (16/18). According to the 2022 ACR/EULAR classification criteria, diagnoses included granulomatosis with polyangiitis (GPA, 11/18) and microscopic polyangiitis (MPA, 1/18), with 6 unclassifiable cases. All but one patient tested positive for ANCA. Sellar biopsies performed in 7 cases, with 2 initial misdiagnoses of lymphocytic hypophysitis (LYH). All patients received corticosteroids in combination with immunosuppressive agents or rituximab, which were effective in most patients. Among 11 patients with median 20-month follow-up (range: 8.5–52.0), no cases demonstrated pituitary functional recovery, while disease recurrence occurred in 5 patients. Eighty-seven cases from the literature were included, mainly GPA and one case of MPA. In contrast to the more common recovery of anterior pituitary function in patients with LYH, 15 out of 60 patients with AAV involving the pituitary demonstrated resolution or improvement of CDI during follow-up. CONCLUSIONS: Diagnosing pituitary-involved AAV is challenging. Sellar biopsies with atypical features require careful interpretation. Regular systemic evaluation and repeated ANCA testing are crucial for accurate diagnosis.
Steatosis indices and penile vascular health: a metabolic association linking liver and vascular phenotypes.
Delbarba A, Ugoccioni M, Gatta E … +6 more , Tiecco G, Quiros-Roldan E, Graziani A, Pirola I, Ferlin A, Cappelli C
J Endocrinol Invest · 2026 Apr · PMID 41961370 · Publisher ↗
OBJECTIVE: To examine the association between non-invasive steatosis indices—Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Dallas Steatosis Index (DSI)—and Penile Color Doppler Ultrasonography (PCDU) derive...
OBJECTIVE: To examine the association between non-invasive steatosis indices—Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Dallas Steatosis Index (DSI)—and Penile Color Doppler Ultrasonography (PCDU) derived parameters of vasculogenic erectile dysfunction, including peak systolic velocity (PSV) and intima–media thickness (IMT). METHODS: In this retrospective study, 96 men evaluated for erectile dysfunction (ED) underwent dynamic PCDU after intracavernosal alprostadil injection. Clinical, biochemical, and metabolic data were collected. Associations between steatosis indices and PCDU parameters were analysed. Multiple regression identified independent predictors of PSV, and ROC analysis assessed the performance of FLI in detecting reduced PSV (< 35 cm/s). RESULTS: Reduced PSV was observed in 24% of participants and was associated with older age, higher FSH and LH levels, lower total and free testosterone, and higher FLI values, while HSI and DSI did not differ between groups. FLI correlated inversely with PSV (R = − 0.305; p = 0.003). In multivariable analysis, only FLI (p = 0.031) independently predicted PSV. ROC curve analysis indicated that an FLI threshold ≥ 67.6 identified reduced PSV with 56% sensitivity and 82% specificity. CONCLUSIONS: FLI is independently associated with impaired penile arterial inflow and may represent a practical, non-invasive marker of vascular andrological risk. These findings suggest that FLI could assist early risk stratification in men with ED.
Management of patients with hypoparathyroidism: a Delphi consensus analysis.
Cianferotti L, Mantovani G, Ravasio R … +4 more , Dinoia A, Torriani A, Vescini F, Chiodini I
J Endocrinol Invest · 2026 Apr · PMID 41961369 · Publisher ↗
PURPOSE: Chronic hypoparathyroidism is a rare endocrine disorder characterized by parathyroid hormone (PTH) deficiency and associated with substantial clinical and therapeutic challenges. Despite conventional therapy and...
PURPOSE: Chronic hypoparathyroidism is a rare endocrine disorder characterized by parathyroid hormone (PTH) deficiency and associated with substantial clinical and therapeutic challenges. Despite conventional therapy and the off-label use of teriparatide, important unmet needs persist regarding metabolic control, prevention of long-term complications, and health-related quality of life (HRQoL). Although recent international and national guidelines have updated recommendations on chronic hypoparathyroidism management, relevant uncertainties and heterogeneity remain in real-world practice, particularly concerning the identification of patients not adequately controlled with conventional therapy, the therapeutic positioning and timing of PTH replacement therapy, monitoring strategies, and the implementation of structured care pathways. This study aimed to assess the level of expert consensus on the current management of hypoparathyroidism in Italy and to identify key gaps and potential areas for therapeutic and organizational improvement. METHODS: A consensus survey was conducted using the Delphi method in two rounds. The Steering Committee defined 41 statements on the management of hypoparathyroidism, which were submitted to 20 expert clinicians via an online survey. Consensus was considered to have been reached with ≥ 70% of responses 4-5 (Likert scale 1-5). RESULTS: The completion rate was 100%. Consensus was reached for 39/41 statements (95.1%). Experts highlighted the limitations of conventional therapy and the off-label use of teriparatide, recognizing the impact of the disease on quality of life and the need for care pathways. The need for hormone replacement therapy was also emphasized, together with the importance of structured monitoring and multidisciplinary follow-up. CONCLUSION: Chronic hypoparathyroidism remains a clinically challenging condition with significant unmet needs. This Italian Delphi consensus complements recent international and national guidelines by providing expert-driven insights on real-world implementation, therapeutic positioning, monitoring, and care pathway development within the Italian healthcare context, supporting the need to introduce hormone replacement therapy and improve multidisciplinary management.
