2026-04-02
Paul Kim, Minji Kang, Hyunji Sang, Sang Youl Rhee, Hyunjung Lim
AimsTo characterize the metabolic profiles associated with the Hepatic Insulin Resistance Index (HIRI), in Korean patients with type 2 diabetes mellitus.MethodsThis cross-sectional study analyzed 2,475 Korean adults with type 2 diabetes from the Korean National Diabetes Program cohort. Participants were categorized into HIRI tertiles based on oral glucose tolerance tests. We examined associations between HIRI and anthropometric measures, glycemic parameters, lipid profiles, liver function markers, and dietary intake. Logistic regression assessed the risk of dyslipidemia and metabolic syndrome components, adjusting for relevant confounders.ResultsHigh-HIRI participants demonstrated greater central obesity (waist circumference 90.92 vs. 85.52 cm, p < 0.0001) and distinctive glycemic profiles: elevated fasting glucose (153.26 vs. 147.53 mg/dL, p < 0.0001) but lower postprandial glucose (273.73 vs. 299.32 mg/dL, p = 0.0001) and HbA1c (7.8 vs. 8.2%, p = 0.0026). They exhibited dyslipidemia with higher triglycerides (190.71 vs. 141.41 mg/dL, p < 0.0001) and lower HDL cholesterol (45.29 vs. 48.40 mg/dL, p < 0.0001).ConclusionsHigh hepatic insulin resistance in Korean patients with type 2 diabetes defines a phenotype characterized by central obesity, atherogenic dyslipidemia, and distinctive glycemic profiles. Recognition of this phenotype supports personalized diabetes management targeting hepatic IR.
DOI: 10.3389/fendo.2026.17911742026-04-02
Iwona Gawron, Karolina Zeman, Justyna Brodowicz, Robert Jach
PurposeTo compare uterine ultrasound measurements in women with normogonadotropic anovulation, specifically those with polycystic ovary syndrome (PCOS) and hypothalamic-pituitary-ovarian dysfunction (HPOD), with those of regularly menstruating women, and to assess the influence of clinical and biochemical parameters on these measurements.MethodsUterine length, width, height, and volume, along with endometrial thickness and volume, measured using two- and three-dimensional transvaginal ultrasonography, were prospectively compared in women aged 18 to 45 from the aforementioned groups. Correlations between clinical parameters and uterine measurements, as well as between biochemical parameters and these measurements in anovulatory women, were analyzed.ResultsWomen with normogonadotropic anovulation had significantly reduced uterine and endometrial measurements compared to healthy women (all p ≤0.001). Women with PCOS showed significantly lower uterine length (p=0.045), height (p=0.004), and volume (p=0.009) than those with HPOD, with no significant endometrial differences. Among women with PCOS, those with hyperandrogenemia had thicker endometrium (p=0.036), with no significant differences in other measurements. All myometrial measurements significantly negatively correlated with anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH), while positively correlating with estradiol and prolactin. Endometrial measurements negatively correlated with AMH and FSH concentrations, and positively with estradiol, prolactin, 17-hydroxyprogesterone, fasting insulin, and insulin resistance.ConclusionsA significant association was identified between menstrual cycle regularity and uterine morphology, influenced by hormonal, metabolic, and clinical factors. Estrogenic stimulation and metabolic status significantly affected uterine and endometrial dimensions, indicating that uterine morphology reflects the cumulative impact of reproductive and endocrine-metabolic influences, with important clinical implications for women with normogonadotropic anovulation.
