The DOI matches its Crossref record; 204 of the 204 references it cites were found in a registry or an index; none of the 230 sources its claims cite is checked for support yet.
European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity
Open accessAbstract
Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.
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Claims the paper makes
169 Sources not found · 21 Own interpretation · 20 No basis given · 3 Own method · 1 Own result
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“treatment of overt hypothyroidism produces only a modest weight loss (usually of less than 10%) (29, 30, 31)”
What the sources say
- Not matchedcites [29]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [30]
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- Not matchedcites [31]
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plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“the prevalence of hypothyroidism in obesity was 14.0% (95% CI: 9.7-18.9), based on 19 studies”
What the sources say
- Not matchedcites [16]
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plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity.”
- Also stated in: § 2. Obesity - a short introduction · plain
“there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
- Also stated in: § 2. Obesity - a short introduction · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Such studies have not been performed in obesity.”
- Also stated in: § 3.5. Clinical questions, eligibility criteria and endpoint definition · hedged
“to the knowledge of the panel no such trials in obesity were published.”
plain- Asserted: passes — The authors put it forward as true.
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- Also stated in: § 3.5. Clinical questions, eligibility criteria and endpoint definition · hedged
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“the effect of treating endocrine disorders on weight loss is only modest.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“Notably, one study noted a tenfold increase of either overt or subclinical hypothyroidism compared to the general population (26).”
What the sources say
- Not matchedcites [26]
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In the paper
“the prevalence of subclinical hypothyroidism was found 14.6% (95% CI: 9.2-20.9), also based on 19 studies”
What the sources say
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In the paper
“For hyperandrogenism in females, reported prevalences of PCOS ranged from 9.1 to 25% (three studies)”
What the sources say
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In the paper
“For male hypogonadism, based on free testosterone measurements, the pooled prevalence was found to be 32.7% (95% CI: 23.1-43.0)”
What the sources say
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In the paper
“For both clinical and subclinical hypothyroidism, the reported prevalence ranged considerably between included studies, suggesting underlying clinical heterogeneity.”
What the sources say
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- It may state two separate claims as one. 62
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, 3819 potentially relevant papers were considered; 68 were included”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“the prevalence of undiagnosed hypothyroidism in Europe was estimated around 5% (22)”
What the sources say
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hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“the reported prevalence in the 11 included papers ranged from 16 to 52%, also suggesting underlying heterogeneity”
What the sources say
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hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“In Europe, the prevalence of overt hypothyroidism varies between 0.2 and 5.3% (20)”
What the sources say
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plain- Asserted: passes — The authors put it forward as true.
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In the paper
“(two studies assessed both hypothyroidism and hypercortisolism (16)).”
What the sources say
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plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“that of subclinical hypothyroidism between 4 and 10% (21)”
What the sources say
- Not matchedcites [21]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“the evidence is currently too weak to recommend testing for thyroglobulin antibodies (50)”
What the sources say
- Not matchedcites [50]
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plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
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In the paper
“L-thyroxine is the hormone of choice; no additional benefits have been demonstrated of L-thyroxine and L-triodothyronine combination (56).”
What the sources say
- Not matchedcites [56]
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boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“The development of TR β -selective agonist supposed to improve metabolic parameters without affecting heart rate did not have a conclusive outcome and the combined peptides that deliver FT3 specifically in the liver are not yet developed (62).”
What the sources say
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plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Raised concentrations of thyroid antibodies are detected in about 11% of the general population (47)”
What the sources say
- Not matchedcites [47]
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plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“FT3 has been described to be higher in obesity than in lean people, this being mainly related to the nutritional status (53).”
What the sources say
- Not matchedcites [53]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The Whickham survey estimated that annual progression of subclinical hypothyroidism to overt hypothyroidism occurs in 2-5% (63) and the rate may be lower in obesity (64).”
