To the Editor:Maternal overt hypothyroidism(OH),subclinical hypothyroidism(SCH),or thyroid autoimmunity(TAI)can lead to adverse pregnancy outcomes.During the last decade,the American Thyroid Association(ATA),the Europ...To the Editor:Maternal overt hypothyroidism(OH),subclinical hypothyroidism(SCH),or thyroid autoimmunity(TAI)can lead to adverse pregnancy outcomes.During the last decade,the American Thyroid Association(ATA),the European Thyroid Association,the Chinese Society of Endocrinology(CSE),and the American College of Obstetricians and Gynecologists(ACOG)issued several guidelines for the management of thyroid disorders during gestation.Over 13 years ago,SCH during pregnancy was defined as a serum thyroid stimulating hormone(TSH)level between 2.5 mIU/L and 10.0 mIU/L with a normal free thyroxine(FT4)concentration.[1]Six years later,the upper limit of the pregnancy-specific TSH reference was raised to 4.0 mIU/L.[2]Levothyroxine(LT4)is the most recommended drug for thyroid hormone supplementation in pregnant women.However,according to diverse guidelines,the conditions triggering the initiation of LT4 supplementation differ among pregnant women.展开更多
Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic sy...Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic syndrome(MS),and we named it metabolic dysfunction syndrome(MDS).The pathogenesis of T2D is not fully understood,with IR andβcell dysfunction playing central roles in its pathophysiology.Dyslipidemia,hyperglycemia,along with other metabolic disorders,results in IR and/or isletβcell dysfunction via some shared pathways,such as inflammation,endoplasmic reticulum stress(ERS),oxidative stress,and ectopic lipid deposition.There is currently no cure for T2D,but it can be prevented or in remission by lifestyle intervention and/or some medication.If prevention fails,holistic and personalized management should be taken as soon as possible through timely detection and diagnosis,considering target organ protection,comorbidities,treatment goals,and other factors in reality.T2D is often accompanied by other components of MDS,such as preobesity/obesity,metabolic dysfunction associated steatotic liver disease,dyslipidemia,which usually occurs before it,and they are considered as the upstream diseases of T2D.It is more appropriate to call“diabetic complications”as“MDS-related target organ damage(TOD)”,since their development involves not only hyperglycemia but also other metabolic disorders of MDS,promoting an up-to-date management philosophy.In this review,we aim to summarize the underlying mechanism,screening,diagnosis,prevention,and treatment of T2D,especially regarding the personalized selection of hypoglycemic agents and holistic management based on the concept of“MDS-related TOD”.展开更多
To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-...To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-producing adrenocortical adenomas(APAA).However,it can also be induced by aldosterone-producing adrenocortical carcinoma(APAC),which is rare.Because of the rarity and malignancy.展开更多
基金This work was supported by the National Natural Science Foundation of China(No.82100851)the Natural Science Foundation of Sichuan Province,China(No.2024NSFSC0583).
文摘To the Editor:Maternal overt hypothyroidism(OH),subclinical hypothyroidism(SCH),or thyroid autoimmunity(TAI)can lead to adverse pregnancy outcomes.During the last decade,the American Thyroid Association(ATA),the European Thyroid Association,the Chinese Society of Endocrinology(CSE),and the American College of Obstetricians and Gynecologists(ACOG)issued several guidelines for the management of thyroid disorders during gestation.Over 13 years ago,SCH during pregnancy was defined as a serum thyroid stimulating hormone(TSH)level between 2.5 mIU/L and 10.0 mIU/L with a normal free thyroxine(FT4)concentration.[1]Six years later,the upper limit of the pregnancy-specific TSH reference was raised to 4.0 mIU/L.[2]Levothyroxine(LT4)is the most recommended drug for thyroid hormone supplementation in pregnant women.However,according to diverse guidelines,the conditions triggering the initiation of LT4 supplementation differ among pregnant women.
基金supported by the National Nature Science Foundation of China(82170830)grants from the 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYGD 18017)grants from Nature Science Foundation of Department of Science and Technology of Sichuan Province(China)(2023YFS0078).
文摘Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic syndrome(MS),and we named it metabolic dysfunction syndrome(MDS).The pathogenesis of T2D is not fully understood,with IR andβcell dysfunction playing central roles in its pathophysiology.Dyslipidemia,hyperglycemia,along with other metabolic disorders,results in IR and/or isletβcell dysfunction via some shared pathways,such as inflammation,endoplasmic reticulum stress(ERS),oxidative stress,and ectopic lipid deposition.There is currently no cure for T2D,but it can be prevented or in remission by lifestyle intervention and/or some medication.If prevention fails,holistic and personalized management should be taken as soon as possible through timely detection and diagnosis,considering target organ protection,comorbidities,treatment goals,and other factors in reality.T2D is often accompanied by other components of MDS,such as preobesity/obesity,metabolic dysfunction associated steatotic liver disease,dyslipidemia,which usually occurs before it,and they are considered as the upstream diseases of T2D.It is more appropriate to call“diabetic complications”as“MDS-related target organ damage(TOD)”,since their development involves not only hyperglycemia but also other metabolic disorders of MDS,promoting an up-to-date management philosophy.In this review,we aim to summarize the underlying mechanism,screening,diagnosis,prevention,and treatment of T2D,especially regarding the personalized selection of hypoglycemic agents and holistic management based on the concept of“MDS-related TOD”.
基金1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University(No. ZYGD18017)
文摘To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-producing adrenocortical adenomas(APAA).However,it can also be induced by aldosterone-producing adrenocortical carcinoma(APAC),which is rare.Because of the rarity and malignancy.
