Endocrine Abstracts

Introduction: The daily maintenance dose of conventional hydrocortisone currently recommended by international guidelines for the management of primary adrenal insufficiency (PAI) or secondary adrenal insufficiency (SAI) is 15−25 mg/day, in 2−3 divided doses. The aim of this analysis was to investigate inter-country differences in glucocorticoid replacement doses in patients with PAI and SAI.Design: EU-AIR (ClinicalTrials.gov identifier: NCT0...

In human adrenals, serotonin (5-HT), released by subcapsular mast cells, increases aldosterone secretion through activation of type 4 serotonin receptors (5-HT4R) but only exerts a modest control on cortisol production. Interestingly, illicit synthesis of 5-HT in adrenocortical cells as well as overexpression of the 5-HT4R and ectopic expression of the type 7 receptor (5-HT7R) have been observed in bilateral macronodular adrenal hyperplasia res...

The cyclic AMP/PKA signalling cascade is involved in the pathogenesis of cortisol-secreting adrenocortical tumors (ACT). Defects in cell cycle checkpoints play a major role in oncogenesis. The PKA regulatory subunits PRKARIA and PRKARIIb are involved in cell survival and steroidogenesis in the adrenocortical carcinoma H295R cell line. We have previously shown that their inactivation enhances the accumulation of cells in the G2 phase and act...

Measurement of plasma aldosterone and renin concentration, or activity, is useful for selecting antihypertensive agents as well as detecting hyperaldosteronism in hypertensive patients. However, it takes several days to get results when measured by radioimmunoassay and development of more rapid assays has been long expected. We have developed chemiluminescent enzyme immunoassays enabling the simultaneous measurement of both aldosterone and renin concentrations in ten-minutes b...

Primary aldosteronism is the most common form of secondary hypertension. Somatic mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D have been described in 50% of aldosterone producing adenomas (APA). To identify genetic alterations in new genes, we performed whole exome sequencing in 23 patients with APA negative for recurrent mutations in known driver genes. A low number of somatic variations were identified per patient, ranging from 1 to 22. N...

Background: Possible Autonomous Cortisol Secretion (pACS) is a condition found in 1–29% of patients with adrenal incidentalomas. The diagnosis of pACS has been variably associated with an increased risk of cardiovascular events and mortality. However, dedicated studies describing the morphologic and functional cardiac alterations in these patients are lacking.Aim: To compare the cardiovascular features of patients with pACS to those with nonfunction...

Background: Cross-sectional studies in small and selected populations indicate a relatively high prevalence of incipient and/or subclinical Cushing’s syndrome (CS) in patients with type 2 diabetes (T2D), which could have therapeutic implications.Aim: To estimate the prevalence of CS in a large, unselected cohort of recently diagnosed T2D patients.Methods: A total of 384 consecutive out – patients with T2D diagnosed after ...

Arterial hypertension usually results from the deregulation and hyperactivity of the renin angiotensin-aldosterone system. One of the available therapeutic approaches for its treatment is the use of mineralocorticoid receptor (MR) antagonists, thus blocking aldosterone action.The aim of this study was to characterize the effects of spironolactone and eplerenone, on the morphology of the adrenal gland of spontaneously hypertensive (SHR) and normotensive (...

NC-CAH is diagnosed in pubertal/post-pubertal women because of androgen excess however, the risk of potential adrenal insufficiency is not known, and indication of systematic glucocorticoid replacement therapy is controversial.Design: Prospective controlled clinical study in a tertiary referral center. 20 women with NC-CAH (serum stimulated 17-OHP >10 ng/ml/250 μg, Synacthen) comparatively to matched healthy women, were included if they had not ...

Introduction: If untreated, adrenal insufficiency (AI) leads to premature death. Hospital record data suggest mortality associated with primary (PAI) and secondary AI (SAI) to be 2–3-fold higher than in the general population. Major causes of death include cardiovascular disease, Addisonian crises, brain tumours and infections; however, there is little further characterization of patients who died.Design: We analysed real-world data from the Europea...