Daily Endocrinology Research Analysis

OBJECTIVE: Disordered eating behaviors may impact the gynecologic health of adolescents through effects on menstrual cycle function and body size; however, few studies have evaluated these associations. This study aimed to prospectively investigate the associations between individual disordered eating behaviors during adolescence, and the risk of subsequent endometriosis diagnosis. DESIGN: Prospective, longitudinal cohort (1996-2021). SUBJECTS: Female participants (n = 11773) from the Growing Up Today Study. EXPOSURE: Frequency of binge eating, laxative use, and self-induced vomiting over the past year were self-reported on repeated questionnaires during follow-up. MAIN OUTCOME MEASURES: Physician-diagnosed endometriosis was reported on repeated questionnaires during follow-up. Multivariable logistic regression models with generalized estimating equations were used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS: Over 25 years of follow-up, we identified 269 incident cases of endometriosis (2.3%), 190 of which were reported as laparoscopically confirmed. A total of 32% of girls reported ever binge eating, 14% reported self-induced vomiting to lose weight, and 9% reported ever using laxatives to lose weight. The odds of laparoscopically-confirmed endometriosis diagnosis was more than three-fold higher (aOR=3.07, 95% CI 1.74, 5.40) for girls who cumulatively reported self-induced vomiting more than monthly during follow-up, compared to girls who never reported self-induced vomiting. A similar effect estimate (aOR=2.41, 95% CI 1.40, 4.12 was noted for girls who reported weekly or more frequent self-induced vomiting at least once during follow-up compared to girls who reported never vomiting. Cumulative exposure to binge eating during follow-up was not associated with diagnosis of laparoscopically-confirmed endometriosis; however, girls who reported a highest ever engagement in binge eating of weekly or more had 52% lower (aOR=0.47, 95% CI 0.25, 0.90) odds of laparoscopically-confirmed endometriosis, compared to girls who reported less than weekly binge eating. Laxative use was not strongly associated with endometriosis diagnosis, although estimates were imprecise. CONCLUSIONS: We observed that females with a greater frequency of self-induced vomiting were more likely to be diagnosed with endometriosis during follow-up, while girls with a history of frequent binge eating had a lower likelihood of endometriosis diagnosis. We found no association between laxative use and endometriosis.

BACKGROUND: Insulin resistance (IR) indices like the TyG index are predictors of type 2 diabetes (T2DM), but their comparative performance across BMI categories in East Asians is unclear. METHODS: This retrospective cohort study enrolled 114,293 Chinese adults without diabetes. Four IR indices (TyG, TyG-BMI, TG/HDL-C, METS-IR) were calculated. Their associations with incident T2DM were assessed using Cox models, restricted cubic splines, and machine learning, stratified by BMI. Findings were replicated in 15,453 Japanese adults from the NAGALA cohort. RESULTS: Over a mean 3.10-year follow-up, 2,435 participants developed T2DM. All indices were independently associated with diabetes risk, but the association strength declined with higher BMI. For TyG, the fully adjusted hazard ratios were 4.60, 3.10, and 2.62 in the non-overweight, overweight, and obese groups, respectively-a "reverse gradient" observed for all indices. Non-linear relationships with clear inflection points were identified. Predictive performance was highest in the non-overweight group (e.g., TyG AUC 76.74%). External replication confirmed these findings. CONCLUSIONS: IR indices, particularly TyG and TyG-BMI, are powerful predictors of T2DM across all BMI categories. Their predictive ability is most pronounced in non-overweight individuals, challenging the obesity-centric diabetes screening paradigm and underscoring the need for early metabolic risk assessment in lean adults.

AIM: . - To assessed hyperglycaemia in pregnancy (HIP) prevalence trends over the past decade, accounting for risk factors and screening practices (France introduced early risk-based HIP screening in 2010). METHODS: . - We analysed national delivery data from the French National Health Data System (SNDS) (2012-2022), excluding women with pre-existing diabetes (n=8,172,911). Poisson regressions with generalized estimating equations estimated prevalence ratios (PR) for HIP risk factors. Counterfactual scenarios quantified contributions of maternal age, early screening, and pre-pregnancy overweight to HIP increase. RESULTS: . - HIP prevalence increased from 7.5% in 2012 to 15.7% in 2022, with early HIP tripling. Prevalence rose in 2020-2021 during the Covid-19 pandemic. After adjustment for maternal age, parity, socioeconomic status, season of pregnancy onset, place of delivery, regional prevalence of pre-pregnancy overweight, and early screening, the aPR were 1.30 [1.11-1.51] in 2021 and 1.15 [0.97-1.36] in 2022 vs. 2012 (unadjusted: 2.24 [2.22-2.26] and 2.08 [2.06-2.10]), suggesting that these factors account for a large proportion of the observed increase. While the observed increase in HIP prevalence was 8.2 percentage points from 2012 to 2022, counterfactual scenarios estimated increases of 6.5 [5.9-7.3] for constant maternal age, 6.2 [5.1-7.7] for constant early screening (13.7%), and 4.3 [2.4-5.9] for constant regional pre-pregnancy overweight (11.8%) at 2012 levels. CONCLUSION: . - Rising maternal age, increased early HIP screening, and higher regional pre-pregnancy overweight prevalence mostly contributed to HIP prevalence increase. Public health strategies should prioritize modifiable risk factors-particularly pre-pregnancy overweight-and evaluate the effectiveness of early screening practices.