Endocrine reviews最新文献_第7页

Management of Acquired Hypothalamic Dysfunction and the Hypothalamic Syndrome; it is more than obesity. 后天性下丘脑功能障碍与下丘脑综合征的治疗这不仅仅是肥胖。

IF 20.3 1区医学

Endocrine reviews Pub Date : 2025-08-01 DOI: 10.1210/endrev/bnaf025

Hanneke M van Santen,Hermann L Müller

{"title":"Management of Acquired Hypothalamic Dysfunction and the Hypothalamic Syndrome; it is more than obesity.","authors":"Hanneke M van Santen,Hermann L Müller","doi":"10.1210/endrev/bnaf025","DOIUrl":"https://doi.org/10.1210/endrev/bnaf025","url":null,"abstract":"The hypothalamus is the key regulator of the human energy's balance. Hypothalamic dysfunction leads to (morbid) hypothalamic obesity, but may have many more consequences such as hypopituitarism, adipsia, disruption of the circadian rhythm, decreased energy expenditure, low core body temperature and behavioral changes. Many patients with hypothalamic dysfunction experience chronic fatigue, increased daytime sleepiness, headaches, inactivity and mood disorders which all in its turn itself may contribute to the development of obesity. Adipsic AVP-deficiency, severe hypothermia, uncontrollable hyperphagia and severe mood disorders may require 24/7 management. Signs and symptoms may be severe or mild. Severe hypothalamic dysfunction is usually readily diagnosed, but less severe hypothalamic dysfunction is much harder to recognize, because, among other things, of its multifaceted presentation. Through raising awareness and by better categorization of the different clinical signs and symptoms of hypothalamic dysfunction within different domains, the underlying cause for fatigue and obesity observed in patients with hypothalamic dysfunction may be better understood, which in its turn, will open new perspectives on successful management options. In this review, the state of the art for diagnostics and management of acquired hypothalamic dysfunction is summarized and a new management algorithm is suggested. The lessons learned from pediatric patients with acquired hypothalamic dysfunction, including hypothalamic obesity management through the different clinical domains, may also prove to be useful for patients with congenital or genetic forms of hypothalamic dysfunction resulting in fatigue and obesity, as well as for children with presumed \"common\" obesity.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":"56 1","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Opposing Metabolic Effects of Growth Hormone and IGF-I: Review and Clinical Implications. 生长激素和igf - 1的对立代谢作用：综述和临床意义。

IF 20.3 1区医学

Endocrine reviews Pub Date : 2025-07-28 DOI: 10.1210/endrev/bnaf022

Zvi Laron,Haim Werner

{"title":"Opposing Metabolic Effects of Growth Hormone and IGF-I: Review and Clinical Implications.","authors":"Zvi Laron,Haim Werner","doi":"10.1210/endrev/bnaf022","DOIUrl":"https://doi.org/10.1210/endrev/bnaf022","url":null,"abstract":"The growth hormone (GH)-insulin-like growth factor-I (IGF-I) endocrine system has a central role in metabolism and growth. The Somatomedin Hypothesis, postulated in the mid-1950s, claimed that the biological activities of pituitary GH are mediated by a liver-produced peptide termed somatomedin or IGF-I. In spite of the fact that this theory has been modified several times throughout the years to accommodate new developments in the field, it is still regarded as the main conceptual framework in the area of GH and IGF-I biology. Regardless of the unifying view that emanates from the Somatomedin Hypothesis, several opposing activities of GH and IGF-I have been described over the years. The present review addresses some of these metabolic activities, including diverging effects of these hormones on serum lipoprotein(a), sex hormone binding globulin, insulin secretion and adiponectin/leptin biology. In addition, we propose a number of potential mechanisms that can probably provide a cellular and biochemical basis for these divergent actions. Understanding the complex interactions between the GH and IGF-I signaling pathways might improve our understanding of basic molecular endocrine processes and result in potential clinical applications.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":"34 1","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A critical assessment of fasting to promote metabolic health and longevity. 禁食促进代谢健康和长寿的关键评估。

