Endocrine Practice

OBJECTIVE: To review evidence of existing literature on the management of statin intolerance. METHODS: We searched for literature pertaining to statin intolerance and treatments in PubMed. We reviewed articles published between 2005 and 2022. RESULTS: Statin-associated myalgia is the most common adverse effect of statin therapy and the most common reason for statin discontinuation. Risk factors for statin intolerance include unexplained muscle pain with other lipid-lowering therapy, unexplained cramps, history of elevated creatinine kinase levels, family history of muscle symptoms, and family history of muscle symptoms with lipid therapy...

OBJECTIVE: The World Professional Association for Transgender Health (WPATH) Standards of Care (SOC) Version 7 recommended that before initiating gender-affirming hormone therapy (GAHT), patients should seek a psychosocial evaluation from a mental health professional documenting a diagnosis of persistent gender dysphoria. The Endocrine Society published guidelines in 2017 recommending against an obligatory psychosocial evaluation, which was affirmed in the recently published WPATH SOC Version 8 from 2022...

OBJECTIVE: Using supervised machine learning algorithms (SMLAs), we built models to predict the probability of type 1 diabetes mellitus (T1DM) patients on insulin pump therapy for meeting insulin pump self-management behavioral (IPSMB) criteria and achieving good glycemic response within six months. METHODS: This was a single-center retrospective chart review of 100 adult T1DM patients on insulin pump therapy (>6 months). Three SMLAs were deployed: multivariable logistic regression (LR), random forest (RF), and K-nearest neighbor (k-NN); validated using repeated three-fold cross-validation...

OBJECTIVE: Detection of residual differentiated thyroid cancer is important but difficult. A variety of imaging modalities and biochemical markers have been used with moderately good success. We hypothesized that elevated perioperative serum anti-thyroglobulin antibodies (TgAb) would also be a predictive marker for persistent or recurrent thyroid cancer. METHODS: We performed a retrospective analysis of 277 differentiated thyroid cancer survivors divided into two groups: those with low or normal serum TgAb (TgAb-) and those with elevated serum TgAb (TgAb+)...

OBJECTIVES: Advancing age is a powerful risk factor for hip fracture. The biological mechanisms through which aging impacts hip fracture risk have not been well studied. METHODS: Biological factors associated with "advancing age" that help to explain how aging is associated with hip fracture risk are reviewed. The findings are based on analyses of the Cardiovascular Health Study, an ongoing observational study of adults ages >65 years with 25 years of follow up...

OBJECTIVE: This retrospective cohort study aimed to assess incidence and predictors of acne among transgender adolescents receiving testosterone. MATERIALS AND METHODS: We analyzed records of patients aged <18 years, assigned female at birth seen at Children's Healthcare of Atlanta Pediatric Endocrinology clinic for testosterone initiation between 1/1/2000-1/1/2019, with at least 1-year follow-up documented. Bivariable analyses to determine association of clinical and demographic factors with new acne diagnosis were calculated...

No abstract text is available yet for this article.

OBJECTIVE: Gender-affirming hormone therapy (GAHT) guidelines describe estradiol doses for intramuscular (IM), but not subcutaneous (SC) routes. Objective was to compare SC and IM estradiol doses and hormone concentrations in transgender and gender diverse (TGD) individuals. METHODS: Retrospective cohort study at a single site tertiary care referral center. Patients were TGD individuals receiving injectable estradiol with at least 2 estradiol measurements. Main outcomes were median doses and achieved serum hormone concentrations between SC and IM routes...

OBJECTIVE: Studies have found a significant decrease in bone mineral density (BMD) in individuals with type 1 diabetes (T1D) compared to healthy controls. Factors associated with this phenomenon have yet to be defined; therefore, this study aimed to explore the association of glycated hemoglobin (HbA1c), disease duration, albuminuria, and glomerular filtration rate (GFR) with BMD in adults with T1D. METHODS: Cross-sectional study carried out in tertiary care. BMD analysis was performed by dual X-ray absorptiometry (DXA)...

OBJECTIVE: Wearable activity monitors are promising tools for improving metabolic outcomes in patients with type 2 diabetes mellitus (T2DM), but no uniform conclusive evidence is available. The study aimed to evaluate the effects of intervention using wearable activity monitors on blood glucose, blood pressure, blood lipid, weight, waist circumference and body mass index (BMI) in T2DM. METHODS: Two independent reviewers searched four online databases (PubMed, the Cochrane Library, Web of Science and Embase) to identify relevant studies published from January 2000 to October 2022...

