Journal of Clinical Endocrinology and Metabolism

OBJECTIVE: To investigate the contemporary presentation of pituitary metastases. PATIENTS: Thirty-eight patients diagnosed with pituitary metastases 1996 to 2018 in Sweden. METHODS: Pituitary metastases were confirmed by histopathology (n = 27) or considered highly likely due to radiological findings, including rapid tumor progression (n = 11). Medical charts were reviewed and sellar images re-examined centrally. RESULTS: Breast and lung cancer were the most common primary tumors, 45% and 21% of the patients...

OBJECTIVE: The etiologic diagnosis of pituitary stalk thickening (PST) remains a major challenge because biopsies of the pituitary stalk are difficult to obtain. This study summarized the etiologies of PST and the natural course of indistinguishable PST. METHODS: Patients with magnetic resonance imaging (MRI)-confirmed PST at Peking Union Medical College Hospital from January 2014 to May 2017 were reviewed. Clinical information, including the symptoms at onset and laboratory, imaging, operative, pathological and follow-up data, was collected...

AIMS: Serum uromodulin has recently emerged as promising biomarker for kidney function and was suggested to be associated with type 2 diabetes (T2D) in coronary patients. Here, we analyzed the association of serum uromodulin with T2D in the population-based KORA F4/FF4 study. METHODS: In 1119 participants of the KORA F4 study aged 62 - 81 years, serum uromodulin was measured and the association of serum uromodulin with T2D was assessed using logistic and linear regression models stratified for sex...

PURPOSE: To investigate the change of IL-10 producing regulatory B cells (Bregs), which function to suppress peripheral immune responses, in patients with thyroid associated ophthalmopathy (TAO). METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from healthy controls (N=54), patients with Grave's disease (N=26), and TAO patients (N=125), and stimulated with CpG/CD40L. The frequency of IL-10 producing Bregs and the expression of IL-10 in response to thyroid-stimulating hormone (TSH) stimulation were measured by flow cytometry...

CONTEXT: Circadian rhythms have not been examined in girls with polycystic ovarian syndrome (PCOS), despite the typical delayed circadian timing of adolescence, an emerging link between circadian health and insulin sensitivity (SI), and decreased SI in PCOS. OBJECTIVE: To examine differences in the circadian melatonin rhythm between obese adolescent girls with PCOS compared to controls and evaluate relationships between circadian variables and SI. DESIGN: Cross-sectional study...

CONTEXT: Mutations in the HESX1 gene can give rise to complex phenotypes that involve variable pituitary hormone deficiencies and other developmental defects. CASE DESCRIPTION: A 14 year old boy presented with short stature and delayed puberty and was diagnosed with GH deficiency, central hypothyroidism, hypogonadotropic hypogonadism, and secondary adrenal insufficiency. He had anterior pituitary hypoplasia, ectopic posterior pituitary and an interrupted pituitary stalk...

BACKGROUND: Acute hyponatremia is a medical emergency which confers high mortality, attributed primarily to cerebral edema. Expert guidelines advocate the use of intravenous boluses of hypertonic saline, rather than traditional continuous infusion, in order to achieve a faster initial rise in plasma sodium concentration. However, there is a limited evidence base for this recommended policy change. METHODS: We prospectively assessed the clinical and biochemical outcomes in patients treated for symptomatic hyponatremia due to syndrome of inappropriate antidiuresis (SIAD), in response to intravenous bolus treatment with 3% saline (100ml, repeated up to two more times), and compared the outcomes to retrospective data from patients treated with continuous intravenous infusion of low dose (20ml/hour) 3% saline...

CONTEXT: There is a 4-5 year variation in age of breast maturation in girls. OBJECTIVE: Examine longitudinal changes in sex hormone values, relative to chronologic age and time relative to breast maturation. SETTING AND DESIGN: Longitudinal observational study. Girls were recruited at 6 to 7 years of age and followed every six months. MAIN OUTCOME MEASURES: maturation status; chronologic age; race; fasting blood specimen...

CONTEXT: xytocin (OT) and vasopressin share anatomical pathways of synthesis and secretion, and patients with central diabetes insipidus (CDI) are presumably at risk for OT deficiency. However, an oxytocin-deficient state in hypopituitary patients has not been established. OBJECTIVES: We hypothesized that in men with CDI compared to (1) patients with similar anterior pituitary deficiencies but no CDI (APD) and (2) healthy controls (HC) of similar age and BMI, plasma OT levels would be lower and associated with increased psychopathology...

OBJECTIVES: The understanding of the mechanisms underlying thyroid cancer immune escape can lead to the identification of new molecular targets and/or efficacy biomarkers. For this purpose, we performed immune expression profiling in thyroid cancers to obtain a comprehensive view on immune mechanisms activated during cancer progression. METHODS: The study was conducted retrospectively in 25 papillary thyroid carcinomas (PTC), 14 poorly differentiated thyroid carcinomas (PDTC), 13 anaplastic thyroid carcinomas (ATC) and 7 normal thyroid tissue samples (NT)...

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.