Journal of Clinical Endocrinology and Metabolism

BACKGROUND: Fibroblast growth factor (FGF)21 acts as a metabolic regulator and its therapeutic use is under investigation. FGF21-signalling requires binding to surface receptors, FGFR1c and β-klotho. FGF21 resistance is observed in metabolic diseases and FGF21-signalling is regulated by fibroblast activation protein (FAP). Metformin is reported to influence expression and secretion of FGF21 in preclinical models, but the effect of metformin on FGF21 in a clinical trial remains unknown...

CONTEXT: Overweight and obesity have become a major health burden with a higher prevalence of obesity in women than in men. Mental stress has been discussed to play a role in this context. OBJECTIVE: We investigated endocrine mechanisms underlying eating after acute psychosocial stress and potential gender differences therein. METHODS: 32 male and 31 female healthy participants underwent the Trier Social Stress Test before they tasted ice cream in a bogus taste test 15 min after stress...

BACKGROUND: Adrenal insufficiency (AI) in HbE/Beta thalassemia, including evaluation of mineralocorticoid axis had not been studied. AIMS AND OBJECTIVES: In this study we attempted to evaluate the prevalence of AI in HbE/Beta thalassemia and wanted to determine if the prevalence of AI varied according to severity of HbE/Beta thalassemia and transfusion requirements. METHODS: In this observational, cross-sectional study, one hundred four patients with HbE/Beta thalassemia were evaluated...

OBJECTIVES: To describe cerebrospinal fluid (CSF) metabolomic pattern of pituitary stalk lesions. METHODS: CSF was collected from patients with different pituitary stalk lesions (germ cell tumor (GCT), n = 27; hypophysitis, n = 10; Langerhans cell histiocytosis (LCH) or Erdheim-Chester disease (ECD), n = 10) treated at Peking Union Medical College Hospital. CSF metabolome profiling was characterized through Liquid Chromatography-Mass Spectrometer (LC-MS)...

BACKGROUND: Discrepant data on the recurrence rate of DTC are reported in scientific reports. The aim of this study was to evaluate the frequency and risk factors of true recurrence in DTC patients with excellent responses (ExR) to the initial therapy. METHODS: A retrospective analysis of the 2302 consecutive DTC patients with ExR to primary therapy, treated during 24 years at single centre. The percentage of recurrence and cumulative recurrence rate (CRR) were analyzed...

CONTEXT: The serum total cortisol response to the ACTH stimulation test is widely used to assess adrenocortical function but is affected by changes in cortisol-binding globulin (CBG) concentration. Salivary cortisol reflects free cortisol concentrations and may offer a reliable alternative. OBJECTIVES: 1: To establish the salivary cortisol response to ACTH stimulation in healthy volunteers and patients with altered CBG concentrations. 2. To evaluate the performance of a lower reference limit (LRL) determined in healthy volunteers in patients with suspected hypoadrenalism (SH-patients)...

No abstract text is available yet for this article.

CONTEXT: The impact of insulin, particularly exogenous hyperinsulinemia, on insulin secretion in humans is debated. OBJECTIVE: We assessed the effects of exogenous hyperinsulinemia on insulin secretion and whether the response is altered in insulin resistance associated with obesity. METHODS: Insulin secretion rates (ISR) during euglycemic hyperinsulinemic clamp studies (52 volunteers) were calculated using a model that employs plasma C-peptide concentrations...

CONTEXT: Turner syndrome (TS) is the most common chromosomal aberration in women; it is the result of structural or numeric abnormalities in the X chromosome. Autoimmune hypothyroidism has been recognized as one of the more prominent disorders associated with TS. OBJECTIVE: To study the prevalence of autoimmune diseases in TS. DESIGN AND SETTING: A cross sectional, longitudinal, 25-year follow-up study of patients from adult Turner Centers at the University Hospitals, Sweden...

Obstructive sleep apnoea (OSA) and obesity are highly prevalent and bidirectionally associated. OSA is however underrecognized, particularly in women. By mechanisms that overlap with those of obesity, OSA increases the risk of developing, or having poor outcomes from, comorbid chronic disorders and impairs quality of life. Using two illustrative cases we discuss the relationships between OSA and obesity with type 2 diabetes, dyslipidemia, cardiovascular disease, cognitive disturbance, mood disorders, lower urinary tract symptoms, sexual function, and reproductive disorders...