Association between long-term exposure to environmental carbon monoxide and the prevalence of thyroid disorders in China: a nationwide study.
Qiao W, Teng D, Liu S … +4 more , Lu C, Shan Z, Teng W, Li Y
J Endocrinol Invest · 2026 Apr · PMID 41940918 · Publisher ↗
BACKGROUND: Thyroid disorders are common endocrine diseases worldwide, with an increasing incidence in recent years. However, the relationship between long-term carbon monoxide (CO) exposure and various types of thyroid...
BACKGROUND: Thyroid disorders are common endocrine diseases worldwide, with an increasing incidence in recent years. However, the relationship between long-term carbon monoxide (CO) exposure and various types of thyroid disorders remains unclear. This study aimed to explore the association between long-term CO exposure and the odds of thyroid disorders in a Chinese adult population. METHODS: Data from the Thyroid Disease, Iodine Nutrition, and Diabetes Epidemiology (TIDE) study were used, including 73,900 adult participants from 31 provinces in mainland China. Individual CO exposure levels were assessed using the Space Time Extra Trees model (1 × 1 km high-resolution data). Thyroid disorders were defined according to standard criteria, incorporating serum antibody levels (for thyroid autoimmunity [TA], thyroglobulin antibody [TgAb], and thyroid peroxidase antibody [TPOAb]) and thyroid function tests (for overt and subclinical hyper- and hypothyroidism). Multivariable generalized linear models were used to compute adjusted odds ratios (ORs). RESULTS: Higher levels of 5-year average CO exposure were associated with an increased prevalence of TA and TgAb positivity. Participants in the highest CO exposure quartile had 1.19 times the odds of TA and 1.33 times the odds of TgAb positivity compared to those in the lowest quartile. The exposure-response curve revealed a linear positive correlation between CO concentrations and the prevalence of TA and TgAb positivity, independent of iodine status and other confounders. No significant associations were observed for other thyroid disorders. CONCLUSION: In this large cross-sectional study, long-term exposure to higher ambient CO levels was associated with increased odds of TA, particularly TgAb positivity, with evidence of a dose-response relationship. These findings suggest a potential link between ambient CO exposure and TA, though causality cannot be established due to the cross-sectional design. Further longitudinal research is needed to elucidate causal mechanisms and potential interactions with other environmental pollutants.
Specific metabolic rate and body weight regulation: racial and ethnic differences in mass-independent energy expenditure.
Hollstein T, Basolo A, Ando T … +3 more , Chang DC, Krakoff J, Piaggi P
J Endocrinol Invest · 2026 Apr · PMID 41940917 · Publisher ↗
PURPOSE: We evaluated inter-individual differences in adjusted energy expenditure (EE) during 24 hours of carefully controlled energy balance conditions in an ethnically diverse cohort and tested whether the relationship...
PURPOSE: We evaluated inter-individual differences in adjusted energy expenditure (EE) during 24 hours of carefully controlled energy balance conditions in an ethnically diverse cohort and tested whether the relationship between adjusted EE and free-living weight change at 1 year differed by race/ethnicity. METHODS: Healthy individuals (n=120: 20 Black participants, 37 Whites, 46 Indigenous Americans, 17 Hispanics) had 24-h EE measured in a whole-room indirect calorimeter during eucaloric conditions and adjusted for DXA-derived body composition and other covariates. RESULTS: Black participants had ~335 kJ/day (~80 kcal/day) lower adjusted 24-h EE (adj24hEE) compared to other groups, reflecting a 20% lower adjusted metabolic rate after accounting for body composition and other known EE determinants. Black participants reported lower mean perceived hunger, dietary disinhibition, and perceived stress. Among fifty-six individuals (including only 11 Black participants) whose free-living weight change was assessed at 1 year, a 1 MJ/day (~239 kcal/day) higher adj24hEE at baseline predicted a mean weight gain of 3.8 kg only in those who did not identify as Black, whereas adj24hEE tended to be inversely associated with 1-year weight change in Black participants (race/ethnicity interaction: p=0.02). Given the small subgroup sizes, particularly for Black participants, these interaction findings should be considered exploratory and hypothesis-generating. CONCLUSION: Relative metabolic rate differs between races/ethnicities and may differentially predict future weight change, although the race-specific interaction findings require confirmation in larger cohorts. For individuals who do not self-identify as Black, relatively higher metabolic demands during sedentary conditions may contribute to energy sensing-mediated overeating and ultimately weight gain.