DOI: 10.3389/fendo.2026.17815932026-04-02
Kaiwen Zheng, Lun Liu, Jianbin You, Jingyi Su, Ling Li, Jiahao Chen, Liangyuan Chen, Yanfen Zeng, Jinhua Chen, Gang Chen, Junping Wen
AimsThis study aims to develop an interpretable machine learning (ML) model for predicting the occurrence of advanced diabetic kidney disease (DKD), with the objective of identifying patients at an early stage of the disease, thereby facilitating timely and appropriate clinical intervention.MethodsVariable selection was performed using a combination of the least absolute shrinkage and selection operator (LASSO) and recursive feature elimination (RFE) techniques. A prediction model was constructed and validated using eight ML algorithms, and the model’s performance was evaluated using area under curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, Brier score, calibration curve, and decision curve analysis (DCA). The SHapley Additive exPlanation (SHAP) and partial dependence plot (PDP) methods were employed to interpret the model both locally and globally. Finally, the prediction model was integrated into a network platform based on the Shiny application for direct use by clinicians and patients.ResultsSerum creatinine, age, hemoglobin, serum urea, serum ALP, serum UA, platelet count, serum osmolality, serum bicarbonate, and monocyte count were identified as the most important variables in the advanced DKD model. Eight ML models were developed using these five variables. Among them, the logistic regression (LR) model demonstrated accurate predictive ability in both internal and external validation, with AUCs of 0.948 (95%CI: 0.920-0.975) and 0.898 (95%CI: 0.883-0.913), respectively. Furthermore, the LR model exhibited excellent performance in terms of accuracy, sensitivity, PPV, NPV, F1 score, and Brier score. The results of the calibration curve and DCA also indicate a high degree of consistency between the predicted and observed risks of the RF model, with a net return approaching full coverage. The model developed is available through LR-based online calculators for clinicians, free of charge: https://dev2333.shinyapps.io/logistics1/.ConclusionThis study developed and validated an interpretable LR model for predicting the occurrence of advanced DKD. The LR model can assist clinical practice by effectively identifying individuals at higher risk of advanced DKD at an early stage, allowing patients to receive timely and personalized treatment, and thereby providing a reliable foundation for improving patient prognosis and optimizing medical resource utilization.
DOI: 10.3389/fendo.2026.17220132026-04-02
Mei Wang, Fangxiang Mu, Fang Wang
AimsThis study investigated the associations of four insulin resistance (IR) indicators—the triglyceride-glucose (TyG) index, the TyG-body mass index (TyG-BMI), the metabolic score for IR (METS-IR), and the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio—with subsequent pregnancy outcomes in women with recurrent pregnancy loss (RPL) and assessed their predictive value.MethodsThis cohort study recruited RPL participants from the Chinese Pregnancy Loss Cohort. Enrollment occurred between September 2019 and December 2022. All participants were followed up every 6 months, with a minimum follow-up duration of 18 months, to document pregnancy outcomes (live birth or subsequent pregnancy loss). Univariate and multivariate logistic regression analyses were performed to assess the associations between four IR indicators (TG/HDL-C, TyG, TyG-BMI, METS-IR) and pregnancy outcomes. Receiver operating characteristic (ROC) analysis was conducted to determine the predictive efficacy of each indicator.ResultsAmong 2,454 screened participants, 897 RPL women were analyzed (638 live births, 71.1%; 259 pregnancy losses, 28.9%). In the fully adjusted model, the highest tertiles of TyG-BMI and METS-IR were associated with significantly elevated odds of pregnancy loss (OR = 1.52, 95% CI: 1.01–2.27, P = 0.044; OR = 1.49, 95% CI: 1.05–2.29, P = 0.045, respectively). METS-IR demonstrated the highest predictive efficacy for pregnancy outcomes (AUC = 0.710), followed by TyG-BMI, TG/HDL-C, and the TyG index.ConclusionsAmong women with RPL, TyG-BMI and METS-IR are independently associated with increased pregnancy loss risk, with METS-IR demonstrating superior predictive performance.
