This study aimed to evaluate short-term changes in depressive symptom burden and sleep quality and factors associated with clinical response in patients with obesity initiating GLP-1-based therapies. In this prospective observational study, patients with obesity initiating semaglutide or tirzepatide were enrolled. Depressive symptom burden and sleep quality were assessed at baseline and month 3 using the Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI), respectively. Clinically significant depressive symptom burden was defined as PHQ-9 ≥ 10 and poor sleep quality as PSQI > 5; clinical response was defined as reductions of ≥ 5 PHQ-9 points and ≥ 3 PSQI points. Multivariable logistic regression models evaluated factors associated with each response. A total of 78 patients were included (tirzepatide n = 52; semaglutide n = 26). Median PHQ-9 decreased from 10.0 (7.0–14.0) to 6.0 (4.0–8.0), and the prevalence of PHQ-9 ≥ 10 declined from 55.1

Abstract Papillary thyroid carcinoma (PTC) may contribute to cardiovascular (CV) morbidity through pro-inflammatory signaling and endothelial dysfunction, yet subclinical myocardial effects remain poorly characterized. While cardiovascular morbidity in papillary thyroid carcinoma (PTC) patients has largely been attributed to treatment-related factors such as TSH suppression, the potential contribution of the disease itself to early, subclinical cardiovascular vulnerability has not been well defined. To address this knowledge gap, we examined treatment-naïve PTC patients for evidence of subclinical cardiovascular dysfunction. This case-control study included 36 untreated PTC patients and 20 benign nodular goiter controls. Comprehensive cardiac assessment utilized transthoracic echocardiography, tissue Doppler imaging, and two-dimensional speckle-tracking echocardiography. Serum integrin αvβ3 and tumor necrosis factor-alpha (TNF-α) levels were quantified via enzyme-linked immunosorbent assay. Central thyroid hormone sensitivity was assessed using the Thyroid Feedback Quantile-based Index (TFQI). Compared with controls, patients with PTC exhibited evidence of subclinical myocardial functional alterations. Circulating integrin αvβ3 and TNF-α levels were significantly higher in patients with PTC. Integrin αvβ3 levels were associated with impaired GLS and diastolic dysfunction, whereas TNF-α showed no direct association with echocardiographic parameters. In addition, TFQIFT4 levels were increased in PTC group and demonstrated a positive correlation with circulating integrin αvβ3 levels, as well as an association with impaired GLS. Treatment-naive, euthyroid patients with PTC exhibit early subclinical myocardial dysfunction despite preserved ejection fraction. Impairment in GLS, derived from echocardiographic assessment, is associated with circulating integrin αvβ3 and altered central thyroid hormone sensitivity, reflecting early CV alterations that warrant confirmation in longitudinal studies.

BACKGROUND:There is uncertainty regarding whether thyroid-stimulating hormone (TSH) suppression therapy in postmenopausal women with differentiated thyroid cancer (DTC) is associated with menopause-specific health concerns. This study aimed to determine whether prolonged TSH suppression confers an additional burden on postmenopausal health by comprehensively evaluating cardiovascular health (CVH), quality of life (QoL), muscle mass, and bone health using menopause-specific assessment tools. METHODS:A cross-sectional study was conducted involving three groups of postmenopausal women 107 patients with DTC receiving TSH suppression therapy following total thyroidectomy for ≥3 years, 80 women receiving levothyroxine (LT4) replacement for primary hypothyroidism, and 97 euthyroid controls. Women with cognitive impairment, a history of osteoporosis, or cardiovascular disease were excluded. CVH was assessed using Life's Essential 8 (LE8) score, carotid intima-media thickness (cIMT), and electrocardiography. QoL was assessed using the Utian QoL (UQoL) Scale, cognition by the Mini-Mental State Examination, body composition by bioelectrical impedance analysis, and bone density by dual-energy X-ray absorptiometry. RESULTS:Women with DTC demonstrated significantly lower LE8 scores, lower UQoL scores, higher cIMT values, higher prevalence of osteoporosis, and reduced muscle mass than those in the other two groups (p < 0.001, p < 0.001, p < 0.001, p = 0.003, and p = 0.017, respectively). Multivariable regression analysis revealed that cumulative LT4 dose was independently associated with lower LE8 and UQoL scores (β = -0.354, p < 0.001; and β = -0.396, p < 0.001, respectively), while higher serum TSH levels were positively associated with both LE8 and UQoL scores (β = 0.271, p = 0.002; and β = 0.487, p < 0.001, respectively). CONCLUSIONS:Prolonged TSH suppression may adversely affect postmenopausal health, particularly in low-risk, disease-free women with DTC. The primary clinical implication of these findings is the need to avoid unnecessary long-term TSH suppression. Menopause-specific assessment tools may have a complementary role in selected patients in whom TSH suppression remains clinically indicated.

