Endokrynologia Polska[JOURNAL]
Sun
200 papers
Age, gender, and BMI in presentation of primary hyperparathyroidism: a single-center experience.
Mlekus Kozamernik K, Vidmar G, Jensterle Sever M … +6 more , Lezaic L, Hocevar M, Jazbinsek S, Remec K, Janez A, Kocjan T
Endokrynol Pol · 2025 · PMID 40892392 · Publisher ↗
BACKGROUND: Primary hyperparathyroidism (PHPT) is a relatively common disease with considerable heterogeneity. We aimed to assess the impact of age, gender, and body mass index (BMI) on the presentation of PHPT. MATERIAL...
BACKGROUND: Primary hyperparathyroidism (PHPT) is a relatively common disease with considerable heterogeneity. We aimed to assess the impact of age, gender, and body mass index (BMI) on the presentation of PHPT. MATERIAL AND METHODS: We retrospectively analyzed the baseline biochemical status, symptoms, renal manifestations, and bone mineral density (BMD) of patients diagnosed with PHPT at the national tertiary endocrine referral clinic from January 2004 to December 2016. RESULTS: We included 415 patients (333 women [41 premenopausal, 292 postmenopausal] and 82 men) with PHPT, aged 64 years on average [standard deviation (SD)13, range 19-89 years], with an average BMI of 28.4 (SD 6.0, range 11.2-51.1 kg/m²). Older age was statisticallysignificantly associated with milder biochemical presentation - lower total and corrected calcium (standardized regression coefficient β = -0.17, p < 0.001 and β = -0.12, p = 0.018). In comparison with premenopausal women, postmenopausal women [estimated odds ratio (OR) = 8.6, 95% confidence interval (CI): 3.9-20.8; p < 0.001] and men (OR = 5.9, 95% CI: 2.5-15.6; p < 0.001) were more likely to suffer from skeletal manifestations of PHPT. Renal manifestations were less likely among postmenopausal than premenopausal women (OR = 0.4, 95% CI: 0.2-0.8; p = 0.014). BMI was negatively associated with skeletal and renal manifestations (OR = 0.94 per unit change, p = 0.002) and symptomatic presentation (OR = 0.96 per unit change, p = 0.012). CONCLUSION: Older patients with PHPT presented with a biochemically less florid disease. Postmenopausal women and men with PHPT were more likely to suffer from skeletal manifestations of PHPT than premenopausal women. Patients with higher BMI had fewer skeletal and renal manifestations of PHPT and were less likely to be symptomatic.
Comparison of triglyceride-glucose index and HOMA-IR in assessing insulin resistance in acromegaly: a case-control study.
Karadeniz Y, Caliskan Burgucu H, Ozturk Y … +4 more , Yarar Z, Kaynak H, Can M, Karakose M
Endokrynol Pol · 2025 · PMID 40892391 · Publisher ↗
INTRODUCTION: The objective was to assess the triglyceride-glucose (TyG) index and the homeostatic model assessment for insulin resistance (HOMA-IR) in the evaluation of insulin resistance in patients with acromegaly and...
INTRODUCTION: The objective was to assess the triglyceride-glucose (TyG) index and the homeostatic model assessment for insulin resistance (HOMA-IR) in the evaluation of insulin resistance in patients with acromegaly and to compare results with healthy controls. MATERIAL AND METHODS: A retrospective case-control study was conducted at the Department of Endocrinology, Necmettin Erbakan University, Meram Faculty of Medicine. The study included 50 acromegalic patients and 50 age- and sex-matched healthy controls. RESULTS: The median age and sex distribution were similar between the acromegaly and control groups (p > 0.05). Compared to the control group, acromegalic patients had significantly higher fasting glucose, HbA1c, total cholesterol, triglyceride, TyG index, and AST levels (p < 0.05 for all), while hemoglobin and platelet counts were significantly lower (p < 0.05). Diabetes mellitus (DM) was present in 24.0% of acromegalic patients. Compared to those without DM, acromegalic patients with DM were significantly older, had greater frequency of cardiovascular disease, and higher glucose, HbA1c, and neutrophil levels (p < 0.05). The TyG index showed a significant correlation with fasting glucose in both groups, but it correlated with insulin and HOMA-IR only in controls. CONCLUSION: Acromegalic patients exhibit significant metabolic alterations, including higher TyG index levels and increased DM prevalence, despite having similar HOMA-IR values to healthy controls.
