Endocrine Practice

OBJECTIVE: We determined 1) If 11-oxygenated androgens better identify PCOS diagnosis in women with obesity compared to total or free testosterone (T) and free androgen index (FAI); 2) How biochemical hyperandrogenism and metabolic factors cluster in a cohort of women with infertility and obesity. METHODS: Women with obesity and PCOS comprised the study group (N=132). Ovulatory women with obesity and idiopathic, tubal or male factor infertility were the control group (N=83)...

BACKGROUND: Puberty blockade and gender affirming hormone therapy can impair fertility. Counseling on fertility preservation is important prior to initiation of therapy. The aim of our study was to assess tanner staging and the presence of virilizing secondary sex characteristics at the time of sperm collection and to correlate the viability of sperm with the tanner staging and degree of virilization. METHODS: A retrospective chart review of 23 transgender girls referred to pediatric urology at our academic pediatric transgender clinic for fertility preservation counseling was performed...

OBJECTIVE: This study aims to explore the significant impact of environmental chemicals on disease development, focusing on their role in developing metabolic and endocrine diseases. The objective is to understand how these chemicals contribute to the increasing prevalence of precocious puberty, considering various factors, including epigenetic changes, lifestyle, and emotional disturbances. METHODS: The study employs a comprehensive review of descriptive observational studies in both human and animal models to identify a degree of causality between exposure to environmental chemicals and disease development, specifically focusing on endocrine disruption...

OBJECTIVE: There is an urgent need for effective predictive strategies to accurately evaluate the risk of fragility fractures in elderly patients in the early stages of diabetic kidney disease (DKD). METHODS: This longitudinal cohort study included 715 older patients in the early stages of DKD diagnosed between January 2015 and August 2019. Patients were randomly allocated to a training cohort (n = 499) and a validation cohort (n = 216). The least absolute shrinkage and selection operator method was used to select key features for dual-energy X-ray absorptiometry (DXA)-based radiomic analysis...

BACKGROUND: Molecular testing is a well-established tool that assists in the management of thyroid nodules. We describe our experience using molecular testing of thyroid nodules with Bethesda III-VI cytology. METHODS: Retrospective multicenter multinational study of thyroid nodules that underwent preoperative molecular profiling with ThyGenX/ThyGeNEXT or ThyroSeq V3 between 2015-2022. The clinical characteristics and mutational profiles of tumors were compared. Collected data included demographics, cytology results, surgical pathology, and molecular alterations...

OBJECTIVE: Low dose radioiodine is an accepted means of remnant ablation in patients with low to intermediate risk differentiated thyroid cancer (DTC) based on the results of several Phase III trials. We evaluated the rate of ablation success and long term recurrence outcomes in the first three years of implementing this practice at our institution. METHODS: Patients who received 1.1-1.2GBq (30mCi) were identified retrospectively from the radionuclide database, 1st January 2012 - 31st December 2014 inclusive...

OBJECTIVE: Clinical guidelines have expanded indications for nonalcoholic fatty liver disease (NAFLD) screening to type 2 diabetes mellitus and obesity, conditions common in populations that receive care in urban, safety-net settings. This study sought to evaluate safety-net primary care and endocrine clinician knowledge of NAFLD, identify barriers and facilitators to screening, and examine perspectives on use of electronic health record tools for risk assessment. METHODS: Sequential explanatory mixed methods using survey and qualitative interviews with primary care, primary care subspecialty, and endocrine clinicians in an urban, safety-net healthcare system...

OBJECTIVE: The aim of this study was to evaluate bone microstructure to determine whether curative surgery of PHPT produces changes in BMD, TBS and 3D-DXA parameters, and whether these changes are comparable. METHODS: We retrospectively studied 85 patients (60 women and 25 men, 60.4 ± 12.5 years) diagnosed with PHPT and undergoing parathyroidectomy. Mean percent changes in BMD (lumbar spine (LS), femoral neck (FN), total hip (TH) and 1/3 radius), TBS and 3D-DXA parameters (trabecular volumetric BMD (vBMD), cortical vBMD, integral vBMD, cortical surface density (sBMD) and cortical thickness at TH) after surgery (12, 24 and/or 36 months) were calculated and compared, and we sought the determinants of these changes...

OBJECTIVE: Amyloid deposition within tumor stroma is a distinctive histologic feature of medullary thyroid cancer (MTC). However, its prognostic significance remains uncertain. We aimed to elucidate the impact of amyloid status on survival outcomes in a large cohort. METHODS: The Surveillance, Epidemiology, and End Results registry was queried to identify patients diagnosed with MTC from 2000-2019. Patients with amyloid positive (ICD-O-3 code 8345/3) and amyloid negative (ICD-O-3 code 8510/3) tumors were analyzed...