DOI: 10.3389/fendo.2026.17673012026-04-02
Yunrui Han, Qiyu Yang, Yuxuan Zhao, Yuxin Zhang, Shengyong Ding, Haicui Wu
PurposeTo investigate the impact of storage duration after vitrification of cleavage-stage embryos on pregnancy and perinatal outcomes.MethodsA retrospective study was conducted on 4205 infertile patients underwent frozen-thawed embryo transfer (FET) between January 2020 and January 2025, categorized by post-vitrification storage duration of their embryo: G1 ( 12 months, n = 366). Multivariate logistic and linear regression analyses were used to determine independent effects of storage duration on pregnancy and perinatal outcomes among groups. Propensity score matching was employed to control confounders, including age, infertility duration, type, and etiology.ResultsRegarding pregnancy outcomes, live birth rate significantly decreased with storage duration (using G1 as reference; G2: adjusted odds ratio [aOR] = 0.82, 95% CI [0.707-0.952], similarly hereinafter; G3: 0.743, 0.579-0.954; G4: 0.624, 0.476-0.818). The miscarriage rate significantly increased with increasing storage duration beyond 6 months (G2: 1.268, 0.967-1.663; G3: 1.652, 1.085-2.515; G4: 1.674, 1.06-2.643). Biochemical pregnancy (G2: 0.883, 0.764-1.02; G3: 0.848, 0.669-1.075; G4: 0.705, 0.547-0.91) and clinical pregnancy rates (G2: 0.885, 0.766-1.022; G3: 0.848, 0.669-1.075; G4: 0.715, 0.554-0.922) significantly decreased with increasing storage duration beyond 12 months. Regarding perinatal outcomes, gestational age significantly decreased with increasing storage duration beyond 6 months (G1 as reference; G2: P = 0.128; G3: P = 0.023; G4: P = 0.008).ConclusionOverall, prolonged storage duration of vitrified cleavage-stage embryos negatively correlates with pregnancy and perinatal outcomes, particularly after 6 or 12 months.
DOI: 10.3389/fendo.2026.17656812026-04-02
Kristina Saravinovska, Daniele Santi, Francesco Costantino, Alessandro Prete, Antoan Stefan Šojat, Giorgia Spaggiari, Miomira Ivović, Irene Lambrinoudaki, Eleni Armeni, Aleksandar Jurišić, Sladjana Mihajlović, Svetlana Vujović, Ljiljana V. Marina
BackgroundEstrogens have been proposed as modulators of gut microbiome (GM) composition, yet evidence from observational studies remains inconsistent.ObjectiveThis meta-analysis aimed to systematically summarise existing evidence on GM alterations in hypoestrogenic women – post-menopausal or premature ovarian insufficiency (POI) – compared to euestrogenic pre-menopausal controls.MethodsPubMed, SCOPUS and Embase were searched through December 2024 for studies comparing GM characteristics between hypoestrogenic and pre-menopausal women. Primary outcome was α-diversity (Shannon index). Secondary outcomes included relative abundances of Bacteroidetes, Firmicutes, and the Bacteroidetes to Firmicutes ratio. Random-effects models were used for data synthesis.ResultsOut of 1092 studies screened, 7 met the inclusion criteria (n = 45 women with POI, n = 1222 post-menopausal women, n = 463 eustrogenic controls). No significant differences were observed in α–diversity (p=0.990), Bacteroidetes (p=0.440), or Firmicutes abundance (p=0.110) between hypoestrogenic and euestrogenic groups, irrespective of POI or postmenopause. Similarly, the Bacteroidetes to Firmicutes ratio showed no significant difference between the groups (p=0.400). Study heterogeneity was high (I² 61-99%).ConclusionCurrent evidence does not support consistent differences in GM diversity or major bacterial phyla between hypoestrogenic and euestrogenic women. Given the substantial heterogeneity, limited control of confounding factors, and variability in methodological quality, these findings should be interpreted with caution. High-quality, well-controlled studies are needed to better define the relationship between estrogen status and the GM.
