Endocrine Abstracts

Hypoparathyroidism is an endocrine disease resulting in hypocalcemia due to inappropriately low circulating parathyroid hormone levels. It is defined as an orphan disease by the European Commission, and commonly managed by endocrinologists and endocrine units. All healthcare personnel involved in the management of patients with chronic hypoparathyroidism should have knowledge about symptoms, treatment and potential complications.Causes: In adults, hypopa...

Background: The incidence of hypophysitis has increased since the introduction of Immuno-oncologic treatment. Treatment with anti-CTLA-4 (Ipilimumab) and anti-PD-1 has improved the prognosis for patients with malign melanoma drastically, but immune-mediated side effects can occur in any organ, including the thyroid and the pituitary. Headache is considered a key symptom of hypophysitis. Here, we report three cases with silent, isolated ACTH-insufficiency following immunotherap...

Background: Bone turnover is increased in active acromegaly. Despite normalization of bone turnover after treatment, the risk for vertebral fractures remains increased. Gonadal status, but not bone mineral density (BMD) is correlated to vertebral fracture incidence. Trabecular and cortical bone are differentially affected by GH and IGF-1. The trabecular bone score (TBS) is related to bone microarchitecture and provides further information not captured by BMD measurement.<p...

Context: Immediate and sustained cure of acromegaly can only be achieved by surgery, however, most growth hormone (GH) producing adenomas are macroadenomas (≥ 10 mm) at diagnosis, with reported surgical cure rates of approximately 50% compared to microadenomas (<10 mm) with an expected higher cure rate (around 80%). Further, long-term data on remission rates after surgery are sparse. Aim: Estimate short- and long-term surgical remission rates o...

Introduction: Remission by complete surgical tumour removal is not achieved in all patients with acromegaly and a subset of patients remain on long-term pharmacological treatment. Repeated surgery or targeted radiation therapy can be considered in patients with residual or recurrent tumour. Identification of residual or recurrent tumour available for surgical treatment can be challenging, and underreporting may lead to a loss in treatment opportunity. The aim of the present st...

Context: Angiopoietin-like protein 4 (Angptl4) is a protein involved in lipolysis, that is regulated by non-esterified free fatty acids (FFA). GH promotes lipolysis and increases circulating FFA. Hypothesis: GH increases circulating Angptl4 levels by modulating its expression and secretion from fat and muscle. Angptl4 might be of metabolic relevance for the insulin resistance associated with GH/IGF1 excess or deficiency.Objective: To evaluate Angptl4 in ...

Context: Adipose tissue distribution is closely related to metabolic disease risk. GH reduces visceral and total body adipose tissue mass, while inducing whole body insulin resistance.Objective: To assess the role of visceral adipose tissue and derived adipokines for the systemic insulin resistance and lipid metabolism, before and after treatment in acromegaly.Patients: Sixty-six adult patients with active acromegaly diagnosed betw...

Introduction: The effect of conventional somatostatin agonists (SA) on somatotroph pituitary adenomas is primarily mediated by somatostatin receptors (sstr) subtype 2. Sstr expression has been proposed as a prognostic marker for response to medical therapy. Earlier studies have shown lower sstr2a expression in SA treated adenomas, but selection bias could not be excluded.Objective: To assess the effect of SA on the immunohistochemical expression of sstr2...

ObjectiveIn order to improve therapeutic outcomes for patients with acromegaly, new treatment algorithms have been developed over the last decades. Valid epidemiological data of acromegaly in Norway is lacking. The overall aim of this study was to investigate incidence, prevalence and mortality of acromegaly in South-Eastern Norway, and to investigate effects of new treatment algorithms.Design and methodPatie...

Background: Surgery is accepted as first line treatment of somatotroph macroadenomas with involvement of the optic chiasm. However, during recent years somatostatin analogues (SA) have increasingly been used as primary treatment improving ultimate cure rate, as SA’s have anti-proliferative effects in most tumours. We demonstrate here positive effect of subacute/acute SA treatment on tumour shrinkage and chiasm decompression in two recently diagnosed acromegalic patients.<...