Abstract in English:

ABSTRACT Objective: We aimed to compare thymus visibility and volume in patients with acromegaly to those of controls, and to evaluate the correlation between growth hormone (GH), insulin-like growth factor-1 (IGF-1) levels, and thymus volume. Subjects and methods: This cross-sectional case-control study included 66 patients with acromegaly who underwent thoracic computed tomography scans. An age- and sex-matched control group of 65 trauma patients without comorbidities was selected. All thoracic computed tomography scans were reassessed to measure thymus volume using imaging software. Comparisons of thymus volume and assessment of correlation with GH and IGF-1 levels were performed. Results: The acromegaly group (28F/38M) and the control group (27F/38M) had similar sex and age distributions. The thymus was more frequently detectable in the acromegaly group (80.3%) compared to controls (44.6%; p = 0.001). Thymus volume was significantly higher in the acromegaly group (13.1 cm3 [9.7-18.7]) than in the control (10.3 cm3 [4.6-12.3]; p = 0.013). Serum IGF-1 levels were nearly significantly higher in acromegalic patients with a visible thymus compared to those without (visible thymus: 608.5 ng/mL [377.6-921.8]; non-visible thymus: 440.5 ng/mL [201.5-596]; p = 0.054). However, no significant differences were found in GH and IGF-1 upper limit of normal levels. No correlation was found between thymus volume and other parameters. Conclusion: Patients with acromegaly have larger and more frequently visible thymus glands than controls. When a mass is detected in the anterior mediastinum, acromegaly should be considered, especially before invasive procedures.

Abstract in English:

ABSTRACT Objective: In Graves' disease (GD), thyroid nodules are the principal determinant of differentiated thyroidcaneer(DTC); however, the predictors of nodules and DTC remain uncertain. The role of thyroid peroxidase antibodies (TPOAb) in this context is controversial. Hence, this study aimed to determine whether TPOAb status is associated with thyroid nodules and DTC in GD and to compare the prevalence of DTC across subtypes of hyperthyroid disease. Subjects and methods: We conducted a retrospective cohort study (September 2020-July 2023) including patients with GD (n = 577) and toxic nodular/multinodular goiter (TNG/ TMNG) (n = 216) who had available TPOAb measurements and thyroid ultrasonography. Within the GD cohort, multivariable logistic regression was used to assess associations of TPOAb titer with nodules and DTC. Results: TPOAb positivity was more frequent in GD than in TNG/TMNG (60.4% vs. 7.4%, p < 0.001). Among GD patients, thyroid nodules were detected in 25.8% and were less frequent in TPOAb-positive patients compared with TPOAb-negative patients (8.3% vs. 52.6%, p < 0.001). Within GD, DTC was rare among those without nodular disease (0.93%) but substantially higher in nodular GD (14.1%, p < 0.001), exceeding the prevalence observed in TNG/TMNG (p = 0.009). TPOAb status further stratified DTC risk in GD: DTC was present in 1.15% of TPOAb-positive compared to 9.21% of TPOAb-negative patients (p < 0.001), with 84% of GD-associated DTCs arising in the TPOAb-negative subgroup. Regression analyses showed that TPOAb titer was independently associated with lower frequencies of both DTC and nodules in GD, whereas thyrotropin receptor antibodies levels showed no independent association. Conclusion: In GD, our study showed that TPOAb positivity was strongly associated with lower prevalence of thyroid nodules and DTC, whereas TPOAb-negative patients constitute a clinically relevant, higher-risk subgroup.

