Endocrine Abstracts

Background: ACTH-independent Cushing syndrome (CS) accounts for 15–20% of endogenous CS. Approximately 10% of these patients have bilateral adrenal lesions where the differential diagnoses are primary bilateral adrenal macronodular hyperplasia (PBMAH), primary pigmented nodular adrenal disease (PPNAD), bilateral cortisol producing adenomas or a unilateral cortisol producing adenoma with a contralateral nonfunctioning adenoma. Also, the prevalence of subclinical CS is high...

ContextPrimary aldosteronism (PA) is the most common cause of secondary hypertension. Yet, the incidence of PA in the population has not been studied.ObjectiveTo estimate the incidence of PA in western Sweden.Design and methodsPatients who had received a diagnostic code for PA between 1987 and 2016 were identified in the Swedish National Patient Registry. Assessme...

Objectives: Clinical studies indicate that primary aldosteronism (PA) is associated with dysregulated bone homeostasis. The aim of this study was to evaluate the incidence of hip fractures in patients with PA.Methods: We studied a nationwide cohort of 2419 patients with PA (1997-2019) and 24 187 age and sex matched controls from the general population. Hip fractures were identified by ICD codes in the Swedish National Patient Register. We estimated hazar...

Introduction: Compared with healthy controls, women with Cushing’s syndrome (CS) in long-term remission have reduced functional brain responses during episodic and working memory testing and decreased overall levels of DNA methylation in blood cells. Here, we sought to test the hypothesis that functional brain responses in the prefrontal cortex and hippocampus are related to epigenetic changes in subjects with CS in long-term remission.Methods: In t...

Background: Patients with secondary adrenal insufficiency have an excess mortality. Data concerning the influence of the glucocorticoid replacement regime on mortality is sparse.Objective: To investigate if the total daily dose of glucocorticoid replacement has an effect on mortality in patients with non-functioning pituitary adenoma (NFPA).Method: Patients with NFPA treated for hypopituitarism in the western region of Sweden were ...

Background: The number of studies on the incidence of pituitary adenomas (PAs) is limited. The aim of this study was to evaluate the annual incidence of PAs in Västra Götaland, Sweden, with a targeted population of 1.6 million inhabitants.Patients and methods: Data from adult patients diagnosed with PA in 2001–2011, living in the Västra Götaland County, were collected from the Swedish Pituitary Registry (SPR). In addition, medica...

Objective: Our study evaluates the contribution of untreated GHD to the phenotype in controlled CD, by comparing patients with GHD due to CD (n=322) and those with non-functioning pituitary adenoma (NFPA n=748) before and after 3 years of GH treatment.Methods: The patient cohorts were obtained from KIMS (Pfizer International Metabolic Database) and matched for age and gender. Duration between pituitary disease onset and GH start was 9.7 (CD...

Context: Excess cortisol exposure and disruption of the circadian cortisol profile are both associated with adverse clinical outcome.Objective: The aim of this study was to identify unique metabolites and metabolic pathways associated with total cortisol exposure and the cortisol time profile.Design: A randomized, 12-week, two period, cross-over clinical trial.Patients and interventions: Eighteen adults with ...

Purpose: We aimed to validate the diagnosis and estimated national incidence of acromegaly reported in the Swedish National Patient Register (NPR), based on clinically reported International Classification of Diseases (ICD-codes), in comparison with the Swedish Pituitary Register (SPR).Methods: All patients in NPR or SPR between 1991-2018 with the ICD-9 or ICD-10 diagnosis of acromegaly and age >18 years at diagnosis were included. The diagnosis was ...

Introduction: Glucocorticoid replacement for adrenal insufficiency (AI) remains inadequate, resulting in high morbidity, premature mortality and quality-of-life (QoL) impairment. This study investigated the long-term safety of dual-release hydrocortisone (DR-HC) in patients with primary AI.Methods: AI patients who completed a randomized, 3-month crossover study of once-daily DR-HC versus thrice-daily conventional immediate-release hydrocortisone plus a 6...