Aims. Type 1 diabetes (T1D) is often associated with early microvascular complications. Previous studies demonstrated that increased systolic (SAP) and diastolic arterial blood pressures (DAP) are linked to microvascular morbidity in T1D. The aim of the study was to investigate the predictive role of neutrophil gelatinase-associated lipocalin (NGAL) in unravelling early cardio-renal dysfunction in T1D. Methods. Two T1D patient groups participating in two-centre prospective cohorts were studied. Group A consisted of 57 participants aged 13.9 years (SD: 3.1) and group B consisted of 59 patients aged 28.0 years (SD: 4.4). Forty-nine healthy children [age: 10.5 years (SD: 6.6)] and 18 healthy adults [age 27.7 years (SD: 4.2)] served as controls. Serum concentrations of NGAL (ELISA) were determined, and SAP and DAP were examined (SAP and DAP also expressed as z-scores in the younger group). Results. NGAL correlated positively with SAP in both patient groups (P=0.020 and P=0.031, resp.) and SAP z-score (P=0.009) (group A) and negatively with eGFR in both groups (P<0.001 and P<0.001, resp.). Conclusions. NGAL may be proposed as a biomarker of early renal dysfunction even in nonalbuminuric T1D patients, since it was strongly associated with renal function decline and increasing systolic arterial pressure even at prehypertensive range in people with T1D, in a broad age range.

Pancreatic neuroendocrine tumors (PanNETs) and lung NETs (LNETs) represent a rare but clinically significant subgroup of neoplasms. While the majority is sporadic, approximately 17% of PanNETs and a subset of LNETs develop in the context of monogenic familial tumor syndromes, especially multiple endocrine neoplasia type 1 (MEN1) syndrome. Other inherited syndromes associated with PanNETs include MEN4, von Hippel–Lindau (VHL) syndrome, neurofibromatosis type 1 (NF1), and tuberous sclerosis complex (TSC). These syndromes are highly penetrant and their clinical manifestations may vary even among members of the same family. They are attributed to genetic mutations involving key molecular pathways regulating cell growth, differentiation, and angiogenesis. Pancreatic NETs in hereditary syndromes are often multiple, develop at a younger age compared to sporadic tumors, and are associated with endocrine and nonendocrine tumors derived from multiple organs. Lung NETs are not as common as PanNETs and are mostly encountered in MEN1 syndrome and include typical and atypical lung carcinoids. Early detection of PanNETs and LNETs related to inherited syndromes is crucial, and specific follow-up protocols need to be employed to optimize diagnosis and management. Genetic screening is recommended in childhood, and diagnostic screening starts often in adolescence, even in asymptomatic mutation carriers. Optimal management and therapeutic decisions should be made in the context of a multidisciplinary team in specialized centers, whereas specific biomarkers aiming to identify patients denoted to follow a more aggressive course need to be developed.

Introduction: To investigate whether circulating chemokines contribute to the development of diabetic peripheral neuropathy (DPN) in patients with type 1 diabetes (T1D).Methods: Fifty‐two patients with childhood‐onset T1D (mean age 28 ± 4 yrs.; diabetes duration 19.5 ± 5.5 yrs.) and 19 control subjects (mean age 26.5 ± 4.5 yrs.) were included in a cross‐sectional analysis of this long‐term longitudinal cohort study. A subgroup of 24 patients was followed prospectively for a further 10 yrs. Plasma levels of Th1‐ (CXCL9, CXCL10 and CXCL11), Th2‐ (CCL17 and CCL22) and Th17‐associated (CXCL8 and CCL20) chemokines were assessed in all subjects. Additionally, the TID patients underwent clinical examination and electroneurography.Results: The frequency of neuropathy was 21% (11/52). Higher levels of CXCL9 levels were found in patients with DPN compared with control subjects (p = .019); by contrast, no difference between patients without DPN and control subjects was seen after adjustment for multiple comparisons. In patients with DPN, CXCL10 correlated negatively with suralis MCV and suralis SNAP (rho −0.966, p < .001 and rho −0.738, p < .001, respectively) and was positively correlated with the vibration perception threshold (rho 0.639, p = .034), while CXCL8 correlated negatively with the cold perception threshold (rho −0.645, p = .032). The frequency of neuropathy increased to 54% (13/24) in the subgroup of 23 TID patients, followed by an additional 10 yrs.Conclusions: Changes in Th1‐ and Th17‐associated chemokines were associated with impaired peripheral sensory nerve function and nerve conduction after long disease duration in childhood‐onset T1D.

Background: Osteoporosis is characterized by reduced bone mineral density (BMD) and disrupted microarchitecture estimated by trabecular bone score (TBS). Osteostrong® is a bone-strengthening system implementing 4 devices and incorporating brief (10-minute), weekly, low-impact, high-intensity osteogenic loading exercises. The aim of this study was to assess changes in BMD and TBS in the lumbar spine and/or hip over 12 months in peri-/post menopausal women with Osteoporosis following Osteostrong® intervention and to compare these outcomes with women who did not receive such intervention. Methods and Subjects: A quasi-experimental case-series study in which 147 participants were separated into 2 groups, following informed consent: 75 in group A receiving Osteostrong® (subgroup G1 without and G2 with antiresorptive medication); and 72 in group B without Osteostrong® (subgroup G3 without and G4 with antiresorptive medication). Changes in lumbar spine and hip BMD and/or TBS were assessed at inclusion and 12 months later. Bonferroni-adjusted non-parametric paired tests examined for significant paired mean differences within each subgroup. Results: After Bonferroni adjustment, significant increases were observed in lumbar spine BMD in G2 (mean paired change: 0.029 g/cm2; Bonferroni-adjusted p < 0.001), and G4 (mean paired change: 0.025 g/cm2; Bonferroni-adjusted p = 0.05) as well as BMD-total hip left in G2 (mean paired change: 0.028 g/cm2; Bonferroni-adjusted p = 0.05). Other within-group changes in femoral neck BMD, total hip BMD, and TBS did not retain significance following Bonferroni correction. Conclusion: The Osteostrong® intervention showed modest lumbar spine BMD improvements over 12 months; some subgroup effects were significant but not when Bonferroni-adjusted, warranting cautious interpretation and further randomized trials.