Sclerostin levels in patients with acromegaly.
Wydra A, Wydra J, Rogowska J … +2 more , Zgliczyński W, Czajka-Oraniec I
Endokrynol Pol · 2025 · PMID 40892390 · Publisher ↗
Acromegaly is a rare, endocrine condition characterized by autonomous excessive secretion of growth hormone, causing numerous complications, including impairment of bone microarchitecture. The increased bone turnover obs...
Acromegaly is a rare, endocrine condition characterized by autonomous excessive secretion of growth hormone, causing numerous complications, including impairment of bone microarchitecture. The increased bone turnover observed in acromegaly can lead to bone fragility and elevated risk of vertebral fractures despite normal bone mineral density measured with dual-energy X-ray-absorptiometry. Treatment of acromegaly improves bone architecture; however, it does not completely reverse this process, and the increased vertebral fracture risk persists despite adequate disease control. Sclerostin, a product of the SOST gene, is one of the markers of bone turnover. Elevated sclerostin levels are correlated with impaired bone formation and serve as an independent risk factor for osteoporotic fractures in postmenopausal women. Inhibition of sclerostin is currently used in the treatment of osteoporosis in postmenopausal women. Considering the increased risk of vertebral fractures in patients with acromegaly, it is important to understand the potential role of sclerostin in this group of patients. This systematic review aimed to evaluate sclerostin levels in patients with acromegaly in comparison to the general population. The search strategy led to 7 studies meeting the inclusion criteria, which resulted in the inclusion of 385 patients with acromegaly in the final analysis. Available studies have provided conflicting results regarding sclerostin levels in acromegaly. Most of the studies showed lower sclerostin concentrations in patients with acromegaly compared to healthy controls, or no differences among groups. Only one study reported positive correlation between sclerostin levels and acromegaly, and its activity, expressed as insulin-like growth factor (IGF-1) and growth hormone (GH) concentrations. The rarity of acromegaly, small subject numbers, and heterogeneity of the groups could impact the results.
Selective estrogen receptor modulators and aromatase inhibitors in the treatment of functional male hypogonadism.
Wydra J, Wydra A, Kucharczyk P … +3 more , Kapuściński G, Zgliczyński W, Rabijewski M
Endokrynol Pol · 2025 · PMID 40892389 · Publisher ↗
Functional hypogonadism is a syndrome characterized by low testosterone levels and clinical features of hypogonadism without organic disease of the hypothalamus-pituitary-gonadal axis. It is most prevalent among middle-a...
Functional hypogonadism is a syndrome characterized by low testosterone levels and clinical features of hypogonadism without organic disease of the hypothalamus-pituitary-gonadal axis. It is most prevalent among middle-aged and older men as late-onset hypogonadism as well as in a wide range of conditions such as obesity, type 2 diabetes, opioid use, or exogenous steroid abuse. As a potentially reversible condition, lifestyle modifications are the basis of initial management of functional hypogonadism. However, if behavioral interventions cannot be expected to be successful in raising testosterone levels in a reasonable amount of time, then both testosterone and alternative treatments must be considered. In young men seeking fertility, testosterone is contraindicated; hence, selective estrogen receptor modulators and aromatase inhibitors might be offered; however, the available literature concerning their use in male functional hypogonadism is rather scarce. This review aims to update information about selective estrogen receptor modulators and aromatase inhibitors in the treatment of functional male hypogonadism.
Clinicopathological insights into primary hyperparathyroidism: a comprehensive single-center retrospective study.
Brodowska-Kania DA, Saracyn M, Osial N … +9 more , Mróz A, Grala B, Remyzovska O, Durma AD, Wiłkojć M, Kowalewski P, Zięcina P, Kołodziej M, Kamiński G
Endokrynol Pol · 2025 · PMID 40892386 · Publisher ↗
INTRODUCTION: Primary hyperparathyroidism (PHPT) is caused by excessive hormone secretion from one or more parathyroid glands. Based on their morphological and immunophenotypic characteristics, parathyroid glands can be...
