Indian Journal of Endocrinology and Metabolism
ISSN / EISSN : 2230-8210 / 2230-9500
Published by: Wolters Kluwer - Medknow (10.4103)
Total articles ≅ 2,204
Latest articles in this journal
Published: 21 July 2021
Indian Journal of Endocrinology and Metabolism, Volume 25, pp 20-22; https://doi.org/10.4103/ijem.ijem_396_20
Alteration in lipid parameters at birth has a strong association with the development of cardiovascular disease in later life. Sixty-one infants below the age of 6 months underwent evaluation of lipid parameters. The infants studied were categorized into two groups of ≤4 and >4 weeks of age, wherein their lipid parameters were compared. The normal distribution of lipid parameters of infants 4 weeks of age groups were statistically not different (total cholesterol 125.0 ± 30.1 mg/dl vs 127.4 ± 23.4 mg/dl, P = 0.727, and LDL-cholesterol 66.0 ± 19.2 mg/dl vs 75.4 ± 21.2 mg/dl, P = 0.780). However, the HDL-cholesterol and triglycerides measured at ≤4 weeks versus >4 weeks age groups were statistically different (HDL-cholesterol 44.9 ± 17.2 mg/dl vs 36.9 ± 10.8 mg/dl, P = 0.031, and triglyceride 147.4 ± 60.2 mg/dl vs 186.5 ± 75.7 mg/dl, P = 0.030). The mean lipid parameters were significantly more atherogenic compared to the Western population. Triglyceride levels and HDL-cholesterol levels change significantly after 4 weeks of age compared to that observed before 4 weeks of age.
Published: 21 July 2021
Indian Journal of Endocrinology and Metabolism, Volume 25, pp 14-19; https://doi.org/10.4103/ijem.ijem_577_20
COVID-19 has emerged as a multi-system disease with the potential for endocrine dysfunction. We aimed to study the hormonal profile of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India. A hospital-based clinical study of endocrine profile of COVID-19 patients conducted from 15th May to 30th June 2020 after ethical approval. Fasting blood samples for free thyroxine (T4), free tri-iodothyronine (T3), thyroid stimulating Hormone (TSH), serum prolactin; basal and 1 h post-intramuscular adrenocorticotropic hormone (ACTH) stimulated cortisol, interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP) were collected within 24 h of admission after written informed consent. All hormones and IL-6 were analyzed by chemiluminescent immunoassay. hsCRP was measured by immune-turbidimetric assay. Of 235 patients studied, 14% had severe disease and 5.5% died. Adrenal insufficiency was present in 14%, most of whom had mild disease. A robust adrenal response was observed in those with severe disease. Basal and post-ACTH serum cortisol were significantly increased in severe disease or those who died compared to those who were mild or asymptomatic. Basal and post-ACTH serum cortisol showed a significant positive correlation with hsCRP but not with IL-6. Low T3 and low T4 syndrome were documented in 25% and 5%, respectively. Serum TSH and FT3 levels declined significantly from asymptomatic to severe category. Hyperprolactinemia was found in 21 patients. hsCRP showed a rising trend with disease severity while IL-6 did not. Endocrine dysfunction in the form of adrenal insufficiency, low T3, and low TSH syndrome and hyperprolactinemia were common COVID-19 hospitalized patients.
Published: 21 July 2021
Indian Journal of Endocrinology and Metabolism, Volume 25, pp 23-30; https://doi.org/10.4103/ijem.ijem_519_20
This study was conducted to investigate the pathway from first symptoms to initiation of insulin regimen in children with new-onset Type 1 Diabetes Mellitus (T1DM) and explore the reasons behind diabetes ketoacidosis (DKA) at onset among children with T1DM. An exploratory study was conducted using a pretested questionnaire, among parents of children diagnosed with T1DM within preceding 3 months. Out of the total 105 children, 56.1% were males. The median age was 7 years. The commonest reported symptoms were polydipsia (97.8%), polyuria (75.2%), and nocturia (75.2%). The mean time taken by parents from onset of symptoms to decide to visit the physician (appraisal gap) was 7.85 ± 7.95 days. The help-seeking gap (from decision-making to visiting a physician) was 3.01 ± 8.31 days, diagnostic gap (from first visit to diagnosis) was 4.19 ± 6.72 days, and the treatment gap (from diagnosis to the start of insulin) was 2.12 ± 6.87 days. The DKA at onset (was present in 39 out of 105 children 37.1%) and was higher among children with lower per-capita income (P-0.017), lack of previous experience among parents (P-0.017), longer appraisal (P-0.023), and treatment gap (P-0.009). Increasing awareness about the diabetes among children among the public and primary healthcare workers can help prevent DKA at onset.
