Journal of Clinical Endocrinology and Metabolism

BACKGROUND: Pheochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumors. Metastases develop in 15-20%. The American Joint Committee on Cancer (AJCC) established inaugural guidelines for PPGL tumor-node-metastasis (TNM) staging. The objective of this analysis is to investigate the associations between TNM staging and overall survival (OS). METHODS: We retrospectively applied the TNM staging at the time of diagnosis of the primary tumor. The primary outcome was OS...

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Graves' disease and Hashimoto's disease form part of the spectrum of autoimmune thyroid disease (AITD), to which genetic and environmental factors are recognised contributors. Epigenetics provides a potential link between environmental influences, gene expression and thyroid autoimmunity. DNA methylation (DNAm) is the best studied epigenetic process, and global hypomethylation of leucocyte DNA is reported in several autoimmune disorders. This review summarises current understanding of DNAm in AITD. Targeted DNAm studies of blood samples from AITD patients have reported differential DNAm in the promoter regions of several genes implicated in AITD, including TNF, IFNG, IL2RA, IL6, ICAM1 and PTPN22...

CONTEXT: Primary aldosteronism (PA) screening relies on an elevated aldosterone to renin ratio with a minimum aldosterone level, which varies from 10 to 15 ng/dL (277 to 415.5 pmol/L) using immunoassay. AIM: To evaluate intraindividual coefficient of variation (CV) of aldosterone and aldosterone to direct renin concentration ratio (A/DRC) and its impact on PA screening. METHODS: A total of 671 aldosterone and DRC measurements were performed by the same chemiluminescence assays in a large cohort of 216 patients with confirmed PA and at least two screenings...

BACKGROUND: Resource trade-off theory suggests that increased performance on a given trait comes at the cost of decreased performance on other traits. METHODS: Growth data from 1889 subjects (996 girls) were used from the GrowUp1974 Gothenburg study. Energy Trade-Off (ETO) between height and weight for individuals with extreme body types was characterized using a novel ETO-Score (ETOS). Four extreme body types were defined based on height and ETOI at early adulthood: tall-slender, short-stout, short-slender, and tall-stout; their growth trajectories assessed from ages 0...

Hypothalamic obesity (HO) is defined as abnormal weight gain due to physical destruction of the hypothalamus. Suprasellar tumors, most commonly craniopharyngiomas, are a classic cause of HO. HO often goes unnoticed initially as patients, families and medical teams are focused on oncologic treatments and management of panhypopituitarism. HO is characterized by rapid weight gain in the first year after hypothalamic destruction followed by refractory obesity due to an energy imbalance of decreased energy expenditure without decreased food intake...

CONTEXT: Cabergoline (CAB) is an off-label medical therapy for acromegaly, overshadowed by first-generation somatostatin receptor ligands, e.g. octreotide (OCT). OBJECTIVE: Head-to-head comparison between OCT and CAB in inhibiting growth hormone (GH) secretion in primary cultures of GH- and GH/PRL-secreting tumors. To investigate the role of somatostatin (SST) and dopamine type 2 (D2R) receptor expression. DESIGN: To evaluate the antisecretory effect of OCT and CAB, together with receptor mRNA expression, in 23 tumor cultures...

Postmenopausal hyperandrogenism is a condition caused by relative or absolute androgen excess originating from the ovaries and/or the adrenal glands. Hirsutism, i.e., increased terminal hair growth in androgen-dependent areas of the body, is considered the most effective measure of hyperandrogenism in women. Other symptoms can be acne and androgenic alopecia or the development of virilization including clitoromegaly. Postmenopausal hyperandrogenism may also be associated with metabolic disorders like abdominal obesity, insulin resistance and type 2 diabetes...

BACKGROUND: Bisphosphonates have been reported to be cardio-protective in some, but not all studies. It is unknown whether denosumab use protects against cardiovascular events (CVE). OBJECTIVES: To determine whether oral bisphosphonate (oBP) or denosumab (Dmab) use is associated with CVE in persons with incident fracture. DESIGN: 267,357 participants from The Sax's Institute 45 and Up Study followed (2005/2009 - 2017). Questionnaire data were linked to hospital admissions (Admitted Patients Data Collection -APDC),1 Pharmaceutical Benefits Scheme (PBS)2 and stored securely3...

Adrenal hemorrhage is an uncommon underrecognized condition that can be encountered in several clinical contexts. Diagnosing adrenal hemorrhage is challenging due to the non-specific clinical features. Therefore, it remains a diagnosis that is made serendipitously on imaging of acutely unwell patients rather than with prospective clinical suspicion. Adrenal hemorrhage can follow abdominal trauma or on a background of predisposing conditions such as adrenal tumors, sepsis, or coagulopathy. Adrenal hemorrhage is also increasingly reported in patients with COVID-19 infection and in the context of vaccine-induced immune thrombocytopenia and thrombosis, in both cases likely as a consequence of adrenal vein thrombosis...