IF 20.3 1区医学

Endocrine reviews Pub Date : 2025-07-23 DOI: 10.1210/endrev/bnaf021

Pouneh K Fazeli,Matthew L Steinhauser

{"title":"A critical assessment of fasting to promote metabolic health and longevity.","authors":"Pouneh K Fazeli,Matthew L Steinhauser","doi":"10.1210/endrev/bnaf021","DOIUrl":"https://doi.org/10.1210/endrev/bnaf021","url":null,"abstract":"The adaptive starvation response allows us to survive periods of starvation - a characteristic of the environment in which humans evolved. We are now in an evolutionary transition from a global environment which was characterized by periods of famine to a world where obesity and caloric excess have become a new reality, but the mechanisms of fasting physiology remain relevant. First, many parts of the world are still plagued by famine with insufficient food resources and therefore the adaptive mechanisms required for survival during periods of decreased caloric intake are not simply relevant to our evolutionary past. Second, the obesity epidemic provides strong rationale for understanding the biology of fasting, as the same efficiencies that have evolved to allow us to survive periods of starvation also likely drive a genetic predisposition to obesity, and therefore some of the adaptive mechanisms may be maladaptive in the setting of food excess. A third compelling reason to explore the biology of fasting is that in model organisms, caloric restriction without overt starvation, is an intervention that prolongs lifespan. The purpose of this review is to provide an overview of the biology of fasting. We will highlight potential mechanisms of benefit from fasting as well as examine data from model organisms and humans that indicate potential health risks to fasting, particularly related to bone fragility. Finally, we will review clinical studies to date that have investigated the effects of fasting on metabolic outcomes and suggest signals of benefit.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":"11 1","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New Horizons in Klinefelter Syndrome: Current Evidence, Gaps, and Research Priorities. 克氏综合征的新视野：目前的证据、差距和研究重点。

IF 22 1区医学

Endocrine reviews Pub Date : 2025-07-15 DOI: 10.1210/endrev/bnaf005

Angela K Lucas-Herald, Lise Aksglaede, Ida Dyhr Caspersen, S Faisal Ahmed, Francesco Carlomagno, Andrea M Isidori

{"title":"New Horizons in Klinefelter Syndrome: Current Evidence, Gaps, and Research Priorities.","authors":"Angela K Lucas-Herald, Lise Aksglaede, Ida Dyhr Caspersen, S Faisal Ahmed, Francesco Carlomagno, Andrea M Isidori","doi":"10.1210/endrev/bnaf005","DOIUrl":"10.1210/endrev/bnaf005","url":null,"abstract":"Klinefelter syndrome (KS) is caused by the presence of a supernumerary X chromosome (conferring the classical 47,XXY karyotype) and is the most common sex chromosome abnormality in men. The clinical features described in the early characterization of the syndrome include tall stature, small testes, hypogonadism, gynecomastia, and neurodevelopmental deficits. However, the syndrome presents a broad phenotypic spectrum that seems to be evolving, along with environmental and general health changes. Although a proportion of men with KS are asymptomatic, others experience numerous severe comorbidities, ranging from cardiovascular to autoimmune disorders. Once considered a hallmark of the syndrome, the inability to conceive can now be overcome with assisted reproductive technology. The neuropsychological stigmata, once overstated, thereafter inadvertently dismissed, now demand a more balanced and objective approach. Significant advances have been made in our understanding of KS over recent years, including the molecular machinery involved in the chromosomal disjunction that gives rise to the syndrome. Our understanding of the risk-benefit of testosterone replacement therapy has greatly improved; however, many gaps persist. Future work should be prioritized according to the needs of people with KS. There are opportunities for new research addressing the fields of fertility, cardiovascular prevention, neurodevelopment, quality of life, and bone health. Above all, solid registries and extensive prospective longitudinal studies are needed to enroll people with KS to determine their evolving needs as they progress through their lifespan. These studies would be best initiated with international collaboration to ensure the results apply to all those with this condition worldwide.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":" ","pages":"447-478"},"PeriodicalIF":22.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Historical Aspects of Testicular Function: Virility, Androgen Production, and Spermatogenesis. 睾丸功能的历史方面：生殖力、雄激素产生和精子发生。

