High-levels of TyG index increases risk of respiratory failure in COPD patients: Study

A new study published in the journal of BMC Pulmonary Medicine showed that a high-level Triglyceride-Glucose (TyG) index and the probability of respiratory failure (RF) incidence in patients with chronic obstructive lung disease (COPD) are mildly correlated, suggesting that using the TyG index to gauge the severity of COPD patients has potential futures.

One prominent group of long-lasting and progressive respiratory conditions with significant rates of disability and mortality is chronic obstructive pulmonary disease. According to data from the WHO, COPD is the third most common cause of mortality worldwide, behind stroke and ischemic heart disease.

A strong indicator of insulin resistance, the TyG index is currently used to evaluate the beginning and prognosis of a number of diseases, including ischemic stroke, chronic kidney disease, and acute coronary syndrome. It is unclear, therefore, if the TyG index may be used to evaluate the risk of RF in individuals with COPD. Investigating the relationship between the TyG index and RF risk in patients with COPD is the goal of the current investigation.

In this study, the MIMIC-IV 2.2 (The Medical Information Mart for Intensive Care IV, version 2.2) database was utilized to get COPD patients in the past. Cox proportional hazards models and restricted cubic spline (RCS) curves were used to assess the relationship between the TyG index and the likelihood of RF in individuals with COPD. Thus, to evaluate the RF risk across the quartile groups, cumulative incidence curves were produced. Ultimately, 1188 patients were chosen from Jiaxing City’s First Hospital in order to externally evaluate the primary outcome’s Cox modeling results.

A total of 1,232 people from the MIMIC database were included in this study. Among these people, RF occurred in 134 cases (10.9%). An one-unit increase in the TyG index was associated with a 1.821-fold increased incidence of RF in the COPD cohort, per Cox regression analysis.

Also, a higher RF risk was substantially associated with higher TyG index values. A linear relationship between the TyG index and RF risk was also indicated by RCS curve analysis (P-Nonlinear = 0.074).

Overall, the TyG index can help predict the RF risk in individuals with COPD to a certain degree. People who have higher TyG index values are more likely to develop RF. It also acts as a warning sign for longer hospital stays and higher use of invasive mechanical ventilation.

Source:

Hu, S., Zhang, Y., Cui, Z., Zhang, Y., Wang, J., Tan, X., & Chen, W. (2025). The impact of the triglyceride-glucose index on the risk of respiratory failure in patients with COPD: a study from the MIMIC database and Chinese cohorts. BMC Pulmonary Medicine, 25(1), 149. https://doi.org/10.1186/s12890-025-03597-x

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Reduced Thyroid Hormone Sensitivity Linked to Higher Thyroid Cancer Risk in Euthyroid Patients: Study Finds

China: A recent study conducted by researchers from the School of Medicine at Nankai University, Tianjin, China, highlights a potential new risk factor for differentiated thyroid cancer (DTC) among individuals with normal thyroid hormone levels. The study, published in Frontiers in Endocrinology, suggests that decreased sensitivity to thyroid hormones, both centrally and peripherally, may play a critical role in the development of DTC and could be valuable in refining preoperative cancer risk assessments.

The research team, led by Huaijin Xu, retrospectively analyzed data from 9,515 euthyroid adults who underwent thyroidectomy for nodular thyroid disease. All participants had normal thyroid hormone levels before surgery, and their nodules were confirmed as either benign or DTC postoperatively. 

To better understand the hormonal dynamics, the researchers examined several composite indicators of thyroid hormone sensitivity, including the thyroid-stimulating hormone index (TSHI), thyrotroph thyroxine resistance index (TT4RI), the ratio of free triiodothyronine to free thyroxine (FT3/FT4), and the thyroid’s secretory capacity (SPINA-GT). These indices reflect how the body responds to and regulates thyroid hormones.

The study led to the following findings:

  • Individuals with higher TSHI and TT4RI, reflecting reduced central thyroid hormone sensitivity, had significantly increased odds of being diagnosed with differentiated thyroid cancer (DTC).
  • Each unit increase in TSHI and TT4RI was linked to a 34% and 35% higher risk of DTC, respectively.
  • Lower FT3/FT4 ratios and SPINA-GT values, indicating reduced peripheral sensitivity and secretory capacity, were also associated with greater cancer risk.
  • These associations remained consistent across subgroups defined by age, sex, metabolic status, thyroid autoimmunity, and nodule size.
  • The relationship between thyroid hormone sensitivity and DTC risk was non-linear, pointing to a more intricate physiological mechanism.
  • TSHI and TT4RI showed stronger associations with thyroid malignancy than traditional markers like TSH.
  • No single thyroid parameter demonstrated both high sensitivity and specificity in differentiating malignant from benign nodules.
  • The findings highlight the potential value of using combined thyroid hormone sensitivity indices in more comprehensive diagnostic models.

