Journal of Clinical Endocrinology and Metabolism

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UNLABELLED: Graves Orbitopathy is both disabling and disfiguring. Medical therapies to reduce inflammation are widely used, but there is limited trial data beyond 18 months of follow-up. METHODS: 3 year follow-up of a subset of the CIRTED trial (N=68) which randomized patients to receive high dose oral steroid with azathioprine/placebo and radiotherapy/sham radiotherapy. RESULTS: Data were available at 3 years from 68 of 126 randomised subjects (54%)...

Middle-aged and older men have typically accumulated comorbidities, are increasingly sedentary, and have lower testosterone concentrations (T) compared to younger men. Both reduced physical activity (PA) and lower T are associated with, and may predispose to, metabolically adverse changes in body composition, which contribute to higher risks of cardiometabolic disease. Exercise improves cardiometabolic health, but sustained participation is problematic. By contrast, rates of T prescription have increased, particularly in middle-aged and older men without organic diseases of the hypothalamus, pituitary or testes, reflecting the unproven concept of a restorative hormone that preserves health...

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PURPOSE: Management of sporadic medullary thyroid microcarcinoma smaller than 1 cm (micro-MTC) is controversial due to conflicting reports of prognosis. As these cancers are often diagnosed incidentally, they pose a management challenge when deciding on further treatment and follow-up. METHODS: Micro-MTCs were identified from a prospectively maintained surgery database and slides were reviewed to determine pathological grade. The primary endpoints were recurrence, time to recurrence and disease-specific survival...

AIMS: Precision medicine has revolutionised our understanding of type 1 diabetes and neonatal diabetes, but has yet to improve insight into gestational diabetes (GDM), the most common obstetric complication, and strongly linked to obesity. Here we explored if patterns of glycaemia (fasting, 1h, 2h) during the antenatal oral glucose tolerance test (OGTT), reflect distinct pathophysiological subtypes of GDM as defined by insulin secretion/sensitivity or lipid profiles. METHODS: 867 pregnant women with obesity (BMI > 30kg/m2) from the UPBEAT trial (ISRCTN 89971375) were assessed for GDM at 28 weeks' gestation (75g oral glucose tolerance test OGTT; WHO criteria)...

Type 1 diabetes (T1D) is usually caused by immune-mediated destruction of islet beta-cells, and genetic and environmental factors are thought to trigger autoimmunity. Convincing evidence indicates that viruses are associated with T1D development and progression. During the coronavirus disease 2019(COVID-19) pandemic, cases of hyperglycemia, diabetic ketoacidosis (DKA), and new diabetes increased, suggesting that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be a trigger for or unmask T1D...

INTRODUCTION: Patients with germline variants in CDH1 who undergo prophylactic total gastrectomy (TG) are at risk of altered nutrient and drug absorption due to modified gastrointestinal anatomy. Bone mineral density loss and micronutrient deficiencies have not been described previously in this patient population. METHODS: In this study we included 94 patients with germline CDH1 variants who underwent prophylactic TG between October 2017 and February 2022. We examined pre- and post-gastrectomy bone mineral density (BMD); serum biomarkers including calcium, phosphorus, alkaline phosphatase, and 25 (OH)-vitamin D; and postoperative adherence to calcium and multivitamin supplementation...

The most common form of congenital adrenal hyperplasia is 21-hydroxylase deficiency (21OHD), which in the classic (severe) form occurs in roughly 1:16,000 newborns worldwide. Lifelong treatment consists of replacing cortisol and aldosterone deficiencies, and supraphysiological dosing schedules are typically employed to simultaneously attenuate production of adrenal-derived androgens. Glucocorticoid titration in 21OHD is challenging as it must balance the consequences of androgen excess versus those from chronic high glucocorticoid exposure, which are further complicated by inter-individual variability in cortisol kinetics and glucocorticoid sensitivity...

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Severe obesity in adolescence negatively impacts upon health and wellbeing. Lifestyle modifications do not usually achieve a sufficient degree or durability of weight loss to mitigate the risk of medical complications. In recent years, metabolic and bariatric surgery (MBS), already a well-established treatment for adults with severe obesity, has emerged as an option in adolescents. Controlled studies in this age group have demonstrated substantial and sustained weight loss, improvements in associated health parameters, and a safety profile surpassing that observed in adult patients...

CONTEXT: Despite having normal GH secretion, individuals with Turner syndrome (TS) have short stature. Treatment with recombinant human GH is recommended for TS girls with short stature. OBJECTIVE: Evaluate the effectiveness and safety of Norditropin® (somatropin, Novo Nordisk) with up to 10 years of follow-up in children with TS. METHODS: Secondary analysis of Norditropin data from two non-interventional studies: NordiNet® IOS (NCT00960128) and the ANSWER Program (NCT01009905)...

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No abstract text is available yet for this article.

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INTRODUCTION: The low-density lipoprotein receptor-related protein 5 (LRP5) and its inhibitor sclerostin, are key components of bone metabolism and potential contributors to type 2 diabetes mellitus susceptibility. This study aims at evaluating the expression of placental LRP5 and sclerostin in pregnancies with gestational diabetes mellitus (GDM) and investigate possible associations with umbilical sclerostin concentrations and clinical outcomes in mothers and their neonates. METHODS: Twenty-six GDM-mothers and 34 non-GDM mothers of Caucasian origin and their neonates admitted in a Gynecology and Obstetrics Department of a university hospital were included in this study...

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CONTEXT: Pheochromocytomas/paragangliomas (PPGLs) with pathogenic mutations in the succinate dehydrogenase subunit B (SDHB) are associated with a high metastatic risk. Somatostatin receptor 2 (SSTR2)-dependent imaging is the most sensitive imaging modality for SDHB-related PPGLs, suggesting that SSTR2 expression is a significant cell surface therapeutic biomarker of such tumors. OBJECTIVE: Exploration of the relationship between SSTR2 immunoreactivity and SDHB immunoreactivity, mutational status, and clinical behavior of PPGLs...