Endocrine Abstracts

Dopamine agonists (DA), mainly cabergoline, are nowadays recommended as the treatment of choice for patients with prolactinomas of any size to lower PRL levels, decrease tumour size, and restore gonadal function. However, some patients do not adequately respond to DA, and resistance to DA may occur in 20-30% of patients treated with bromocriptine and nearly 10-20% of those receiving cabergoline. In these patients, multimodal therapy, including surgery and/or radiotherapy, may ...

Disorders of calcium metabolism arise in a familial or sporadic setting. The resulting hypo- or hypercalcemia can induce serious clinical features. Calcium sensing receptor (CaSR) plays a key role in maintaining this balance and its molecular investigation is useful to determine the nature of a certain condition or to choose the appropriate therapeutic approach.In the present study we reported two clinical cases. A 16-year-old patient had a mild hypercal...

Prolactin (PRL) exerts independent hypertrophic effects on prostate in in vivo and in vitro experimental models, and prostatic PRL receptors are known to activate cell proliferation pathways such as MAPK and STAT. Nevertheless, in men with hyperprolactinemia the risk of prostate cancer has been found reduced suggesting a role of concomitant hypogonadism. Chronic cabergoline treatment generally normalizes PRL treatment and improves gonadal function. The curren...

Hyperprolactinemia is associated with abnormalities in glucose and lipid profile with development of insulin resistance and metabolic syndrome (MetS), which have been found to be improved by treatment with cabergoline (CAB). The current study aimed at investigating hormonal and metabolic effects of long-term CAB withdrawal in patients with prolactinomas. In 46 patients (37 F, 9 M, aged 34.5±11.5 yrs, 36 microadenomas and 10 macroadenomas) anthropometric (weight, BMI, wais...

Conventional glucocorticoids (CGCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), resulting in increased metabolic morbidity and impaired quality of life (QoL). Non-physiological cortisol pattern and elevated evening cortisol levels may be responsible for the increased risk of metabolic disorders observed in AI patients under CGCs. Once daily dual-release-hydrocortisone (DR-HC), which better reproduces physiological daily cortisol profile, si...

Conventional glucocorticoids (GCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), with a significant impact on morbidity and mortality. Possible explanations are supra-physiological doses and impaired cortisol profile. In particular, elevated evening cortisol levels were related to glucose tolerance and insulin sensitivity alterations and visceral obesity. Once-daily-dual-release-hydrocortisone (OD-DR-HC), better reproducing the physiological ...

Aim: To evaluate the effects of short and long-term treatment with PEG on rhythm disturbances in a cohort of acromegalic patients resistant to long-term high-dose therapy with SA.Patients and methods: Thirteen patients (4 M, 9 F, aged 44±9.25 years) entered the study. All patients started PEG at initial dose of 10 mg daily, then increased of 5 mg every 6 weeks on the basis of IGF1 levels, until IGF1 normalisation or until the achievement of the maxi...

The aim of the present study was to evaluate cardiac valve insufficiency prevalence after 12-month combined treatment with somatostatin analogues (SA) and CAB in acromegalic patients partially responsive to high-dose and long-term SA monotherapy. Twenty-four patients entered the study. A standard echocardiography was performed in all patients at diagnosis, after high-dose and long-term SA therapy and 12 months after CAB addition to SA to evaluate ejection fraction (EF) and mit...

GH and IGF-I excess causes a specific cardiomyopathy, often complicated by diastolic and systolic dysfunction until heart failure. The aim of this study is to evaluate the effects of long-term treatment with pegvisomant on cardiac performance in acromegalic patients. Twelve patients (4 men and 8 women, age 29–58 years) entered the study. A radionuclide angiography at rest and during exercise was performed at baseline and after 18 months of treatment with pegvisomant with ...

The pseudo-Cushing states (PCS) include several clinical conditions such as obesity, polycystic ovary syndrome, depression and alcoholism, characterized by physical features and abnormalities of hypothalamus–pituitary–adrenal axis similar to Cushing’s syndrome (CS). The differential diagnosis between CS and PCS is often complicated and requires several hormonal tests. The aim of this study is to evaluate the diagnostic accuracy of the cortisol response to the or...