Endocrine Abstracts

Background: The dexamethasone suppression test (DST) is among essential tests for hypercortisolism diagnosis. Due to high sensitivity and specificity, liquid chromatography-tandem mass spectrometry (LC-MS/MS) is replacing obsolete immunoassays (IA) for steroid measurement. However, exhaustive data about IA and LC-MS/MS concordance in the frame of DST are still not available.Aim: To compare cortisol measurements by two routine IAs and LC-MS/MS in basal (F...

Context: Although Trabecular Bone Score (TBS) has been widely and independently associated with fragility fractures, its diagnostic power in certain populations remains to be established. Women initiating aromatase inhibitors for breast cancer should be screened for bone health to prevent cancer treatment-induced bone loss as much as possible. TBS is regarded as an adjunctive tool to evaluate these patients, but thresholds of pharmacologic interventions are still a gray zone, ...

Introduction: Diabetes mellitus (DM) develops early in Turner syndrome (TS) and appears not related to common risk factors. The precise mechanism of its development is still a matter of debate: a defective insulin response seems to be involved, but the role of incretins is still undefined.Objective: To evaluate the implication of incretin release in the early stages of DM development in TS. Materials and Methods: 153 Turner patient...

Background: Steroid profiling by LC-MS/MS is increasingly used in endocrine research, and is being introduced in the clinical practice. Due to the large disagreement with previous immunoassays, and to the enlarged panel of measurable steroids, novel and robust reference intervals (RIs) need to be established. Steroid circulating levels are known to be influenced by several physio-pathological factors, such as age, gender, stress and metabolic status. Therefore, generating unbi...

Endocrine clinical practice strongly relies on normative data for the assessment of hormonal imbalance. However, the generation of robust steroids reference intervals (RIs) remains a challenge. As the steroids circulating levels are influenced by many procedural aspects related to blood collection (time, fasting state) and physio-pathological factors, such as age, sex, stress and metabolic status, the need for partitioning RIs is mandatory. Furthermore, unbiased healthy, drug-...

Introduction: Adjuvant therapy with aromatase-inhibitors (AIs) increases bone loss and fracture risk. Concomitant antiresorptive treatment is currently recommended. The aim of this study was to evaluate the effects of AIs on bone metabolism and mineral density at 12 and 24 months.Methods: Among 400 women on AIs who attended our Endocrinology Unit from 2014 to 2016, we retrospectively evaluated those who initially refused antiresorptive and took cholecalc...

Context: ß-CTX are considered useful markers of response to denosumab and other anti-resorbtive treatments for osteoporosis. We report an unusual case of a completely absent effect of both denosumab and bisphosphonates on bone resorption markers.Case description: In 2017 a 74-year-old woman sought medical attention at the Endocrinology Unit of Policlinico di Sant’Orsola for the evaluation of an adrenal adenoma associated with osteoporosis. Meno...

Cushing disease and hypophosphatasia are rare conditions that may be both responsible of an important impairment of bone metabolism with increased fracture risk. We reported for the first time a case of a 43-year-old woman that came at our attention for recent onset of alopecia and amenorrhea. At the anamnesis, she denied any past relevant events and no drug assumption. At the physical examination, she presented rubeosis and facies lunaris and central adipose distribution (wai...

Monoclonal antibodies against the Programmed cell death-1 protein (PD-1) are a new treatment for advanced cancer. Endocrine and metabolic diseases are known to be frequently associated with this class of drugs. We describe two cases of Nivolumab-induced diabetes mellitus.Case 1: A 73-year-old man with a mutated BRAF-V600K advanced stage melanoma was treated with Nivolumab (240 mg IV every 2 weeks). He had normal-weight (BMI: 21.6 Kg/mq), and no previous ...

Introduction: Primary aldosteronism (PA) features a higher prevalence of cardiovascular events and renal complications as compared with essential hypertension. The effects of aldosterone excess on ascending aorta have never been investigated in human subjects.Methods: From August 2014 to December 2015, we enrolled forty-seven consecutive PA outpatients who had not undergone surgery of the adrenal mass. Hypercortisolism and pheochromocytoma were excluded....