OBJECTIVE: Hypothyroidism is one of the most common endocrine disorders affecting 5 to 10 times more women than men. Given this higher incidence in women, it is possible that hormonal differences or medications more commonly used by women may play a role in the risk of developing hypothyroidism. We hypothesized that hormonal contraception affects the risk of developing hypothyroidism. METHODS: Using the TriNetX database, we developed a case-control study and identified women aged 18 to 45 years in 4 distinct groups: (1) estrogen-progestin contraceptive (EPC) use, (2) progestin-only contraceptive (POC) use, (3) progestin-containing intrauterine device (IUD) use, and (4) controls...

OBJECTIVE: Gestational diabetes mellitus (GDM) and metabolic syndrome (MetS) share common characteristics and risk factors. Both conditions increase the risk of chronic diseases and, thus, may share a common pathogenesis. This review begins with a clinical vignette, followed by evidence supporting the risk of MetS after GDM among women and their offspring and the risk of having GDM among pregnant women who have MetS before pregnancy. METHODS: Research studies published between 2010 and 2023 were identified via several databases, including PubMed, the Web of Science, MEDLINE, Science Direct, ERIC, and EBSCOhost...

OBJECTIVE: To assess the effect of relacorilant, a selective glucocorticoid receptor modulator under investigation for the treatment of patients with endogenous hypercortisolism (Cushing syndrome [CS]), on the heart rate-corrected QT interval (QTc). METHODS: Three clinical studies of relacorilant were included: (1) a first-in-human, randomized, placebo-controlled, ascending-dose (up to 500 mg of relacorilant) study in healthy volunteers; (2) a phase 1 placebo- and positive-controlled thorough QTc (TQT) study of 400 and 800 mg of relacorilant in healthy volunteers; and (3) a phase 2, open-label study of up to 400 mg of relacorilant administered daily for up to 16 weeks in patients with CS...

Magnetic resonance imaging is the mainstay imaging modality of choice in the assessment, treatment planning and follow-up of pituitary adenomas (PAs). Pituitary adenomas are discovered incidentally during imaging for a variety of unrelated conditions, because of clinical symptoms related to mass effects on the adjacent structures, or during work up for functional alterations of the adenoma. Imaging is also utilized in the preoperative and postoperative phases of assessment of PAs, for surgical and radiotherapy planning, for postoperative surveillance to assess for adenoma stability and detection of adenoma recurrence, and for surveillance to monitor for adenoma growth in unoperated PAs...

OBJECTIVE: Thyroid nodules are common, yet fewer than 1 in 10 harbors malignancy. When present, thyroid cancer is typically indolent with excellent survival. Therefore, patients who are not candidates for thyroid cancer treatment due to comorbid disease may not require further thyroid nodule evaluation. The goal of this study was to determine the rate of deferrable thyroid nodule biopsies in patients with limited life expectancy. METHODS: We identified patients who underwent thyroid fine-needle aspiration (FNA) between 2015-2018 at our institution...

No abstract text is available yet for this article.

OBJECTIVE: To investigate general practitioners' course of action after detection of elevated thyroid stimulating hormone (TSH) levels regarding repeat testing, direct levothyroxine replacement, or neither. METHODS: We conducted a retrospective study of adults without prior evidence of thyroid disease and with a first detection of elevated TSH levels from January 1, 2015, to December 31, 2020, using data from electronic medical records of a Swiss primary care database...

OBJECTIVE: To investigate the usefulness of ultrasound (US) for the localization of ectopic hyperparathyroidism and compare it with 99m Tc-sestamibi (99m Tc-MIBI), 4D-CT, and 11 C-choline PET/CT. METHODS: Of the 527 patients with surgically confirmed primary hyperparathyroidism, 79 patients with ectopic hyperparathyroidism were enrolled. The diagnostic performance of US, 99m Tc-MIBI, US+MIBI, 4D-CT, and 11 C-choline PET/CT was calculated, and the factors affecting the sensitivity of US and 99m Tc-MIBI were analyzed...

OBJECTIVE: To review clinical trial data for incretin therapies that are approved or in late-stage development for overweight or obesity management, along with clinical implications of these therapies and future directions. METHODS: We searched for clinical trials involving incretin therapies studied specifically for overweight or obesity management in ClinicalTrials.gov and PubMed from registry inception through December 2023. RESULTS: Glucagon-like peptide-1 (GLP-1) receptor agonism, alone and in combination with glucose-dependent insulinotropic polypeptide (GIP) receptor agonism or glucagon agonism, leads to significant weight reduction in people with overweight or obesity...

No abstract text is available yet for this article.

OBJECTIVE: Somatostatin receptor (SST) functional imaging with positron emission tomography (PET)/computed tomography (CT) has broadened the diagnostic and staging capabilities for medullary thyroid cancer (MTC). Gallium-68 (68 Ga)-DOTA-conjugated peptide (Tyr3)-octreotate (DOTATATE) is a radiotracer with a high affinity for type 2 SSTs expressed in several, but not all, MTCs. The utility of 68 Ga-DOTATATE PET/CT and 18 fluorine-labeled fluoro-2-deoxy-D-glucose (18 F-FDG)-PET/CT imaging in predicting MTC prognosis is also unknown...