Background/Objectives: Papillary thyroid carcinoma (PTC) accounts for the majority of thyroid cancers, with lymph node metastasis, including skip metastasis (SM), playing a crucial role in guiding prognosis and therapeutic planning. SM, characterized by lateral lymph node spread in the absence of central compartment involvement, has been observed in PTC with a wide range of reported frequencies. The identification of risk factors for SM is crucial for preoperative evaluation and surgical planning. This research aims to explore the clinicopathological features and potential risk factors linked to SM in patients with PTC, while also offering valuable insights for preoperative risk evaluation. Methods: A retrospective cohort study was conducted on 81 PTC patients who underwent central and lateral cervical lymph node dissection (LND) in our center. Clinical, demographic, and pathological data, including age, sex, tumor size, location, subtype, extrathyroidal extension, lymphovascular invasion, and the number of lymph node metastases were analyzed. Clinicopathological characteristics were analyzed between SM-positive and SM-negative patient groups using suitable statistical methods. Additionally, a regression analysis was performed to identify the risk factors for SM. Results: Of the 81 patients, 17.3% (n = 14) were diagnosed with skip metastasis (SM). The SM-positive group had a significantly higher age (p = 0.006), smaller tumor size (p < 0.001), and higher rates of extrathyroidal extension (p = 0.006). The proportion of female patients was elevated in the SM-positive group, but this observation did not achieve statistical significance (p = 0.128). Tumors located in the upper pole were more common in the SM-positive group (p = 0.016). Multivariate analysis revealed that female sex, older age, and tumor location in the upper pole were significant risk factors for SM (p = 0.031, p = 0.004, and p = 0.017, respectively), while a lower number of lateral lymph node metastases was significantly associated with SM (p = 0.010). Additionally, an age over 43.5 years predicted SM with a sensitivity of 78.6% and a specificity of 72.7%. Conclusions: Skip metastasis is not uncommon in PTC and may be associated with older age, female sex, upper pole tumor location, and fewer lateral lymph node metastases. Recognizing these factors during preoperative assessment may aid in anticipating atypical lymphatic spread patterns and optimizing surgical strategies.

ABSTRACTObjectivePatients with mild autonomous cortisol secretion (MACS) are at increased risk of cardiometabolic outcomes, such as hyperglycemia, metabolic syndrome, and cardiovascular diseases. Nonalcoholic fatty liver disease (NAFLD) is also associated with increased cardiometabolic risk. We aimed to investigate the prevalence and predictors of NAFLD in metabolically healthy subjects with MACS.MethodsForty patients with MACS and 60 patients with nonfunctioning adrenal incidentaloma (NFAI) matched for age, gender, and body mass index were included. We excluded various diseases that may lead to NAFLD, such as diabetes, cardiovascular diseases, and liver disorders. Non‐alcoholic fatty liver disease was evaluated with unenhanced abdominal computed tomography and noninvasive fatty liver indices.ResultsPatients with MACS had lower mean liver attenuation values (Hounsfield units, HU) than those with NFAI (p = 0.001). Visceral adiposity index, hepatic steatosis index, and fatty liver index were higher in the MACS group than in the NFAI group (p = 0.009, p = 0.002, p = 0.023, respectively). However, there was no significant association between the mean liver HU value and these indices. There was a significant association between serum cortisol level after the 1 mg dexamethasone suppression test (DST) and mean liver HU value independent of other traditional risk factors in various models performed in multivariable linear regression analysis.ConclusionsOur findings suggest that MACS is associated with an increased risk of NAFLD, and serum cortisol level after 1 mg DST is an independent predictor of NAFLD in patients with MACS.

