Endocrine Abstracts

Objective: The current cut-offs to diagnose adrenal insufficiency (AI) have been established using outdated immunoassays. More modern methods have demonstrated less cross-reactivity with other steroids. The aim of our study was to evaluate the correlation between the cortisol assay Roche Cortisol I (R1), the newly available Roche Cortisol II (R2) and liquid chromatography tandem mass spectrometry (LC-MS/MS), the gold standard procedure for the measurement of steroids.<p cl...

IntroductionThe management of patients with adrenal incidentaloma (AI) and mild autonomous cortisol secretion (MACS) is debated. This randomized study aimed to evaluate the effects of adrenalectomy on arterial hypertension (AH), glucose and lipid metabolism.MethodsWe consecutively evaluated 626 AI patients (referred to 3 Italian Centers between 06/2016 and 02/2020). According to the inclusion criteria, we enr...

IntroductionIrisin is a molecule secreted from skeletal muscle and contributes to maintenance of metabolic homeostasis leading to increased energy expenditure and reducing the risk of obesity and diabetes. Literature data suggest that patients with Cushing disease have lower irisin values than controls and remission of hypercortisolism increases these values. Moreover, other plasma inflammation markers implicated in the pathogenesis of atherosclerosis, i...

Introduction: In patients with unilateral adrenal incidentaloma (AI) and mild autonomous cortisol secretion (MACS) the best therapeutic approach is still a matter of debate. The only available randomized study showed a short-term beneficial effect of surgery on diabetes and hypertension. Importantly, recent data demonstrated that MACS is associated to an increased risk of mortality, especially due to cardiovascular causes.Study aim: to evaluate, in the m...

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of Cushing’s syndrome (CS). Some familial forms have been associated to gene ARMC5 (Armadillo repeat-containing protein 5) inactivating mutations. This study aimed to evaluate the prevalence and the complications of ARMC5 mutations in our cohort of patients with bilateral adrenal incidentalomas (BAI).Methods: 72 patients, referred to our Center...

Adrenocortical carcinomas (ACCs) are rare endocrine tumors with poor prognosis. They overexpress the insulin-like growth factor 2 (IGF2), that drives a proliferative autocrine loop by binding to IGF1R and IR. The majority of studies focused on IGF1R as mediator of IGF2 biological effects, but recently a high expression of IR, in particular of the isoform A, was observed in most ACCs, suggesting a potential role of this receptor in modulating IGF2 effects in adrenocortical tumo...

Most adrenal incidentalomas are benign and can be divided into nonfunctioning adrenal tumors (NFAT) and tumors with mild autonomous cortisol secretion (MACS). Several studies suggest that MACS may result in an increased risk for mortality and cardiometabolic disease. The cardiometabolic risk in MACS is possibly related to the increased frequency of cardiovascular risk factors such as diabetes mellitus (DM) and hypertension (HT) induced by cortisol excess. This is confirmed by ...

Objective: The identification of hyperandrogenism represents the cornerstone for the assessment of polycystic ovary syndrome (PCOs). However, its definition has always been troubling, mostly because of the poor accuracy shown by routine androgens assays. As suggested by literature, the application of more precise steroid measurement methods (such as liquid chromatography tandem mass spectrometry, LC-MS/MS) could improve the diagnostic workup. The aim of our study is to evaluat...

The cAMP signaling pathway plays a major role in the pathogenesis of cortisol-producing adrenocortical adenomas (CPA). In adrenocortical cells cAMP induces dramatic changes in cell morphology accompanied by actin cytoskeleton rearrangements that precede steroidogenesis, the causal relationship between these events being still undefined. In this study we investigated cAMP effects on cytoskeleton rearrangements and steroidogenic response in mouse (Y1) and human adrenocortical tu...

Objective: The diagnosis of central hypoadrenalism (HPAI) is a major clinical challenge. The gold standard procedure remains insuline tolerance test (ITT). Liquid chromatography tandem mass spectrometry (LC-MS/MS) is considered the best procedure for the evaluation of cortisol levels. This study aimed to evaluate cut-offs of serum (TM-SeC) and salivary cortisol (SaC) by LC-MS/MS and serum cortisol by ECLIA assay (E-SeC) after Standard dose ACTH test (SDCT) in diagnosing HPAI.<...