OBJECTIVE: To investigate bone fragility in patients with hereditary connective tissue disorders (HCTD), including Ehlers-Danlos syndrome (EDS), Marfan's syndrome (MFS) and Loeys-Dietz syndrome (LDS). METHODS: From inception to June 2022, potentially eligible studies were identified in the Medline and EMBASE databases using search strategy that included terms for "HCTD", "Fracture" and "Osteoporosis". Eligible studies must consist of a group of patients with HCTD and report prevalence/incidence of fracture/osteoporosis in their participants, with or without comparison with healthy individuals...

No abstract text is available yet for this article.

OBJECTIVE: Graves disease (GD), an autoimmune disease of the thyroid, is likely caused by a combination of genetic predisposition and environmental triggers. Recent data suggests that Coronavirus-19 disease may be associated with development of autoimmune disease. The aim of this study was to assess the incidence and characteristics of new GD diagnoses in youth prior to and during the COVID-19 pandemic. METHODS: We performed a retrospective chart review of all new GD diagnoses in patients 0-18 years of age diagnosed at a tertiary care pediatric hospital between 1/1/2018-12/31/21...

OBJECTIVE: Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect cortisol biosynthesis and the need for glucocorticoid treatment is lifelong. The complexities of CAH can greatly affect teenage life and the transition from pediatric to adult care. The aim was to assess transition readiness and the impact on quality of life (QoL) as well as medication adherence rates in adolescents and young adults with CAH. METHODS: Prospective assessment of transition readiness was conducted through standardized questionnaires for adolescents and young adults (aged 16-35)...

OBJECTIVE: To determine the effect of a 4 hour postoperative serum parathyroid hormone (PTH) guided calcium and calcitriol supplementation protocol on the incidence of hypocalcemia and hospital readmissions in patients undergoing total thyroidectomy. METHODS: This was a single institution, retrospective chart review of patients who underwent total thyroidectomy, 148 had been operated on prior to the protocol implementation and 389 after. Hypocalcemia risk was stratified as low (PTH >30 pg/ml), medium (15-30 pg/ml), and high (<15 pg/ml), using serum PTH values obtained 4 hours postoperatively...

OBJECTIVE: Metformin is widely used as the first-line drug for type II diabetes mellitus (T2DM), and has numerous benefits apart from lowering blood glucose. However, metformin-retained regimen is challenged by newly launching, powerful glucose-lowering antiglycemic agents. This population-based cohort study examined the association between metformin adherence and the risk of dementia and Parkinson's disease (PD). METHODS: Diabetic patients with metformin-included combination antiglycemic therapy were identified from the National Health Insurance Research Database and categorized into metformin-adherent and -nonadherent groups according to the medical record of the first year prescription...

OBJECTIVE: The aim of this study was to compare long-term outcomes in terms of new onset or worsening of GO in patients with Graves' disease treated with different therapeutic modalities for hyperthyroidism. METHODS: A total of 1163 patients with Graves' disease entered this study; 263 patients were treated with radioiodine and 808 patients received MMI therapy for a median of 18 months of whom, 178 patients continued MMI for a total of 96 months (long-term MMI)...

OBJECTIVE: Previous studies have shown inconsistent results about the usefulness of prolactin adjustment in bilateral inferior petrosal sinus sampling (BIPSS) in the differential diagnosis of adrenocorticotropic hormone (ACTH) -dependent Cushing syndrome (CS). This meta-analysis compared the diagnostic accuracy of prolactin adjustment vs. no adjustment in BIPSS. METHODS: This study searched PubMed, Embase, Web of Science, Cochrane library, and Wanfang database for published data on the use of prolactin adjustment in BIPSS to differentially diagnose ACTH-dependent CS as of March 2022...

OBJECTIVES: Vitamin D deficiency impairs female fertility and the success of in vitro fertilization (IVF). The recommended serum 25-hydroxy vitamin D (25(OH)D) level in IVF-conceived pregnancies is still debated. We aimed to explore the relationship of preconception serum 25(OH)D level with pregnancy outcome following IVF treatment. We also explored the utility of the currently recommended serum 25(OH)D cut-off of ≥50 nmol/L for women undergoing IVF therapy. METHODS: Retrospective cohort of women who had undergone IVF therapy...

OBJECTIVE: This systematic review and meta-analysis aimed to investigate the predictive ability of plasma connecting peptide (C-peptide) levels in discriminating type 1 diabetes (T1D) from type 2 diabetes (T2D) and to inform evidence-based guidelines in diabetes classification. METHODS: We conducted a holistic review and meta-analysis using PubMed, MEDLINE, EMBASE, and Scopus. The citations were screened from 1942 to 2021. The quality criteria and the preferred reporting items for systematic reviews and meta-analysis checklist were applied...