Background: Non-functional adrenal incidentaloma (NFAI) is associated with an increased risk of adverse cardiometabolic outcome. Identifying predictors of atherosclerotic cardiovascular disease (ASCVD) may enable more appropriate management strategies in patients with NFAI. We aimed to investigate the body composition parameters and ASCVD risk in patients with NFAI.Methods: Eighty patients with NFAI and 80 controls matched for age, gender and body mass index (BMI) were included. ASCVD risk was assessed on Framingham Risk Score (FRS) and American Heart Association /American College of Cardiology (AHA/ACC) score. Body composition was evaluated using a segmental body composition analyzer.Results: There were no significant differences in age, gender, blood pressure or body composition parameters between the two groups. Patients with NFAI had higher FRS and AHA/ACC scores than controls (p=0.017, p=0.024, respectively). In patients with NFAI, independent predictors for FRS were serum cortisol level after 1 mg dexamethasone suppression test (DST) and waist/hip ratio (WHR), while independent predictors for AHA/ACC score were serum cortisol level after 1 mg DST, WHR and fasting plasma glucose (FPG), in various multivariate linear regression models.Conclusions: FRS and AHA/ACC scores may be useful in determining ASCVD risk in patients with NFAI, and serum cortisol level after 1 mg DST is an independent predictor of ASCVD in these patients, even in the absence of hypercortisolism.

BACKGROUND AND OBJECTIVES:Gross total resection of pituitary adenomas (PAs) remains challenging despite advancements in transsphenoidal surgery, primarily due to difficulty in distinguishing adenoma tissue from the normal pituitary gland. Fluorescence-guided surgery using sodium fluorescein (SF) has shown promise in addressing this issue. This study evaluates the feasibility, safety, and efficacy of SF-guided endoscopic endonasal approach (EEA) for PA resection and presents preliminary results. METHODS:Twenty-six patients with functioning intrasellar PAs underwent SF-guided EEA. A 4-mm endoscope with yellow and blue filters was used to visualize the adenoma and pituitary gland. Intravenous SF (5 mg/kg, 10%) was administered, and fluorescence staining was observed. Fluorescence emission was quantified using color spectrophotometry. Extent of resection was assessed by dynamic contrast-enhanced MRI at 3 months and postoperative hormone levels. RESULTS:The cohort included 15 growth hormone-secreting (57.7%), 5 adrenocorticotropic hormone-secreting (19.2%), 4 prolactin-secreting (15.4%), and 2 FSH-secreting (7.7%) adenomas. Quantification revealed significant differences in fluorescence emission among dura (564 ± 5.621 nm), adenoma (549.65 ± 8.299 nm), and pituitary gland (531.42 ± 5.886 nm) ( P < .001). Residual tumor was detected in 14 patients (53.8%) under blue filter evaluation. Gross total resection was achieved in 88.5% of patients and near-total resection in 11.5%. Early biochemical remission was achieved in 84.6% of cases, including 80% of growth hormone-secreting, 80% of adrenocorticotropic hormone-secreting, 100% of prolactin-secreting, and 100% of FSH-secreting adenomas. No SF-related complications or adverse events occurred. CONCLUSION:This study represents the first series of fully endoscopic SF-guided EEA for intrasellar PAs, demonstrating the technique's feasibility, safety, and efficacy. SF enhances intraoperative discrimination between adenoma and pituitary tissue, providing real-time guidance without prolonging surgery or causing adverse effects. These findings suggest SF is a valuable adjunct for improving PA resection outcomes.