INTRODUCTION: Primary hyperparathyroidism (PHPT) is caused by excessive hormone secretion from one or more parathyroid glands. Based on their morphological and immunophenotypic characteristics, parathyroid glands can be considered as neuroendocrine organs, and their neoplasms as neuroendocrine tumors. The 2022 World Health Organization (WHO) Classification of Endocrine and Neuroendocrine Tumors introduced updated diagnostic criteria, advancing the understanding of parathyroid neoplasms. This study aimed to analyze the clinicopathological features of PHPT, emphasizing tumor localization and histopathological findings. MATERIAL AND METHODS: The retrospective study analyzed 39 surgically treated patients for PHPT at a single tertiary referral center between 2022 and 2024. Localization methods included neck ultrasonography (US), technetium-99m methoxyisobutylisonitrile single photon emission computed tomography/computed tomography ([99mTc]Tc-MIBI SPECT/CT), and ¹⁸F-fluorocholine positron emission tomography/computed tomography (¹⁸F-FCH PET/CT). Postoperative histopathological evaluation of specimens was conducted according to the 2022 WHO criteria. RESULTS: The cohort comprised 85% female patients with a mean age of 57.8 years. Lower parathyroid glands were more frequently affected, reflecting their distinct embryological origins. Pathological analysis identified 77.5% parathyroid adenomas (PA), 12.5% atypical parathyroid tumors (APT), and 7.5% parathyroid carcinomas (PC), with the incidence of APT and PC exceeding reported ranges. PET/CT showed superior diagnostic accuracy (100% detection) compared to neck US (65.8%) and [99mTc]Tc-MIBI SPECT/CT (65.7%). Maximum standardized uptake value (SUVmax) from PET/CT significantly correlated with serum calcium, PTH concentration, and lesion volume, suggesting their utility as markers of metabolic activity. Surgery achieved a 92.3% cure rate, with successful reoperations in all recurrent cases. CONCLUSIONS: The study underscores the neuroendocrine nature of parathyroid glands, highlights the diagnostic value of the updated WHO classification, and demonstrates the superior accuracy of 18F-FCH PET/CT in localizing parathyroid lesions. A deeper understanding of the neuroendocrine characteristics of parathyroid glands and their embryological migration patterns could further improve diagnostic and therapeutic strategies. Early diagnosis and precise localization of affected parathyroid glands remain critical for achieving curative outcomes in PHPT.
Association between adipose insulin resistance, serum lipoprotein(a) level, and MASLD in adult patients with T2DM in China.
Liu Y, Sun J, Zhang X
Endokrynol Pol · 2025 · PMID 40728432 · Publisher ↗
INTRODUCTION: The aim was to explore the correlation between adipose tissue insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), and to assess how the serum lipoprotein(a) [Lp(a)] leve...
INTRODUCTION: The aim was to explore the correlation between adipose tissue insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), and to assess how the serum lipoprotein(a) [Lp(a)] level modifies the association between adipose insulin resistance and MASLD. MATERIAL AND METHODS: We analyzed hospitalized type 2 diabetes mellitus (T2DM) patients and calculated the adipose insulin resistance (Adipo-IR) index as the product of the fasting insulin and free fatty acid concentration. There were 2247 participants in the study, 64.6% (n = 1452) with MASLD. RESULTS: Compared to subjects in the first quartile of the Adipo-IR index, there were 1.29 [odds ratio (OR): 2.29, 95% confidence interval (CI): 1.56-3.36], 2.55 (OR: 3.55, 95% CI: 2.34-5.37), and 2.00 (OR: 3.00, 95% CI: 1.94-4.63) fold higher odds of having MASLD among subjects in the second, the third, and the fourth Adipo-IR index quartile, respectively. As the Adipo-IR index was in the range lower than 7.5, Adipo-IR was a risk factor for MASLD (OR: 1.349, 95%CI: 1.226-1.484). Conversely, if the Adipo-IR index was higher than 7.5, it became a protective factor for MASLD (OR: 0.980, 95% CI: 0.964-0.997). Subjects with high Lp(a) and low Adipo-IR showed the lowest risk of MASLD. Compared to this group, the ORs of MASLD was 2.411 (95% CI: 1.590-3.656) for the high Adipo-IR and low Lp(a) group, 2.770 (95% CI: 1.808-4.246) for the high Adipo-IR and high Lp(a) group, and 1.473 (95% CI: 1.003-2.164) for the low Adipo-IR and low Lp(a) group. CONCLUSIONS: In patients with T2DM, with the increase of Adipo-IR, the incidence of MASLD showed a trend of first an increase and then a decrease. Among patients with T2DM, those with low Adipo-IR combined with high Lp(a) had the lowest risk of developing MASLD.
