Daily Endocrinology Research Analysis

Polycystic ovary syndrome (PCOS) is a common and heterogeneous endocrine disorder that affects 11%-13% of women worldwide, with profound implications for fertility and long-term metabolic health. Here we identify four reproducible subtypes-PCOS with hyperandrogen, with obesity, with high-sex hormone-binding globulin and with high-luteinizing hormone-anti-Müllerian hormone-through unsupervised clustering of 9 clinical variables in 11,908 affected women, validated across 5 international cohorts. Prospective 6.5-year follow-up and in vitro fertilization treatment data revealed distinct reproductive and metabolic trajectories: hyperandrogenic PCOS showed the highest risk of second trimester pregnancy loss and dyslipidemia incidence; PCOS with obesity exhibited the most severe metabolic complications, lowest live birth rates and highest PCOS remission rate; PCOS with high-sex hormone-binding globulin demonstrated favorable reproductive outcomes and the lowest incidence of diabetes and hypertension; and PCOS with high-luteinizing hormone-anti-Müllerian hormone had the greatest risk of ovarian hyperstimulation and the lowest PCOS remission rate. These findings advance understanding of PCOS heterogeneity and provide a framework for subtype-based risk stratification and personalized management.

BACKGROUND: Childhood obesity is a pressing global public health challenge requiring scalable prevention strategies. This study evaluated a tiered school-family-clinic intervention for obesity prevention among primary schoolchildren in China. METHODS: This cluster randomized controlled trial enrolled 1,627 third-grade students (intervention: n = 838; control: n = 789) from six primary schools in Ningbo, China. Intervention intensity was tailored to baseline weight status. In intervention schools, children without overweight or obesity received OptiChild, comprising health education and school weight-management policies. Children with overweight or obesity received SCIENT, adding teacher-led structured physical activity and individualized family dietary guidance from clinical nutritionists, supported by mobile health tools. Control schools maintained standard curricula. The primary outcome was change in body mass index (BMI). Secondary outcomes included BMI Z score, body fat distribution, blood pressure, and health behaviors. FINDINGS: After one academic year, BMI gain was attenuated in the intervention vs. control group (+0.02 vs. +0.24 kg/m CONCLUSIONS: A tiered school-family-clinic intervention effectively mitigated BMI gain and reduced obesity prevalence, with promising implications for broader public health adoption. FUNDING: Major Science and Technology Projects for Health of Zhejiang Province.

OBJECTIVE: Heart failure (HF) is common in diabetes and may be asymptomatic in early stages. N-terminal pro-brain natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) (collectively natriuretic peptides [NPs]) are markers that can be used to detect early HF in asymptomatic individuals who may benefit from disease-modifying therapies. We examined the prognostic role of NP levels in people with type 1 diabetes (T1D) or type 2 diabetes (T2D) without known HF. RESEARCH DESIGN AND METHODS: Optum's de-identified Market Clarity Data were queried for adults (aged ≥18 years) with T1D or T2D without known HF who received an outpatient NP test between 2017 and 2023. Associations between NP levels and incident HF or death were assessed using multivariable Cox proportional hazard models. RESULTS: Among 116,466 eligible adults (n = 2,990 with T1D; n = 113,476 with T2D) followed for up to 7 years (54% female; median age 64 years; mean HbA1c 7.1% at baseline), approximately 39.6% of individuals with T1D and 42.3% of individuals with T2D had BNP ≥50 pg/mL or NT-proBNP ≥125 pg/mL. In adjusted Cox models, increased NT-proBNP level was significantly associated with increased risk of incident HF or mortality among individuals with T1D (for NT-proBNP level 125-300 pg/mL: HR [95% CI] 2.04 [1.35-3.07], for NT-proBNP level >300 pg/mL: 4.48 [3.11-6.47], reference: NT-proBNP <125 pg/mL) and T2D (for NT-proBNP level 125-300 pg/mL: HR [95% CI] 1.85 [1.74-1.97], for NT-proBNP >300 pg/mL: 3.58 [3.39-3.78], reference: NT-proBNP <125 pg/mL). Similar findings were observed for BNP. CONCLUSIONS: Increased NP levels among individuals with diabetes are highly prognostic for future risk of HF or mortality. These findings support the implementation of NP screening for HF risk assessment in people with diabetes.