Endocrine Abstracts

Introduction: Thyroid nodules are discovered by ultrasound (US) in a large percentage of population. In most cases they are benign and asymptomatic. When to perform or not a fine-needle-aspiration (FNA) is still matter of debate. Aim of this study was to evaluate the usefulness of a easy-to-use US classification, based on three US classes.Methods: We prospectively evaluated US features of 1118 thyroid nodules, allocating each nodule in one of three class...

GH deficiency (GHD) in adults leads to impairment in body composition and function, as well as to deranged lipoprotein and carbohydrate metabolism implying increased cardiovascular morbidity. The morphologic and metabolic alterations in GHD syndrome are more marked in patients with the most severe GHD, even when evaluated by maximal provocative test such as GHRH + arginine. IGF1 synthesis and secretion are function of the GH status but also of major metabolic factors such as i...

Background: When evaluating a patient for central adrenal insufficiency (CAI), there is a wide range of morning cortisol values for which no final conclusion on hypothalamus-pituitary-adrenal (HPA) axis function can be drawn; in these cases, a stimulation test is required. Aim of this study was to develop an integrated model for the prediction of CAI when morning cortisol is in the grey zone, here defined as 40.0-160.0 μg/l.Methods: Overall, 119 pat...

Introduction: The onset and progression of liver damage in non-alcoholic fatty liver disease (NAFLD) is tightly associated with metabolic derangements. Steroids may affect lipid metabolism but their alterations in the setting of NAFLD remain to be fully explored.Patients and Methods: We analyzed data from 121 patients with biopsy-proven NAFLD and 108 controls (CT). A panel of 26 steroids (including glucocorticoids, mineralocorticoids, androgens, and prog...

Objective: This study aimed to evaluate the performance of simple and clinical/imaging-corrected unconventional indices in predicting the selectivity of adrenal vein sampling (AVS) and the lateralization of aldosterone hypersecretion in patients with primary aldosteronism (PA).Methods: Data of all consecutive patients with a proven diagnosis of PA who underwent AVS for subtype differentiation in two Italian referral centers were analyzed retrospectively....

Introduction: The diagnosis of GH deficiency (GHD) in adults is based on a reduced GH response to provocative tests. The proportion of patients with low GH response to provocative tests increases with the number of other pituitary hormone deficiencies and several studies involving panhypopituitary patients have shown that under certain circumstances GH stimulation tests may be unnecessary to diagnose GHD.Objective: Aim of this study was to re-evaluate th...

Introduction: Recent studies found an increased cardiometabolic risk in patients with Non-Functioning Adrenal Incidentaloma (NFAI), but all these data have low quality of evidence.Objective: To establish whether cardiometabolic risk and complications in NFAI patients can be associated to the presence of a non-secreting adrenal tumor, independently from potential confounding factors.Subjects and Methods: In this cross-sectional and ...

Background: The systematic use of confirmatory tests in the diagnosis of primary aldosteronism (PA) increases costs, risks and complexity to the diagnostic work-up. In light of this, some authors proposed aldosterone-to-renin (ARR) cut-offs and/or integrated flow-charts to avoid this step. Patients with resistant hypertension (RH), however, are characterized by a dysregulated renin-angiotensin-aldosterone system, even in the absence of PA. Thus, it is unclear whether those str...

Background: Primary aldosteronism (PA) is the most frequent form of secondary hypertension, with a high prevalence in resistant hypertension (RH), a condition of insufficient blood pressure (BP) control despite a 3-drug based treatment at full dose, including a diuretic. The prevalence of PAin refractory hypertension (ReH), a condition of persistently elevated BP values despite therapy with 5 drugs, is not known.Objective: To investigate the prevalence o...

The screening for primary aldosteronism (PA) is based on the aldosterone/renin ratio (ARR), which is calculated with the plasma renin activity (PRA) as denominator. A direct measurement of active renin (DRA) is being used as an alternative to PRA, but its diagnostic performance remains uncertain.Aim of the study was to head-to-head compare the ARR based on PRA (ARR-P) to on DRA (ARR-D), at baseline and post-captopril, for identifying aldosterone-producin...