Breast neuroendocrine neoplasms - characteristics in contrast-enhanced mammography.
Niewiadomska A, Grażyńska A, Rosiek V … +6 more , Winder M, Szczudło-Chraścina J, Hrapkowicz M, Barczyk-Gutkowska A, Kuźbińska A, Steinhof-Radwańska K
Endokrynol Pol · 2025 · PMID 40728431 · Publisher ↗
INTRODUCTION: Neuroendocrine neoplasms of the breast (Br-NENs) constitute a heterogeneous group of rare tumors, whose number may be underestimated. Our study aims to evaluate and compare the analysis of the radiological...
INTRODUCTION: Neuroendocrine neoplasms of the breast (Br-NENs) constitute a heterogeneous group of rare tumors, whose number may be underestimated. Our study aims to evaluate and compare the analysis of the radiological features of Br-NEN and carcinomas with neuroendocrine differentiation (NEDBC), which were visualized in contrast-enhanced mammography (CEM) images. MATERIAL AND METHODS: The histories of patients who, between 2015 and 2023, underwent CEM and core needle biopsy/postoperative histopathological examination confirming the nature of the lesion were retrospectively analyzed. All CEM images were acquired on two digital mammograms designed for dual-energy CEM acquisition (SenoBright et al., 3000 N. Grandview Blvd., Waukesha, WI, USA and Giotto Class, IMS Giotto, Sagittario, 5, 40037 Sasso Marconi BO, Italy). Two radiologists with at least eight years of experience describing CEM analyzed the studies and classified them into appropriate morphological categories. RESULTS: Ten patients with histopathologically diagnosed Br-NEN and 14 with NEDBC were retrospectively assessed. The mean age of patients at the time of diagnosis of Br-NEN was 56.5 years, and for NEDBC it was 67.4 years. All Br-NEN lesions and 93% of NEDBC lesions were observed as masses on low-energy CEM images. In the Br-NEN group, lesions most often had an oval shape (40%), while NEDBC lesions were irregular (43%) and obscure (43%). Multifocality and multicentricity of the tumor process were observed much more often in the Br-NEN group than in the NEDBC group. In the recombinant images, all lesions from the two groups were enhanced after intravenous administration of the iodinated contrast agent. CONCLUSION: Br-NEN and NEDBC show similar radiological features on CEM images, differing only in a few aspects.
An update on biochemical findings for stages of nutritional rickets.
Korkmaz HA
Endokrynol Pol · 2025 · PMID 40728430 · Publisher ↗
Rickets is a disease of the growing skeleton resulting from impaired hypertrophic chondrocyte apoptosis and growth plate mineralization. According to the present data on children with nutritional rickets, there are three...
Rickets is a disease of the growing skeleton resulting from impaired hypertrophic chondrocyte apoptosis and growth plate mineralization. According to the present data on children with nutritional rickets, there are three stages of biochemical findings. Using these biochemical findings, we aimed to update the stages of nutritional rickets in this review.
Elevated thyroglobulin levels in fine-needle aspiration washout fluid from thyroid nodules: a potential marker of benign nature?
Uysal S, Sulu C, Kocaman BB … +7 more , Muradov I, Soltanova L, Sahin S, Ozkaya HM, Konukoglu D, Damci T, Gonen MS
Endokrynol Pol · 2025 · PMID 40728429 · Publisher ↗
INTRODUCTION: To investigate the relationship between thyroglobulin (Tg) levels obtained from thyroid fine-needle aspiration (FNA) and cytopathological results. MATERIAL AND METHODS: This cross-sectional study included p...
