Endocrine Abstracts

Background: Several evidences suggested that conventional glucocorticoids (CGCs) used as replacement treatment in adrenal insufficiency (AI) are inadequate to mimic physiological cortisol circadian rhythm (CCR), and that CCR disruption, represented by non-physiological pattern of peaks and troughs and elevated evening GC levels, might be responsible for the increased metabolic and, consequently, cardiovascular risk. It has been demonstrated that once daily dual-release-hydroco...

Background: Novel treatment options are required for patients with adrenocortical carcinomas (ACCs). mTOR-inhibitors are anti-neoplastic drugs that target the mTOR-pathway.Aim: To describe the expression of the mTOR-pathway in normal and pathological adrenocortical tissues.Methods: We evaluated mRNA expression levels of mTOR, S6K and 4EBP1 in 10 normal adrenals (NA), 11 adrenal hyperplasias (AH), 19 adrenal adenomas (ACA) and 26 AC...

Aim: To evaluate the effects of short and long-term treatment with PEG on rhythm disturbances in a cohort of acromegalic patients resistant to long-term high-dose therapy with SA.Patients and methods: Thirteen patients (4 M, 9 F, aged 44±9.25 years) entered the study. All patients started PEG at initial dose of 10 mg daily, then increased of 5 mg every 6 weeks on the basis of IGF1 levels, until IGF1 normalisation or until the achievement of the maxi...

The GH-receptor antagonist PEG, used as monotherapy or in combination to SA, has been demonstrated to normalize IGF1 levels in up to 90% of acromegalic patients after unsuccessful surgery and/or radiotherapy and resistant to conventional SA treatment. The aim of this study is to evaluate the efficacy and safety of combined treatment with SA plus PEG in a cohort of acromegalic patients resistant to conventional SA therapy. Thirty-two acromegalic patients (17 M, 15 F, age 39.6&#...

Obesity is a disease very prevalent and often associated with morbidities and cardiovascular risk factors. We explore the relationship between the presence of obesity with cardiovascular risk factors more frequent and the presence of cardiovascular disease (CVD) after (ischemic heart disease, cerebrovascular disease, peripheral artery).Material and methods: A sample of 1491 individuals of both sexes, over 14 years, elected by random sampling three of the...

The metabolic syndrome (MS) is a pathological entity that carries a high cardiovascular risk, and whose risk factors may occur at an early age. No data are available in our area on the influence of age on the prevalence of MS.Objectives: To determine the prevalence of MS in our area, by age group and compare the frequency of occurrence of MS in young adults (<40 years) (J) and mature adults (>40 years) (M).Methods: Observat...

Background: Adrenocortical carcinoma (ACC) is an uncommon malignancy with a still scantily understood pathogenesis and generally poor prognosis. Surgery, performed at early stages, offers the best chance for cure, but unfortunately, it is often noncurative. Medical treatment produced disappointing responses. mTOR inhibitors, such as sirolimus (S) and temsirolimus (T), are promising antineoplastic drugs in several types of carcinomas.Methods: To evaluate ...

The aim of the present study was to evaluate cardiac valve insufficiency prevalence after 12-month combined treatment with somatostatin analogues (SA) and CAB in acromegalic patients partially responsive to high-dose and long-term SA monotherapy. Twenty-four patients entered the study. A standard echocardiography was performed in all patients at diagnosis, after high-dose and long-term SA therapy and 12 months after CAB addition to SA to evaluate ejection fraction (EF) and mit...

GH and IGF-I excess causes a specific cardiomyopathy, often complicated by diastolic and systolic dysfunction until heart failure. The aim of this study is to evaluate the effects of long-term treatment with pegvisomant on cardiac performance in acromegalic patients. Twelve patients (4 men and 8 women, age 29–58 years) entered the study. A radionuclide angiography at rest and during exercise was performed at baseline and after 18 months of treatment with pegvisomant with ...

The pseudo-Cushing states (PCS) include several clinical conditions such as obesity, polycystic ovary syndrome, depression and alcoholism, characterized by physical features and abnormalities of hypothalamus–pituitary–adrenal axis similar to Cushing’s syndrome (CS). The differential diagnosis between CS and PCS is often complicated and requires several hormonal tests. The aim of this study is to evaluate the diagnostic accuracy of the cortisol response to the or...