DOI: 10.3389/fendo.2026.17808062026-04-01
Nabil Ismaili
BackgroundThe year 2025 has been a transformative moment in GU oncology, with paradigm-shifting clinical trial results presented at major conferences and rapidly published. These developments are recasting therapeutic standards across bladder, kidney, prostate, penile, and testicular cancers through novel mechanisms and refined personalization.ObjectivesThis systematic review aimed to identify, synthesize, and critically evaluate pivotal phase II and III randomized controlled trials presented at ASCO/ESMO 2025 or published in 2025, focusing on innovative therapeutic strategies across GU malignancies.MethodsConducted per PRISMA 2020 guidelines, the review involved exhaustive searches of conference proceedings, PubMed/MEDLINE, and Embase (January-December 2025). Included studies were phase II and III RCTs in GU oncology reporting overall or progression-free survival for novel therapies. Study selection, data extraction, and risk-of-bias assessment using the Cochrane RoB 2 tool were performed.ResultsForty studies met inclusion criteria: bladder cancer (13), kidney cancer (9), prostate cancer (16), testicular cancer (1), and penile cancer (1). Key advances include: (1) In bladder cancer, perioperative durvalumab (NIAGARA) and enfortumab vedotin plus pembrolizumab (KEYNOTE-905/EV-303) set new standards, while HER2-targeted disitamab vedotin plus toripalimab (RC48-C016) improved metastatic survival. Upfront MRI staging (BladderPath) and kidney-sparing approaches (DISTINCT-I) advanced. (2) In kidney cancer, adjuvant durvalumab (RAMPART) and transcriptomic-guided therapy (OPTIC RCC) were established. LenCabo compared post-immunotherapy regimens, and FRUSICA-2 introduced a novel VEGF-TKI/IO combination. (3) In prostate cancer, enzalutamide plus leuprolide improved survival in high-risk biochemical recurrence (EMBARK). Capivasertib plus abiraterone benefited PTEN-deficient metastatic hormone-sensitive disease (CAPItello-281). The PSMAddition trial demonstrated that adding [177Lu]Lu-PSMA-617 to standard therapy significantly improved radiographic PFS in PSMA-positive mHSPC. Docetaxel scheduling was optimized (ARASAFE), and an AI model (STAMPEDE) identified patients for AR inhibitor benefit. Novel agents like saruparib and pasritamig showed promise. (4) In testicular cancer, de-escalated therapy was established for seminoma (SAKK 01/10). (5) In penile cancer, chemotherapy optimization progressed.ConclusionThe 2025 evidence establishes multiple new standards of care across GU cancers, emphasizing biomarker-driven strategies, immunotherapy integration, novel resistance mechanisms, and treatment optimization. This synthesis provides an evidence-based framework for updating guidelines and highlights the move toward more personalized management, while noting persistent challenges and future research needs.
DOI: 10.3389/fendo.2026.17802592026-04-01
Hui Han, Libo Hou, Jinghua Lu, Hao Sun, Wenwen Ning, Yue Liang, Yujie Gu, Huichao Yin, Qiang Gao
BackgroundType 2 diabetes mellitus (T2DM) is prevalent worldwide, with cognitive dysfunction emerging as a significant complication. Despite extensive research into its pathological mechanisms and clinical management, the knowledge structure, research priorities, and developmental trends within this field remain unsystematically integrated.MethodsTo ensure comprehensive coverage and compatibility with bibliometric analysis tools, relevant publications on type 2 diabetes mellitus (T2DM) and cognitive dysfunction were primarily retrieved from the Web of Science Core Collection (WOSCC) database from its inception to November 5, 2025. Searches were also conducted in PubMed and Scopus to verify completeness, but the final dataset was derived mainly from WOSCC due to its optimal export format for CiteSpace (plain text with full records and cited references) and high overlap after deduplication. Employing bibliometric methods and tools such as CiteSpace (version 6.4 Advanced) and SCImago Graphica (version 1.0.39), we conducted visual analyses of publication trends, country/region collaboration, institutional distribution, author contributions, journal impact, co-cited references, and keywords.ResultsA total of 1,752 publications were included. Annual publication volume exhibited a marked upward trend, accelerating particularly after 2018. China, the United States, and the United Kingdom were the primary contributing nations, with close inter-institutional collaboration. High-frequency keywords included ‘type 2 diabetes mellitus’, ‘Alzheimer’s disease’, and ‘cognitive impairment’. Research focus has shifted from early risk factors to microscopic levels, including neuroimaging, gut microbiota, and molecular mechanisms.ConclusionResearch on cognitive dysfunction in T2DM exhibits multidisciplinary characteristics, balancing fundamental research with clinical translation. Future efforts should enhance multidimensional integration of mechanism studies to advance early screening and personalised treatment strategies.