What the sources say
- Not matchedcites [63]
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- Not matchedcites [64]
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hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The relation of BMI with FT3 and FT4 is inconsistent, but a negative relation between BMI and FT4 and a positive relation between BMI and FT3 with a decrease FT4/FT3 ratio have been described (48, 53).”
What the sources say
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- Not matchedcites [53]
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plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Obesity is associated with modifications of thyroid parameters: TSH levels are usually higher than in normal-weight, age- and gender-matched individuals and are correlated with BMI (48).”
What the sources say
- Not matchedcites [48]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Overall, these studies have demonstrated only minor effects in terms of efficacy, while increased urinary nitrogen excretion has been observed, indicating loss of fat-free tissue beside the occurrence of adverse effects on bone metabolism and affective status.”
What the sources say
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boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There are very few data on the incidence of non-thyroidal illness in the obese population but one publication suggested that inflammation may increase non-thyroidal illness in obesity (52).”
What the sources say
- Not matchedcites [52]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“In obesity, treatment of hypothyroidism is followed by a mild increase in resting energy expenditure (34) but only a modest weight loss is achieved (29), mainly determined by excretion of excess body water.”
What the sources say
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Couldn’t be matched to a paper in Crossref, so it can’t be checked.
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plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Despite a previous study has shown a prevalence of CS of 9.3% among a series of 150 patients with obesity (80), in most series the diagnosis of CS in obesity has been very uncommon, ranging from 0 to 0.7%, though patients with severe obesity have been included (81, 82).”
What the sources say
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plainn = 150- Asserted: passes — The authors put it forward as true.
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In the paper
“Some experimental and clinical data points to a dysregulation in the activity of HPA axis in some patients with abdominal obesity, including excessive cortisol response to physical and psychological stimuli, reduced glucocorticoid feedback sensitivity and increased activity of 11-beta hydroxysteroid dehydrogenase in adipose tissue (94).”
What the sources say
- Not matchedcites [94]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Other features that may increase the probability of CS are nephrolithiasis, frequent infections and hypokalaemia, though are less specific than catabolic manifestations (Table 4).”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Each 5-unit increase in BMI was associated with 30% greater risk of thyroid cancer and both general and abdominal adiposity increased the risk.”
What the sources say
- Not matchedcites [75]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, subclinical CS has been reported to be more common in patients with obesity than in the general population (86), though its diagnostic criteria and treatment program have not been well established yet.”
What the sources say
- Not matchedcites [86]
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hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Harms of treatment were poorly studied and sparsely reported, and low TSH values are frequently found in patients treated with l -thyroxine potentially causing side effects.”
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Obesity was positively related to papillary, follicular and anaplastic thyroid cancers, but negatively with medullary thyroid cancer (75).”
What the sources say
- Not matchedcites [75]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The link between mild hypothyroidism and coronary heart disease is generally observed in the youngest population only and on the contrary, cohort studies have demonstrated that extreme longevity is associated with higher TSH levels (68).”
What the sources say
- Not matchedcites [68]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“In addition to biochemical changes, structural changes of the thyroid have also been associated with obesity. These include increases in thyroid volume and hypoechogenicity as well as thyroid nodules (27, 73), which may be due to increased TSH stimulation or increase in inflammatory mediators produced by the adipose tissue (27).”
What the sources say
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- Not matchedcites [73]
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hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Although the prevalence of CS in patients with severe obesity is generally low (81, 82, 91), a study of 16 patients operated of bariatric surgery has shown that CS diagnosis, persistence or recurrence was unrecognised, suggesting that CS may be responsible for less than expected improvement in hypertension and diabetes control as well as intense weight regain after bariatric surgery (92).”
What the sources say
- Not matchedcites [81]
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- Not matchedcites [91]
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- Not matchedcites [92]
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hedgedconditionaln = 16- Asserted: passes — The authors put it forward as true.
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In the paper
“The impact of obesity on thyroid cancer aggressiveness has still to be defined (76).”
