Prediction model of adnexal masses with complex ultrasound morphology.

Background: Based on the ovarian-adnexal reporting and data system (O-RADS), we constructed a nomogram model to predict the malignancy potential of adnexal masses with sophisticated ultrasound morphology. Methods: In a multicenter retrospective study, a total of 430 subjects with masses were collected in the adnexal region through an electronic medical record system at the Fourth Hospital of Harbin Medical University during the period of January 2019-April 2023. A total of 157 subjects were included in the exception validation cohort from Harbin Medical University Tumor Hospital. The pathological tumor findings were invoked as the gold standard to classify the subjects into benign and malignant groups. All patients were randomly allocated to the validation set and training set in a ratio of 7:3. A stepwise regression analysis was utilized for filtering variables. Logistic regression was conducted to construct a nomogram prediction model, which was further validated in the training set. The forest plot, C-index, calibration curve, and clinical decision curve were utilized to verify the model and assess its accuracy and validity, which were further compared with existing adnexal lesion models (O-RADS US) and assessments of different types of neoplasia in the adnexa (ADNEX). Results: Four predictors as independent risk factors for malignancy were followed in the preparation of the diagnostic model: O-RADS classification, HE4 level, acoustic shadow, and protrusion blood flow score (all p < 0.05). The model showed moderate predictive power in the training set with a C-index of 0.959 (95%CI: 0.940-0.977), 0.929 (95%CI: 0.884-0.974) in the validation set, and 0.892 (95%CI: 0.843-0.940) in the external validation set. It showed that the predicted consequences of the nomogram agreed well with the actual results of the calibration curve, and the novel nomogram was clinically beneficial in decision curve analysis. Conclusion: The risk of the nomogram of adnexal masses with complex ultrasound morphology contained four characteristics that showed a suitable predictive ability and provided better risk stratification. Its diagnostic performance significantly exceeded that of the ADNEX model and O-RADS US, and its screening performance was essentially equivalent to that of the ADNEX model and O-RADS US classification.

Thyroid structure, function and iodine status by pregnancy trimester in Harbin, China.

BACKGROUND AND OBJECTIVES: Thyroid disease in pregnancy can have devastating effect on the fetus. In Harbin, China, there is insufficient knowledge about the incidence of and contributing factors to thyroid disease in pregnancy. This study investigates whether urine iodine concentration (UIC), as a proxy for iodine intake, affects the thyroid structure and/or function during each trimester. METHODS AND STUDY DESIGN: Data of 24000 pre-pregnant women were collected from January 2017 to August 2019. Serum thyroid hormone levels were measured, and thyroid ultrasonography was performed. If thyroid ultrasonography and thyroid function findings were normal before pregnancy and were abnormal after pregnancy, the current gestational age was recorded and the UIC was measured. Finally, a total of 500 participants were included in the study. RESULTS: There were significant differences in the incidence of abnormal thyroid structure and function between trimester groups (p<0.05). Thyroid nodular lesions were the most common abnormal ultrasound finding, and positive thyroid peroxide antibodies (TPOAb) were the most common abnormal thyroid function test results. There were significant differences in the median UIC between trimester groups (p<0.001); the median UIC decreased with increasing gestational age. The incidence of abnormal thyroid structure or function was not significantly different across UIC groups (p>0.05). CONCLUSIONS: In women from Harbin, thyroid structural or functional abnormalities commonly occur in the second and third trimesters of pregnancy. Thyroid nodular lesions and positive TPOAb are the commonest thyroid abnormalities. The median UIC significantly declines with increasing gestational age. Pregnant women in Harbin have iodine-deficient states.

Urine iodine level and multiple risks are associated with thyroid structural abnormalities among adults in Heilongjiang Province, China.

BACKGROUND AND OBJECTIVES: The prevalence of adult thyroid structural abnormalities has increased significantly worldwide. However, no study has examined the thyroid structure and urine iodine levels of adults in Heilongjiang Province in the last decade. Therefore, this study aims to investigate the rate and risk factors of thyroid structural abnormalities among the residents of this province. METHODS AND STUDY DESIGN: A probability proportional sampling method was used, and a total of 3,645 individuals in Heilongjiang Province were included. The subjects was asked to complete a thyroid ultrasound and fill out a questionnaire. Furthermore, urine iodine levels and salt iodine content were determined, and multivariate logistic regression was used to identify the independent risk factors for thyroid diseases. RESULTS: The prevalence of thyroid structural abnormalities in Heilongjiang Province was 56.0%. Univariate analysis showed that there were significant differences between the structural abnormalities group and the normal thyroid group in terms of sex, age, body mass index, hypertension, diabetes, smoking, alcohol consumption, frequency of seafood consumption and pickled food consumption, employment status, and urine iodine level (p<0.05). Multivariate analysis showed that the following were independent risk factors of thyroid disease: female, increased age, hypertension, diabetes, cigarette smoking frequent seafood consumption, employment, and urine iodine levels. CONCLUSIONS: The prevalence of thyroid structural abnormalities in adults in Heilongjiang Province was relatively high. Therefore, to help prevent the occurrence of thyroid disease in adults in Heilongjiang Province, the risk factors of thyroid structural abnormalities should be better understood.

Plasma preptin levels are decreased in patients with essential hypertension.

The pancreatic hormone preptin amplifies glucose-mediated insulin secretion, and we investigated its circulating levels in patients with essential hypertension and possible association with carotid atherosclerosis. Ninety-eight patients were divided into hypertensive and control groups. Relationships between plasma preptin levels, clinical parameters, and carotid artery intima-media thickness (IMT) were analyzed. Plasma preptin levels were significantly lower in the hypertensive group than in the control group (1930.30±268.47 vs. 2182.88±325.81 pg/mL, P < 0.01). Simple linear regression analysis showed that systolic blood pressure (SBP), mean arterial pressure (MAP), and levels of serum low-density lipoprotein (LDL) and cholesterol (CHOL) were related to plasma preptin levels. Furthermore, multivariate linear regression analysis showed that SBP and serum CHOL levels were independent of plasma preptin levels, which were inversely correlated with carotid artery IMT (r = -0.47, P < 0.01) in all subjects. Plasma preptin levels of patients with carotid atherosclerotic plaques were significantly lower than those of patients without plaques (1961.69±296.07 vs. 2117.97±322.52 pg/mL, P < 0.05). This preliminary study revealed that plasma preptin levels are decreased in patients with essential hypertension, negatively correlated with carotid artery IMT, and significantly lower in patients with carotid atherosclerotic plaques. Therefore, decreased plasma preptin level might play a role in hypertension and its vascular complications.