Background and Objectives: Thyroid nodules are common, and distinguishing benign from malignant lesions is essential for clinical decision-making. While EU-TIRADS provides ultrasound-based risk stratification, fine-needle aspiration biopsy (FNAB) and the Bethesda System remain central diagnostic tools. This study aimed to compare the diagnostic performance of EU-TIRADS and Bethesda classifications and to identify ultrasonographic features independently associated with malignancy. Materials and Methods: This retrospective single-center study included 824 patients (1132 nodules) who underwent FNAB between August 2021 and June 2024. All ultrasound examinations and FNAB procedures were performed by the same endocrinologist. Sonographic features, EU-TIRADS categories, Bethesda classes, surgical indications, and histopathology were analyzed. Diagnostic accuracy was assessed using ROC curves, and multivariable logistic regression was applied to determine independent predictors of malignancy. Results: Among all nodules, 51.0% were EU-TIRADS 3, 28.6% were EU-TIRADS 4, and 19.2% were EU-TIRADS 5. Bethesda class II constituted 62.7% of FNAB results. Of the 289 surgically treated nodules, 53.3% were malignant. Malignant nodules were smaller, more often solitary and unilateral, and more frequently located in the upper pole (p < 0.05). Irregular margins (OR = 8.15, p < 0.001) and microcalcifications (OR = 10.01, p = 0.003) were independent predictors of malignancy. Taller-than-wide shape also showed significant association. ROC analyses demonstrated that EU-TIRADS (AUC = 0.808) and Bethesda (AUC = 0.869) were both significant predictors, with Bethesda showing higher specificity. Malignancy rates were 0% in EU-TIRADS II, 4.3% in III, 14.5% in IV, and 37.8% in V. Conclusions: EU-TIRADS is a practical and sensitive non-invasive tool for malignancy risk stratification; however, Bethesda classification remains superior in overall diagnostic accuracy. Microcalcification and irregular margins were the strongest ultrasonographic predictors of malignancy, while macrocalcification, parenchymal heterogeneity, and thyroiditis showed no significant association. These findings support the complementary roles of EU-TIRADS and FNAB and highlight key sonographic markers that enhance malignancy prediction in thyroid nodule evaluation.

OBJECTIVE:This study aimed to evaluate the diagnostic performance of biochemical markers in normocalcemic primary hyperparathyroidism (nPHPT), analyse their temporal variations, and assess their correlation with adenoma localisation and size. METHODS:In this multicenter retrospective study-the largest patient cohort reported in the literature to date (n = 474) we comprehensively profiled normocalcemic patients diagnosed with primary hyperparathyroidism nPHPT was diagnosed based on persistently elevated PTH levels with normal serum calcium after excluding secondary causes such as vitamin D deficiency, renal impairment, and other conditions. This retrospective multicenter study included a large cohort of patients whose biochemical markers-including serum calcium, phosphorus, magnesium, vitamin D, parathyroid hormone (PTH), and glomerular filtration rate (GFR)-were measured at three time points, using standardised laboratory protocols. Although in routine clinical practice these measurements are typically performed at regular intervals of 3-6 months, resulting in approximately three assessments during an 18-month follow-up period. Urinary calcium and creatinine levels were also determined, and imaging modalities (ultrasonography, sestamibi scintigraphy, and computed tomography) were employed for adenoma detection. Statistical analyses comprised repeated measures ANOVA, logistic regression, correlation analysis, and ROC analysis, performed using Jamovi software. RESULTS:Serial evaluations revealed significant temporal changes in key biochemical parameters, including a significant decline in serum calcium and PTH levels alongside a significant increase in urinary calcium excretion. Logistic regression analysis identified higher PTH levels, higher corrected calcium, and larger adenoma size as independent predictors of adenoma localisation, while ROC analysis confirmed that PTH exhibited the highest diagnostic accuracy (AUC = 0.91, 95% CI: 0.84-0.95, p < 0.001). CONCLUSION:The large scale of our patient cohort reinforces the robustness of our statistical analyses and provides comprehensive insight into the dynamic nature of nPHPT. Our findings demonstrate that, even in normocalcemic patients, higher PTH levels and relatively higher calcium levels within the normal range are important indicators of parathyroid adenoma. Integrating serial biochemical measurements with targeted imaging can facilitate earlier diagnosis, potentially preventing future complications and informing more tailored management strategies.

