Endocrine Abstracts

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 267 patients with biopsy-proven NAFLD and 112 controls (CT). A panel of 26 steroids (including glucocorticoids, mineralocorticoids, androgens, and prog...

Background: Benign adrenal tumours are discovered in 3-10% of adults and can be non-functioning (NFAT) or associated with adrenal hormone excess, most frequently mild autonomous cortisol secretion (MACS) defined by the failure to suppress cortisol after 1 mg dexamethasone overnight but lack of distinct signs of Cushing’s syndrome (CS). We found that MACS increases the prevalence and severity of type 2 diabetes and hypertension and primarily affects women (Ann Int Med. 202...

Background: Adrenal crises (AC) still occur even in educated patients with adrenal insufficiency. Identifying predisposing factors can improve risk assessment and facilitate prevention in this patient population.Objectives: Investigating clinical and biochemical fingerprints of increased susceptibility to AC.Material and methods: Our study population included 71 patients with adrenal insufficiency, classified in high and low risk a...

Cushing’s syndrome (CS) is a hormonal disorder characterized by chronic high levels of circulating cortisol. Patients treated for CS develop chronic adrenal insufficiency (AI) and hypothalamus-pituitary-adrenal (HPA) axis dysfunction. Long-term treatment with glucocorticoids (GC) is mandatory to overcome AI. Fibroblast growth factor (FGF) -21, a key regulator of metabolism, has a bidirectional relationship with GC that bypasses the negative feedback of the HPA axis. In th...

Background: Adrenal venous sampling (AVS) is the gold standard to differentiate patients with unilateral primary aldosteronism (UPA) from those with bilateral disease (BPA).Objective: The aim of this study was to evaluate the efficiency of using the online Integer scoring system in predicting BPA, as a possible surrogate for AVS.Methods: We performed a retrospective analysis of 105 patients (66 female, median age at diagnosis 53 ye...

Background: Adrenal venous sampling (AVS) is considered the gold standard for differentiating an aldosterone- producing adenoma (aPA) from bilateral adrenal hyperplasia (BAH).Objective: The aim of this study is to present our experience with this method in our hospital.Methods: We performed a retrospective analysis of 105 patients who underwent the AVS protocol at our centre between 2015 and 2022 for PA.Resul...

Background: The adrenal gland produces corticosteroids essential for hydromineral and metabolic homeostasis. It is organised, in mice, in two concentric layers. The zona glomerulosa (zG) and fasciculate (zF), renewed from progenitors located in the capsular periphery. Centripetal renewal and maintenance of cortical zonation are dependant of a balance between WNT/β-catenin and ACTH/PKA signalling pathways. They provide recruitment and consecutive differentiation of progeni...

Background: Autoimmune polyglandular syndrome type 1 (APS-1) is a rare autosomal recessive, monogenic disease, that could be presented as a group of various symptoms, but clinical diagnosis requires existence of minimum two of three leading disorders: chronic mucocutaneous candidiasis, hypoparathyroidism, and primary adrenocortical insufficiency.Case Presentation: We report the clinical cases of two siblings with APS-1, one 28-year-old male and one 25-ye...

Background: Duration of postoperative follow-up in patients with pheochromocytoma/paraganglioma (PPGL) is still not clearly specified. It is estimated that 5-year risk of a new events (metastatic/recurrent disease) after surgery is 27% in young patients, 25% in those with paraganglioma and around 10% in older patients and those with pheochromocytoma. Arterial aneurysms (AA) accompanying PPGL are described as complication/comorbidity that affects prognosis in these patients.</p...

Introduction: Malignant pheochromocytomas and paragangliomas (PPGLs) are rare, and knowledge of the natural history is limited. Material Methods: Data of 7 (7.6%) (out of 109) patients with malignant PPGLs referred to a Tertiary Centre of Endocrinology from Bucharest, Romania, were retrospectively collected. Follow-up ranged from 2004 to 2022. Demographic data, genetic status, site and size of primary tumor, biochemical activity, metastasis time (synchro...

Background: Recent studies showed that cortisol autonomy is age and sex dependent and highly associated with higher all-cause mortality in patients with adrenal incidentalomas (AI). Dehydroepiandrosterone sulphate (DHEAS) has been recognized as a valuable diagnostic tool in patients with (possible) autonomous cortisol secretion.Objectives: As DHEAS levels are sex and age specific we aimed to evaluate its value as a diagnostic tool in patients with adrena...

The genetic heterogeneity of pheochromocytomas and paragangliomas (PPGL) offers opportunities to develop individualized treatment approaches for affected patients. Therefore, an improved understanding of the molecular features associated with different tumor phenotypes is required. Hypoxia-inducible factor (HIF) 2α-regulated pathways involving the MYC/MAX complex are directly linked to differentiation and aggressiveness in PPGLs. However, the distinct functions of the two...