Endocrine Abstracts

Objectives: (1) to establish the relative level of osteoporotic fracture in the thyroid population compared to the general population, and (2) to establish whether osteoporotic fracture in patients receiving thyroxine was associated with plasma thyroid stimulating hormone (TSH) level or thyroxine dose.Method: A database of clinical information from subjects with treated thyroid disease was linked to morbidity records describing all in-patient episodes of...

Introduction: Thyroid nodules are discovered by ultrasound (US) in a large percentage of population. In most cases they are benign and asymptomatic. When to perform or not a fine-needle-aspiration (FNA) is still matter of debate. Aim of this study was to evaluate the usefulness of a easy-to-use US classification, based on three US classes.Methods: We prospectively evaluated US features of 1118 thyroid nodules, allocating each nodule in one of three class...

Clinically silent adrenal masses discovered by abdominal imaging procedures performed for non-adrenal disorders, i.e. adrenal incidentalomas, have become a common finding in clinical practice and they represent a clinical concern because of the risk not only of malignancy but also of subclinical hormonal hypersecretion (SCS) that represents a new risk factor for cardiovascular diseases and/or osteoporosis. We studied 73 patients (39F, 34M; mean±S.E.M.: 61.6...

HPA response to glucocorticoids (GCs) feedback is usually tested by dexamethasone (DEX), a synthetic GC; it poorly crosses BBB and preferentially activates pituitaric glucocorticoid receptor (GR), with a binding potency to GR 7 fold higher and an anti-inflammatory potency about 35 fold higher than cortisol. Cortisol, which easily penetrates into CNS, could better evaluate the GC feedback by acting also at supra-pituitary level. We studied the effects of 150 min infusion of hyd...

Hyper- and hypo-thyroidism are considered as clinical conditions of sleep alterations. At present, however, these clinical reports have never been confirmed by studies providing a structured description of subjective and objective sleep quantity and quality. To this aim, we enrolled 15 patients with naïve overt hyperthyroidism (HYPER), 9 with naïve overt primary hypothyroidism (HYPO) and 15 healthy age-, sex- and BMI-matched control subjects (CS). Clinical conditions...

Central serotoninergic activity (CSA) is known to influence the hypothalamus–pituitary–adrenal (HPA) axis, and a CSA loss seems to play a role in human brain aging and in etiology of functional hypercortisolism and depression, whose incidence increase with advancing age. Citalopram (CT), a SSRI, has been considered a good tool to evaluate CSA in humans. Aim of this study was to evaluate the neuroendocrine response to CT in healthy adult subjects during lifespan. We e...

In primary adrenal insufficiency hydrocortisone or cortisone are commonly used at doses of 30–37.5 mg/day as replacement therapy, though recent studies showed that cortisol normal production is about 5.7 mg/m2, equivalent to 20 mg/day of hydrocortisone, suggesting that supraphysiological doses are used. In 19 Addison’s disease patients (8 M, 11 F, 23–71 yr) under conventional glucocorticoid replacement therapy (37.5 mg cortisone/day) with low DHEAS le...

Acylated ghrelin (AG) participates in the modulation of the hypothalamic-pituitary-gonadal axis functions, with a predominantly inhibitory effect upon the reproductive system in animals. Animal studies have shown that ghrelin suppresses LH secretion in vivo, decreases LH responsiveness to GnRH in vitro and partially delays the timing of puberty in males. Aim of this study was to evaluate the effects of AG infusion on spontaneous and stimulated gonadotropin secret...

Insulin tolerance test (ITT) is considered the golden standard test to evaluate HPA axis in suspected hypopituitarism. Low dose (1 μg) ACTH1–24 short stimulation test (LDSST) and metyrapone are often used when ITT is contraindicated. The diagnostic reliability of LDSST is, however, controversial, as even this dose has been considered supramaximal, while very low ACTH doses have been suggested more reliable to assess the adrenal sensitivity. Thus, in...

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 ...