The primary objective of this study was to retrospectively evaluate the demographic, biochemical, and clinical characteristics of patients with asymptomatic primary hyperparathyroidism (aPHPT), analyze their long-term outcomes, and discuss the effectiveness of current therapeutic strategies in light of the existing literature. We anticipate that our study will provide clinicians with guidance regarding surgical decision-making beyond the standard criteria for aPHPT. This was a nationwide, multicenter, observational, retrospective cohort study. All tertiary care endocrinology departments across the country were invited to participate. Center inclusion criteria required the enrollment of a sufficient number of aPHPT patients, confirmed by careful diagnostic evaluation in accordance with established guidelines, regular follow-up for at least one year, and systematic monitoring for complications. Data from 27 centers representing various regions of Turkey were included in the study. A total of 829 patient records were reviewed, and after excluding 25 patients who did not meet eligibility criteria, 804 patients were included in the final analysis. The mean age was 55.59 ± 11.54 years, with a female predominance (85

Background and Objectives: Thyroid nodules are a common endocrine disorder, with 10–15% exhibiting malignancy. Accurate differentiation of malignant and benign nodules is crucial for optimizing treatment outcomes. Current diagnostic tools, such as the Bethesda classification and fine-needle aspiration biopsy (FNAB), are limited in sensitivity and specificity, particularly in indeterminate cases. Tumor-infiltrating immune cells (TIICs) in the tumor microenvironment (TME) play a significant role in thyroid cancer progression. CD66b+ neutrophil-like monocytes constitute a novel subset of myeloid cells that are implicated in the modulation of anti-tumor immune responses, but their role in thyroid cancer remains unclear. Materials and Methods: Peripheral blood and thyroid nodule tissue samples were obtained from 24 patients with papillary thyroid carcinoma, and from 10 patients who underwent surgery for symptoms of tracheal compression due to benign thyroid nodules. Myeloid cell populations were assayed by flow cytometric immunophenotyping with CD45, HLA-DR, CD14, and CD66b. The data were statistically analyzed with the clinical properties of the patients. Results: The neutrophil-like monocytes, which were determined as HLA-DR+CD14+CD66b+ cells, found in the circulation (11.9 ± 2.4% of total mononuclear immune cells) of the patients with papillary thyroid carcinoma, were significantly elevated (p < 0.001). Accordingly, these cells were more frequently detected in tumor tissues (21.1 ± 2.1% of total tumor-infiltrating immune cells) compared to non-tumor thyroid tissues (p = 0.0231). The infiltration levels of neutrophil-like monocytes were significantly higher in malignant nodules as well as in the peripheral blood of the papillary thyroid carcinoma patients compared to the samples obtained from the patients with benign nodules. The tumor tissues exhibited increased immune cell infiltration and harbored CD66b-expressing neutrophil-like HLA-DR+CD14+ monocytic cells, which indicates an inflammatory milieu in malignant thyroid cancer. Conclusions: This study identifies neutrophil-like monocytes as a potential biomarker for differentiating malignant and benign thyroid nodules. Elevated levels of this novel subtype of immune cells in malignant tissues suggest their role in tumor progression and their utility in enhancing diagnostic accuracy. Incorporating these findings into clinical practice may refine surgical decision-making and improve outcomes through personalized diagnostic and therapeutic strategies, particularly for radioiodine-refractory thyroid cancer.

