Endocrine Abstracts

Macronodular adrenal hyperplasia refers to adrenal enlargement by large nodules that may be related to ACTH-dependent or ACTH-independent pathologies. The term Primary Macronodular Adrenal Hyperplasia (PMAH) was recently introduced to replace the term ACTH-independent macronodular adrenal hyperplasia, since in some cases paracrine ACTH production may contribute to cortisol secretion, and also to encompass cases of unilateral macronodular hyperplasia. PMAH is a heterogeneous di...

Corticosteroid-binding globulin (CBG) transports glucocorticoids in blood and is a serine protease inhibitor family member. Plasma CBG has a reactive center loop (RCL) structure that when cleaved by specific proteases, including neutrophil elastase, results in a loss of high affinity steroid-binding activity. Measurements of CBG levels are typically based on functional assays of its steroid-binding capacity or immunoassays, including enzyme-linked immunosorbant assays (ELISAs)...

Although the prevalence of subclinical hypercortisolism (SH) in unilateral incidentalomas (UI) has been extensively reported, patients with bilateral incidentalomas (BI) have not been thoroughly investigated. Moreover, the management of BI poses great dilemmas if surgery is considered, since bilateral adrenalectomy leads to life-long replacement. In the present study, we aimed to describe the characteristics of patients with BI in comparison to their unilateral counterparts. W...

Introduction: Congenital adrenal hyperplasia (CAH) encompasses a group of enzymatic defects in cortisol biosynthesis resulting in adrenal hyperplasia through chronic compensatory ACTH stimulation. Aldosterone synthase deficiency, however, is associated with normal cortisol secretion and there are no reports on whether it may be associated with adrenocortical hyperplasia.Case Presentation: A 37-year-old, Greek female was referred for further investigation...

Introduction: Several markers based on anthropometric and biochemical parameters like fatty liver index (FLI), lipid accumulation product (LAP) index and visceral adiposity index (VAI), have been proposed for the detection of nonalcoholic fatty liver disease (NAFLD).Objective: To evaluate the diagnostic performance of FLI, LAP and VAI as markers of NAFLD in premenopausal women with and without polycystic ovary syndrome (PCOS), assessed for hepatic steato...

Introduction: Visceral adiposity index (VAI), initially developed as an indicator of visceral adipose function for the assessment of cardiometabolic risk, has been also proposed for the detection of nonalcoholic fatty liver disease (NAFLD). However, the diagnostic performance of VAI as a marker of hepatic steatosis (HS) is still under investigation.Objective: To evaluate the accuracy of VAI as a marker of HS in a cohort of overweight and obese premenopau...

Introduction: The interplay of cortisol (F) and adipose tissue is complex and in many aspects is still obscure. Plasma F has been shown to be positively associated with lipolysis.Aim: To study in adipose tissue indices of lipolysis vs tissue F with microdialysis (MD).Subjects and methods: We studied 46 mechanically ventilated patients with a diagnosis of septic/non-septic shock, systemic inflammatory response syndrome or s...

Several alterations of the metabolic processes develop during sepsis. Adiponectin and resistin are amongst the main adipokines that may contribute to the metabolic adaptations observed in the context of critical illness. However, there is scarce data on the circulating pattern of these adipokines in human sepsis. Therefore we aimed to describe the variation in circulating levels of resistin and adiponectin during the course of sepsis and examine whether they are related to the...

The role of endogenous glucocorticoid (GC) production and metabolism in the pathogenesis of obesity, insulin resistance and type 2 diabetes remains unclear. Patients with Cushing’s syndrome develop central obesity, insulin resistance and in some cases type 2 diabetes (T2DM), yet circulating cortisol levels are not elevated in simple obesity. Alterations in GC metabolism, including 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that generates active cortisol ...

The diagnosis of Cushing’s syndrome (CS) remains a major clinical challenge especially in a proportion of patients that have discordant results in the available tests. Although the measurement of 24-h urine free cortisol (UFC) is a useful test for the diagnosis of CS, 10–15% of patients have at least one measurement within the normal range and multiple measurements may be required in order to raise its sensitivity. In this study we sought to evaluate the value of the...