Endocrine Abstracts

GH deficiency (GHD) in adults leads to impairment in body composition and function, as well as to deranged lipoprotein and carbohydrate metabolism implying increased cardiovascular morbidity. The morphologic and metabolic alterations in GHD syndrome are more marked in patients with the most severe GHD, even when evaluated by maximal provocative test such as GHRH + arginine. IGF1 synthesis and secretion are function of the GH status but also of major metabolic factors such as i...

ITT is the test of reference for the diagnosis of adult GH deficiency (GHD), but it is recognized that also GHRH in combination with arginine (ARG) or GH secretagogues (GHS) are equally reliable tests. It has also been suggested that testing with GHS would represent a potent stimulus exploring also the integrity of hypothalamic pathways controlling somatotropic function. We therefore aimed to clarify the diagnostic reliability of testing with ghrelin, the natural GHS. We studi...

In acromegalic patients not suitable for first-line surgical treatment, pharmacotherapy is a valuable choice. Depot somatostatin analogs (SSA) represent efficacious and well-tolerated drugs; however, they normalize hormonal parameters in no more than 65–75%. Pegvisomant (PEGA), a GH receptor antagonist, has been shown to normalize IGF-I levels in more than 90% of patients. We report our experience in 13 acromegalic patients (7 M, 6 F; age: 50.2±3.9 yrs; 7 macroadenom...

Introduction: To date, there are no clear biochemical parameters to identify early COVID-19 cases at risk of complications in the Intensive Care Unit (ICU). Aim: To evaluate the prognostic potential of endocrine biomarkers associated with acute inflammatory conditions in ICU patients for COVID-19.Methods: Between 1/3/2020 and 31/12/2020 we recruited 126 consecutive patients at the admission to ICU 1U, Molinette University Hospital ...

Background: Despite the benign nature of pituitary adenomas, microscopic examination of surgical specimens showed that dural invasion occurs in about 42-85% of cases. No studies about dura mater invasion were conducted specifically in acromegaly, so the aim of the present study was to evaluate the relationship between histologically verified dural invasion and the “aggressiveness” features of GH-secreting adenomas.Methods: A prospective study i...

Acromegaly is due to increased GH secretion usually sustained by a GH-secreting pituitary adenoma. Somatostatin analogues (SSA) can control GH hypersecretion in 60% of patients and tumor volume in 30%. The disease control is, in turn, associated with lower mortality and therefore to verify the optimal control of the disease activity is of critical importance to adapt the dose and the choice of alternative treatment. The criteria for optimized disease control had been assumed a...

Introduction: Somatostatin analogues (SSA) are one of the main effective drug used in acromegaly. Sludge and/or cholelithiasis development represents oneof the more common side effect. The aim of the study was to analyze the frequency of biliary adverse events (BAE) and possible predictive factors, to propose a work-up strategy for their management.Method: This is a single centre, longitudinalretrospective study; we enrolled 91 acromegaly patients during...

Background: When evaluating a patient for central adrenal insufficiency (CAI), there is a wide range of morning cortisol values for which no final conclusion on hypothalamus-pituitary-adrenal (HPA) axis function can be drawn; in these cases, a stimulation test is required. Aim of this study was to develop an integrated model for the prediction of CAI when morning cortisol is in the grey zone, here defined as 40.0-160.0 μg/l.Methods: Overall, 119 pat...

Purpose: The aim of this study was to identify any predictive factors for need of high doses of cabergoline (CAB) in prolactinomas and to study any relationship between adverse events onset and CAB cumulative dose.Methods: Forty-two patients harboring resistant prolactinomas (High Dose group-HD; cabergoline dose ≥ 3.5 mg/week) were matched by gender, age and pituitary tumor diameter at diagnosis with subjects under standard doses (Standard Dose gro...

Introduction: First-generation SRL (fg-SRL) represent the treatment of choice in acromegaly patients with post-neurosurgical adenomatous remnant and GH-hypersecretion. Anyway, approximately 60% of patients do not achieve adequate disease control. The main predictors of resistance include male sex, young age, invasiveness of the lesion and its hyperintensity on T2-weighted MRI scans; but also, SSTR2 expression, the cytokeratin pattern, Ki-67 and the presence of AIP gene mutatio...