Aims: Fibroblast Growth Factor 21 (FGF-21) is a member of the FGF family involved in biological processes such as embryonic development. cell growth. morphogenesis. tissue repair. tumour growth and invasion. with mitogenic and cytogenetic activity at 19q13.33.Breast cancer is a deadly and increasing disease in women. and recent studies have shown a relationship between some cancers. including breast cancer. and hormones secreted from adipose tissue.The aim of the present study was the measurement of FGF-21 levels in patients with breast cancer and its association with breast cancer. Methods: The study included 39 patients with newly diagnosed breast cancer and 39 healthy controls. During the patients’ routine blood tests. a venous blood sample was taken and the serum levels of FGF-21 were determined by ELISA. Results: Demographic and laboratory data were compared between the newly diagnosed breast cancer group and the control group. The control group consisted of 39 participants with a mean age of 52.49 ± 7.02 years. In the patient group. 39 participants with a mean age of 52.15 ± 6.21 years were included in the study. there was no statistical difference regarding age(p>0.05).In the control group. the mean FGF-21 level was 121.35 ± 88.4 pg/ml. while the mean FGF-21 level in the patient group was 171 ± 117.45 pg/ml. a statistically significant difference was detected(p value=0.036). Conclusion: FGF-21 is thought to have significant and beneficial effects on glucose. lipid and energy metabolism. as well as slowing the growth of cancer cells. and may later be used as a biological marker for breast cancer.

Thyroid hormones play an important role in the regulation of glucose metabolism. Recently, some studies determined the relationship between diabetes and abnormality of indices of thyroid hormone sensitivity. Thyroid dysfunction may play a role in the etiology of gestational diabetes mellitus (GDM). In the present study, we aim to determine central and peripheral thyroid hormone resistance by evaluating indices of thyroid hormone sensitivity and thyroid function tests and to investigate its effect on the etiology of GDM. A total of 1416 euthyroid pregnant women were included in this study. Of these, 241 (17

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS leads to metabolic dysfunction such as dyslipidemia, obesity, and glucose intolerance based on hyperandrogenemia, hyperinsulinemia, and dysregulated adipokine secretion. Objective: The aim of this study was to investigate whether a new marker, InsuTAG (fasting insulin×fasting triglycerides) could predict insulin resistance (IR) in patients of PCOS. Methods: In this study, retrospective data of 300 female patients diagnosed with PCOS were analyzed. The relationship between InsuTAG and HOMA-IR, TyG, and TG/HDL-C scores related to insulin resistance was evaluated. In addition, the distribution of the cases according to the cut-off values was determined. Results: Log-transformed forms of InsuTAG and HOMA-IR, TyG and TG/HDL-C results were positively correlated, respectively. (r = 0.85, p < 0.001; r = 0.78, p < 0.001; r = 0.72, p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive values for InsuTAG were calculated as 85%, 85%, 82% and 88%, respectively. Conclusions: This study is the first to compare the InsuTAG, another predictor of insulin resistance, with other IR markers in women with PCOS. InsuTAG is a novel biomarker based on plasma sampling of insulin and triglyceride, with minimally invasive, inexpensive and orientally accessible features.

