Journal of Clinical Endocrinology and Metabolism

CONTEXT: Obesity is associated with hypothyroidism and goiter. OBJECTIVE: The aim of the study was to verify whether thyroid structure and function would improve, after weight loss. DESIGN AND PATIENTS: We evaluated 96 overweight/obese children, who showed an altered parenchymal pattern at thyroid ultrasound without circulating anti-thyroid antibodies. At phase 1, BMI standard deviation score (SDS), body composition, fT4, TSH, high sensitivity C Reactive Protein (CRPhs), white blood cells (WBC), metabolic profile and a thyroid ultrasound were assessed...

CONTEXT: Modern management of differentiated thyroid cancer requires individualized care plans which tailor the intensity of therapy and follow-up to the estimated risks of recurrence and disease-specific mortality. EVIDENCE ACQUISITION: This summary is based on the authors' knowledge and extensive clinical experience supplemented by review of published review articles, thyroid cancer management guidelines, published staging systems, and original articles identified through a PubMed search which included terms such as risk stratification, staging, clinical outcomes, and differentiated thyroid cancer...

OBJECTIVE: changes in bile flow after bariatric surgery may beneficially modulate secretion of insulin and incretins leading to diabetes remission. However, the exact mechanism(s) involved are still unclear. We here propose an alternative method to investigate the relation between alterations in physiological bile flow and insulin and incretin secretion by studying the changes in gut-pancreatic function in extrahepatic cholestasis in non-diabetic humans. METHODS: to pursue this aim, 58 non-diabetic patients with recent diagnosis of periampullary tumors underwent an OGTT, and a subgroup of 16 patients also underwent 4-hour mixed meal tests and hyperinsulinemic euglycemic clamps...

INTRODUCTION: Pegvisomant (PEG) in monotherapy or combined with somatostatin analogs (SSAs) is used to control acromegaly, improving metabolism. However, the metabolic changes induced by PEG have not been systematically reviewed. OBJECTIVE: To address the following questions: Does 1) PEG or 2) the combination of PEG and SSAs affect fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), glucose load (2h-OGTT), insulin levels (FPI), homeostatic model assessment of insulin resistance and β-cell function (HOMA-I and HOMA-β), triglycerides (TGDs), total cholesterol, HDL-cholesterol, LDL-cholesterol or body mass index? 3) Are the effects disease-related or drug-related? DATA SOURCES: Indexed databases up to January 2019...

No abstract text is available yet for this article.

CONTEXT: For decades, there has been epidemiologic evidence linking chronic toxic metal exposure with cardiovascular disease, suggesting a therapeutic role for metal chelation. Given the lack of compelling scientific evidence however, the indications for metal chelation were never clearly defined. To determine the safety and efficacy of chelation therapy, the National Institutes of Health funded the Trial to Assess Chelation Therapy (TACT). TACT was the first double blind, randomized, controlled trial to demonstrate an improvement in cardiovascular outcomes with edetate disodium therapy in patients with prior myocardial infarction...

CONTEXT: Fibrogenesis imperfecta ossium (FIO) is a rare and progressive skeletal bone disorder of undetermined etiology. Given its FIO, the pathogenesis of FIO remains elusive and no effective treatment exists. Based on review of all published cases and our collective experience of FIO, we offer a comprehensive approach for the diagnosis and management of this complex and fatal disorder. EVIDENCE ACQUISITION: A review of electronic and print medical literature comprising case reports and articles retrieved from PubMed database up to March 2018 was conducted using the search term "fibrogenesis imperfecta"...

CONTEXT: The patterns of the association between high-density lipoprotein cholesterol (HDL-C) concentrations and mortality among the elderly are still unclear. OBJECTIVE: To examine the association of HDL-C concentrations with mortality, and to identify the optimal HDL-C concentration range that predicts the lowest risk of all-cause mortality among the elderly. DESIGN: This was a nationwide, community-based prospective cohort study. METHODS: This study included 7,766 elderly individuals (aged ≥65 years; mean age: 74...