INTRODUCTION: To investigate the relationship between thyroglobulin (Tg) levels obtained from thyroid fine-needle aspiration (FNA) and cytopathological results. MATERIAL AND METHODS: This cross-sectional study included patients who underwent FNA between January 2023 and August 2024 in accordance with the American College of Radiology Thyroid Imaging Reporting and Data System risk scoring. Patients with pure cystic nodules, non-thyroid malignancy, and major psychiatric disorders that could interfere with compliance during the procedure were excluded from the study. FNA-Tg samples were obtained from the nodules using a 22-gauge needle on the first attempt. FNA-Tg levels were then measured by electrochemiluminescence immunoassay. These levels were compared among different patient groups and classified according to the cytopathological examination results based on the Bethesda System for Reporting Thyroid Cytopathology. Statistical analyses were performed using the Statistical Package for the Social Sciences, version 20. RESULTS: The study included 193 FNA samples in 193 patients. In 148 (76.7%) out of 193 samples the aspirate was diagnostic. Of these, 101 (68.2%) were benign (Bethesda II), 29 (19.6%) were indeterminate (Bethesda III-IV), and 18 (12.2%) were malignant (Bethesda V-VI). FNA-Tg levels were significantly higher in benign nodules compared to malignant ones (p < 0.001). There was no significant difference between concomitant serum Tg levels in patients with benign and malignant nodules (p = 0.614). An FNA-Tg value above 13,262 ng/mL predicted benign cytology with 71.3% sensitivity and 77.8% specificity. CONCLUSIONS: FNA-Tg levels may provide valuable insights into FNA cytology and serve as an effective marker for distinguishing benign nodules from those with malignant characteristics.
Physical activity variability with the risk of type 2 diabetes: findings from a National Prospective Cohort Study.
Wang Z, Zhao A, Ma C … +2 more , Zhang Z, Zhang Y
Endokrynol Pol · 2025 · PMID 40728428 · Publisher ↗
INTRODUCTION: The objective was to investigate the association between physical activity variability (PAVar) and the risk of type 2 diabetes mellitus (T2DM) among middle-aged and older adults. MATERIAL AND METHODS: This...
INTRODUCTION: The objective was to investigate the association between physical activity variability (PAVar) and the risk of type 2 diabetes mellitus (T2DM) among middle-aged and older adults. MATERIAL AND METHODS: This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), following participants from 2011 to 2020. A total of 3970 individuals with sufficient physical activity (PA) data were categorized into quartiles based on the coefficient of variation (CV) for PAVar. The incidence of T2DM was assessed using Cox proportional hazards models adjusted for demographic, socioeconomic, and lifestyle factors. Mediation analysis was performed to evaluate whether sleep duration influenced the relationship between PAVar and T2DM risk. Sensitivity analyses excluded individuals with missing baseline data to ensure the reliability of the findings. RESULTS: Higher PAVar was associated with an elevated risk of T2DM. In fully adjusted models, participants in the highest CV quartile had a 70% greater risk of developing T2DM [hazard ratio (HR): 1.70, 95% confidence interval (CI): 1.54-1.88] compared to those in the lowest quartile. Mediation analysis showed that sleep duration accounted for 18.5% of the total effect of PAVar on T2DM risk. Sensitivity analyses confirmed the robustness of these findings. CONCLUSIONS: This study demonstrates the harmful effects of high PAVar on T2DM risk and underscores the need to promote consistent physical activity patterns and adequate sleep to prevent diabetes, particularly in aging populations.
Cardiometabolic index is a novel predictor for osteoporosis in type 2 diabetes mellitus patients with MAFLD: a cross-sectional study.
Zhang Y, An J, Li X … +3 more , Li L, Bai J, Lv H
Endokrynol Pol · 2025 · PMID 40728427 · Publisher ↗
INTRODUCTION: As a new index of obesity and metabolism, the cardiometabolic index (CMI) has been shown to play an important role in the prediction and diagnosis of metabolic diseases. However, the relationship between CM...