What the sources say
- Not matchedcites [76]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
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In the paper
“Indeed, between 10 and 33% of individuals on l -thyroxine therapy have TSH values below normal and approximately one third to one half of these TSH levels are less than 0.1 mIU/L (66).”
What the sources say
- Not matchedcites [66]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Increased body fatness leads to a number of hormonal changes, the most obvious example being insulin resistance.”
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the guideline used GRADE (Grading of Recommendations Assessment, Development and Evaluation) as a methodological base.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“thyroid hormones have an important role in energy metabolism”
What the sources say
- Not matchedcites [20]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [27]
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plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Screening of the general population is mostly not recommended (24)”
What the sources say
- Not matchedcites [24]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A draft of the guideline was reviewed by the experts in the field; it was also submitted for comments by ESE members. All comments and suggestions were then discussed and implemented as appropriate by the panel.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Additionally, concomitant hormonal diseases can be present and have to be properly diagnosed”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Thyroid function is commonly assessed, independently of obesity, because hypothyroidism is one of the most common endocrine diseases.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“thus BMI is considered an adequate indicator of obesity and sufficient as first diagnostic measure”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Symptoms of hypothyroidism (such as fatigue, depression, cramps, menstrual disturbance or weight gain) are nonspecific (23) and can be confused with those of obesity.”
What the sources say
- Not matchedcites [23]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Obesity is an emerging condition and plays a central role in the development of non-communicable diseases like diabetes, hyperlipidaemia, hypertension, cardiovascular disease and cancer (1).”
What the sources say
- Not matchedcites [1]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“the presence of such reference standard is crucial when formally grading studies on diagnostics (12).”
What the sources say
- Not matchedcites [12]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This interpretation is in line with lower FT4 levels in obesity, together with the need for higher doses of substitutive l -thyroxine in hypothyroid patients with obesity.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The TSH elevation could reflect decrease in thyroid hormones concentrations, explained by an increased plasmatic volume or increased rate of thyroid hormone disposal in obesity, causing in turn a compensatory activation of the pituitary-thyroid axis (54).”
What the sources say
- Not matchedcites [54]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“According to American guidelines (45), TSH is the best screening test for thyroid dysfunction for the vast majority of clinical situations, in which normal TSH is enough to rule out primary hypothyroidism.”
What the sources say
- Not matchedcites [45]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Hypothyroidism contributes to an unfavorable lipid profile, and thus, potentially increases vascular risk (43, 44).”
What the sources say
- Not matchedcites [43]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [44]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Other mechanisms proposed to explain these modifications include increases in leptin and insulin (27).”
What the sources say
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Candidates to bariatric surgery commonly present with obesity-related comorbidities such as hypertension, metabolic syndrome and type 2 diabetes, which are also frequent in CS.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Obesity is commonly listed among the different entities of so-called pseudo-Cushing states (77, 78).”
What the sources say
- Not matchedcites [77]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [78]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Despite that subjects with abdominal obesity may display less cortisol suppression in some cases, the vast majority of authors consider that this test shows an acceptable performance to rule out CS (78, 87, 95).”
What the sources say
- Not matchedcites [78]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [87]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [95]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients with obesity often complain of symptoms suggestive of hypothyroidism that may prompt the practitioner to introduce thyroid hormone treatment.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“The presence of uncontrolled hypertension and/or type 2 diabetes despite conventional therapy in young patients with abdominal obesity may also raise the possibility of CS and justify the screening for detection of hypercortisolism (78).”
What the sources say
- Not matchedcites [78]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Guidelines recommend investigating whether patients are on glucocorticoid treatment before starting evaluation for potential endogenous CS (78, 87, 95).”
What the sources say
- Not matchedcites [78]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [87]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [95]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
In the paper
“Despite CS being a very rare disease, eventually some candidates to bariatric surgery may have endogenous hypercortisolism that could lead to severe adverse effects after surgery if undiagnosed (89).”