DOI: 10.3389/fendo.2026.18092452026-04-01
Jing Bai, Jirui Cai, Zhiwei Huang, Jin Wang, Bing He, Li Guo, Li Wu, Dongliang Liu, Guirang Zhao, Qiaotao Xie, Haoran Wang
BackgroundCommunity screening programs increasingly use World Health Organization (WHO) cardiovascular disease (CVD) risk charts to identify individuals at high predicted 10-year risk. The atherogenic index of plasma (AIP), derived from triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), may capture atherogenic dyslipidemia and support pragmatic risk stratification.MethodsWe conducted a cross-sectional analysis of baseline data from the China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) community screening program in Luohe, China. Among 6,860 screened participants, 6,702 with complete data for AIP computation, WHO risk classification, and prespecified covariates were included. The outcome was the WHO CVD risk chart-defined predicted 10-year CVD high-risk category (high risk: ≥20%), rather than adjudicated or incident CVD events. AIP was calculated as log10(TG [mmol/L]/HDL-C [mmol/L]) and modeled as both a continuous and categorical exposure; spline models tested nonlinearity, and ROC analyses evaluated discrimination and derived a Youden-index cutoff. In addition, we performed an explainable machine-learning pipeline for CVD high-risk prediction using LASSO logistic regression for feature selection (AIP forced-in), followed by a random forest classifier and SHAP-based interpretation.ResultsOf 6,860 screened participants, 6,702 were included in the analytic sample (median age 58 years; 38% men). The WHO CVD risk chart-defined predicted 10-year CVD high-risk category was present in 1,440 (21%) participants and was more frequent in the high-AIP group than in the low-AIP group. Higher AIP was associated with higher odds of CVD high-risk status. Restricted cubic splines supported a non-linear association. Discrimination was modest for AIP alone (AUC 0.557) and improved in adjusted models (AUC 0.650). In the machine-learning pipeline (LASSO + random forest), the random forest model achieved an AUC of 0.792, and SHAP analyses ranked LDL-C and history of hypertension as the strongest contributors, with AIP remaining among the top predictive features.ConclusionIn this community-based ChinaHEART population, higher AIP was non-linearly associated with the WHO CVD risk chart-defined predicted 10-year CVD high-risk category. Although AIP alone had limited discrimination, it may serve as a simple adjunct marker to triage individuals for intensified risk assessment in primary-care screening settings.