INTRODUCTION: As a new index of obesity and metabolism, the cardiometabolic index (CMI) has been shown to play an important role in the prediction and diagnosis of metabolic diseases. However, the relationship between CMI and osteoporosis (OP) in type 2 diabetes mellitus (T2DM) patients with metabolism-associated fatty liver disease (MAFLD) remains unclear. The present study aims to explore the relationship between them and provide new insights for the clinical management of OP in patients with T2DM. MATERIAL AND METHODS: A total of 429 T2DM patients with MAFLD were selected. Characteristics of the participants were compared across the quartiles of CMI. Spearman correlation analysis was conducted to examine the correlation between CMI and BMD. Regression models were utilized to investigate the relationship between CMI and bone mineral density (BMD) as well as OP. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic efficacy of CMI for identifying OP in T2DM patients with MAFLD. RESULTS: The present study found that after adjustment for multivariate analysis, CMI was negatively correlated with lumbar spine (LS) BMD (β = -0.158, p < 0.001), femoral neck (FN) BMD (β = -0.129, p = 0.004), and hip BMD (β = -0.350, p < 0.001) in T2DM patientswith MAFLD. Furthermore, CMI was significantly associated with OP [odds ratio (OR) = 2.297, 95% confidence interval (CI): 1.198-4.424, p = 0.012]. The receiver operating characteristic curve (ROC) curve revealed that the area under the curve (AUC) of CMI for predicting OP in T2DM patients with MAFLD was 0.755 (95% CI: 0.676-0.833, p < 0.001), with an optimal threshold of 1.948. The predictive accuracy for OP was higher in female patients (AUC: 0.863, p < 0.001) compared to male patients (AUC: 0.716, p < 0.001). CONCLUSION: CMI shows a significant negative correlation with BMD in T2DM patients with MAFLD. It is an independent risk factor for OP in this patient population, offering a new direction for the prevention and screening of OP in individuals with T2DM. Moreover, CMI demonstrated greater diagnostic efficiency in postmenopausal female patients over the age of 50 years compared to male patients of the same age group.
Clinical insight into hypercalcemia in children.
Korkmaz HA
Endokrynol Pol · 2025 · PMID 40728426 · Publisher ↗
Plasma calcium levels are regulated by many factors, including the levels of calcium-sensitive receptors, parathyroid hormone, parathyroid hormone receptors, vitamin D, vitamin D receptors, and other proteins. Plasma cal...
Plasma calcium levels are regulated by many factors, including the levels of calcium-sensitive receptors, parathyroid hormone, parathyroid hormone receptors, vitamin D, vitamin D receptors, and other proteins. Plasma calcium is also related to genetic structure; albumin, creatinine, and phosphorus levels; and blood pH. Multiple factors affect hypercalcemia in children, making its management challenging. These factors have led to accurate diagnosis for mostly mild and moderate cases of hypercalcemia, resulting in a management dilemma. In many clinics, physicians face undiagnosed cases of hypercalcemia even if the hypercalcemia algorithms are followed accurately. In this narrative review, we discuss a logical approach to the investigation and subsequent clinical management of hypercalcemia in children.
Virilizing insulinoma.
Kochan-Olszewska D, Kopczyński J, Kowalska A
Endokrynol Pol · 2025 · PMID 40728419 · Publisher ↗
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Primary hepatic neuroendocrine carcinoma coexisting with atypical lung adenocarcinoma.
Yin L, Lin Y, Kou T … +2 more , Lin Z, Li Q
Endokrynol Pol · 2025 · PMID 40586412 · Publisher ↗
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Metastatic follicular thyroid carcinoma with excellent response to radioiodine therapy.
Martins Fernandes A, Elvas AR, Augusto Silva L … +3 more , Marques B, Rovira E, Rodrigues FJ
Endokrynol Pol · 2025 · PMID 40586411 · Publisher ↗
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Inappropriate antidiuretic hormone secretion syndrome following COVID-19 infection misdiagnosed as cerebral infarction.
Li Y, Wei J, Lan C … +1 more , Liu Y
Endokrynol Pol · 2025 · PMID 40586410 · Publisher ↗
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Reference intervals for thyroid hormones in pregnant women.
Sun T, Liu X, Yin C
Endokrynol Pol · 2025 · PMID 40586409 · Publisher ↗
INTRODUCTION: To determine the trimester-specific reference range of thyroid function in a single centre in Beijing. MATERIAL AND METHODS: A total of 361 healthy pregnant women and 122 normal non-pregnant women tested fo...
