Journal of Clinical Endocrinology and Metabolism

CONTEXT: Coronavirus disease 2019 (COVID-19) is a proinflammatory and prothrombotic condition, but its impact on adrenal function has not been adequately evaluated. CASE REPORT: A 46-year-old woman presented with abdominal pain, hypotension, skin hyperpigmentation after COVID-19 infection. The patient had hyponatremia, serum cortisol <1.0 ug/dL, ACTH of 807 pg/mL and aldosterone <3 ng/dL. Computed tomography (CT) findings of adrenal enlargement with no parenchymal and minimal peripheral capsular enhancement after contrast were consistent with bilateral adrenal infarction...

CONTEXT: Severe forms of Growth Hormone Insensitivity (GHI) are characterized by extreme short stature, dysmorphism and metabolic anomalies. OBJECTIVE: Identification of the genetic cause of growth failure in 3 'classical' GHI subjects. DESIGN: A novel intronic GHR variant was identified, and in vitro splicing assays confirmed aberrant splicing. A 6Ω pseudoexon GHR vector and patient fibroblast analysis assessed the consequences of the novel pseudoexon inclusion and the impact on GHR function...

Diabetes mellitus (DM) in children is most often caused by impaired insulin secretion (type 1 DM). In some children, the underlying mechanism for DM is increased insulin resistance, which can have different underlying causes. While the majority of these children require insulin dosages less than 2.0 U/kg/day to achieve normoglycemia, higher insulin requirements indicate severe insulin resistance. Considering the therapeutic challenges in patients with severe insulin resistance, early diagnosis of the underlying cause is essential in order to consider targeted therapies and to prevent diabetic complications...

PURPOSE: Duodenopancreatic neuroendocrine tumors (dpNETs) frequently occur in patients with Multiple Endocrine Neoplasia Type 1 (MEN1), and metastatic dpNET is the primary cause of disease-related mortality. There is a need for biomarkers that can identify patients with MEN1-related dpNETs that are at high risk of developing distant metastasis. Polyamines have tumor promoting roles in several cancer types. We hypothesized that MEN1-dpNET-related disease progression is associated with elevated levels of circulating polyamines...

Thyrotropin, traditionally seen as a pituitary hormone that regulates thyroid glands, has additional roles in physiology including skeletal remodeling. Population-based observations in subjects with euthyroidism or subclinical hyperthyroidism indicated a negative association between bone mass and low-normalTSH. The findings of correlative studies were supported by small intervention trials using recombinant human TSH (rhTSH) injection, and genetic and case-based evidence. Genetically-modified mouse models, which disrupt the reciprocal relationship between TSH and thyroid hormone, have allowed us to examine an independent role of TSH...

BACKGROUND: China experienced a rapid increase in the prevalence of diabetes. OBJECTIVES: To assess the prevalence of diabetes among Chinese adults who attend preventive physical examination, and analyzed geographical and gender difference in seasonal variation of fasting blood glucose (FBG). METHODS: The study used data from 1,390,088 participants attending preventive health examination at 430 health screening centers in 220 cities. Diagnosis of diabetes and prediabetes were based on FBG and hemoglobinA1c and self-report physician's diagnosis...

PURPOSE: To determine whether pre-pregnancy weight loss improved the early metabolic environment as measured by early gestational diabetes diagnosis. METHODS: This was a secondary analysis of a pragmatic randomized clinical trial conducted between May 2015 and October 2019 in an integrated health system that encouraged first trimester gestational diabetes screening for high-risk women, including those with obesity. Women aged 18-40 years with BMI ≥27 kg/m 2 who were planning pregnancy were randomized to a behavioral weight loss intervention or usual care...

CONTEXT: Primary hyperparathyroidism (PHPT), a leading cause of hypercalcemia and secondary osteoporosis, is underdiagnosed. OBJECTIVE: To establish a foundation for an electronic medical record-based intervention that would prompt serum parathyroid hormone (PTH) assessment in patients with persistent hypercalcemia and identify care gaps in their management. DESIGN: Retrospective cohort study. SETTING: Tertiary academic health system...

CONTEXT: The SAGIT ® instrument (SAGIT) has been developed to enable accurate characterization of acromegaly disease activity. OBJECTIVE: Evaluate the ability of SAGIT to discriminate between acromegaly disease control status. DESIGN: Multicenter, non-interventional, prospective and retrospective, longitudinal study. SETTINGS AND PATIENTS: Academic and private clinical practice sites; patients aged ≥18 years with diagnosis of controlled (n=109) or non-controlled (n=105) acromegaly, assessed by clinical global evaluation of disease control (CGE-DC) questionnaire, investigator therapeutic decision and international guidelines...