Abstract in English:

ABSTRACT Objective: To assess whether combining nutritional counseling with recreational sports confers greater improvements in cardiovascular risk factors among adolescents compared to recreational sports alone. Subjects and methods: This 12-week randomized clinical trial included 40 adolescents (aged 11-14 years; 67% female; 45% overweight/obese) randomly assigned to a beach tennis (BT, n = 20) or BT plus nutrition counseling (BT+N, n = 20) group. Sports sessions (BT) were performed twice a week and nutritional counseling (BT+N) once a week. Outcomes assessed at baseline and after 12 weeks included biochemical parameters (high- and low-density lipoprotein, total cholesterol; triglycerides; fasting glucose; and insulin), blood pressure, and body composition. Analyses were performed following the intention-to-treat principle. Results: Both groups showed significantly higher high-density lipoprotein levels (BT: +3.8 mg/dL, p < 0.05; BT+N: +5.9 mg/dL, p < 0.001) and no differences between groups. Fasting glucose decreased only in the BT+N group. Time x group interactions significantly differed between groups for triglycerides (p < 0.01), waist circumference (p < 0.001), body fat percentage (p < 0.05), and systolic blood pressure (p < 0.001), favoring the BT+N group. No significant changes were observed in low-density lipoprotein, total cholesterol, or insulin levels. Conclusion: Recreational BT alone improved some cardiometabolic parameters; however, its combination with nutritional counseling provided broader benefits, underscoring the value of integrated lifestyle interventions for reducing cardiometabolic risk factors in adolescents.

Abstract in English:

ABSTRACT Objective: This study investigated the association among fibroblast growth factor 23 (FGF23), Klotho, and coronary artery calcification (CAC) in patients with diabetic kidney disease (DKD). Subjects and methods: A total of 176 DKD patients and 160 age-and diabetes-matched controls were retrospectively analyzed. We measured serum FGF23 and Klotho levels by enzyme-linked immunosorbent assay and assessed CAC by CAC scoring. Correlation and receiver operating characteristic analyses were performed to evaluate the associations of these biomarkers with CAC and their ability to discriminate CAC. Results: FGF23 levels were significantly higher and Klotho levels were lower in patients with DKD than in controls. FGF23 correlated negatively with estimated glomerular filtration rate and positively with the albumin-to-creatinine ratio and blood urea nitrogen, whereas Klotho correlated positively with estimated glomerular filtration rate and negatively with albumin-to-creatinine ratio and blood urea nitrogen. In patients with CAC, FGF23 levels were higher and Klotho levels were lower. Receiver operating characteristic analysis showed that both FGF23 and Klotho discriminated CAC, and FGF23 showed a higher area under curve than Klotho. Correlation analysis further confirmed the association of FGF23 and Klotho with CAC severity. Conclusion: FGF23 and Klotho were associated with renal impairment and CAC in patients with DKD and may serve as potential biomarkers of renal and cardiovascular risk.

Abstract in English:

ABSTRACT Objective: To compare bone microarchitecture and fracture patterns between elderly men and women with similar spine and hip bone mineral densities (BMDs). Subjects and methods: Twenty-eight men and 84 age-BMI-BMD-matched women aged 65 years and older with at least one major osteoporotic fracture underwent laboratory tests, dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and trabecular bone score (TBS). Results: There were no sex differences in biochemistry, BMD or lowest T-scores. TBS values were low in 67% of the cohort and significantly correlated with HR-pQCT parameters. At HR-pQCT evaluation, men had greater bones (total area and cortical perimeter at distal radius and tibia) and better trabecular vBMD and microstructure at distal radius, but similar values for cortical vBMD and cortical thickness. When compared with Brazilian age-sex-reference HR-pQCT data from healthy individuals, all parameters tested were numerically lower in the study group. These differences seemed more pronounced in men, particularly for cortical thickness at the distal tibia, where relative deficits reached -46.9% in men and -35.4% in women. There was no sex difference in vertebral fractures, but wrist and shoulder fractures were more common in women (p = 0.006), whereas hip fractures were more common in men (p = 0.03). Conclusion: To achieve similar DXA values, men appear to have greater relative bone deficits than women when compared to age-sex-matched healthy Brazilian population. This study highlights the importance of HR-pQCT to understand sex-specific differences in fracture pattern in the study population.