Pregnancy after bariatric surgery: a point of view on unresolved questions.
Burlina S, Dalfrà MG, Lapolla A
J Endocrinol Invest · 2026 Apr · PMID 41940916 · Publisher ↗
Bariatric surgery is an established therapeutic option for morbid obesity increasing worldwide, including women of childbearing age, due to improved fertility. From this perspective, several issues related to the managem...
Bariatric surgery is an established therapeutic option for morbid obesity increasing worldwide, including women of childbearing age, due to improved fertility. From this perspective, several issues related to the management of pregnancy after bariatric surgery will be analyzed and discussed, including alterations in glucose homeostasis, diagnosis of gestational diabetes, postprandial hyperinsulinemic hypoglycemia, and nutritional deficiencies.
The role of nutrition on thyroid health and disease: myths and facts.
Ruggeri RM, Virili C, Mocini E … +6 more , Campennì A, Centanni M, Rotondi M, Cannavò S, Croce L, Migliaccio S
J Endocrinol Invest · 2026 Apr · PMID 41940915 · Publisher ↗
PURPOSE: This narrative review examines the role of essential nutritional factors in thyroid function, moving beyond the traditional focus on iodine supplementation. The specific aim was to explore the association betwee...
PURPOSE: This narrative review examines the role of essential nutritional factors in thyroid function, moving beyond the traditional focus on iodine supplementation. The specific aim was to explore the association between food intake, specific nutrients, dietary patterns, and thyroid diseases, with particular emphasis on autoimmune mechanisms. METHODS: A structured literature search was conducted using online databases to identify relevant studies published over the past two decades. Articles investigating the relationship between nutrients, dietary patterns, thyroid function, and autoimmune thyroid disorders were selected and analyzed. RESULTS: Evidence confirms the crucial role of iodine and selenium in thyroid hormone synthesis and redox balance. Iron and zinc support enzymatic activity and endocrine stability. Vitamin D has emerged as a potential immunoregulatory factor in autoimmune thyroid diseases. Additionally, certain macronutrients and bioactive compounds, including polyphenols and omega-3 fatty acids, demonstrate beneficial effects due to their anti-inflammatory, antioxidant, and immunomodulatory properties. Adherence to the Mediterranean diet has been associated with favorable thyroid outcomes. In contrast, Western-style dietary patterns high in fat, calories, and red meat may negatively affect thyroid health, while gluten-free or lactose-free regimens do not appear to provide significant benefits. CONCLUSIONS: Evidence-based nutritional strategies represent valuable adjunctive approaches in the prevention and clinical management of thyroid disorders. Adherence to a Mediterranean dietary pattern and reduced meat consumption may improve thyroid function and help protect against autoimmune diseases.
Adipokines modulation through exercise training: a comparative study of different training models in men with obesity.
Saeidi A, Saghari S, Shams S … +9 more , Amani-Shalamzari S, Mojarad ME, Shafei A, Nasser MNA, Almaqhawi A, Hejazi K, Escubar KA, Supriya R, Zouhal H
J Endocrinol Invest · 2026 Apr · PMID 41940914 · Publisher ↗
BACKGROUND: Obesity is linked to dysregulation of adipokines and an increased risk of cardiometabolic issues. While various exercise modalities are recommended for managing obesity, their comparative effects on emerging...
BACKGROUND: Obesity is linked to dysregulation of adipokines and an increased risk of cardiometabolic issues. While various exercise modalities are recommended for managing obesity, their comparative effects on emerging adipokines are still unclear. OBJECTIVE: To compare the efficacy of 12-week Tabata, high-intensity interval training (HIIT), and moderate-intensity continuous training (MICT) on the adipo-myokine landscape and metabolic health in men with obesity. METHODS: Forty-four participants living with obesity were randomly assigned to Tabata, HIIT, MICT, or control groups. Anthropometric, metabolic (lipid profiles, fasting blood sugar, insulin), and adipokine data were assessed pre- and post-intervention. Data were analyzed using repeated-measures ANOVA with Sidak post-hoc tests. Effect sizes (η²) were reported. RESULTS: All training modalities significantly improved lipid profiles (p < 0.05). Notably, high-intensity protocols (Tabata and HIIT) demonstrated superior efficacy in modulating the asprosin-spexin axis compared to MICT. Spexin and irisin levels significantly increased, while lipocalin-2 and asprosin decreased across the training groups, with the largest effect sizes observed in the Tabata and HIIT interventions (η² = 0.26-0.37). Furthermore, these improvements in adipo-myokine profiles occurred alongside significant reductions in fat mass, reinforcing the role of exercise intensity in metabolic regulation. CONCLUSION: Conclusion: While all exercise models are beneficial, high-intensity strategies-particularly Tabata-provide a more potent and time-efficient stimulus for improving the adipokine profile and cardiometabolic risk factors in individuals living with obesity. These findings advocate for the inclusion of high-intensity interval modalities in clinical weight management programs.
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