Endocrine Abstracts

Background: Adrenal incidentalomas are found in 3–7% of radiological series and many of them are adrenal adenomas. Autonomous cortisol secretion without clinical signs of overt hypercortisolism is a common finding in these patients. Studies reported metabolic derangement and increased cardiovascular risk associated with this state of subtle cortisol excess, however scanty data are available on the natural history of this condition.Aim: To assess the...

Introduction: Some variants of the glucocorticoid receptor (GR) gene have been found to alter glucocorticoid sensitivity and have been associated with worsen metabolic profiles.Objective: The aims of the present study were: i) to examine whether the prevalence of N363S, ER22/23EK and BclI variants was different in patients with adrenal incidentaloma (AI) and/or subclinical Cushing’s syndrome (SCS) than control subjects and ii) whether the presence o...

The association between acromegaly and increased cardiovascular morbidity and mortality is widely recognised. The aim of this retrospective multicentric study is to evaluate the impact of different therapeutic approaches on the progression of cardiovascular risk (CVR) in acromegalic patients. At diagnosis and last follow up (follow up time of 13 ± 8 years),we assessed BMI, blood pressure, glycaemic and lipid profile, GH and IGF1 levels in 199 patients with acromegaly (116...

Purpose: Mitotane is the reference systemic therapy for adrenocortical carcinoma (ACC), but its mechanism of action and possible predictors of treatment response remain poorly defined. Our aim was to evaluate the gene expression of ribonucleotide reductase large subunit 1 (RRM1) and excision repair cross-complementation group 1 (ERCC1) in ACC as potential biomarkers for clinical outcome and response to mitotane.Experimental design: Forty-five and 47 tiss...

The effects of glucocorticoids are mediated by the glucocorticoid receptors (GR) and some single nucleotide polymorphisms (SNPs) have been associated to enhanced sensitivity (N363S, BclI) or reduced sensitivity (ER22/23EK) to glucocorticoids.Aim of the present study was: 1) to assess the frequency of N363S, BclI and ER22/23EK in 46 patients with Cushing’s syndrome (CS) and 73 patients with adrenal incidentaloma (AI) compared to 186 healthy subjects;...

Diagnosis of primary aldosteronism (PA) is made by screening, confirmation testing and subtype diagnosis (CT scan and adrenal vein sampling, AVS). However, some tests are costly and unavailable in most hospitals. We evaluated the role of serum 18-hydroxycorticosterone (s18OHB) and urinary and serum 18-hydroxycortisol (u and s18OHF) and 18-oxocortisol (u and s18oxoF) in the diagnosis of PA and its subtypes, aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (...

We have demonstrated that adjuvant mitotane prolong recurrence free survival (RFS) in patients with radically resected ACC. Aim of the present study was to correlate mitotane levels with patient outcome in an adjuvant setting in 3 different referral centres in Europe. There were 120 patients (45 W, 75 M, median age 44 years, range 16–76) radically resected for ACC who were treated adjuvantly with mitotane from 1996 to 2010. ACC was stage I in 10 cases, II in 73, III in 31...

Introduction: O,p’DDD is the drug of choice for patients with adrenocortical carcinoma (ACC). Monitoring o,p’DDD serum level has been proposed as predictor of tumour response. Measurement of o,p’DDD metabolites involved in the active pathway may provide an improved prediction of o,p’DDD activity. The objective of our study was to (1)to confirm the currently used threshold o,p’DDD serum level of 14mg/l for achieving a tumour response and (2)compare the ...

The potential side effects of the rhGH therapy have been evaluated only during treatment and the accessible databases have been developed as a post-marketing surveillance only by the Companies distributing rhGH. Aim of the present study was to evaluate health consequences (metabolic diseases and/or malignancies) in adults previously treated with rhGH during childhood. We recruited 284 patients (median age at diagnosis 12 years, range 3–17) who underwent rhGH treatment bet...

The optimal treatment of recurrent adrenocortical cancer (ACC) remains to be established since there are discrepant opinions on the value of repeat surgery. We did a retrospective analysis of the outcome of patients who were referred to our units from 1988 to 2006 for a recurrence of ACC, which occurred 2–83 years after radical removal of the tumor. In that period, the treatment policy of ACC recurrence differed among our units, since oncologists were more accustomed to u...