IF 22 1区医学

Endocrine reviews Pub Date : 2025-07-15 DOI: 10.1210/endrev/bnaf009

Alan D Rogol, Marco Cappa

{"title":"Historical Aspects of Testicular Function: Virility, Androgen Production, and Spermatogenesis.","authors":"Alan D Rogol, Marco Cappa","doi":"10.1210/endrev/bnaf009","DOIUrl":"10.1210/endrev/bnaf009","url":null,"abstract":"From antiquity, man has been fascinated by at least 2 processes of testicular function: virility and reproduction; their biological basis was uncovered beginning in the mid-19th century. We have divided the search into 3 epochs: the speculative and observational, the experimental, and the biochemical/physiological. The first begins with Susruta, approximately 3000 years ago, and winds its way through the Greek, Roman, the Christian Bible, Arabic, Chinese, and Indian pathways before coalescing in Europe at the dawn of the Renaissance. The second began with. Thomas Willis, who postulated a virilizing factor from the testis. A century later de Bordeu hypothesized a neurosecretory function for the hypothalamus/pituitary. After John Hunter began to study testis implantation, it was Berthold who showed a secretory function of the testis following implantation. Charles-Éduard Brown-Séquard focused the medical and lay communities on testis secretion with self-experimentation with animal testis extracts leading to more than 4 decades of uncertainty in the newly launched science of endocrinology. Multiple series of testicular implants and vas deferens ligations for the purposes of rejuvenation of older men followed. The medical experimentation continued in the biochemical/physiological epoch where androgenic steroids were isolated, purified, identified, synthesized, and used in clinical trials. The effects of castration, some known from antiquity, were placed on a modern scientific basis with studies of the Skoptzy, a self-castrating sect from Russia and the castrati opera singers. Details of hypothalamic-pituitary-gonadal axis function as well as the embryology of male sexual differentiation and spermatogenesis were defined during this epoch.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":" ","pages":"549-575"},"PeriodicalIF":22.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bone in Parathyroid Diseases Revisited: Evidence From Epidemiological, Surgical and New Drug Outcomes. 甲状旁腺骨疾病重访：来自流行病学、外科手术和新药疗效的证据。

IF 22 1区医学

Endocrine reviews Pub Date : 2025-07-15 DOI: 10.1210/endrev/bnaf010

Afroditi Roumpou, Andrea Palermo, Symeon Tournis, Valeria Hasenmajer, Janice L Pasieka, Gregory Kaltsas, Andrea Isidori, Eva Kassi

{"title":"Bone in Parathyroid Diseases Revisited: Evidence From Epidemiological, Surgical and New Drug Outcomes.","authors":"Afroditi Roumpou, Andrea Palermo, Symeon Tournis, Valeria Hasenmajer, Janice L Pasieka, Gregory Kaltsas, Andrea Isidori, Eva Kassi","doi":"10.1210/endrev/bnaf010","DOIUrl":"10.1210/endrev/bnaf010","url":null,"abstract":"PTH-related disorders have a major impact on bone metabolism and skeletal properties because of the pivotal role of PTH in calcium and phosphate homeostasis and bone remodeling. Hyperparathyroidism is characterized by continuous exposure to excessive endogenous PTH, causing increased bone turnover in favor of bone resorption. Depending on the background of PTH overproduction, hyperparathyroidism is divided into primary, secondary, and tertiary hyperparathyroidism. The clinical presentation varies from deterioration of bone microarchitecture and decreased bone mineral density to profound bone involvement, such as osteitis fibrosa cystica and fragility fractures. Although successful parathyroidectomy represents the definitive treatment and may promote regression of most of the skeletal defects, the medical approach of calcimimetics and antiresorptive agents is a promising alternative in cases where parathyroidectomy is not feasible or unsuccessful. Hypoparathyroidism is the pathophysiological counterpart of hyperparathyroidism and also leads to disorders of bone metabolism and structure. Chronic PTH deprivation is associated with low bone remodeling and increased bone mineral density. The defective microarchitecture might affect bone strength and raise the risk for adverse skeletal events. Recombinant human PTH acts as a replacement therapy and is safe and efficient in restoring calcium/phosphate homeostasis and bone turnover. However, it is approved only for refractory cases, as conventional management with calcium and active vitamin D remains the first-line treatment. This article reviews the skeletal involvement in the most frequent parathyroid disorders, hyperparathyroidism and hypoparathyroidism, and rare familial disorders of PTH metabolism, as assessed by clinical, laboratory, and imaging parameters, and the effect of the available treatment strategies.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":" ","pages":"576-620"},"PeriodicalIF":22.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Subtyping of Primary Aldosteronism by Adrenal Venous Sampling. 原发性醛固酮增多症的肾上腺静脉取样分型。

