Endocrine Abstracts

The Standards of Care version 8 (SOC 8) for transgender and gender diverse people suggest maintaining estradiol (E2) levels between 100-200 pg/ml in Assigned Male at Birth (AMAB) subjects who desire a complete feminization during gender affirmation hormone therapy (GAHT). However, data about estrogen dose therapy and corresponding serum concentrations are scarce, especially regarding gel formulations. Our aim was to retrospectively compare E2 serum levels in AMAB patients unde...

Introduction: Aggressive ACTH-independent Cushing’s syndrome is rare and frequently related to malignant adrenocortical tumor. However, in exceptional situations, ectopic steroids secretion has been described.Case report: We report the case of an 87 years-old woman referred to our clinic in September 2020 after a low trauma sacral fracture. Her recent medical history revealed the onset, in the previous months, of severe hypokalemia, uncontrolled typ...

Introduction Primary bilateral macronodular adrenal hyperplasia (PBMAH) is potentially responsible for variable degree of cortisol excess. In patients with PBMAH the complete remission of cortisol hypersecretion can be achieved only by performing bilateral adrenalectomy, leading to a persistent hypocortisolism and to a consequent need of a lifelong glucocorticoid replacement therapy. Therefore, bilateral adrenalectomy is worth doing only in patients with severe hypercortisolis...

Introduction: Primary aldosteronism (PA) has been described in association with endocrine and non-endocrine neoplasms. Aldosterone-producing adenomas mainly associate with hyperparathyroidism, prolactinomas and pancreatic endocrine tumors, particularly in the context of multiple endocrine neoplasia type 1 MEN1 syndrome. Next-generation sequencing (NGS) studies have shown frequent somatic mutations underlying PA and, rarely, germline mutations of CYP11B1/CYP11B2</e...

Background: The Endocrine Society Guidelines recommend screening for hypercortisolism especially in patients with specific features that best discriminate Cushing’s Syndrome (CS): easy bruising, facial plethora, proximal myopathy and striae. Clinical experience suggests that these features, though suggestive of hypercortisolism, are not enough sensitive. Indeed, patients with hypercortisolism frequently manifest primarily less discriminatory cortisol-related features, suc...

Introduction: It is known that very-low-calorie-ketogenic-diet (VLCKD) has beneficial effects on body weight in overweight diabetic patients. Adopting this diet with artificial meals or natural foods in type 2 diabetes (T2DM) has been largely studied, and conflicting results have been reported regarding its effects on glycemic profiles, dyslipidemia, and liver function. In fact, the high level of fat content in natural foods could have a negative impact on hepatic steatosis, a...

Introduction: Feminizing hormone therapy (HT) for male-assigned at birth (AMAB) includes estrogens, often in combination with anti-androgens. Several studies have reported an increased incidence of cardiovascular diseases and venous thromboembolism in AMAB receiving estrogens. Indeed, procoagulant changes induced by estrogen-based HT occur in transwomen as well as in cisgender individuals. Therefore, using estrogen in gender-affirming HT is relatively contraindicated in those ...

Most adrenal incidentalomas are benign and can be divided into nonfunctioning adrenal tumors (NFAT) and tumors with mild autonomous cortisol secretion (MACS). Several studies suggest that MACS may result in an increased risk for mortality and cardiometabolic disease. The cardiometabolic risk in MACS is possibly related to the increased frequency of cardiovascular risk factors such as diabetes mellitus (DM) and hypertension (HT) induced by cortisol excess. This is confirmed by ...