OBJECTIVE: To investigate the link between dietary sugar consumption and two separate pathogenetic mechanisms associated with metabolic syndrome: de novo lipogenesis (DNL) and non-enzymatic glycation. DESIGN AND PARTICIPANTS: We assessed changes in serum D-lactate (the detoxification end-product of methylglyoxal) concentration in response to nine days of isocaloric fructose restriction in 20 children with obesity and metabolic syndrome, and examined correlations with changes in DNL, liver fat, insulin sensitivity and other metrics of hepatic metabolism...

No abstract text is available yet for this article.

CONTEXT: Congenital Adrenal Hyperplasia (CAH) was among the first genetic disorders included in newborn screening (NBS) programs worldwide, based on 17α-hydroxyprogesterone (17-OHP) levels in dried blood spots. However, the success of NBS for CAH is hampered by high rates of false positive (FP) rates, especially in preterm and low birth-weight infants. OBJECTIVE: To establish a set of cutoff values adjusting for both gestational-age (GA) and birth-weight (BW), with the aim of reducing FP rates...

CONTEXT: Accumulating evidences suggest a link between adrenocortical zona glomerulosa and parathyroid gland through mechanisms that remain unexplored. OBJECTIVES: To test the hypothesis that in vivo Angiotensin (Ang) II blockade affects parathyroid hormone (PTH) secretion in hypertensive patients and that aldosterone and Ang II directly stimulate PTH secretion ex vivo. DESIGN AND SETTING: We investigated the changes of serum PTH levels induced by oral captopril (50 mg) administration in patients with primary essential hypertension (EH) and with primary aldosteronism (PA) due to bilateral adrenal hyperplasia (BAH) or to aldosterone-producing adenoma (APA), the latter before and after adrenalectomy...

CONTEXT: Primary aldosteronism (PA) is associated with higher cardiovascular morbidity and metabolic risks. Recent studies report glucocorticoid co-secretion as a relevant phenotype of PA, which could contribute to associated risks, including type 2 diabetes mellitus (T2DM). The relationship between autonomous cortisol secretion (ACS) and glucose metabolism in PA has not been investigated. OBJECTIVE: To evaluate the prevalence of impaired glucose homeostasis in PA patients according to cortisol co-secretion...

No abstract text is available yet for this article.

CONTEXT: It remains unclear whether risk of cardiovascular diseases is increased in patients with mild (˂1.45 mmol/l) to moderate (≥1.45-1.60 mmol/l) primary hyperparathyroidism (PHPT). OBJECTIVE: We aimed to determine the short-term effect of parathyroidectomy (PTX) on arterial stiffness, cholesterol levels, and blood pressure (BP). DESIGN: This study was a clinical trial randomly allocating patients to either PTX- or a control-group (no surgery)...

No abstract text is available yet for this article.

CONTEXT: GH and IGF-I are crucial for attainment of normal body size and regulation of food intake, nutrients storage, and insulin sensitivity. Enteroendocrine connections exist between the GH/IGF-I axis and insulin, ghrelin, and glucagon-like peptide 1 (GLP-1). The status of these connections in GH deficiency (GHD) is unknown. OBJECTIVE: To study the enteroendocrine connections before and after a standard meal test in a homogeneous population of adults with congenital untreated isolated GHD (IGHD) due to a mutation in the GHRH receptor gene...

No abstract text is available yet for this article.

CONTEXT: Pituitary neuroendocrine tumors (PitNETs) comprise a commonly underestimated pathology in terms of incidence and associated morbimortality. Currently, an appreciable subset of patients is resistant or poorly responsive to the main current medical treatments [i.e. somatostatin-analogues (SSAs)/dopamine-agonists]. Thus, development/optimization of novel/available medical therapies is necessary. Biguanides (metformin/buformin/phenformin) are antidiabetic drugs that exert antitumoral actions in several tumor types, but their pharmacological effects on PitNETs are poorly known...

CONTEXT: Radiofrequency ablation (RFA) of benign thyroid nodules has been gaining consensus. However, solid information on its long-term efficacy is yet to be obtained. OBJECTIVE: To analyze the long-term results of single-session RFA. DESIGN: Retrospective longitudinal observational study. SETTING: Primary care center. PATIENTS OR OTHER PARTICIPANTS: Adult outpatients who underwent a single-session RFA and post-treatment follow-up of at least three years...