What the sources say
- Not matchedcites [89]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“However, other factors such as chronic stress may also be involved and hair cortisol measurement, when available, may offer a better reflection of chronic cortisol exposure than plasma or salivary samples (95).”
What the sources say
- Not matchedcites [95]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Factors such as hypercoagulability, catabolic state and increased cardiovascular risk may be responsible for severe postoperative complications, making this scenario especially sensible for CS detection (90).”
What the sources say
- Not matchedcites [90]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Although obesity is associated with an increased prevalence of hypogonadism, no adjustments for BMI are used to confirm the biochemical diagnosis of hypogonadism (107).”
What the sources say
- Not matchedcites [107]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“However, since the gold standard procedure to measure free testosterone (equilibrium dialysis) is not widely available, it may be preferable to calculate bioavailable testosterone by using testosterone, sex hormonebinding globulin (SHBG) and albumin concentrations (111, 123).”
What the sources say
- Not matchedcites [111]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [123]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Moreover, testosterone measurements are affected by chronic diseases, medications, genetics, lifestyle, and intra-individual variations (126).”
What the sources say
- Not matchedcites [126]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The increase in aromatase activity in adipose tissue, responsible for converting testosterone into oestradiol, may also contribute to inhibit LH secretion and reduce testosterone (117), as well as oestradiol blood levels (109).”
What the sources say
- Not matchedcites [117]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [109]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Moreover, obesity impairs sperm concentration, motility and morphology (108).”
What the sources say
- Not matchedcites [108]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Male testosterone levels decrease with age, though recent reports suggest that the magnitude of testosterone reduction seems to be lower than previously thought (124, 125).”
What the sources say
- Not matchedcites [124]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [125]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“Male obesity-secondary hypogonadism is associated with low plasma gonadotrophin concentrations, and in some cases with predominance of FSH over LH (107), in contrast with primary hypogonadism, where gonadotrophins are elevated.”
What the sources say
- Not matchedcites [107]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“This suggestion applies especially to obesity, since body fat excess and insulin resistance are commonly associated with low SHBG circulating values (111, 116), complicating the interpretation of testosterone concentrations.”
What the sources say
- Not matchedcites [111]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [116]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“A 1 mg overnight dexamethasone suppression test is simple, well standardized and used in the majority of previous studies (79).”
What the sources say
- Not matchedcites [79]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“growth hormone deficiency (in some patients)”
What the sources say
- Not matchedcites [186]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [187]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [189]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“and lack of normal pubertal development (in majority of patients) (186, 187, 189).”
What the sources say
- Not matchedcites [186]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [187]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [189]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“In severely obese patients, bariatric surgery is a very effective means of increasing testosterone levels and recovery of the hypothalamic -pituitary gonadal axis function besides achieving significant and sustained weight loss (134, 135).”
What the sources say
- Not matchedcites [134]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [135]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“obesity is associated with reductions in total and free 25OHD but unchanged vitamin-D binding proteins”
What the sources say
- Not matchedcites [181]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [182]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“There is compelling evidence highlighting the potential of a vicious cycle where obesity can lead to functional male hypogonadism, while male hypogonadism can further promote adiposity. Indeed, increased fat mass and reduced fat free mass is a common feature among men with androgen deficiency (129), although rarely having a significant impact on BMI (130).”
What the sources say
- Not matchedcites [129]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [130]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the ideal vitamin D replacement therapy and target 25OHD concentrations in the obese or bariatric populations are unknown.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“and correlates with BMI and body fat content (185).”
What the sources say
- Not matchedcites [185]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Both leptin- and leptinreceptor gene mutations are associated with hypothalamic hypothyroidism (low FT4 and TSH levels)”
What the sources say
- Not matchedcites [186]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [187]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [189]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“These patients typically present with significant weight gain in childhood, significantly increased appetite, GH deficiency, hypogonadism, sleep disturbances and other abnormalities.”
