European Journal of Endocrinology最新文献

{"title":"Advancing understanding of metabolic consequences of a Cholecystectomy: review reflection.","authors":"Stijn Bluiminck, Frank G Schaap, Philip R de Reuver","doi":"10.1093/ejendo/lvae152","DOIUrl":"https://doi.org/10.1093/ejendo/lvae152","url":null,"abstract":"","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686385","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}

{"title":"Response to \"Advancing understanding of metabolic consequences of Cholecystectomy: review reflection\".","authors":"Andreas H Lange, Miriam G Pedersen, Anne-Marie Ellegaard, Henriette H Nerild, Andreas Brønden, David P Sonne, Filip K Knop","doi":"10.1093/ejendo/lvae153","DOIUrl":"https://doi.org/10.1093/ejendo/lvae153","url":null,"abstract":"","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681127","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}

{"title":"Prevalence and determinants of dyslipidemia in 2,338 Dutch childhood cancer survivors: a DCCS-LATER 2 Study.","authors":"M Bolier, V G Pluimakers, D T C de Winter, M Fiocco, S A A van den Berg, D Bresters, E van Dulmen-den Broeder, M van der Heiden-van der Loo, I Höfer, G O Janssens, L C M Kremer, J J Loonen, M Louwerens, H J van der Pal, S M F Pluijm, W J E Tissing, H M van Santen, A C H de Vries, A J van der Lely, M M van den Heuvel-Eibrink, S J C M M Neggers","doi":"10.1093/ejendo/lvae149","DOIUrl":"https://doi.org/10.1093/ejendo/lvae149","url":null,"abstract":"<p><strong>Objective: </strong>Childhood cancer survivors (CCS) face an increased risk of early cardiovascular disease. In our nationwide CCS cohort, we assessed the prevalence and determinants of dyslipidemia, a well-established risk factor for accelerated atherosclerosis and cardiovascular disease.</p><p><strong>Methods: </strong>Prevalence of dyslipidemia was cross-sectionally assessed in 2,338 adult CCS and compared to adults with no cancer history (Lifelines, n=132,226). Dyslipidemia was defined by multiple classifications as well as lipid abnormalities to investigate the impact on prevalence and determinants. Logistic regression models, adjusted for age, sex, and BMI, were used to assess the cohort effect on presence of dyslipidemia. Determinants of dyslipidemia were identified through multivariable logistic regression.</p><p><strong>Results: </strong>CCS (median age 34.7y, median follow-up 27.1y) had significantly increased odds of dyslipidemia compared to the reference cohort according to all classifications (NCEP-ATP-III, WHO, EGIR, CTCAEv.4.03). In survivors without lipid-lowering agents (n=2,007), lipid abnormalities were present in 20.6% (triglycerides>1.7mmol/L), 30.3% (HDL-c<1.0/1.3mmol/L (male/female)), 29.9% (total cholesterol>5.2mmol/L), 7.3% (LDL-c>4.1mmol/L), and 7.7% (apolipoprotein-B>130mg/dl). Compared to references without lipid-lowering agents (n=126,631), survivors had increased odds of high triglycerides (aOR=1.89, 95%CI=1.68-2.13), low HDL-c (aOR=2.73, 95%CI=2.46-3.03), and high apolipoprotein-B (aOR=1.84, 95%CI=1.53-2.20). Sex, age, BMI, physical activity, abdominal/pelvic, cranial, and total body irradiation, alkylating agents, smoking, growth hormone deficiency, and diabetes mellitus were associated with (≥1 definition of) dyslipidemia in CCS.</p><p><strong>Conclusions: </strong>CCS are at increased risk of dyslipidemia, with various modifiable and non-modifiable determinants identified, underscoring the importance of survivor-specific risk assessment tools to control cardiovascular morbidity and mortality in this high-risk population.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675383","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}

