Endocrine Abstracts

Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy with incompletely understood pathogenesis and poor prognosis. Recent data from the German ACC Registry (n=377) demonstrate an overall 5-year survival of 46%. Survival is clearly stage-dependent (P<0.01) with a 5-year survival of 85% in stage 1, 56% in stage 2, 42% in stage 3, and 16% in stage 4, respectively.In stages I –III open surgery by an expert surgeon aimi...

Introduction Retrospective analyses suggest that patients with adrenal insufficiency (AI) have an increased risk for cardiovascular diseases which was mainly attributed to non-physiological cortisol profiles and/or supraphysiological replacement doses.Material and methodsWe analyzed the 24-hour blood pressure (BP) profiles in patients with primary (PAI) and secondary (SAI) AI. BP threshold criteria for hypert...

Introduction: Retrospective analyses suggest an increased risk for cardiovascular diseases in patients with adrenal insufficiency (AI), mainly due to supraphysiological replacement doses.Objective: To evaluate the 24-hour blood pressure (BP) profile in patients with primary (PAI) and secondary (SAI) AI.Material and methods: BP threshold criteria for hypertension and dipping status of the 2018 ESC/ESH guidelines were used (24-h: &#8...

Introduction: Glucocorticoid (GC) replacement regimens in adrenal insufficiency (AI) only roughly correspond to physiological steroid profiles. Moreover, control of substitution quality is difficult and signs of clinically relevant mild chronic over- or under-replacement might be omitted. FKBP5 regulates GC receptor sensitivity by reducing its affinity to cortisol when bound to the receptor complex. FKBP5 methylation has been inversely correlated with cortisol levels both in h...

Background: Hypercalciuria is a relevant complication in patients with treated hypoparathyroidism. Hypercalciuria is usually estimated by 24 h urinary calcium excretion (24 hUCa). In contrast, in pediatric endocrinology the calcium-creatinine-ratio (CaCrR) is more often used due to feasibility. This study aims to compare these two approaches in adult patients with hypoparathyroidism.Methods: In 181 systematically evaluated patients with primary hypoparat...

Background: Potentially fatal adrenal crises (AC) still occur in educated patients with adrenal insufficiency (AI). Our study investigates clinical and biochemical fingerprints of increased susceptibility to AC.Material and methods: 199 patients with chronic AI (disease duration ≥6 years), classified into tertiles according to the frequency of AC/patient-years (group 1 no AC, group 2 ≤0.07 AC/py, group 3 >0.07 AC/py). Following parameters...

Introduction: Reduction of quality of life in patients with chronic hypoparathyroidism (HPT) has been reported by several studies. Additionally, self-report data point to a higher prevalence of anxiety disorders in HPT compared to patients after thyroidectomy.Objectives: To characterize psychiatric diseases in a systematically reviewed cohort of patients with chronic HPT.Methods: We systematically assessed psychiatric comorbidities...

Objective: We have developed (123/131I)iodometomidate (IMTO) for specific adrenal imaging and radiotherapy of adrenocortical carcinoma. IMTO binds with high affinity and specificity to the two adrenocortical enzymes aldosterone synthase (CYP11B2) and 11β-hydroxylase (CYP11B1). Metabolic analysis has revealed very rapid metabolization of IMTO both in vitro and in vivo by hepatic esterases. Due to the low metabolic stability of (123/131</su...

Objective: The saline infusion test (SIT) is a standard confirmatory test for primary aldosteronism (PA) and based on impaired aldosterone suppression in PA compared to essential hypertension (EH). In the past, aldosterone was quantified using immunoassays (IA). Due to the more widespread use of liquid chromatography tandem mass spectrometry (LC-MS/MS) in clinical routine, we aimed at a method-specific aldosterone threshold for the diagnosis of PA during SIT and explored the d...

Introduction: Even though it is well known that long-term complications, such as renal insufficiency and brain calcifications can occur in patients with hypoparathyroidism (HPT), the risk of cardiovascular diseases still remains unclear.Objective: To perform a systematic assessment of cardiovascular function in a well-characterized cohort of patients with HPT compared to population-based controls.Methods: 133 patients with chronic ...