What the sources say
- Not matchedcites [192]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Vitamin D deficiency elicits a compensatory rise in parathyroid hormone (PTH), which increases bone turnover and calcium mobilization from the skeleton, leading to a decrease in bone mineral density and increase in the risk of osteopenia and osteoporosis (177).”
What the sources say
- Not matchedcites [177]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“which are among the most polymorphic proteins known and different alleles can have substantial impact on its biologic functions (181, 182).”
What the sources say
- Not matchedcites [181]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [182]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No specific data is available in the literature concerning the impact of obesity on PTH regulation during pregnancy”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unfortunately, no study has specifically studied the hormonal modification induced by age in obese people.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: Ageing is associated with alterations of hormonal secretions with variable amplitude for each endocrine system.
- Rests on an assumption: The symptoms of endocrine disease change with aging and are often less pronounced, which can lead to missing of the diagnosis.
- Rests on an assumption: The consequences of endocrine diseases can change in elderly with greater health risks (notably for muscle mass and cardiovascular functions).
- Rests on an assumption: The indication to treat is different in elderly because the benefit to risk ratio may be less favourable.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, few studies have reported the effects of interactions between obesity and pregnancy on endocrine functions.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In men: Decreased testosterone secretion (208 ) and bioavailability”
What the sources say
- Not matchedcites [208]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Decreased ghrelin (208 )”
What the sources say
- Not matchedcites [208]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
In the paper
“Because, during pregnancy, urine and plasma aldosterone increase”
What the sources say
- Not matchedcites [197]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The increase in CBG (200), result in a two to threefold increase of plasma cortisol levels and a lesser increase in free cortisol (197).”
What the sources say
- Not matchedcites [200]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [197]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Obesity may alter the consequences of age-related hormonal changes.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: Ageing is associated with alterations of hormonal secretions with variable amplitude for each endocrine system.
- Rests on an assumption: The symptoms of endocrine disease change with aging and are often less pronounced, which can lead to missing of the diagnosis.
- Rests on an assumption: The consequences of endocrine diseases can change in elderly with greater health risks (notably for muscle mass and cardiovascular functions).
- Rests on an assumption: The indication to treat is different in elderly because the benefit to risk ratio may be less favourable.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Obesity can further decrease GH, but the consequences are not known.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
- Rests on an assumption: Pregnancy induces profound changes in endocrine functions that affect the gonadotropic axis, hormones of lactation, placental hormones, and other endocrine glands such as the adrenal and thyroid glands.
In the paper
“GH decreases during pregnancy but IGF1 increases because of placental growth hormone production (197).”
What the sources say
- Not matchedcites [197]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper relies on this without support.
Weight loss restores hormonal imbalances in obesity.
“weight loss in obesity should be emphasized as key to restoration of hormonal imbalances”
The paper relies on this without support.
For obese patients, the same normal thyroid hormonal values apply as for non-obese patients.
“We suggest that for obese patients the same normal hormonal values are applied as for non-obese (+000).”
The paper relies on this without support.
For patients with obesity, the same normal values for hypercortisolism testing apply as for non-obese patients.
“We suggest that for patients with obesity the same normal values are applied as for non-obese (+000).”
The paper relies on this without support.
Obesity is not a rare condition.
“as obesity is not a rare condition”
The paper relies on this without support.
BMI is easily calculated in clinical practice.
“BMI is easily calculated in clinical practice”
The paper relies on this without support.
In most cases, obesity is not caused by other endocrine diseases or hormonal disturbances.
“In most cases, despite obesity being a condition of endocrine and metabolic imbalance, obesity is not caused by other endocrine diseases or hormonal disturbances.”
The paper relies on this without support.
The prevalence of obesity is such that standard referral to an endocrinologist would not be compatible with available resources in most countries.
“Furthermore, the prevalence of obesity is such that standard referral to an endocrinologist would not be compatible with available resources in most countries.”
The paper relies on this without support.
The prevalence of endocrine disturbances is related to obesity severity.
“because the prevalence of endocrine disturbances is related to obesity severity”
The paper relies on this without support.