Objective: Cushing's syndrome increases the risk of cardiovascular disease. The triglyceride-glucose (TyG) index has been linked to an increased risk of cardiometabolic disorders. Whether patients with non-functioning adrenal incidentaloma (NFAI) or cortisol-secreting adrenal incidentaloma (CSAI) have altered TyG index is unknown. Therefore, we aimed to investigate the TyG index between adrenal incidentaloma patients and controls. Materials and methods: This cross-sectional study retrospectively included patients with NFAI, CSAI and healthy controls admitted to a tertiary endocrinology service. Subjects receiving hormone replacement, or having cancer, diabetes mellitus, alcoholism, psychiatric disorders, hepatic and/or renal insufficiency or morbid obesity were excluded. TyG index was calculated using the following formula: (Ln [fasting triglyceride (mg/dL) x fasting glucose (mg/dL)]/2). The primary endpoint was the difference in TyG index between patients with NFAI, CSAI and healthy controls. Results: A total of 142 patients with incidentaloma [NFAI, n=95, age: 60.9 +/- 10.6 years, women: 75.8%; CSAI, n=47, age: 59.6 +/- 13.7 years, women: 63.8%] and 116 age and sex matched healthy controls (age: 59.8 +/- 13.4 years, women: 76.7%) were evaluated. Compared with healthy controls, patients with overall incidentaloma, NFAI and CSAI had increased TyG index (6.39 +/- 1.87 vs. 8.85 +/- 0.52, 8.76 +/- 0.25, and 8.81 +/- 0.51, respectively, P<0.001 for all). There was no difference in TyG index between patients with NFAI and CSAI (8.76 +/- 0.25 vs. 8.81 +/- 0.51), and with possible autonomous cortisol secretion, autonomous cortisol secretion and Cushing's syndrome (8.80 +/- 0.54, 8.86 +/- 0.52 and 9.31 +/- 0.37). Conclusion: This study showed increased TyG index in patients with NFAI or CSAI, emphasizing the importance of cardiometabolic risk assessment in patients with adrenal incidentaloma even if it is non-functioning.

Aims: Patients with adrenal incidentaloma (AI) are at increased risk of impaired glucose metabolism, which is known to be associated with pancreatosteatosis (PS). We aimed to investigate the risk of developing dysglycemia for patients with non-functioning AI (NFAI) versus those without, and whether the presence of PS predicts future dysglycemia in patients with NFAI. Method: In 80 patients with NFAI and 127 controls matched for age, sex, and body mass index, changes in fasting plasma glucose (FPG) and hemoglobin A1c(HbA1c) were evaluated at 2 years. PS was evaluated with data obtained from non-contrast abdominal computed tomography (CT) performed at the initial evaluation. Results: Mean FPG levels increased significantly after 2 years in both groups (P < 0.001, for both), albeit significantly higher among patients than the controls (P = 0.002). The increases in HbA1c and FPG levels were significantly higher among patients with PS than without PS, in the adenoma group (p < 0.001, P = 0.00, respectively). The change in Hba1c levels was associated with the presence of PS in patients with NFAI (p < 0.001). Conclusions: Our findings suggest that the presence of PS may provide significant information in predicting newly developed dysglycemia in patients with NFAI.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Purpose Asymptomatic primary hyperparathyroidism (aPHPT) has been recognized as a condition that can lead to renal complications. Timely identification of prognostic indicators for renal impairment holds the potential to facilitate proactive monitoring and treatment strategies in these patients. This study aims to investigate the utility of acoustic radiation force impulse (ARFI) imaging and renal resistive index (RRI), in identifying renal parenchymal and vascular changes in patients with aPHPT. Methods Forty-two patients with aPHPT and 42 controls matched for age, sex, and body mass index were included in the study. The presence of renovascular changes was evaluated by RRI measurement with Doppler ultrasonography, and the presence of renal parenchymal involvement was evaluated by ARFI quantification, given as shear wave velocity (SWV). Results In aPHPT patients, both the mean RRI and mean SWV values exhibited substantial elevation compared to the control group ( P < 0.001 for both). Significant associations were observed between SWV values and serum calcium, parathyroid hormone (PTH), and adenoma size within the patient group ( P < 0.001, P < 0.001, P = 0.016, respectively). Similarly, the mean RRI demonstrated positive correlations with serum calcium and PTH levels in the patient group ( P < 0.001, P = 0.011, respectively). Multivariate linear regression analysis underscored the connection between mean RRI and mean SWV values with serum calcium levels within the patient group. In addition, serum PTH levels affected mean SWV positively and significantly. Conclusion The use of ARFI imaging and RRI measurements appears to hold potential in identifying renal involvement in patients with aPHPT.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)