DOI: 10.3389/fendo.2026.17987352026-04-01
Shengming Huang, Zhiwei Huang, Jin Wang, Jirui Cai, Li Guo, Jianwei Xiong, Guirang Zhao, Qiaotao Xie, Yijun Song, Haoran Wang
BackgroundStroke remains a major cause of disability and death. While central adiposity may contribute to vascular risk, the role of the body roundness index (BRI) (a waist-height-derived anthropometric indicator) in community screening populations is not well defined. We therefore investigated the association between BRI and prevalent stroke in a community-based screening sample.MethodsUsing data from a ChinaHEART cohort branch (6,858 adults), BRI was calculated from anthropometric measurements. Prevalent stroke was ascertained by self-reported physician diagnosis. Receiver operating characteristic (ROC) analysis was used to determine the optimal BRI cutoff. Logistic regression, adjusted for age, sex, marital status, smoking, alcohol use, hypertension, diabetes, blood pressure, fasting glucose, and lipid parameters, was performed to examine the association between BRI and prevalent stroke. Restricted cubic spline (RCS) analysis and subgroup/interaction analyses were further conducted.ResultsAmong 6,858 participants, 192 (2.8%) reported prior stroke. The bootstrap-derived BRI cutoff was 4.597 (95% CI 4.149–4.798). High BRI (≥4.6) was associated with higher odds of prevalent stroke in the fully adjusted model (OR 1.766, 95% CI 1.279–2.438). BRI alone showed limited discrimination (AUC 0.584), while multivariable models achieved higher AUC (0.740 in the fully adjusted model). Adding BRI produced ΔAUC increases. RCS showed no evidence of nonlinearity.ConclusionsOur findings support BRI as a simple, non-invasive anthropometric measure that may offer complementary discriminatory information for community screening/triage; prospective studies with validated outcomes are warranted to confirm clinical utility.
DOI: 10.3389/fendo.2026.17616302026-04-01
Juan J. Díez
Hypoparathyroidism is a rare endocrine disorder characterized by deficient secretion of parathyroid hormone (PTH), resulting in hypocalcemia, hyperphosphatemia, and impaired mineral homeostasis. Although most cases are postsurgical, the disease encompasses a heterogeneous group of etiologies, including genetic, autoimmune, and infiltrative causes. For much of its history, hypoparathyroidism was considered unique among endocrine deficiencies in that it was not treated with hormone replacement, owing to limited understanding of parathyroid physiology and the absence of safe and effective PTH-based therapies. This review provides a historical perspective on the evolution of hypoparathyroidism, from the anatomical discovery of the parathyroid glands in the nineteenth century to recent advances in molecular biology, laboratory diagnostics, and targeted treatments. Key milestones include the elucidation of calcium and phosphate regulation, the isolation and characterization of PTH, the identification of the calcium-sensing receptor, and the discovery of regulatory pathways involving fibroblast growth factor 23 and klotho. Parallel advances in clinical chemistry enabled increasingly accurate measurement of serum calcium and PTH, facilitating improved diagnosis and disease monitoring. Therapeutic strategies have evolved from conventional treatment with calcium and active vitamin D toward physiological hormone replacement. Clinical development of recombinant PTH formulations, long-acting prodrugs, and novel receptor agonists has transformed the therapeutic landscape and renewed interest in disease-modifying approaches. Emerging therapies, including oral agents, long-acting formulations, and cell-based strategies, suggest that the management of hypoparathyroidism is entering a new era focused on restoring physiological mineral metabolism and improving long-term outcomes.