Clinical signs and symptoms of endocrine conditions can be difficult to distinguish from obesity.
“because clinical signs and symptoms of endocrine conditions can be difficult to distinguish from obesity”
The paper relies on this without support.
For most hormones (TSH, cortisol, testosterone), the proper equilibrium is usually restored following weight reduction, irrespective of therapeutic strategy.
“For most hormones (TSH, cortisol. testosterone), the proper equilibrium is usually restored following weight reduction, irrespective of therapeutic strategy”
The paper relies on this without support.
Several dietary supplements are commonly taken by patients with obesity, with the aim of facilitating weight loss or well-being, controlling glucose metabolism or preventing cardiovascular events.
“several dietary supplements are commonly taken by patients with obesity, with the aim of facilitating weight loss or well-being, controlling glucose metabolism or preventing cardiovascular events.”
The paper relies on this without support.
Hypothyroidism can be easily diagnosed by blood tests.
“Hypothyroidism can be easily diagnosed by blood tests.”
The paper relies on this without support.
Untreated hypothyroidism could blight the attempts at loosing body weight.
“Finally, untreated hypothyroidism could blight the attempts at loosing body weight.”
The paper relies on this without support.
The most common cause of hypothyroidism is chronic autoimmune thyroiditis.
“The most common cause of hypothyroidism is chronic autoimmune thyroiditis.”
The paper relies on this without support.
Thyroid antibody profiles are helpful to diagnose autoimmune hypothyroidism and to determine patients at risk of developing hypothyroidism.
“Thyroid antibody profiles are helpful to diagnose autoimmune hypothyroidism and to determine patients at risk of developing hypothyroidism.”
The paper relies on this without support.
Among women of reproductive age, subclinical hypothyroidism has been associated with infertility, an increased risk of adverse pregnancy and neonatal outcomes, and possibly with an increased risk of neurocognitive deficits in offspring.
“Among women of reproductive age, subclinical hypothyroidism has been associated with infertility, an increased risk of adverse pregnancy and neonatal outcomes, and possibly with an increased risk of neurocognitive deficits in offspring.”
The paper relies on this without support.
Autoimmune thyroiditis is often characterized by a hypoechogenic pattern on thyroid ultrasonography.
“Autoimmune thyroiditis is often characterized by a hypoechogenic pattern on thyroid ultrasonography.”
The authors state this as an assumption.
Obesity has epidemic proportions.
“Assuming the epidemic proportions of obesity”
The authors state this as an assumption.
Obesity has a multifactorial origin.
“its multifactorial origin”
The paper relies on this without support.
Adjustment of the dexamethasone dose to body weight does not substantially improve the sensitivity of the dexamethasone suppression test in individuals with obesity, particularly when near-maximal doses are administered.
“In line, a study has shown that adjustment of the dexamethasone dose to body weight does not seem to substantially improve the sensitivity of the test, even in individuals with obesity, particularly when near-maximal doses are administered.”
The paper relies on this without support.
The ability to sustain male gonadal benefits after weight loss achieved through conservative interventions is relatively small, as weight regain is also very common.
“Besides, the ability to sustain the male gonadal benefits after weight loss achieved through conservative interventions is relatively small, as weight regain is also very common.”
The paper relies on this without support.
Testosterone results depend on the assay technique used.
“Testosterone results also depend on the assay technique used.”
The paper relies on this without support.
Most available testosterone assays are immunoassays (RIA, enzyme immunoassay or fluoroimmunoassay), which are rapid, simple, and inexpensive.
“Most available testosterone assays are immunoassays (RIA, enzyme immunoassay or fluoroimmunoassay), which are rapid, simple and inexpensive.”
The paper relies on this without support.
Most reference ranges have been established using immunoassays.
“Moreover, most reference ranges have been established using immunoassays.”
The paper relies on this without support.
The accuracy of immunoassays is lower than that obtained by mass spectrometry, which is more expensive and requires regular calibration.