{"title":"Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in adults: Recommendations From the European Calcified Tissue Society.","authors":"Julien Paccou, Maria P Yavropoulou, Anda Mihaela Naciu, Manju Chandran, Osvaldo D Messina, Tim Rolvien, John J Carey, Stella D'oronzo, Athanasios D Anastasilakis, Kenneth G Saag, Willem F Lems","doi":"10.1093/ejendo/lvae146","DOIUrl":"10.1093/ejendo/lvae146","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;This report presents the recommendations of the European Calcified Tissue Society (ECTS) for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) in adults. Our starting point was that the recommendations be evidence based, focused on non-bone specialists who treat patients with GC and broadly supported by ECTS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The recommendations were developed by global experts. After a comprehensive review of the literature, twenty-five recommendations were formulated, based on quality evidence. For stratifying fracture risk and the most appropriate first line of treatment, we have classified patients into 3 categories: those at medium risk of fractures i.e. adults without a recent (in the last 2 years) history of fracture, those at high risk of fractures i.e. adults with recent history of fracture, and/or at least one vertebral fracture (grade ≥ 2 according to Genant classification), and those at very high risk of fractures i.e. adults aged ≥ 70 years with a recent hip fracture, pelvis fracture, and/or at least one vertebral fracture (grade ≥ 2 according to Genant classification) . The subtopics in the recommendations include Who to assess, How to assess, Who to treat, How to treat, and Follow-up and Monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;General measures are recommended for all patients who are being prescribed glucocorticoids (GCs) for &gt; 3 months: i.e. calcium and protein intake should be normalized, a 25(OH) vitamin D concentration of 50-125 nmol/L should be attained, and the risk of falls be minimized. 1)Who to assess? (R1-2) A preliminary assessment of fracture risk should be routinely performed in patients likely to receive oral GCs for ≥ 3 months: (i) women and men ≥ 50 years and (ii) patients at increased risk of fracture (history of fragility fracture and/or have comorbidities or are on medications that are frequently associated with osteoporosis.2)How to assess (fracture risk)? (R3-6) Clinical risk factors including history of fragility fracture, systematic vertebral imaging, and GCs dose-adjusted FRAX, measurement of BMD by DXA, fall risk, and biochemical testing.3) Who to treat? (R7-12) Anti-osteoporosis treatment is indicated for women and men ≥ 50 years with (i) the presence of a recent history of vertebral and/or non-vertebral fracture (less than 2 years) (ii)and/or a GCs dosage ≥ 7.5 mg/day, (iii)and/or age ≥ 70 years (iv)and/or a T-score ≤ -1.5, (v)and/or 10-year probability risk above the country specific GC dose-adjusted FRAX® thresholds. In premenopausal women and men &lt; 50 years with a Z-score ≤ -2 and/or a history of fragility fracture, it is recommended to refer the patient to a bone specialist.4) How to treat? (R13-18) In women and men ≥ 50 years, (i) alendronate or risedronate is preferred as the first line of treatment in patients at medium risk of fractures, (ii) zoledronic acid or denosumab in patients at high risk of fractures, and (iii) t","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667629","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}