INTRODUCTION: To determine the trimester-specific reference range of thyroid function in a single centre in Beijing. MATERIAL AND METHODS: A total of 361 healthy pregnant women and 122 normal non-pregnant women tested for thyroid function in the outpatient clinic of our hospital were selected as the research subjects. After being grouped according to the inclusion criteria, the test values of thyroid function indicators thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were recorded, respectively. According to the method of establishing reference value standards given in the guide, using the 2.5 percentile of the data distribution as the lower limit of the reference value and the 97.5 percentile as the upper limit of the reference value, we established the laboratory thyroid function indicators TSH and FT4 pregnancy-specific reference value range. RESULTS: The values of pregnancy-specific thyroid function indexes in the first, second, and third trimesters were as follows: TSH (0.02-3.39 mIU/L, 0.03-3.43 mIU/L, 0.27-3.88 mIU/L); FT4 (12.24-20.77 pmol/L, 10.78-20.75 pmol/L, 9.54-16.02 pmol/L). Serum TSH and FT4 levels showed a weak negative correlation throughout pregnancy. The established reference value range was used to evaluate the thyroid function of pregnant women in this study. The overall screening found subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and the prevalence of hyperthyroidism to be 3.5%, 0%, 2.5%, and 0.3%, respectively. CONCLUSIONS: The reference range specific to pregnancy differs from that recommended by the American Thyroid Association (ATA), affecting the diagnosis and treatment of thyroid disease in pregnant women. To correctly detect and control these diseases, the pregnancy-specific reference must be set up clinically to avoid clinical over-diagnosis and missed diagnosis.
Normalization strategies in neonatal steroid metabolomics: a comparative analysis of probabilistic quotient and peer group approaches.
Lorek M, Stradomska TJ, Siejka A … +3 more , Fuchs J, Januś D, Gawlik-Starzyk A
Endokrynol Pol · 2025 · PMID 40586408 · Publisher ↗
INTRODUCTION: Steroid metabolomics in neonatal populations is challenged by considerable physiological heterogeneity and technical variability, which complicate the interpretation and comparability of metabolite profiles...
INTRODUCTION: Steroid metabolomics in neonatal populations is challenged by considerable physiological heterogeneity and technical variability, which complicate the interpretation and comparability of metabolite profiles. Effective normalization strategies are essential to ensure accurate data analysis in this context. MATERIAL AND METHODS: We analyzed 24-hour urinary steroid profiles in a cohort of 50 neonates (including very preterm, late preterm, and full-term infants) using gas chromatography-mass spectrometry. Two normalization techniques were compared: probabilistic quotient normalization (PQN) and peer group normalization (PGN). Normalization performance was assessed via distribution metrics, correlation with anthropometric variables, and principal component analysis (PCA). RESULTS: PGN achieved superior distributional normalization, with 27 of 30 metabolites conforming to normality assumptions, compared to 21 using PQN. PGN also eliminated all significant correlations between steroid levels and anthropometric parameters, indicating effective reduction of physiological confounding. In contrast, PQN partially mitigated such associations but was less robust in handling high-abundance metabolites. PCA confirmed improved sample dispersion and group separation after normalization, with method-dependent differences in Scores Plot. CONCLUSIONS: Peer group normalization is a sophisticated approach to reducing physiological variability in neonatal steroid profiling. These observations lend further credence to PGN as a promising strategy for standardizing steroid metabolomics in the field of neonatology. Nevertheless, further validation is necessary to substantiate these findings.
Calcitonin and procalcitonin measurement after cholecystokinin-2/gastrin receptor agonist stimulation in patients with advanced medullary thyroid cancer: results from the GRAN-T-MTC study.
Trofimiuk-Müldner M, Bajuk Studen K, Erba PA … +16 more , Lezaic L, Decristoforo C, Zaletel K, Kolenc P, Przybylik-Mazurek E, Virgolini I, Fröberg AC, Skalniak A, Mikołajczak R, de Jong M, Solnica B, Fedak D, Gaweda P, Rangger C, Skórkiewicz K, Hubalewska-Dydejczyk A
Endokrynol Pol · 2025 · PMID 40586407 · Publisher ↗
INTRODUCTION: Medullary thyroid cancer (MTC) is characterized by overexpression of cholecystokinin-2/gastrin receptors (CCK2R). There are limitations of calcitonin as a tumor marker in MTC diagnosis and prognosis. Procal...