DOI: 10.3389/fendo.2026.17692622026-04-01
Ronghua Sun, Hongyun Xu, Rui Ma, Juan Xu, Yong Liu, Dongwei Mao
BackgroundEndometriosis, PCOS, adenomyosis, and dysmenorrhea are major illnesses. Hormonal as well as non-hormonal treatments were evaluated for COCs, progestins, GnRH analogues, LNG-IUS, relugolix, and adjunctive therapies. These treatments resulted in the categorization of the benefits in varying degrees.Methods149 clinical trials have been included. Evaluating the methodological quality was done through the Jadad scale, while the GRADE criteria were used to assess the reliability of the evidence. When these data were available, effect sizes, standardized mean differences (SMD), 95% confidence intervals (CI), and p-values were extracted.ResultsIt was observed that COCs and progestins considerably lowered pelvic pain and menstrual irregularities (SMD -0.35 to -0.58, 95% CI -0.90 to -0.08, p<0.05), and among various trials, dienogest was reported to be the most effective in alleviating dysmenorrhea (SMD -0.58, 95% CI -0.90 to -0.26, p<0.001). The use of relugolix in combination resulted in considerable pain reduction related to endometriosis (SMD -0.72, 95% CI -0.94 to -0.50, p<0.001), and the study was rated as excellent quality with GRADE and Jadad scores of 5. GnRH analogs led to pain reduction all the time (SMD -0.65, 95% CI -0.88 to -0.42, p<0.001), while the application of LNG-IUS was linked to less menorrhagia and lower recurrence after surgery (RR 0.51, 95% CI 0.33–0.79, p=0.002). Besides the main treatments, usage of the like of antioxidants, NAC, melatonin, and digital therapeutics, too, gave extra pain relief and quality-of-life benefits (SMD -0.40 to -0.62, p<0.05). the studies frequently proved to have a very rigorous quality of methodology (Jadad 3–5) and moderate-to-high grade certainty of evidence (GRADE).ConclusionsEndometriosis disorder have been treated well with hormonal therapies. Different endocrine therapies based on the patient’s specific characteristics and the degree of tolerability should be used to achieve the maximum effect of clinical outcomes.
DOI: 10.3389/fendo.2026.17927932026-04-01
Ji Yong Park, Su Woong Yoo, Sung Sun Kim, A Ram Hong, Jee Hee Yoon, Hee Kyung Kim, Ho-Cheol Kang
BackgroundHyperfunctioning distant metastases from differentiated thyroid carcinoma (DTC) are rare but increasingly reported. We report hormone-producing lung and bone metastases from an HRAS-mutated high-grade differentiated thyroid carcinoma (HGDTC) originating from follicular thyroid carcinoma (FTC), with a brief literature review. The metastases showed a marked response to radioactive iodine (RAI).Patient findingsA 68-year-old woman presented with an enlarging thyroid nodule and multiple pulmonary nodules after starting antithyroid therapy for Graves’ disease. Histopathology confirmed HGDTC arising from FTC, and next-generation sequencing identified an HRAS Gln61Arg mutation. Thyrotoxicosis persisted after total thyroidectomy. A post-therapeutic whole-body radioiodine scan demonstrated iodine-avid pulmonary nodules and a left iliac bone lesion, consistent with hyperfunctioning distant metastases.SummaryAfter two RAI treatments, thyroid function shifted from hyperthyroidism to hypothyroidism, and follow-up chest computed tomography showed a significant reduction in pulmonary metastatic lesions.ConclusionsHyperfunctioning distant metastases from DTC present diagnostic and therapeutic challenges. This case highlights the consideration of functioning metastases in persistent post-thyroidectomy thyrotoxicosis and demonstrates the potential effectiveness of RAI therapy when metastatic lesions retain iodine avidity. Oncogenic mutations such as HRAS may contribute to the pathophysiology of hormone-producing metastases and provide insights into tumor differentiation and therapeutic responsiveness.
DOI: 10.3389/fendo.2026.18174482026-04-01
Yajing Gao, Chuang Gao, Jiaqian Zhu, Yong Han
ObjectiveResearch on the relationship between Total Cholesterol, High-Density Lipoprotein, and Glucose (CHG) index and diabetes mellitus (DM) risk remains limited. This study aims to investigate the association between CHG and DM incidence.MethodsThis retrospective cohort study included 8,844 participants who underwent comprehensive health examinations at Shenzhen Kuichong People’s Hospital between 2018 and 2023. The maximum individual follow-up duration reached 5 years, with a median (interquartile range) follow-up period of 2.72 (2.58–4.78) years. Cox proportional hazards regression models were used to evaluate the association between CHG and DM risk. ROC analysis was conducted to evaluate the predictive capability of CHG for DM. Finally, subgroup analyses and sensitivity analyses were performed to further verify the stability of these findings.ResultsAfter multivariate adjustment, the CHG index was independently associated with increased DM risk, with an HR of 1.150 (95% CI: 1.098–1.204) per 0.1 unit increase in CHG. Furthermore, ROC curve analysis demonstrated that CHG had the highest AUC (0.7377) for predicting DM risk, compared to TC (0.5375), HDL-c (0.6105), and FPG (0.6761). The stability of these results was further validated through sensitivity and subgroup analyses.ConclusionThis study found an independent positive relationship between CHG and DM risk. Additionally, CHG demonstrates a certain predictive value for DM risk. This helps clinicians identify high-risk individuals for DM early and provides a new perspective for optimizing clinical prevention and management of DM.
