Endocrine Abstracts

Background: Hypopituitarism can occur post trans-sphenoidal adenomectomy(TSA). Accurate prediction of HPA axis recovery would inform hydrocortisone replacement strategies but there are limited studies on this. In our centre, HPA axis is assessed with pre-operative short synacthen test (SST), day-8 post TSA 9am cortisol and 6-week post-TSA SST. Patients are commenced on hydrocortisone post TSA until 6 weeks review.Methods: We performed a single-centre, lo...

Adrenal insufficiency (AI) requires life-long glucocorticoid (GC) treatment, which is associated with an increased risk of metabolic syndrome (MS), probably due to cortisol overexposure for multiple drug daily doses, together with an impairment of quality of life (QoL). Moreover treatment compliance (TC) is reported to be suboptimal in AI patients. The current study aimed at investigating the impact of the switch from twice/thrice daily conventional GCs to once daily dual-rele...

Background: Cyclical Cushing’s syndrome has been considered to be a rare clinical entity, characterised by periodic increases in cortisol levels followed by regression of the Cushing’s syndrome. The cycles of hypercortisolism may occur before the establishment of the diagnosis, rendering actual diagnosis difficult, or may occur after inadequate or ineffective treatment and affect disease management. The aim of this study was to investigate the prevalence of cyclicity...

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...

Background: Little is known about possible predictors for hormonal function following pituitary surgery. Tumor consistency has recently emerged as a key factor in surgical planning for pituitary adenomas, influencing both the surgical outcome and the onset of postoperative complications. However, its impact on postoperative endocrine function has yet to be explored.Objectives: To evaluate the impact of tumor consistency on the development of postoperativ...

Background: Experimental studies on Klinefelter syndrome (KS) reported increased intratesticular testosterone (T) levels coexisting with reduced circulating levels. Abnormalities in testicular microcirculation have been claimed; however, no studies investigated in vivo testicular blood flow dynamics in humans with KS.Objective: To analyze the testicular microcirculation in KS by contrast-enhanced ultrasonography (CEUS) and correlate vascular par...