Endocrine Abstracts

Background: Patients with Cushing’s syndrome (CS) typically show an alteration in the intrinsic coagulation pathway, leading to an increased risk of venous thromboembolism. Cortisol autonomy has been variably associated with higher risk of cardiovascular events and mortality compared to patients with non-functioning adrenal adenomas (NFA), particularly in women younger than 65 years. However, dedicated studies describing coagulation status in patients with adrenal inciden...

Introduction: The new Italian cytological classification of thyroid nodules published in 2014 has replaced the TIR3 ‘indeterminate’ category into two subcategory with different risk of thyroid cancer (TC): TIR3A, low-risk indeterminate lesion and TIR3B, high-risk indeterminate lesion. The aim of our study was to describe the incidence of TIR3B in a large prospective cohort of patients, the risk of TC, and its correlation with anamnestic, ultrasonographic (US) and cyt...

Introduction: Cushing’s Syndrome (CS) is associated with an increased frequency and severity of infections. Mild hypercortisolism (MI) from adrenal incidentalomas has been associated with various complications, but data on infections are scarce. Retrospective data on patients with adrenal insufficiency (AI) showed an increased mortality attributed to infections. The approach used was very heterogeneous for all these studies. The aim of the study is to prospectively evalua...

Background: Possible Autonomous Cortisol Secretion (pACS) is a condition found in 1–29% of patients with adrenal incidentalomas. The diagnosis of pACS has been variably associated with an increased risk of cardiovascular events and mortality. However, dedicated studies describing the morphologic and functional cardiac alterations in these patients are lacking.Aim: To compare the cardiovascular features of patients with pACS to those with nonfunction...

One third of diabetic patients suffer from Diabetic Nephropathy (DN) that leads to end-stage renal disease (ESRD). The molecular pathways involved remain underexplored. We showed that chronic phosphodiesterase-5 inhibition (PDE5i) improve vascular inflammation [1] and tissue remodelling, reducing proteinuria [2] in murine diabetes. Our aim was to investigate the effect of PDE5i on animal and human models of DN.Materials and methods: 16 mice were randomly...

Introduction: Glucose metabolism impairment is a common complication of acromegaly. Pegvisomant (PEG) is used as second-line medical treatment in acromegaly. Data from literature suggest a positive effect of PEG on glucose metabolism but a meta-analysis has never been performed.Aim: To address the following questions: i) does PEG affect glucose metabolism? ii) does the effect correlate with disease control?Methods: We performed a m...

The 250 mg short synacthen test (SST) is the most commonly used tool to assess the integrity of hypothalamic-pituitary-adrenal (HPA) axis. There are many instances when compromise to HPA-axis function is potentially reversible (including the use of suppressive dose of prescribed glucocorticoids), but currently there are no data to guide clinicians as to the frequency of repeat testing or to the likelihood of HPA-axis recovery. We performed an observational, retrospective, anal...

Introduction: Although possible autonomous cortisol secretion (pACS) is the commonest endocrine dysfunction detected in patients with adrenal incidentalomas, the diagnosis of this condition is still challenging. Dehydroepiandrosterone sulfate (DHEAS) is an adrenal androgen secreted by adrenal glands under the regulation of ACTH. DHEAS does not follow a circadian rhythm and has a long half-life in serum. Because of these features, low blood concentration of DHEAS has been recen...

Introduction: Low-grade incomplete post-dexamethasone cortisol suppression in patients with adrenal incidentalomas, recently redefined as possible autonomous cortisol secretion (pACS), has been associated with increased cardiovascular events and mortality. However, prospective studies documenting cardiac abnormalities in these patients are lacking.Methods: In the context of ERGO trial NIH (NCT02611258), between July 2016 and September 2017, 71 consecutiv...

Introduction: Even if obesity has been associated to several hormonal imbalances, pituitary appearance at Magnetic Resonance Imaging (MRI) in obese patients is understudied.Aim: To measure pituitary signal intensity and homogeneity at MRI in obese subjects free of focal pituitary disease, in the context of the CHIasM study (Changes in the Hypotalamic-pItuitary region of patients with Metabolic syndrome and obesity).Materials and me...