Endocrine Abstracts

Background: Chronic hypercortisolism is known to alter the circadian rhythm and to impair protein metabolism. Altered amino acid (AA) and biogenic amine (BA) levels were found in basal blood in patients with hypercortisolism. However, poor information is available on the physiologic circadian fluctuation of these molecules. Furthermore, the potential derangement caused by hypercortisolism was never investigated.Aim: To characterize diurnal levels and flu...

Background: The dexamethasone suppression test (DST) is among essential tests for hypercortisolism diagnosis. Due to high sensitivity and specificity, liquid chromatography-tandem mass spectrometry (LC-MS/MS) is replacing obsolete immunoassays (IA) for steroid measurement. However, exhaustive data about IA and LC-MS/MS concordance in the frame of DST are still not available.Aim: To compare cortisol measurements by two routine IAs and LC-MS/MS in basal (F...

Background: Steroid profiling by LC-MS/MS is increasingly used in endocrine research, and is being introduced in the clinical practice. Due to the large disagreement with previous immunoassays, and to the enlarged panel of measurable steroids, novel and robust reference intervals (RIs) need to be established. Steroid circulating levels are known to be influenced by several physio-pathological factors, such as age, gender, stress and metabolic status. Therefore, generating unbi...

Endocrine clinical practice strongly relies on normative data for the assessment of hormonal imbalance. However, the generation of robust steroids reference intervals (RIs) remains a challenge. As the steroids circulating levels are influenced by many procedural aspects related to blood collection (time, fasting state) and physio-pathological factors, such as age, sex, stress and metabolic status, the need for partitioning RIs is mandatory. Furthermore, unbiased healthy, drug-...

Introduction: Adjuvant therapy with aromatase-inhibitors (AIs) increases bone loss and fracture risk. Concomitant antiresorptive treatment is currently recommended. The aim of this study was to evaluate the effects of AIs on bone metabolism and mineral density at 12 and 24 months.Methods: Among 400 women on AIs who attended our Endocrinology Unit from 2014 to 2016, we retrospectively evaluated those who initially refused antiresorptive and took cholecalc...

Context: ß-CTX are considered useful markers of response to denosumab and other anti-resorbtive treatments for osteoporosis. We report an unusual case of a completely absent effect of both denosumab and bisphosphonates on bone resorption markers.Case description: In 2017 a 74-year-old woman sought medical attention at the Endocrinology Unit of Policlinico di Sant’Orsola for the evaluation of an adrenal adenoma associated with osteoporosis. Meno...

Introduction: Primary aldosteronism (PA) features a higher prevalence of cardiovascular events and renal complications as compared with essential hypertension. The effects of aldosterone excess on ascending aorta have never been investigated in human subjects.Methods: From August 2014 to December 2015, we enrolled forty-seven consecutive PA outpatients who had not undergone surgery of the adrenal mass. Hypercortisolism and pheochromocytoma were excluded....

Background: Subclinical Cushing’s syndrome (SCS) is defined as alterations in hypothalamic–pituitary–adrenal axis without classic signs or symptoms of glucocorticoid excess. This condition has been associated to increased risk of adverse metabolic and cardiovascular outcomes, independently of other potential risk factors. However, is still not known if this condition could lead to a higher mortality respect to non-secreting adrenal masses (NSA).<p class="abs...

Aims: SC can be discovered in 5–20% of the incidentalomas. Subclinical secretion is defined by the failure to suppress plasma cortisol after 1 mg-overnight dexamethasone <50 nmol/l, but there is no agreement in literature. The aim of our study was to evaluate cortisol response to oral glucose tolerance test (OGTT) as potential marker of autonomous activity of these adenomas.Methods: Ninety subjects, 47 females and 43 males, underwent the protoco...

Aim: ACC is an extremely rare heterogeneous aggressive disease. Clinical presentation are various. The prognosis is very poor. There are limited data to define prognostic markers for survival beyond stage.The aim of this study is to describe the experience of our institution with patients affected by ACC.Material and methods: This study was performed on 13 patients aged between 26 and 76 years, from 1992 to 2009 who turned to our I...