DOI: 10.3389/fendo.2026.17749652026-04-01
Razvigor Darlenski, Vesselina Mihaylova, Karen Manuelyan, Denitza Zheleva, Georgi Bogdanov, Ivan Bogdanov, Todor Kundurzhiev, Pavlina Gateva, Mikael Fogelholm, Anne Raben, Teodora Handjieva-Darlenska
ObjectiveTo explore whether specific cutaneous findings are associated with prediabetes among adults with overweight or obesity, and may assist in clinical risk stratification.Materials and methodsThis single-center, cross-sectional analysis included 191 adults with overweight or obesity (BMI ≥25 kg/m²) recruited during screening visits of the Bulgarian PREVIEW cohort; 151 participants had prediabetes, and 40 did not. A trained dermatologist performed a standardized skin examination. Xerosis, pruritus, and yellowish skin tone were assessed using 10-point visual scales. The prevalence of dermatological conditions was compared between groups, and exploratory binary logistic regression was used to examine associations with prediabetes.ResultsHorseshoe-like plantar hyperkeratosis (HSLPH) was more frequent in participants with prediabetes than in those without (25.2% vs. 10.0%, p = 0.039). The presence of HSLPH was associated with higher odds of prediabetes (odds ratio 3.03, 95% confidence interval 1.01–9.06). HSLPH showed high specificity (90%) but low sensitivity (25%). The prevalence of other common skin conditions, including skin tags, onychomycosis, signs of chronic venous insufficiency, seborrheic dermatitis, and tinea pedis, did not differ between groups. Skin tag counts were not associated with body weight or BMI. No significant differences were observed in xerosis, pruritus, or yellowish skin tone scores.ConclusionIn adults with overweight or obesity, HSLPH was the only cutaneous finding associated with prediabetes and behaved as a specific but insensitive clinical sign. Its presence may serve as a visible clinical red flag prompting metabolic evaluation, whereas its absence does not exclude dysglycemia. Other common obesity-related skin findings were not discriminatory for prediabetes in this cohort.
DOI: 10.3389/fendo.2026.17966072026-04-01
Hu Li, Zhaoyi Jing, Rui Li, Zheng Shen, Tianyu Bai, Qingyu Song
BackgroundThis study aims to deepen the understanding and assessment of the global burden of polycystic ovary syndrome (PCOS), providing a basis for policy-making and resource allocation to help achieve global health goals.MethodsThis study focused on analyzing the disease burden of PCOS at the global, regional, and national levels, considering age factors and predicting trends up to 2035. This study also involved cross-national inequality analysis, frontier analysis, and decomposition analysis.ResultsThe burden of PCOS is increasing, with the age of onset concentrated in the 10–19 age group, while the number of cases and DALYs is predominantly in the 15–49 age group. Countries with a higher Socio-demographic Index (SDI) bear a heavier burden of PCOS, effectively controlling its growth trend. Inequality persists. Population growth and epidemiological changes are driving the increase in the burden of PCOS. By 2035, the burden of PCOS is projected to continue increasing.ConclusionThe global burden of PCOS shows an overall increasing trend, with significant differences among different regions and countries. Greater support is needed for low SDI to standardize diagnostic criteria, raise public health awareness, and better protect women’s health.
DOI: 10.3389/fendo.2026.1662823