Daily Endocrinology Research Analysis
Three impactful endocrinology studies stood out: an intraoperative dual near-infrared imaging strategy halved 1-year hypoparathyroidism after total/completion thyroidectomy; patient-derived medullary thyroid cancer organoids were established with preserved function, enabling future TKI and PET tracer testing; and a meta-analysis of randomized trials showed whole fruit-based products modestly improve HbA1c in type 2 diabetes. Collectively, these works advance surgical safety, precision oncology m
Summary
Three impactful endocrinology studies stood out: an intraoperative dual near-infrared imaging strategy halved 1-year hypoparathyroidism after total/completion thyroidectomy; patient-derived medullary thyroid cancer organoids were established with preserved function, enabling future TKI and PET tracer testing; and a meta-analysis of randomized trials showed whole fruit-based products modestly improve HbA1c in type 2 diabetes. Collectively, these works advance surgical safety, precision oncology modeling, and pragmatic nutrition therapy.
Research Themes
- Intraoperative imaging to prevent post-thyroidectomy hypoparathyroidism
- Patient-derived organoids for precision endocrinology-oncology
- Dietary whole fruit interventions for glycemic control in T2D
Selected Articles
1. Combined near-infrared autofluorescence and preresection indocyanine green angiography for parathyroid gland preservation during thyroid surgery: A clinical controlled trial.
In a matched controlled study (154 intervention, 462 controls), combining intraoperative parathyroid near-infrared autofluorescence with preresection ICG angiography significantly reduced 1-year hypoparathyroidism after total/completion thyroidectomy. Adjusted analyses showed an 84% relative risk reduction.
Impact: Demonstrates a pragmatic intraoperative imaging protocol that halves long-term hypoparathyroidism—a major morbidity of thyroidectomy—potentially shifting standard surgical workflow.
Clinical Implications: Adopting dual NIR autofluorescence and preresection ICG angiography can improve parathyroid identification and perfusion preservation, reducing long-term calcium/vitamin D dependence and readmissions. Training and equipment integration into endocrine surgery programs should be considered.
Key Findings
- 1-year hypoparathyroidism occurred in 6.5% with dual NIR imaging vs 12.3% with standard care.
- Unadjusted odds ratio 0.50 (95% CI 0.248–0.996); adjusted odds ratio 0.16 (95% CI 0.048–0.560).
- Matched, controlled comparison across 154 intervention and 462 control patients undergoing total/completion thyroidectomy.
Methodological Strengths
- Matched controlled design with 1:3 matching and multivariable adjustment for key surgical and patient factors.
- Clinically meaningful, long-term endpoint (1-year hypoparathyroidism) in a sizable cohort.
Limitations
- Nonrandomized, single-institution design with retrospective controls may introduce residual confounding.
- Generalizability may be limited by device availability, learning curve, and institutional expertise.
Future Directions: Prospective multicenter randomized trials to validate efficacy, cost-effectiveness analyses, and standardized training curricula for widespread adoption.
BACKGROUND: This was a single-institution controlled trial examining whether the intraoperative combination of near-infrared-induced autofluorescence of the parathyroid glands and preresection indocyanine green near-infrared angiograms of the parathyroid feeding vessels can reduce the incidence of postoperative hypoparathyroidism 1 year after surgery in patients undergoing total or completion thyroidectomy. METHODS: Included patients underwent total or completion thyroidectomy. The intervention group was prospective and underwent surgery with bimodal near-infrared-induced autofluorescence of the parathyroid glands and preresection indocyanine green near-infrared angiograms. The control group was retrospective and underwent standard surgery. Patients were matched with a 1:3 ratio for intervention/control. Minimal matching criteria were procedure (completion/total thyroidectomy), surgical indication (compressive symptoms/hyperthyroidis
2. A meta-analysis of available data of the effects of selected whole and powdered fruits on glycemia in type 2 diabetes.
This meta-analysis of five RCTs (n=245) found that whole fruit-based products produce modest but significant improvements in glycemic control in T2D, lowering HbA1c by 0.33%, reducing fasting glucose, and increasing HDL. Heterogeneity was low-to-moderate and no serious adverse events were reported.
Impact: Provides evidence-based support for recommending whole fruit as part of T2D dietary management, countering concerns about fruit sugars and informing guidelines.
Clinical Implications: Clinicians can encourage incorporation of whole fruit or selected fruit-based products into T2D diets to achieve modest HbA1c reductions and lipid benefits, while monitoring individual glycemic responses and portion sizes.
Key Findings
- HbA1c decreased by −0.33% (95% CI −0.54% to −0.11%) with whole fruit-based products.
- Fasting blood glucose decreased by −6.59 mg/dL; HDL increased by 2.72 mg/dL.
- Heterogeneity was low to moderate (I²=44% for HbA1c; 0% for FBG and HDL); no serious adverse events reported.
Methodological Strengths
- Randomized controlled trials only; pre-registered meta-analysis (PROSPERO).
