Endocrine Abstracts

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among premenopausal women affecting up to 20% of the population. Even though androgen excess is the main diagnostic criterion for PCOS, the evaluation of hyperandrogenemia relies on methods with low accuracy and mainly able to measure total androgen amounts. Liquid chromatography-tandem mass spectrometry (LC–MS/MS) allows high accuracy steroids measurement and if applied to saliva, it also allows the measurem...

Clinical vignetteA 65-year-old woman was hospitalized due to severe hypercalcemia (albumin-corrected calcium 16.9 mg/dl) associated with severe renal failure (creatinine 3.48 mg/ml), normal phosphate levels (3.9 mg/dl) and PTH < 5 pg/ml. Her past medical history included total thyroidectomy complicated by chronic hypoparathyroidism, for which she was followed by her primary care physician. One year before hospital admission, renal function was normal...

Background: Many questions concerning Turner Syndrome (TS) remain unresolved, such as the long-term complications and, therefore, the optimal care setting for adults. Most controversials regard tumors. Very few data are available on thyroid carcinoma and no specific screening protocol of monitoring is advised in the current official guidelines. This long-term cohort study was primarily aimed at estimating the incidence and time to comorbid conditions along the life course, inc...

Background: The dexamethasone suppression test (DST) is among essential tests for hypercortisolism diagnosis. Due to high sensitivity and specificity, liquid chromatography-tandem mass spectrometry (LC-MS/MS) is replacing obsolete immunoassays (IA) for steroid measurement. However, exhaustive data about IA and LC-MS/MS concordance in the frame of DST are still not available.Aim: To compare cortisol measurements by two routine IAs and LC-MS/MS in basal (F...

Context: Although Trabecular Bone Score (TBS) has been widely and independently associated with fragility fractures, its diagnostic power in certain populations remains to be established. Women initiating aromatase inhibitors for breast cancer should be screened for bone health to prevent cancer treatment-induced bone loss as much as possible. TBS is regarded as an adjunctive tool to evaluate these patients, but thresholds of pharmacologic interventions are still a gray zone, ...

Introduction: Diabetes mellitus (DM) develops early in Turner syndrome (TS) and appears not related to common risk factors. The precise mechanism of its development is still a matter of debate: a defective insulin response seems to be involved, but the role of incretins is still undefined.Objective: To evaluate the implication of incretin release in the early stages of DM development in TS. Materials and Methods: 153 Turner patient...

Background: Steroid profiling by LC-MS/MS is increasingly used in endocrine research, and is being introduced in the clinical practice. Due to the large disagreement with previous immunoassays, and to the enlarged panel of measurable steroids, novel and robust reference intervals (RIs) need to be established. Steroid circulating levels are known to be influenced by several physio-pathological factors, such as age, gender, stress and metabolic status. Therefore, generating unbi...

Endocrine clinical practice strongly relies on normative data for the assessment of hormonal imbalance. However, the generation of robust steroids reference intervals (RIs) remains a challenge. As the steroids circulating levels are influenced by many procedural aspects related to blood collection (time, fasting state) and physio-pathological factors, such as age, sex, stress and metabolic status, the need for partitioning RIs is mandatory. Furthermore, unbiased healthy, drug-...

Introduction: Adjuvant therapy with aromatase-inhibitors (AIs) increases bone loss and fracture risk. Concomitant antiresorptive treatment is currently recommended. The aim of this study was to evaluate the effects of AIs on bone metabolism and mineral density at 12 and 24 months.Methods: Among 400 women on AIs who attended our Endocrinology Unit from 2014 to 2016, we retrospectively evaluated those who initially refused antiresorptive and took cholecalc...

Context: ß-CTX are considered useful markers of response to denosumab and other anti-resorbtive treatments for osteoporosis. We report an unusual case of a completely absent effect of both denosumab and bisphosphonates on bone resorption markers.Case description: In 2017 a 74-year-old woman sought medical attention at the Endocrinology Unit of Policlinico di Sant’Orsola for the evaluation of an adrenal adenoma associated with osteoporosis. Meno...