INTRODUCTION: Medullary thyroid cancer (MTC) is characterized by overexpression of cholecystokinin-2/gastrin receptors (CCK2R). There are limitations of calcitonin as a tumor marker in MTC diagnosis and prognosis. Procalcitonin is gaining a role as a complementary tumor marker. This study aimed to assess the feasibility of procalcitonin measurements on top of the calcitonin measurements after CCK2R agonist stimulation in patients with MTC. MATERIAL AND METHODS: The assessment was part of the GRAN-T-MTC translational study conducted through a Phase I multicenter clinical trial in patients with locally advanced and/or disseminated MTC. Patients were administered intravenously the CCK2R agonist CP04 labelled with indium-111 ([¹¹¹In]In-CP04); the first four patients at a lower mass amount of 10 μg, and afterwards the whole group at a higher mass amount of 50 μg. Blood samples for calcitonin and procalcitonin measurements were obtained shortly before and 2, 5, 10, and 20 minutes after start of [¹¹¹In]In-CP04 administration. RESULTS: Sixteen patients were included in the study. After injection of the higher mass amount of [¹¹¹In]In-CP04, the median maximum ratio for stimulated calcitonin was 2.97 (interquartile range [IQR] 2.35) pg/mL and procalcitonin 2.01 (IQR 2.07) pg/mL. The maximum stimulated/baseline calcitonin ratio was 5.2 ± 4.0 and 4.1 ± 3.8 in the low and high mass amount groups, respectively, and the maximum stimulated/baseline procalcitonin ratio was 4.6 ± 5.1 and 2.9 ± 3.1 in the low and high mass amount groups, respectively. There was a significant linear correlation between calcitonin and procalcitonin concentrations (p < 0.001) at each test time point and between the maximum procalcitonin and maximum calcitonin increment ratio (r = 0.94, p < 0.0001). Mild, short-lasting side effects (transient tachycardia, flushing) were observed in one patient during the injection of low and in two patients during the injection of high mass amount of [¹¹¹In] In-CP04. The side effects were not related to the baseline calcitonin or procalcitonin concentrations. CONCLUSION: Procalcitonin concentrations after CP04 stimulation were highly correlated with calcitonin concentrations. Unlabeled CP04, if available commercially, may be considered an alternative stimulating agent in MTC patients, even in lower mass amounts. Further studies, including healthy controls, are required to prove this concept and calculate the diagnostic thresholds.
Association between the cumulative metabolic score for insulin resistance and diabetes mellitus incidence: a prospective nationwide cohort study in China.
Wen S, Huang X, Huang Z … +4 more , Deng Z, Zhou C, Chen N, Huang Y
Endokrynol Pol · 2025 · PMID 40586406 · Publisher ↗
INTRODUCTION: The relationship between changes in metabolic score for insulin resistance (METS-IR) and diabetes mellitus (DM) remains to be elucidated. The present study sought to explore whether changes in METS-IR were...
INTRODUCTION: The relationship between changes in metabolic score for insulin resistance (METS-IR) and diabetes mellitus (DM) remains to be elucidated. The present study sought to explore whether changes in METS-IR were associated with incident DM. MATERIAL AND METHODS: This study included 4031 individuals aged over 45 years from the China Health and Retirement Longitudinal Study. Utilizing the K-Means clustering method, participants were divided into four groups. Cumulative METS-IR was employed as a quantitative indicator reflecting changes in METS-IR. Multivariable logistic regression models and restricted cubic splines (RCS) were employed to assess the relationship between changes in METS-IR and DM. RESULTS: During the five-year follow-up, 338 (8.4%) incident DM cases were identified. After adjusting for potential confounders, compared to class 1, the incident DM was significantly higher in class 4 [odds ratio (OR): 2.731, 95% confidence interval (CI): 1.411-5.527, p = 0.003]. When cumulative METS-IR (per SD increase) was introduced as a continuous variable into the multivariate regression model, the association remained significant in Model 3 (OR: 1.393, 95% CI: 1.125-1.715, p = 0.003). Additionally, when cumulative METS-IR was categorized into quartiles, compared to the first quartile, the incident DM was significantly higher in the fourth quartile (OR: 2.022, 95% CI: 1.171-3.501, p = 0.011). In addition, cumulative METS-IR exhibited a nonlinear association with DM (poverall = 0.001, pnon linear = 0.038). CONCLUSIONS: Substantial changes in METS-IR were independently associated with the risk of DM in middle-aged and elderly Chinese people. Long-term METS-IR monitoring is significant for early identification and prevention of DM, with significant implications for clinical practice.
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