- Consistent directionality across outcomes with low heterogeneity for key secondary endpoints.
Limitations
- Only five trials with relatively small total sample; variable fruit types and formulations (whole vs powdered).
- Short-to-moderate intervention durations limit assessment of long-term sustainability and complications.
Future Directions: Larger, longer RCTs comparing specific fruits, doses, and delivery forms (whole vs processed) with standardized co-interventions, and evaluation of CGM-derived glycemic variability.
OBJECTIVE: Our intent was to evaluate the effects of whole fruit-based products consumption on HbA1c levels in patients with type 2 diabetes mellitus through a systematic review and meta-analysis. METHODS: We searched PubMed, Cochrane Library, and Embase from inception to April 22, 2024, for randomized controlled trials (RCTs) examining the effects of whole fruit-based products consumption on HbA1c in type 2 diabetes mellitus (PROSPERO: CRD42024566638). A random-effects meta-analysis was performed. Mean difference (MD) and 95 % confidence intervals (CIs) were calculated; heterogeneity was assessed using I². RESULTS: Five RCTs involving 245 participants were included. Fruit consumption significantly reduced HbA1c levels (MD, -0.33 %; 95 % CI, -0.54 % to -0.11 %; I² = 44 %). FBG was also reduced (MD, -6.59 mg/dL; 95 % CI, -10.59 to -2.59 mg/dL; I² = 0 %), and HDL increased (MD, 2.72 mg/dL; 95 % CI, 1.32 to 4.12 mg/dL; I² = 0 %). One study had high risk of bias; no serious adverse events were reported. CONCLUSIONS: Whole fruit-based products consumption may improve HbA1c, fasting blood glucose, and HDL cholesterol levels in patients with type 2 diabetes mellitus. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: PROSPERO number CRD42024566638. The registration date was August 2nd, 2024.
3. Patient-derived medullary thyroid cancer organoids: a potential model for mechanistic studies on diagnostics and therapy.
The authors successfully established patient-derived MTC organoids from 10 biopsies that preserved calcitonin/CEA production and MTC-specific gene/protein profiles, with self-renewal across passages. Proof-of-principle exposure to TKIs and PET tracers suggests feasibility for individualized diagnostic and therapeutic testing.
Impact: Introduces a first-of-its-kind MTC organoid platform enabling functional testing where clinical trials are constrained by rarity, laying groundwork for precision selection of TKIs and imaging tracers.
Clinical Implications: While not yet ready for routine use, patient-derived MTC organoids could inform personalized TKI choice and PET tracer selection, potentially reducing ineffective therapy and optimizing surveillance imaging.
Key Findings
- Established organoids from 10 MTC biopsies with sustained self-renewal across passages.
- Organoids preserved MTC functionality, producing calcitonin and CEA; MTC-specific markers confirmed by qPCR and immunofluorescence.
- Proof-of-principle TKI and PET tracer exposures demonstrated feasibility for future personalized testing.
Methodological Strengths
- Use of patient-derived tissue with validation of gene/protein expression and functional hormone secretion.
- Assessment of self-renewal and preliminary pharmacologic/imaging tracer feasibility.
Limitations
- Small sample size (n=10) limits generalizability and statistical inference.
- TKI and PET tracer experiments were preliminary without correlation to clinical outcomes.
Future Directions: Develop multicenter MTC organoid biobanks, standardize assays linking in vitro responses to clinical outcomes, and explore co-culture and microenvironment modeling.
OBJECTIVE: Medullary thyroid carcinoma (MTC) is a rare neuroendocrine thyroid tumor, with only 30 new patients annually in the Netherlands. PET imaging provides information on distant metastases, after which tyrosine kinase inhibitors (TKIs) may be initiated. The rarity of the disease impedes large controlled trials, and therefore the challenge of selecting the best TKI and PET tracer for individual patients persists. To explore whether an in vitro model could be developed to guide the selection of appropriate PET tracers or TKI therapies in the future, we aimed to establish an MTC organoid model for the first time. METHODS: Dispersed cells from MTC biopsies were suspended in Matrigel, allowing organoid formation. The self-renewal potential was tested by dissociation and re-plating cells and determining organoid-forming efficiency. MTC-specific gene and protein expression were characterized by qPCR and immunofluorescent staining. Moreover, MTC-organoids (MTOs) were exposed to TKIs and PET tracers in proof-of-principle experiments. RESULTS: Ten MTC biopsies were processed and successfully cultured as MTOs. MTC-derived cells showed self-renewal potency for several passages, indicating the presence of putative stem cells. Gene and protein expression of MTC-specific markers in tissue and MTOs, and function measurements showed the production of calcitonin and CEA. Interpretation of the preliminary experiments with TKIs and PET tracers was limited by sample size but demonstrates their future potential. CONCLUSION: We were able to culture MTC organoids that resemble the original tissue in gene expression, protein expression, and functionality. However, international, multi-center studies are required to meet the standards for future clinical applications.