PURPOSE: Pancreatogenic diabetes refers to diabetes mellitus (DM) that develops in the setting of a disease of the exocrine pancreas, including pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP). We sought to evaluate whether a blunted nutrient response of pancreatic polypeptide (PP) can differentiate these DM subtypes from type 2 DM (T2DM). METHODS: Subjects with new onset DM (<3 years duration) in the setting of PDAC (PDAC-DM, n = 28), CP (CP-DM, n = 38), or T2DM (n = 99) completed a standardized mixed meal tolerance test (MMTT), then serum PP concentrations were subsequently measured at a central laboratory...

CONTEXT: MicroRNAs (miRNAs) are short, single-stranded, non-coding RNAs which regulate gene expression. They originate from various tissues including bone and regulate different biological mechanisms including bone metabolism. OBJECTIVE: The aim of this project was to investigate circulating miRNAs as promising biomarkers for treatment monitoring in women with postmenopausal osteoporosis on denosumab (DMAB) therapy. DESIGN, SETTING AND PATIENTS: In this prospective, observational, single-centre study twenty-one postmenopausal women treated with DMAB were included for a longitudinal follow-up of two years...

INTRODUCTION: Determination of steroid levels in the amniotic fluid gives some insight on foetal adrenal and gonadal functions. Our objectives were to establish reference ranges of 12 steroid levels throughout pregnancy and to compare them with steroid levels from pregnancies with foetuses presenting 21-hydroxylase deficiency (21OHD). MATERIALS AND METHODS: Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) was applied to 145 "control" amniotic fluid samples from gynaecology activity (12 + 6 to 32 + 4 Gestational Weeks, GW)...

CONTEXT: Low skeletal muscle mass often accompanies abdominal obesity in the aging process. OBJECTIVE: We aimed to investigate the effect of reduced skeletal muscle mass and its interaction with abdominal obesity on incident type 2 diabetes. METHODS: This retrospective longitudinal study included a total of 36,304 diabetes-free Koreans who underwent two or more health check-ups annually or biennially. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI) adjusted for body weight...

BACKGROUND: Statin blunts cardiorespiratory fitness improvements after exercise training and may affect fat oxidation adaptations to training. METHODS: One hundred and six metabolic syndrome individuals either chronically medicated with statins (i.e., STATIN group; n = 46) or statin naïve (i.e., CONTROL group; n = 60) completed a 16-week supervised high-intensity interval training (HIIT) program. Maximal rates of oxygen consumption (V̇O2MAX), fat oxidation (FOMAX), and the shape of the workload-fat oxidation curve were assessed before and 48 h after training in an overnight fasted state...

CONTEXT: Mutations in Androgen receptor (AR) gene might be associated with infertility mainly because they cause various degree of androgen insensitivity. OBJECTIVE: The aim of the study was to evaluate the frequency and type of AR variants in a large cohort of infertile males. PATIENTS AND SETTING: 8224 males of Italian idiopathic infertile couples referred University Hospital of Padova. MAIN OUTCOME MEASURES: Mutational screening of AR, computational and functional analyses...

CONTEXT: The influences of diabetes duration and glycemic control and their potential interplays on the risk of heart failure (HF) remain unclear. OBJECTIVE: This work aimed to investigate the association of diabetes duration and glycemic control with the risk of HF. METHODS: A total of 23 754 individuals with diabetes but without HF during the baseline recruitment of UK Biobank were included in this study. Duration of diabetes was self-reported, and the status of glycemic control was reflected by glycated hemoglobin A1c (HbA1c) levels...

OBJECTIVE: Tyrosine kinase inhibitors (TKIs) can be used to treat locally unresectable or distantly metastatic pheochromocytomas/paragangliomas (PPGLs), such as sunitinib in the NCCN Guidelines in 2022. However, the precise effect of different TKIs in metastatic PPGLs is still unclear. The aim of this meta-analysis is to assess the efficacy and safety of TKIs in metastatic PPGLs. METHODS: The PubMed, Cochrane Library, Scopus, Clinical Trial and Embase databases were searched by synonyms of 48 TKIs and metastatic PPGLs from the inception up to August 2022...

CONTEXT: While T2D is a risk factor for liver fibrosis in NAFLD, the specific contribution of insulin resistance (IR) relative to other factors is unknown. OBJECTIVE: Assess the impact on liver fibrosis in NAFLD of adipose tissue (Adipo-IR) and liver (HOMA-IR) IR in people with T2D and NAFLD. DESIGN: Participants were screened by elastography in the outpatient clinics for hepatic steatosis and fibrosis, including routine metabolites, cytokeratin-18 (marker of hepatocyte apoptosis/steatohepatitis), and HOMA-IR/Adipo-IR...

No abstract text is available yet for this article.