IF 22 1区医学

Endocrine reviews Pub Date : 2025-07-15 DOI: 10.1210/endrev/bnaf007

Gian Paolo Rossi, Michele Battistel, Teresa Maria Seccia, Federico Bernardo Rossi, Giacomo Rossitto

{"title":"Subtyping of Primary Aldosteronism by Adrenal Venous Sampling.","authors":"Gian Paolo Rossi, Michele Battistel, Teresa Maria Seccia, Federico Bernardo Rossi, Giacomo Rossitto","doi":"10.1210/endrev/bnaf007","DOIUrl":"10.1210/endrev/bnaf007","url":null,"abstract":"Primary aldosteronism (PA), the most common cause of arterial hypertension, is surgically curable if a unilateral source of the hyperaldosteronism is discovered. To identify which patients are curable, all current guidelines recommend adrenal venous sampling (AVS), a procedure which, albeit simple in principle, remains scarcely available and markedly underutilized, because it is still perceived as technically challenging, invasive, and difficult to interpret. The lack of uniformly accepted standards for performance and interpretation of AVS, alongside the diffuse concerns that (although quite rarely) it can be complicated by adrenal vein rupture, contribute to the scant utilization of AVS. In the last decade, several major studies have led to a greater understanding of the use of AVS in PA patients, thus paving the way to a more rational and effective application that can enable diagnosis of many more PA patients with a unilateral form of the disease to be referred for curative adrenalectomy. Moreover, microcatheters and androstenedione have been introduced to increase the success rate. This review provides updated information on the subtyping of PA by means of AVS and examines key issues on the selection and preparation of patients, the optimal performance of the procedure, and the interpretation of its results for diagnostic purposes, even in the most challenging cases. Situations when AVS can be omitted before surgery and alternative functional imaging techniques that have been proposed to identify unilateral surgical curable PA to circumvent the bottleneck represented by the limited availability of AVS worldwide, are also discussed.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":" ","pages":"501-517"},"PeriodicalIF":22.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Oxytocin System and Implications for Oxytocin Deficiency in Hypothalamic-Pituitary Disease. 下丘脑-垂体疾病中催产素系统及其缺乏的意义。

IF 22 1区医学

Endocrine reviews Pub Date : 2025-07-15 DOI: 10.1210/endrev/bnaf008

Anna Aulinas, Elizabeth A Lawson

{"title":"The Oxytocin System and Implications for Oxytocin Deficiency in Hypothalamic-Pituitary Disease.","authors":"Anna Aulinas, Elizabeth A Lawson","doi":"10.1210/endrev/bnaf008","DOIUrl":"10.1210/endrev/bnaf008","url":null,"abstract":"Oxytocin (OXT) is a hypothalamic-posterior pituitary hormone with multiple effects, ranging from regulation of energy homeostasis to bone health and psychological well-being, in addition to its well-known effects on labor and lactation. Patients with hypothalamic and pituitary damage have a higher risk for medical and psychiatric comorbidities despite standard-of-care hormone replacement, and a clinically relevant OXT-deficient state has been identified in patients with arginine vasopressin deficiency (formerly known as central diabetes insipidus) in the last decade. Therefore, OXT deficiency in patients with hypothalamic and pituitary damage is an emerging field. While intranasal oxytocin is readily available to patients, it is not Food and Drug Administration approved in the United States and the quality of compounded formulations is unclear. In addition, more research is needed to establish the safety and efficacy of OXT-based therapeutics in patients with hypothalamic and pituitary damage before recommending treatment. This review summarizes the current knowledge of the OXT system, OXT deficiency in other clinical conditions, and relevance to patients with hypothalamic and pituitary damage. We highlight emerging data supporting OXT deficiency in hypothalamic-pituitary disease, diagnostic challenges, development of therapeutic strategies, and future research directions to advance the field.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":" ","pages":"518-548"},"PeriodicalIF":22.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Glucose-Dependent Insulinotropic Polypeptide in Incretin Physiology: Role in Health and Disease. 葡萄糖依赖型胰岛素多肽在肠促胰岛素生理学中的作用：在健康和疾病中的作用。