CONTEXT: Patients with type 2 diabetes mellitus (T2DM) are at significantly increased risk of Alzheimer's disease (AD). However, no biomarkers are available for early identification of T2DM patients with cognitive impairment (T2DM-CI). Mitochondrial dysfunction is linked to AD. Silent Information Regulator 1 (SIRT1), which is responsible for regulating mitochondrial biogenesis, and its related miRNAs were also altered in AD. OBJECTIVE: This study aimed to determine whether mitochondrial function in peripheral blood mononuclear cells (PBMCs) of T2DM-CI patients was altered and if these alterations could be used as biomarkers...

OBJECTIVES: Excessive salt consumption is known to increase the risk of hypertension and cardiovascular disease, but the association between salt intake and incident type 2 diabetes has not been extensively researched. In this study, we aimed to investigate the relationships between the frequency of adding salt to foods and incident type 2 diabetes, as well as any potential interactions with genetic predisposition. METHODS: We included 368,137 eligible participants, aged 37 to 73 years, from the UK Biobank...

Acromegaly treatment has greatly evolved in recent decades, but there are still patients whose acromegaly is not controlled with currently available treatments, and there is a need to improve the treatment burden. Fortunately, there are new treatments under development that may increase treatment efficacy and convenience.

CONTEXT: Graves disease (GD) is a leading cause of hyperthyroidism. Detailed investigations and predictors of long-term outcomes are missing. OBJECTIVE: This work aimed to investigate the outcomes in GD 25 years after initiating antithyroid drug treatment, including disease course, clinical and biochemical predictors of relapse, and quality of life. METHODS: A retrospective follow-up was conducted of GD patients that participated in a randomized trial from 1997 to 2001...

BACKGROUND: Some evidence suggests gene-treatment interactions might cause persistent symptoms in individuals receiving levothyroxine (LT4) treatment. We investigated, as previously hypothesized, if single nucleotide polymorphisms (SNPs) in rs225014 (Thr92Ala), rs225015, or rs12885300 (ORFa-Gly3Asp) in the Deiodinase 2 gene (DIO2), or rs17606253 in the Monocarboxylate Transporter 10 gene (MCT10) were associated with outcomes indicative of local tissue hypothyroidism in LT4-treated patients and controls...

CONTEXT: Guidelines recommend use of population- and trimester-specific TSH and FT4 reference intervals (RIs) in pregnancy. Since these are often unavailable, clinicians frequently rely on alternative diagnostic strategies. We sought to quantify the diagnostic consequences of current recommendations. METHODS: We included cohorts participating in the Consortium on Thyroid and Pregnancy. Different approaches were used to define RIs: a TSH fixed upper limit of 4.0 mU/L (fixed limit approach), a fixed subtraction from the upper limit for TSH of 0...

BACKGROUND: Limited studies have shown a protective effect of very long chain saturated fatty acids （VLSFAs） on healthy aging, diabetes, heart failure and risk factors related to cardiovascular disease (CVD), but the role of VLSFAs on mortality risk is unclear. We aimed to investigate the association of serum docosanoic acid (C22:0) and serum lignoceric acid (C24:0) with all-cause and disease-specific mortality and to confirm the effect of VLSFAs on mortality risk in the whole, hyperlipidemia and hypertensive populations...

CONTEXT: The risk of vertebral fractures (VFx) in patients with adrenal incidentalomas (AI) and mild autonomous cortisol secretion (MACS) is debated. OBJECTIVE: To evaluate the VFx prevalence and incidence in patients with AI and MACS. DESIGN: Cross-sectional and longitudinal study on retrospective data. SETTING: Four Italian endocrinology units. PATIENTS: 444 patients (cross-sectional arm) and 126 patients (longitudinal arm, follow-up 24...

No abstract text is available yet for this article.

BACKGROUND: Differentiated thyroid cancer (DTC) is very common in women of reproductive age. However, it remains unclear whether pregnancy is associated with DTC progression before surgical treatment. METHODS: This retrospective cohort study, conducted at the Peking University Third Hospital in Beijing, China between January 2012 and December 2022, included 311 eligible women aged 20 to 45 years. To control for potential confounders, we first used propensity score matching (PSM) to match the pregnant group (n = 48) with the non-pregnant group (n = 154) on age, tumor size, tumor type, and Hashimoto's thyroiditis status at baseline, and then used Cox proportional risk models stratified by the matched pairs to estimate the association of pregnancy with DTC progression...