The researchers emphasize that their findings shed new light on the pathophysiology of thyroid cancer in patients with euthyroid profiles. They propose that thyroid hormone sensitivity indices could serve as supplementary tools in preoperative evaluation and guide clinical decisions regarding the likelihood of malignancy in thyroid nodules.

“Recognizing the role of thyroid hormone sensitivity may enhance our understanding of thyroid cancer development and aid in building more accurate predictive models,” the authors noted.

“The study opens the door for future research to explore how modulating hormone sensitivity could influence thyroid cancer outcomes and whether these indices can be incorporated into clinical guidelines for managing thyroid nodules,” they concluded.

Reference:

Xu, H., Liu, H., Hu, X., Jia, X., Xue, Z., Wang, A., Kang, S., & Lyu, Z. (2025). Reduced sensitivity to thyroid hormones is associated with differentiated thyroid cancer in the euthyroid thyroidectomy population. Frontiers in Endocrinology, 16, 1595002. https://doi.org/10.3389/fendo.2025.1595002

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Smartphone tests could accelerate drug development for Huntington’s disease

A series of digital tests carried out via a smartphone app could enhance the detection of disease progression in Huntington’s disease and improve the efficiency of clinical trials, finds research led by scientists at University College London (UCL) and Roche.

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Significant gaps in testing for genetic cancer risk, study finds

Patients with womb cancer are not being tested for a genetic condition that increases their chance of developing further cancers, a study has found. The work is published in the journal BMJ Oncology.

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Atypical left-handers use right brain hemisphere for language and left for inhibition, study finds

Approximately 10% of the human population is left-handed. Among them, one in five exhibits a peculiar brain phenomenon known as atypical language lateralization. While most people attribute their language capability to their left hemisphere, this atypical group of left-handers utilizes their right hemisphere to speak. One of the oldest questions in neuroscience is how this phenomenon impacts brain organization and human behavior.

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A glycoprotein marks cocaine-activated brain neurons and regulates cocaine reward

Cocaine, a drug of abuse, activates just a portion—10% to 20%—of the neurons in the brain’s nucleus accumbens, a critical region linked to motivation and addiction. Though small in numbers, this activated neuronal population strongly controls drug-related behavior through downstream changes in gene expression, nerve synapses, neural circuitry and neural function that lead to behavioral change, including addiction.

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Study: Appendix cancer incidence has quadrupled in older Millennials

In a study estimating the incidence rates of appendiceal adenocarcinoma (AA), or appendix cancer, across birth cohorts in the United States, researchers observed a sharp increase in AA incidence rates for those born after 1945, particularly for Generation X and Millennials. These patterns suggest a timely need for etiologic research and increased AA awareness among physicians and the public.

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Renowned Gynaecologist Dr Shobha Chakraborty no more

Ranchi: Dr Shobha
Chakraborty, a renowned gynaecologist and a respected figure in the
medical community, passed away in Ranchi on Wednesday at the age of 85.

Dr Chakraborty was widely
recognised for her decades-long contribution to women’s healthcare and maternal
well-being. Her dedication and expertise earned her admiration from both
patients and peers. Jharkhand Governor
Santosh Kumar Gangwar and Chief Minister Hemant Soren expressed their condolences on her passing.

Also Read:Former RIMS Director Moves HC over Dismissal

“The news of the demise
of renowned gynaecologist Dr Shobha Chakraborty is extremely sad. Her valuable
contribution to the medical world will always be remembered. Her departure is
an irreparable loss to society. My deepest condolences to the bereaved
family,” Gangwar said on X.

In another post on X,
Soren said, “I received the sad news of the demise of Jharkhand’s renowned
gynaecologist Dr Shobha Chakraborty. Dr Chakraborty had dedicated her entire
life to the service of women’s health. Her departure is an irreparable loss for
the medical world.”

One of her students
posted on social media, stating, “It’s very difficult to accept that our
respected mam Dr Shobha Chakraborty, Teacher of teachers, Mentor and guide for
many, has left us for heavenly abode. It’s an unbearable loss for the medical
fraternity, Jharkhand, and Bihar both. End of an Era. Homage and heartfelt
condolences to the great soul from every member of the Ranchi Obstetrics and Gynaecological Society.”

