Endocrine Abstracts

Background: Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is characterized by impaired cortisol synthesis, requiring life-long glucocorticoid (GC) replacement therapy. Given the detrimental systemic effects of GCs in the long term, the aim of our study was to assess whether CAH patients have increased metabolic and cardiovascular alterations compared with age-matched controls.Materials and methods: For this cross-sectional...

Introduction: Transsphenoidal surgery (TSS) is the first-choice treatment in Cushing’s disease (CD). When performed by experienced neurosurgeon, post-operative remission can be achieved in 70–80% of cases; however, recurrences during follow-up are quite frequent, involving around 20–30% of patients initially in remission. Early detection of relapses is crucial to avoid cortisol-related comorbidities. The aim of the study was to find reliable predictors of rec...

Osteoprotegerin (OPG) has been identified as a decoy receptor that inhibits osteoclast differentiation and recently as a paracrine regulator of vascular calcification. OPG is suppressed by glucocorticoid administration. In this study, we evaluated OPG and bone metabolism in Cushing’s syndrome (CS) before and after surgical treatment. Twenty-nine patients with CS (26 women and 3 men, mean age: 40.7–2.8 years) and 27 age and sex-matched controls have been studied for b...

Glucose-dependent insulinotropic polypeptide (GIP) receptor is a member of the G protein-coupled receptors family. According to its incretin properties, GIPR is expressed in tissues such as pancreas, stomach and adipose tissue. However GIPR expression pattern appears to be broader, as it was detected in other tissues such as heart, lung and the central nervous system, thus suggesting either novel ligands for GIPR or novel actions for GIP. Moreover, in some patients with food-d...

Cushing’s syndrome (CS) is associated with hypercoagulable state, mainly dependent on corticosteroid-induced increase of von Willebrand factor (VWF) levels, even though this does not affects all patients. In normals plasma VWF levels are genetically determined by ABO blood groups and polymorphisms G/C −1793, C/T −1234, A/G −1185, G/A −1050 of VWF promoter. These SNPs segregate as haplotype 1 (G/C/A/G) and haplotype 2 (C/T/G/A) with genotype 1/1 (GG...

Adrenocortical carcinoma (AC) is a rare neoplasm with poor prognosis. Medical treatment of AC is actually based on the use of op’DDD (mitotane) with or without traditional chemotherapeutic agents. Only very few information are available about the effectiveness of somatostatin analogs in AC. In human adrenal gland the expression of all five somatostatin receptor (SSTR) subtypes was previously demonstrated. A differential expression was shown in adrenal adenomas and carcino...

Background: ACTH-secreting pituitary adenomas represent two-thirds of Cushing’s syndrome (CS), the so-called Cushing’s disease (CD). These tumors are sometimes >10 mm in maximal diameter (macro-CD), but the majority of them are <10 mm (micro-CD). The aim of this study was to compare baseline characteristics of patients with micro-CD and macro-CD.Materials and methods: Clinical, hormonal and radiological data of 226 patients with CD were...

Introduction: Adrenal crisis (AC) is the most severe manifestation of adrenal insufficiency, still responsible for a high mortality of affected patients, especially with primary adrenal insufficiency (PAI). Its presentation is insidious, leading to a delayed diagnosis and treatment. Patient education is crucial in the prevention and self-management of AC.Aim of the study: We want to evaluate the incidence, features (symptoms, signs, laboratory findings),...

Background: The recommended first-line screening tests for Cushing’s syndrome (CS) are serum cortisol after 1-mg dexamethasone suppression test (FDST), urinary free cortisol (UFC), and late-night salivary cortisol (LNSC). CS is often diagnosed late: the clinical presentation of endogenous hypercortisolism overlaps with common clinical conditions.Methods: We analyzed the diagnostic test accuracy of FDST, UFC, and LNSC in patient...

In the diagnosis of Cushing’s disease (CD) desmopressin (dDAVP) stimulation test may be a convenient and more readily available alternative to CRH test; however the sensibility and specificity of ACTH response to dDAVP test has been reported in adult patients inferior to CRH test. In childhood patients with CD there are no data for the use of dDAVP test in this clinical setting. We studied 9 patients ranging in age from 11 to 19 years (7 females and 2 males) with a suspec...