CONTEXT: Diabetes mellitus (DM) is a systemic disease characterized by chronic hyperglycemia associated with inflammation and oxidative stress, and the lung may be a target organ of diabetic microvascular damage. Several studies have indicated a positive association between idiopathic pulmonary fibrosis (IPF) and diabetes with controversial findings. OBJECTIVE: Primary outcomes were to compare the prevalence of DM among individuals with IPF to non-IPF controls, and the prevalence of IPF among individuals with DM to non-DM controls...

CONTEXT: As subclinical hyperthyroidism increases the risk of osteoporosis and fractures, concerns are growing about the long-term skeletal safety of thyrotropin (TSH) suppression therapy after total thyroidectomy in patients with differentiated thyroid cancer (DTC). OBJECTIVE: We aimed to determine the effect of TSH suppression therapy on bone mineral density (BMD) in DTC patients. METHODS: We searched PubMed, Embase, the Cochrane library, and other sources...

CONTEXT: The independent contribution of young adult exposure to overweight and obesity to later life incident diabetes is not well studied. OBJECTIVE: To assess the associations of exposures to elevated body mass index (BMI) and waist circumference (WC) in young adulthood (ages 18 to 39 years) with incident diabetes later in life (≥40 years). DESIGN: Pooled data from six US prospective cohorts (ARIC, CARDIA, CHS, Framingham Offspring, Health ABC, MESA)...

CONTEXT: Pericyte populations abundantly express tyrosine-kinases (TK, e.g. PDGFR-β) and impact therapeutic response. Lenvatinib is a clinically available TK inhibitor (TKI) that targets PDGFR-β. Duration of therapeutic response was shorter in patients with greater disease burden and metastasis. Patients may develop drug resistance and tumor progression. OBJECTIVES: to develop a gene signature of pericyte abundance to assess with tumor aggressiveness, and determine both the response of thyroid-derived pericytes to lenvatinib and their synergies with thyroid carcinoma-derived cells...

CONTEXT: A comprehensive understanding of the association between body mass index (BMI) and COVID-19 is still lacking. OBJECTIVE: To investigate associations between BMI and risk of COVID-19 diagnosis, hospitalisation with COVID-19, and death after a COVID-19 diagnosis or hospitalisation (subsequent death), accounting for potential effect modification by age and sex. DESIGN: Population-based cohort study. SETTING: Primary care records covering >80% of the Catalan population, linked to region-wide testing, hospital, and mortality records from March to May 2020...

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CONTEXT: In a recent study a pattern of 27 metabolites, including serum glycine, associated with bone mineral density (BMD). OBJECTIVE: To investigate associations for serum and urinary glycine levels with BMD, bone microstructure and fracture risk in men. METHODS: In the population based MrOS Sweden study (men, 69-81 years) serum glycine and BMD were measured at baseline (n=965) and 5-year follow up (n=546). Cortical and trabecular bone parameters of the distal tibia were measured at follow-up using high resolution peripheral quantitative computed tomography...

CONTEXT: Accumulating evidence indicates "type 2 diabetes (T2D)" is phenotypically heterogeneous. Defining and classifying variant forms of T2D are priorities to better understand its pathophysiology and usher clinical practice into an era of "precision diabetes". EVIDENCE ACQUISITION AND METHODS: We reviewed literature related to heterogeneity of T2D over the past five decades and identified a range of phenotypic variants of T2D. Their descriptions expose inadequacies in current classification systems...

BACKGROUND: The prevalence of both asthma and early onset diabetes is on the rise, however the association between them remains unclear. We examined a possible association of asthma at adolescence with type 2 diabetes in young adulthood. METHODS: This is a nationwide, population-based study of 1,718,541 Israeli adolescents (59% males; mean age 17.3 years; range 16-19 years), examined before compulsory military service during 1992-2016, with data linked to the Israeli National Diabetes Registry...

PURPOSE: This study examined the association between remnant cholesterol (remnant-C) and cardiovascular mortality in patients with type 2 diabetes (T2D), chronic kidney disease (CKD) stages 3-5 and newly diagnosed diabetic nephropathy (DN). METHODS: This study determined the baseline lipid profile and searched for deaths with cardiovascular disease (CVD) within 2 years of baseline among 2282 adults enrolled between 01/01/2015 and 31/12/2016 who had T2D, CKD stages 3-5 and newly diagnosed DN...

BACKGROUND: Fatty liver disease is a common metabolic abnormality in adolescents with obesity, but remains under-studied in early childhood. OBJECTIVES: To describe hepatic fat deposition in prepubertal children and examine associations with metabolic markers and body composition. METHODS: Data were from 286 children ages 4-8 years old in the Healthy Start Study, a longitudinal pre-birth cohort in Colorado. Assessments included magnetic resonance imaging to quantify hepatic and abdominal fats, fasting blood draws to measure metabolic markers, and air displacement plethysmography to measure body composition (fat mass and fat-free mass)...