Another posted, “It is with immense sadness and a heavy heart that I share the news of the passing of our beloved teacher and a true legend, Dr. Shobha Chakraborty few minutes ago. Dr. Chakraborty touched countless lives with her wisdom, passion, and unwavering dedication. She was more than just a teacher, she was a mentor, an inspiration, and a guiding light for so many of us. Her legacy will undoubtedly live on in the hearts and minds of all who had the privilege of knowing her. May God grant her soul eternal peace. She will be deeply missed.”

Dr Chakraborty held a
prominent place in the state’s healthcare landscape, having been unanimously
elected as the first president of the Jharkhand chapter of the Indian Medical
Association (IMA) during its inaugural elections in 2007. Alongside her, Dr R.C.
Jha was elected as the secretary. Their leadership marked the beginning of a
structured and organized medical community in the newly formed state. Her tenure, which lasted
until 2009, saw important foundational developments for the IMA in Jharkhand.
In 2009, the leadership baton was passed on to Dr A.K. Chatterjee of Deoghar
and Dr Shekhar Choudhary Kajal, who served as president and secretary, respectively, for the 2009-2011 term.

Also Read:Gujarat Doctors Slam Fee Hike for MBBS, PG Medical Courses, Urge CM to Roll Back Decision

Dr. Ajoy Kumar Singh
told The Jharkhand Story, “With her passing, an era in the IMA and medical
education in the state has come to an end. She was a guiding force not only
within the IMA but also played a significant role in the Medical Council of
India (MCI). In 2008, despite her busy schedule, she accepted the then Health
Minister Bhanu Pratap Shahi’s request to represent Jharkhand in the MCI, acting
in the best interests of the state.”

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Merck RSV antibody Enflonsia gets USFDA okay for infants

Rahway: Merck, known as MSD outside of the United States and Canada, has received approval from the U.S. Food and Drug Administration (FDA) for ENFLONSIA (clesrovimab-cfor) for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates (newborns) and infants who are born during or entering their first RSV season.

ENFLONSIA is a preventive, long-acting monoclonal antibody (mAb) designed to provide direct, rapid and durable protection through 5 months, a typical RSV season, with the same 105 mg dose regardless of weight. A typical RSV season usually spans autumn to spring of the next year.

“RSV disease is the leading cause of infant hospitalization in the U.S. and can lead to serious respiratory conditions like bronchiolitis and pneumonia,” said Dr. Octavio Ramilo, chair of the Department of Infectious Diseases at St. Jude Children’s Research Hospital and investigator for the CLEVER (MK-1654-004) and SMART (MK-1654-007) trials. “ENFLONSIA combines dosing convenience with strong clinical data showing significant reductions in RSV disease incidence and hospitalizations, making it a promising new intervention to help protect infants from RSV.”

ENFLONSIA should not be administered to infants with a history of serious hypersensitivity reactions, including anaphylaxis, to any component of ENFLONSIA.

The approval is based on results from the pivotal Phase 2b/3 CLEVER trial (MK-1654-004) evaluating a single dose of ENFLONSIA administered to preterm and full-term infants (birth to 1 year of age). The trial met its primary and key secondary endpoints, as outlined below.

  • ENFLONSIA demonstrated a reduction in incidence of RSV-associated medically attended lower respiratory infections (MALRI) requiring ≥1 indicator of lower respiratory infection (LRI) or severity compared to placebo through 5 months (primary endpoint) by 60.5% (95% CI: 44.2, 72.0, p<0.001) (incidence rates: ENFLONSIA, 0.026; placebo, 0.065).
  • ENFLONSIA demonstrated a reduction in RSV-associated hospitalizations through 5 months (key secondary endpoint) by 84.3% (95% CI: 66.7, 92.6, p<0.001) (incidence rates: ENFLONSIA, 0.004; placebo, 0.024), showing increasing efficacy with increasing disease severity.

The approval is also supported by results from the Phase 3 SMART trial (MK-1654-007) evaluating the safety and efficacy of ENFLONSIA versus palivizumab in infants at increased risk for severe RSV disease.

“ENFLONSIA provides an important new preventive option to help protect healthy and at-risk infants born during or entering their first RSV season with the same dose regardless of weight,” said Dr. Dean Y. Li, president, Merck Research Laboratories. “We are committed to ensuring availability of ENFLONSIA in the U.S. before the start of the upcoming RSV season to help reduce the significant burden of this widespread seasonal infection on families and health care systems.”