{"title":"Influence of smoking on cardiometabolic profile and surgical outcomes in patients with primary aldosteronism. A cohort study.","authors":"Marta Araujo-Castro, Miguel Paja Fano, Marga González-Boillos, Eider Pascual-Corrales, Paola Parra Ramírez, Patricia Martín Rojas-Marcos, Ana García-Cano, Jorge Gabriel Ruiz-Sanchez, Almudena Vicente, Emilia Gómez-Hoyos, Ana Casterás, Albert Puig-Perez, Iñigo García Sanz, Mònica Recasens, Rebeca Barahona San Millan, María José Picón César, Patricia Díaz Guardiola, Carolina Perdomo, Laura Manjón-Miguélez, Ángel Rebollo Román, Cristina Robles Lázaro, José María Recio, Manuel Morales-Ruiz, María Calatayud, Noemi Jiménez López, Diego Meneses, Miguel Sampedro Nuñez, Elena Mena Ribas, Alicia Sanmartín Sánchez, Cesar Gonzalvo Diaz, Cristina Lamas, María Del Castillo Tous, Joaquín Serrano, Theodora Michalopoulou, Susana Tenes Rodrigo, Ricardo Roa Chamorro, Fernando Jaén Aguila, Eva María Moya Mateo, Sonsoles Gutiérrez-Medina, Felicia Alexandra Hanzu","doi":"10.1093/ejendo/lvae143","DOIUrl":"10.1093/ejendo/lvae143","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the influence of smoking on cardiometabolic profile and surgical outcomes in patients with primary aldosteronism (PA).</p><p><strong>Methods: </strong>Multicenter retrospective study of patients with PA in 36 Spanish tertiary hospitals with available information on smoking habits (smokers and non-smokers [never smokers and ex-smokers]).</p><p><strong>Results: </strong>A total of 881 patients were included, of whom 180 (20.4%) were classified as smokers and 701 as non-smokers. At diagnosis, smokers and non-smokers did not differ in blood pressure or serum potassium levels between. However, smokers had a higher prevalence of left ventricular hypertrophy (LVH) than non-smokers (OR 2.0, 95% CI 1.23 to 3.25), and smokers were more likely to have severe LVH than non-smokers (12.5% vs. 6.6%, P=0.164). A larger mean tumor size of the adrenal nodule/s was observed in the smoking group (18.6±9.66 vs. 15.8±8.66 mm, P=0.002). In addition, the odds of mild autonomous cortisol secretion (MACS) was greater in smokers than in non-smokers (OR 2.1, 95% CI 1.14 to 4.06), but these differences disappeared when adjusted for the size of the adrenal nodule/s (adjusted OR 1.6, 95% CI 0.76 to 3.37). The rate of biochemical and hypertension cure was similar in both groups; however, hypertension cure tended to be more frequent in the non-smoker group (41.2% vs 29.9%, P=0.076).</p><p><strong>Conclusions: </strong>Patients with PA who smoke have a higher prevalence of LVH and MACS and larger adrenal nodule/s than non-smokers. Smoking has no significant effect on the probability of hypertension response after adrenalectomy in patients with PA.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667627","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}

{"title":"Cardiovascular status in endogenous cortisol excess: the prospective CV-CORT-EX study.","authors":"C Morbach, M Detomas, F Sahiti, K Hoffmann, M Kroiss, G Gelbrich, S Frantz, S Hahner, P U Heuschmann, M Fassnacht, S Störk, T Deutschbein","doi":"10.1093/ejendo/lvae145","DOIUrl":"10.1093/ejendo/lvae145","url":null,"abstract":"<p><strong>Objective: </strong>Cushing´s syndrome (CS) results in increased cardiovascular morbidity and mortality. Subtype-specific differences and possible reversibility after biochemical cure are not well investigated.</p><p><strong>Design: </strong>Prospective cohort study evaluating the cardiovascular status in different forms of endogenous cortisol excess.</p><p><strong>Methods: </strong>Patients with overt CS (n=40, 47±13 years, 75% women; 18 pituitary, 13 adrenal, 9 ectopic), biochemically cured CS (n=56, 53±12 years, 79% women; 30 pituitary, 21 adrenal, 5 ectopic), and adrenal incidentalomas with mild autonomous cortisol secretion (MACS) (n=18, 62±11 years, 56% women) underwent comprehensive biochemical, metabolic, and cardiovascular assessment. Results were compared with a representative sample of the general population of Würzburg (n=4965, 55±12 years, 52% women).</p><p><strong>Results: </strong>Overt CS was associated with left ventricular (LV) remodeling along with hypertrophy and impaired longitudinal systolic/diastolic function at echocardiography. In 20 CS patients followed for a median of 8 (quartiles: 6, 11) months after biochemical remission, hypertension and hyperglycemia were better controlled, while cardiac alterations only partially improved. Patients with previous CS (median time of biochemical remission: 95 (36, 201) months) had worse diastolic function than the general population (LV relaxation velocity e´ 0.08 (0.07, 0.10) ms-1 vs 0.10 (0.08, 0.12) ms-1, p<0.001). In MACS, cardiac remodeling was even more pronounced than in individuals with metabolic syndrome.</p><p><strong>Conclusions: </strong>In patients with overt CS, cured CS, and MACS, we found a sizable and significant deviation from the general population mean regarding cardiac structure and function. Even mild cortisol excess is associated with glucocorticoid-induced cardiac alterations which appear to persist despite long-term biochemical remission.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667615","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}

