Endocrine Abstracts

Patients with craniopharyngioma suffer from excess mortality and morbidity, especially patients with childhood onset of the disease. The impaired outcome in these patients is in part related to hypothalamic obesity, which is mainly caused by hypothalamic damage. The hypothalamic damage seems to result in autonomic nervous system dysfunction as well as leptin and insulin resistance. These factors negatively affect food intake, food satisfaction, metabolism and energy expenditur...

Background: Diabetes insipidus (DI) is characterized by polyuria and consequently thirst and polydipsia. Excessive water intake can also cause polyuria, i.e. primary polydipsia. It is of utmost importance to differentiate between the two disorders since the treatment is different.Aims: To study the clinical value of the standard 8-hour as well as an extended water deprivation test in patients with polyuria and polydipsia.P...

Background: Clinical features of acromegaly develop insidiously and the diagnosis is often delayed. However, diagnostic delay (DD) in acromegaly has not been systematically investigated. Our primary aim was to investigate DD in a nationwide cohort of patients with acromegaly. Secondary aim was to study the impact of DD on morbidity and mortality.Methods: Adult patients diagnosed with acromegaly between 2001 and 2013 were identified in the Swedish Nationa...

Objective: Patients who receive ≥5 mg prednisolone per day, for more than 2–3 weeks, are at risk of developing glucocorticoid (GC) induced adrenal insufficiency (tertiary adrenal insufficiency, 3° AI). The aim of this study was to a) determine the prevalence of GC use in doses that are associated with development of 3° AI, b) assess prescription pattern of short and long-term GC treatment in adults and children, and c) investigate the indication for the GC...

Patients with hypopituitarism and untreated growth hormone (GH) deficiency have excess mortality. GH replacement therapy (GHRT) has many beneficial effects, but its impact on mortality has not been proven and there are still safety concerns regarding the potential cancer risk. We have therefore studied the mortality in non-functioning pituitary adenoma (NFPA) patients with and without GHRT. Only patients with NFPA were studied in order to eliminate the influence of the aetiolo...

Background: Carpal tunnel syndrome (CTS) is common in patients with acromegaly, with a reported prevalence of 19–64%. We have studied CTS in a large national cohort of patients with acromegaly, and the temporal relationship between the diagnosis of the two diseases.Methods: Retrospective nationwide cohort study including patients diagnosed with acromegaly in Sweden between 2005 and 2017. Patients with acromegaly were identified in the Swedish Natio...

Growth hormone (GH) and insulin like growth factor 1 (IGF-I) modulate and stimulate angiogenesis and endothelial function. Excess of GH, as in acromegaly, is associated with cardiovascular morbidity and mortality, which is reversible after normalization of IGF-I and GH. Diabetes mellitus (DM) is a common comorbidity in acromegaly, but the prevalence of diabetes retinopathy in patients with acromegaly is unknown. Also, the roles of GH and IGF-I in diabetes retinopathy are not f...

ContextPrimary aldosteronism (PA) is the most common cause of secondary hypertension. Yet, the incidence of PA in the population has not been studied.ObjectiveTo estimate the incidence of PA in western Sweden.Design and methodsPatients who had received a diagnostic code for PA between 1987 and 2016 were identified in the Swedish National Patient Registry. Assessme...

Background: Diabetes is an important risk factor for cardiovascular morbidity and mortality but its impact on outcome in acromegaly is unknown.Methods: This was a nationwide, observational, matched-cohort study. Adult patients with acromegaly due to a pituitary adenoma were identified in the Swedish National Patient Registry between 1987 and 2020 and those with coexistent type 2 diabetes in the National Diabetes Registry and Drug Registry. Overall mortal...

Background: Patients with secondary adrenal insufficiency have an excess mortality. Data concerning the influence of the glucocorticoid replacement regime on mortality is sparse.Objective: To investigate if the total daily dose of glucocorticoid replacement has an effect on mortality in patients with non-functioning pituitary adenoma (NFPA).Method: Patients with NFPA treated for hypopituitarism in the western region of Sweden were ...