The U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices is expected to meet later this month to discuss and make recommendations for the use of ENFLONSIA in infants. Ordering is anticipated to begin in July, with shipments delivered before the start of the 2025-2026 RSV season.

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Merck posts positive phase 3 trials results evaluating Enlicitide Decanoate in adults with Hyperlipidemia

Rahway: Merck, known as MSD outside of the United States and Canada, has announced positive topline results from the first two of three Phase 3 clinical trials evaluating the safety and efficacy of enlicitide decanoate, an investigational, oral proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor being evaluated for the treatment of adults with hyperlipidemia on lipid-lowering therapies, including at least a statin.

The CORALreef HeFH and CORALreef AddOn trials successfully met their primary and all key secondary endpoints, demonstrating statistically significant and clinically meaningful greater reductions in low-density lipoprotein cholesterol (LDL-C) for enlicitide compared to placebo (CORALreef HeFH) and compared to other oral non-statin therapies (CORALreef AddOn). There were no clinically meaningful differences in incidences of adverse events (AE) and serious adverse events (SAE) in either trial.

Enlicitide is an investigational, potentially first oral PCSK9 inhibitor designed to lower LDL-C via the same biological mechanism as currently approved monoclonal antibody injectable PCSK9 inhibitors but in a daily pill form. Enlicitide is a novel oral macrocyclic peptide that binds to PCSK9 and inhibits the interaction of PCSK9 with LDL receptors.

PCSK9 plays a key role in cholesterol homeostasis by regulating levels of the LDL receptor, which is responsible for the uptake of cholesterol into cells. Inhibition of PCSK9 with enlicitide prevents the interaction of PCSK9 with LDL receptors. This results in greater numbers of LDL receptors available on the cell surface to remove LDL cholesterol from the blood.

Results from the three Phase 3 trials in the CORALreef clinical development program will be presented at a future scientific congress.

Key takeaways from CORALreef HeFH and CORALreef AddOn studies:

  • CORALreef HeFH: statistically significant and clinically meaningful reductions in LDL-C for enlicitide versus placebo in adults with heterozygous familial hypercholesterolemia (HeFH) who have a history of or are at risk for atherosclerotic cardiovascular disease (ASCVD) and are treated with a statin.
  • CORALreef AddOn: statistically significant and clinically meaningful reductions in LDL-C for enlicitide versus ezetimibe, versus bempedoic acid and versus ezetimibe and bempedoic acid in adults with hyperlipidemia who have a history of or are at risk for ASCVD and are treated with a statin.

“We are thrilled to bring forward the first Phase 3 results from our clinical development program evaluating enlicitide, which, if approved, would be the first marketed oral PCSK9 inhibitor in the U.S.,” said Dr. Dean Y. Li, president, Merck Research Laboratories. “Enlicitide is a novel macrocyclic peptide that has the potential to deliver antibody-like efficacy and specificity for the validated PCSK9 mechanism in the form of a daily oral pill. We are working with urgency to make this oral therapy available to patients worldwide.”

“Atherosclerotic cardiovascular disease accounts for 85 percent of cardiovascular deaths. Despite available treatment options, cardiovascular-related deaths remain the leading cause of death worldwide and continue to rise,” said Dr. Christie M. Ballantyne, principal investigator of the CORALreef HeFH study and Professor of Medicine at Baylor College of Medicine. “LDL-C is a major modifiable risk driver for atherosclerosis and prioritization of LDL-C management should be a cornerstone of cardiovascular risk prevention. Early intervention and intensification of lipid treatment would allow more patients to achieve LDL-C goals.”

The efficacy and safety of enlicitide are being evaluated through the comprehensive CORALreef Phase 3 clinical development program, which aims to enroll approximately 17,000 patients across several trials, including two large ongoing trials, CORALreef Lipids and CORALreef Outcomes.

Hyperlipidemia is a disorder characterized by an excess of lipids or fats in the blood, affecting approximately 86 million adults (aged 20 and older) in the U.S. Despite adjusting diet or other lifestyle factors, some individuals may not reach recommended lipid levels and will require medication to treat and manage hyperlipidemia. Hyperlipidemia is a major risk driver for the development of ASCVD events, such as heart attacks and strokes, which account for 85 percent of cardiovascular deaths.

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