Endocrine Abstracts

Obesity and its consequent metabolic disorders are severe health problems. The mechanistic target of rapamycin complex 1 (mTORC1) pathway is an important hypothalamic integrator of the actions of nutrients and hormones on food intake (FI). Nutrient availability also affects the formation of reactive oxygen species (ROS) in the hypothalamus and regulates neuronal activity. In the present study, we hypothesise that modulation of mTORC1 activity mediates ROS effects on FI. To thi...

Background: Early diagnosis of Cushing’s syndrome and initiation of effective treatment are essential to limit long-term morbidity and early mortality. However, diagnosis is often delayed due to the non-specificity of symptoms, or because symptoms are not recognised by physicians, leading to more complex treatment needs and a worsening of patient quality of life. A survey was conducted to better understand the patient experience of Cushing’s syndrome and the true b...

Background: According to the Endocrine Society’s guidelines, the screening and diagnosis of Cushing’s syndrome (CS) are based on the results of the overnight dexamethasone suppression test (DST), midnight salivary cortisol and 24-hour urinary free cortisol (UFC) measurements. These 3 tests reflect cortisol levels at the time of sampling without providing retrospective information. Hair cortisol concentration is a non-invasive way to measure cortisol exposure over lon...

The performance of late-night salivary cortisol (LNSC) and optimal number of samples to accurately diagnose post-operative recurrence of Cushing’s disease (CD) at an early-stage are unknown. We performed a retrospective analysis in a single tertiary-care center to compare the accuracy of multiple salivary sampling strategies to diagnose early-stage recurrences of CD. 36 patients in remission of CD after surgery were followed up for 69.2±10.6 mo with multiple successi...

Cortisol ([C]) biological activity depends on its free fraction diffusion into the intracellular compartment. The diagnosis of adrenal insufficiency requires investigations such as the synacthen test and studies in intensive care units suggest that free plasma [C] could provide a better indicator of efficient [C] than total plasma [C]. We undertook this study to compare various determinations of free [C] levels with regard to adrenal status evaluated on total plasma [C] after ...

Evidence has accumulated about the involvement of the CRF system in the regulation of energy balance. The effects of CRF are mediated by two receptors: CRFR1 and CRFR2. The role of the CRFR1 in the regulation of energy balance is not well defined. To address this issue, adult male CRFR1 KO mice and WT littermates were given low fat (LFD) or high-fat (HFD) diets for 4 months. Under LFD no differences between genotypes were seen on body weight (BW) and caloric intake. KO mice ha...

Introduction: Combination therapy using pegvisomant and cabergoline with first-generation long-acting somatostatin analogs (1GSSA) is a common procedure in acromegalic patients that are not fully controlled by surgery and 1GSSA. Pasireotide-LAR is a new multireceptor-targeted somatostatin receptor ligand that has superior efficacy over octreotide LAR to control GH and IGF1 levels. Little data is available about the efficacy and safety of pasireotide monotherapy in patients tre...

Introduction: Osilodrostat decreases cortisol production by inhibiting 11β-hydroxylase, increasing adrenal hormones above the blockade. Here, we describe these effects of osilodrostat and associated adverse events (AEs). The efficacy and safety of osilodrostat in patients with Cushing’s disease (CD) were confirmed in the published Phase III, prospective LINC 3 study (NCT02180217).Methods: 137 patients with CD (mUFC >1.5x upper limit of norm...

The characteristics of adrenal involvement in Multiple Endocrine Neoplasia type 1 (MEN1) have been defined from studies involving a limited number of patients. We have assessed retrospectively the prevalence, characteristics and evolution of adrenal involvement from the French group for the study of endocrine tumours (GTE) registry, involving 688 patients with MEN1. In our series, adrenal tumours identified at abdominal imaging occurred in 130 patients (18.9%). The mean age of...

Context: Mosaicism is a feature of several inherited tumor syndromes but is rarely systematically looked for in routine. MEN1 is an autosomal dominant hereditary syndrome characterized by several endocrine tumors affecting parathyroids, pancreas, and anterior pituitary most of the time, due to inactivating mutations in the MEN1 gene. Few cases of mosaicism in Multiple Endocrine Neoplasia type 1 (MEN1) have been described. MEN1 mosaicism is probably under-diag...