IF 22 1区医学

Endocrine reviews Pub Date : 2025-07-15 DOI: 10.1210/endrev/bnaf006

M Michael Wolfe, Michael O Boylan, William W Chin

{"title":"Glucose-Dependent Insulinotropic Polypeptide in Incretin Physiology: Role in Health and Disease.","authors":"M Michael Wolfe, Michael O Boylan, William W Chin","doi":"10.1210/endrev/bnaf006","DOIUrl":"10.1210/endrev/bnaf006","url":null,"abstract":"Glucose-dependent insulinotropic polypeptide (GIP) is a 42-amino acid hormone that is synthesized and released from upper intestinal enteroendocrine K cells in response to the ingestion of glucose or fat. The structure of GIP places it in the secretin/vasoactive intestinal polypeptide family of gastrointestinal regulatory peptides. Although originally named \"gastric inhibitory polypeptide\" on the basis of its ability to inhibit gastric acid secretion, GIP accounts for 60% to 80% of the postprandial insulin response, consistent with the notion that this regulatory peptide constitutes the principal physiological incretin. Under normal conditions, GIP plays a major role in nutrient deposition and storage, both directly through its insulin-mimetic properties and indirectly by enhancing insulin release. GIP is overexpressed in obese individuals, which may exacerbate insulin resistance manifested by many patients with type 2 diabetes mellitus. Enhanced postprandial secretion of GIP also initiates a vicious cycle characterized by increased nutrient uptake and storage in adipocytes, leading to insulin resistance and hyperinsulinemia, which then further increases adipocyte nutrient uptake and storage. Despite the deleterious consequences of GIP overexpression, when combined with glucagon-like peptide-1 analogues, GIP agonism has been demonstrated to provide benefit in treating obesity by mechanisms currently not fully elucidated. In contrast, consistent with the etiologic role of GIP overexpression in the pathogenesis of obesity, both genetic abrogation and immunoneutralization of GIP signaling have been shown to reduce the development of obesity in preclinical models. Whether these beneficial effects of GIP antagonism will be extended to humans needs to be determined.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":" ","pages":"479-500"},"PeriodicalIF":22.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Treatment of Acromegaly: Navigating the Present, Shaping the Future. 肢端肥大症的医学治疗：导航现在，塑造未来。

IF 20.3 1区医学

Endocrine reviews Pub Date : 2025-07-11 DOI: 10.1210/endrev/bnaf020

Mônica R Gadelha,Luiz Eduardo Wildemberg,Nelma Veronica Marques,Leandro Kasuki

{"title":"Medical Treatment of Acromegaly: Navigating the Present, Shaping the Future.","authors":"Mônica R Gadelha,Luiz Eduardo Wildemberg,Nelma Veronica Marques,Leandro Kasuki","doi":"10.1210/endrev/bnaf020","DOIUrl":"https://doi.org/10.1210/endrev/bnaf020","url":null,"abstract":"Acromegaly is a chronic systemic disease associated with significant morbidity due to its many complications, which lead to increased mortality rates. Adequate treatment is essential to reduce the development of long-term complications and to restore mortality rates to those of the general population. Three modalities of treatment are currently available (surgery, medical therapy and radiotherapy). Surgery is considered the first-line treatment and achieves disease cure in approximately 50% of patients in reference centers. Three drug classes are currently available (somatostatin receptor ligands, dopamine agonists and growth hormone receptor antagonists); however, disease control is not achieved in a considerable proportion of patients (approximately 40%). Despite significant advances in medical therapy over the last few decades, the treatment burden is still high, and quality of life is not fully restored in many patients, even when biochemical control is achieved. Therefore, the development of medications with greater efficacy and/or easier and more convenient administration is an unmet need in the treatment of acromegaly. In addition, shifting from the current trial-and-error approach to a more precise treatment strategy guided by biomarkers predictive of the response to different medical therapies will optimize and improve patient outcomes. In this review, current treatments as well as new drugs in different phases of development are detailed, and the role of precision medicine in the treatment of acromegaly is discussed.","PeriodicalId":11544,"journal":{"name":"Endocrine reviews","volume":"11 1","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0