Endocrine Abstracts

Introduction: Subclinical hypercortisolism (SH), affecting about 30% of patients with unilateral adrenal incidentaloma (UAI), has been associated to hypertension (HT), type 2 diabetes mellitus (T2DM), dyslipidemia (DL), osteoporosis and vertebral fractures (FX). The prevalence of SH in patients with bilateral adrenal incidentaloma (BAI) seems to be even higher. Data on metabolic and bone complications in these patients are lacking.Methods/design: We enro...

There are limited data on the natural history of normocalcemic PHPT and it is unclear how the patients should be regarded vis a vis parathyroid surgery. Among the 1500 admissions/year for 10 years referred to our outpatient endocrine clinics for a variety of diseases, we collected 481 subjects with high serum levels of PTH. In the presence of hypercalcemia, a diagnosis of primary hyperparathyroidism was performed in 127 (26%). Other 354 (74%) subjects were normocalcemic: 186 (...

We previously described aberrant expression of microRNAs belonging to the chromosome 19 cluster (C19MC) and the close miR-371-373 cluster in two-thirds of parathyroid carcinomas (PCas). Therefore, we investigated the involvement of the miR-371-373 cluster in parathyroid tumours, where miR-372 was the most consistently upregulated. miR-372 is known to be highly expressed in human embryonic stem cells and definitely downregulated upon differentiation. Moreover, miR-372 promotes ...

Though there is no evidence of a constitutive nuclear accumulation of β-catenin, the Wnt/β-catenin pathway might be deregulated in parathyroid tumours. We investigated unphosphorylated active β-catenin distribution by western blot in 16 typical parathyroid adenomas (PAds): β-catenin accumulation in the nuclear protein fractions varied from the levels detected in Caco-2 cells with constitutively active Wnt signalling (three PAds) to the levels measured in HE...

Introduction: The management of patients with adrenal incidentaloma (AI) and possible subclinical hypercortisolism (SH) is debated. This randomized study was aimed to evaluate the effects of adrenalectomy on arterial hypertension (AH).Methods: We consecutively evaluated 590 AI patients (referred to 3 Italian Centres between 06/2016 and 12/2019). Among these, 134 patients showed a possible SH (i.e. 1 mg DST between 1.8 and 5 µg/dl). Based on the excl...

Background: Several criteria (i.e., cortisol supprimibility after 1 mg overnight dexamethasone suppression test -F-dex-, low ACTH levels, high 24 h urinary free cortisol levels -UFC-, high midnight serum cortisol levels) have been used for defining SH. Nevertheless, a real gold standard combination of tests is lacking. Recently midnight salivary cortisol (MSC) has been described as a sensitive marker for the diagnosis of overt hypercortisolism, while the role of MSC in the dia...

In order to evaluate hypothalamic-pituitary-adrenal activity in diabetic patients in relation to neuroautonomic balance, we studied 50 consecutive hospitalized T2D patients (22F, 28M) without symptoms of neuropathy or hypercortisolism. We measured: morning, midnight and post-dexamethasone suppression cortisol (F8, F24 and F-Dex respectively) 24-hours urinary free cortisol (UFC), morning ACTH, systolic and diastolic blood pressure levels (SBP, DBP) and performed deep-breathing ...

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...

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 ...