“However, their accuracy is lower than that obtained by mass spectrometry, which is more expensive and requires regular calibration.”
The paper relies on this without support.
Equilibrium dialysis represents the gold standard method to measure free testosterone but is expensive and technically challenging.
“Equilibrium dialysis represents the gold standard method to measure free testosterone but is expensive and technically challenging.”
The paper relies on this without support.
Most guidelines recommend direct measurements or calculation of free testosterone by a formula.
“For practical reasons, most guidelines recommend direct measurements or calculation of free testosterone by a formula.”
The paper relies on this without support.
The injectable preparation of testosterone undecanoate (1000 mg every 12 weeks) is widely used as treatment of hypogonadism because it leads to steady testosterone plasma levels.
“The injectable preparation of testosterone undecanoate (1000 mg every 12 weeks) is widely used as treatment of hypogonadism because it leads to steady testosterone plasma levels.”
The paper relies on this without support.
Testosterone replacement therapy given to men with hypogonadism is associated with weight loss and body composition improvement, but no evidence of this beneficial effect is observed in eugonadal subjects.
“Although TRT given to men with hypogonadism is associated with weight loss and body composition improvement, no evidence of this beneficial effect is observed in eugonadal subjects.”
The paper relies on this without support.
Vitamin D is essential for bone-mineral health and calcium homeostasis.
“Vitamin D is essential for bone-mineral health and calcium homeostasis.”
The paper relies on this without support.
The diagnosis of Prader-Willi syndrome can be established based on clinical features, hormonal abnormalities and genetic testing.
“The diagnosis of this syndrome can be established based on clinical features, hormonal abnormalities and genetic testing.”
The paper relies on this without support.
Hypothyroidism can be accompanied by both obesity and hypertension.
“Hypothyroidism can be accompanied by both obesity and hypertension”
The paper relies on this without support.
None of these conditions (obesity and hypertension in hypothyroidism) is usually severe.
“although none of these conditions is usually severe.”
The paper relies on this without support.
Other causes of endocrine hypertension can be present in obesity.
“Other causes of endocrine hypertension can be present in obesity”
The paper relies on this without support.
Other causes of endocrine hypertension are not characterized by increased prevalence of obesity.
“nevertheless, these are not characterized by increased prevalence of obesity.”
The paper relies on this without support.
Pregnancy induces profound changes in endocrine functions that affect the gonadotropic axis, hormones of lactation, placental hormones, and other endocrine glands such as the adrenal and thyroid glands.
“Pregnancy induces profound changes in endocrine functions that affect not only the gonadotropic axis (increase in oestrogens, progesterone and androgens), hormones of lactation (increase in oxytocin and prolactin) and placental hormones (notably human chorionic gonadotropin: HCG), but also other endocrine glands such as the adrenal and thyroid glands.”
The paper relies on this without support.
During the 1st trimester, HCG induces a transient increase in free thyroid hormones levels and a decrease in TSH.
“during the 1st trimester, HCG induces a transient increase in free thyroid hormones levels and a decrease in TSH.”
The paper relies on this without support.
Later in pregnancy, serum free hormones concentrations decrease of approximately 10-15%, and TSH returns to normal.
“Later, serum free hormones concentrations decrease of approximately 10-15%, and TSH returns to normal.”
The paper relies on this without support.
Most scientific societies recommend specific reference ranges for free thyroid hormones and TSH throughout pregnancy.
“Thus, most scientific societies recommend specific reference ranges for free thyroid hormones and TSH throughout pregnancy.”
The paper relies on this without support.
Glucocorticoids are vital for normal foetal growth.
“Glucocorticoids are vital for normal foetal growth.”
The paper relies on this without support.
During pregnancy, a number of endocrine changes induce activation in maternal hypothalamic-pituitary-adrenal (HPA) axis.
“During pregnancy, a number of endocrine changes induce activation in maternal hypothalamic-pituitaryadrenal (HPA) axis.”