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/2230-8210.332238
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/ijem.ijem_270_21
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/ijem.ijem_52_21
Introduction: Radionuclide therapy is a promising treatment modality in metastatic pheochromocytoma/paraganglioma (PPGL). There is scarce data on 131I-metaiodobenzyl guanidine (131I-MIBG) therapy from the Indian subcontinent. Hence, we aim to study the safety and effectiveness of low-dose, low-specific activity (LSA) 131I-MIBG therapy in patients with symptomatic, metastatic PPGL. Methods: Clinical, hormonal, and radiological response parameters and side effects of LSA 131I-MIBG therapy in patients with symptomatic, metastatic PPGL were retrospectively reviewed. World health organizations' (WHO) symptomatic, hormonal, and tumor response, and response evaluation criteria in solid tumors (RECIST1.1) criteria were used to assess the response. Results: Seventeen (PCC: 11, sympathetic PGL: 06) patients (15 with disease progression) received low-dose LSA 131I-MIBG therapy. Complete remission (CR), partial remission (PR), stable disease (SD), and progressive disease (PD) were 18% (3/17), 24% (4/17), 18% (3/17), and 41% (7/17), respectively, for WHO symptomatic response; 20% (2/10), 10% (1/10), 30% (3/10), and 40% (4/10), respectively, for WHO hormonal response; and 19% (3/16), 6% (1/16), 31% (5/16), and 44% (7/16), respectively for tumor response based on RECIST1.1. All patients with symptomatic PD and 50% (2/4) with hormonal PD had progression as per RECIST1.1 criteria. Side effects included thrombocytopenia, acute myeloid leukemia, mucoepidermoid carcinoma, and azoospermia in 6% (1/17) each. Conclusions: Our study reaffirms the modest efficacy and safety of low-dose, LSA 131I-MIBG therapy in patients with symptomatic, metastatic PPGL. Symptomatic, but not hormonal, progression after 131I-MIBG therapy correlates well with tumor progression and should be further evaluated with imaging. In resource-limited settings, anatomic imaging alone may be used to assess tumor response to 131I-MIBG therapy.
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/ijem.ijem_785_20
Purpose of the Study: Reversible proximal tubular dysfunction associated with distal renal tubular acidosis (dRTA) mimics type 3 RTA, a condition classically associated with features of both proximal RTA (pRTA) and dRTA. Proximal tubulopathy has been reported in children with primary dRTA, but the data in adults are lacking. Study Design: In this hospital record-based retrospective study, data from 66 consecutive cases of RTA, between January 2016 to December 2018, were retrieved and analyzed. Results: Mean age of the study population was 25.3 years (range: 3 months to 73 years). Six (9.1%) of them had pRTA, 58 (87.9%) had dRTA, 1 (1.5%) had type 3 RTA, and the remaining 1 (1.5%) had type 4 RTA. Ten patients (17.2%) with dRTA and 3 patients of pRTA (50%) had underlying secondary etiologies. Data on proximal tubular dysfunction were available for 30 patients with dRTA, of whom 1 had isolated dRTA, and the rest 29 patients had accompanying completely reversible proximal tubular dysfunction. Among the 10 cases of secondary dRTA, 6 were not evaluated for proximal tubular dysfunction. Of the remaining 4, 3 had reversible form of proximal tubular abnormality. Fifty-two patients with dRTA came from a population, indigenous to the “Rarh” region of India. Conclusions: Proximal tubular dysfunction often accompanies dRTA; 75% of the children with primary dRTA, at least 29% of adults with primary dRTA, and at least 30% of adults with secondary dRTA manifest such completely reversible form of proximal tubulopathy. “Rarh' region of India probably is a hotspot for endemic dRTA.
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/ijem.ijem_173_21
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/ijem.ijem_18_21
Indian Journal of Endocrinology and Metabolism, Volume 25; https://doi.org/10.4103/ijem.ijem_198_21
Background: Exposure to dichlorodiphenyltrichloroethane (DDT), a potent lipophilic organochlorine pesticide, has long been linked as a risk factor for type 2 diabetes mellitus (T2DM). However, its presence in the adipose tissues of the T2DM subjects has not been explored in the Indian population, where this long-banned pesticide is still in use. The present study was conducted to evaluate the possible association of DDT and its metabolites in obese and non-obese T2DM subjects. Methods: Subjects with normal glucose tolerance (n = 50) and T2DM (n = 50) were divided into equal numbers in obese and non-obese groups. Their plasma glucose levels, HbA1c, and lipid profile were measured. The adipose tissues were collected intraoperatively, and DDT and its metabolites were measured using a gas chromatograph equipped with an electron capture detector. Results: Obese subjects, irrespective of their glycemic status, and T2DM subjects had higher concentrations of DDT. p, p′ DDT was found to increase the odds for diabetes, and o, p′ DDT for central obesity. p, p′ DDD was also strongly correlated with central obesity, glycemic parameters, and triglycerides. Conclusion: The excess deposition of p, p′ DDD, o, p′ DDT, and p, p′ DDT in obese subjects may proceed to T2DM by disrupting triglycerides and glycemic parameters.