The paper relies on this without support.
The foeto-placental unit produces large amounts of steroid and peptide hormones including CRH.
“The foeto-placental unit produces large amounts of steroid and peptide hormones including CRH.”
The paper relies on this without support.
Renin-angiotensin-aldosterone (RAA) axis is activated during pregnancy to compensate vasodilation and to increase extracellular fluid volume.
“Renin-angiotensin-aldosterone (RAA) axis is activated during pregnancy to compensate vasodilation and to increase extracellular fluid volume.”
The paper relies on this without support.
Alterations of RAA axis have been incriminated in the pathophysiology of preeclampsia.
“Alterations of RAA axis have been incriminated in the pathophysiology of preeclampsia”
The paper relies on this without support.
Preeclampsia is more prevalent in obese pregnant women.
“that is more prevalent in obese pregnant women.”
The paper relies on this without support.
Around 30 g of calcium is transferred to the foetus, especially in the last trimester of pregnancy, needed for bone mineralization.
“Around 30 g of calcium is transferred to the foetus, especially in the last trimester of pregnancy, needed for bone mineralization.”
The paper relies on this without support.
Ageing is associated with alterations of hormonal secretions with variable amplitude for each endocrine system.
“Ageing is associated with alterations of hormonal secretions with variable amplitude for each endocrine system.”
The paper relies on this without support.
The symptoms of endocrine disease change with aging and are often less pronounced, which can lead to missing of the diagnosis.
“Furthermore, the symptoms of endocrine disease change with aging and are often less pronounced, which can lead to missing of the diagnosis.”
The paper relies on this without support.
The consequences of endocrine diseases can change in elderly with greater health risks (notably for muscle mass and cardiovascular functions).
“The consequences of endocrine diseases can also change in elderly with greater health risks (notably for muscle mass and cardiovascular functions).”
The paper relies on this without support.
The indication to treat is different in elderly because the benefit to risk ratio may be less favourable.
“Finally, the indication to treat is also different, because the benefit to risk ratio may be less favourable.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ 4. Summary of results from the systematic review
“the prevalence of subclinical hypothyroidism was found 14.6% (95% CI: 9.2-20.9), also based on 19 studies.”
§ Reasoning:
“the prevalence of subclinical hypothyroidism was found 14.6% (95% CI 9.4-20.9).”
Citations
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Metadata
- Authors
- Pasquali, R., Casanueva, F., Haluzik, M., van Hulsteijn, L., Ledoux, S., Monteiro, M. P., Salvador, J., Santini, F., Toplak, H., & Dekkers, O. M.
- Affiliations
- University of Bologna (IT)
- Complejo Hospitalario Universitario de Santiago (ES)
- 3Diabetes Centre and Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine and Institute of Endocrinology, Prague, Czech Republic
- University Medical Center Groningen (NL)
- Hôpital Louis-Mourier (FR)
- Universidade do Porto (PT)
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (ES)
- Azienda Ospedaliera Universitaria Pisana (IT)
- Medical University of Graz (AT)
- Leiden University Medical Center (NL)
- Corresponding author
- Pasquali, R
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-01
- Volume
- 182
- Issue
- 1
- Pages
- G1-G32
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2994986481
- Semantic Scholar
- 305b19ef98c1ddb882ff636c4548d296e5feed93
- Cited by
- 188
- References
- 126
- Citations by year
- 2026: 21 · 2025: 30 · 2024: 45 · 2023: 25 · 2022: 26 · 2021: 29 · 2020: 12
- FWCI
- 15.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- European Journal of Endocrinology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, other-oa)
- Funders
- European Society of Endocrinology
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- obesity, thyroid function tests, hypothyroidism, hypercortisolism, male hypogonadism, body mass index, weight loss, hormonal imbalance
- MeSH terms
- Endocrinology, Humans, Hypothyroidism, Obesity, Thyroid Function Tests, Comorbidity, Body Mass Index, Prevalence
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