{"title":"Targeted Multiplex Proteomics for the Development and Validation of Biomarkers in Primary Aldosteronism Subtyping.","authors":"Fangli Zhou, Yun Ding, Tao Chen, Qiming Tang, Jingjing Zhang, Sheeno Thyparambil, Bo Jin, Zhi Han, C James Chou, James Schilling, Ruben Y Luo, Haoming Tian, Karl G Sylvester, John C Whitin, Harvey J Cohen, Doff B McElhinney, Li Tian, Xuefeng B Ling, Yan Ren","doi":"10.1093/ejendo/lvae148","DOIUrl":"10.1093/ejendo/lvae148","url":null,"abstract":"<p><strong>Objective: </strong>Primary aldosteronism (PA), a significant cause of secondary hypertension affecting approximately 10% of patients with severe hypertension, exacerbates cardiovascular and cerebrovascular complications even after blood pressure control. PA is categorized into two main subtypes: unilateral aldosterone-producing adenomas (APA) and bilateral hyperaldosteronism (BHA), each requiring distinct treatment approaches. Accurate subtype classification is crucial for selecting the most effective treatment. The goal of this study was to develop novel blood-based proteomic biomarkers to differentiate between APA and BHA subtypes in patients with PA.</p><p><strong>Design and methods: </strong>Five subtyping differential protein biomarker candidates (APOC3, CD56, CHGA, KRT5, and AZGP1) were identified through targeted proteomic profiling of plasma. The subtyping efficiency of these biomarkers was assessed at both the tissue gene expression and blood protein expression levels. To explore the underlying biology of APA and BHA, significant differential pathways were investigated.</p><p><strong>Results: </strong>The five-protein panel proved highly effective in distinguishing APA from BHA in both tissue and blood samples. By integrating these five protein biomarkers with aldosterone and renin, our blood-based predictive methods achieved remarkable ROC AUCs of 0.986 (95% CI: 0.963-1.000) for differentiating essential hypertension (EH) from PA, and 0.922 (95% CI: 0.846-0.998) for subtyping APA versus BHA. These outcomes surpass the performance of the existing Kobayashi score subtyping system. Furthermore, the study validated differential pathways associated with the pathophysiology of primary aldosteronism, aligning with current scientific knowledge and opening new avenues for advancing PA care.</p><p><strong>Conclusions: </strong>The new blood-based biomarkers for PA subtyping hold the potential to significantly enhance clinical utility and advance the practice of PA care.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667633","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}

{"title":"Secretin infusion decreases food intake in healthy men - a randomized, placebo-controlled, double-blind, crossover study.","authors":"Sebastian M N Heimbürger, Maria J Bentzen, Hüsün S Kizilkaya, Bolette Hartmann, Jens J Holst, Mette M Rosenkilde, Flemming Dela, Svend H Hansen, Jens F Rehfeld, Mikkel B Christensen, Filip K Knop","doi":"10.1093/ejendo/lvae147","DOIUrl":"10.1093/ejendo/lvae147","url":null,"abstract":"<p><strong>Design: </strong>The hormone secretin, best known for regulating pH in the duodenum, has anorectic properties in mice proposedly mediated via secretin-induced brown adipose tissue (BAT) activation. We investigated the effects of exogenous secretin on ad libitum food intake, BAT activity, and postprandial physiology in healthy male volunteers.</p><p><strong>Methods: </strong>In a randomized, placebo-controlled, double-blind, crossover study, 25 healthy men underwent two 5-hour i.v. infusions of secretin (1 pmol/kg/min) and placebo (saline), respectively, with an interposed two-month wash-out period. After 30 min of infusion, a standardized liquid mixed meal was ingested and after 5 hours, food intake and meal duration were assessed during an ad libitum meal test. BAT activity was assessed regularly by thermal imaging-measured supraclavicular skin temperature.</p><p><strong>Results: </strong>Compared to placebo, secretin significantly decreased ad libitum food intake by 173 ± 88 kcal [95% CI 0.76 to 0.99, P = 0.039], but did not alter ad libitum meal duration. Secretin acutely decreased BAT activity but increased it postprandially compared to placebo. Acetaminophen-assessed gastric emptying was not affected by exogenous secretin, but secretin increased gallbladder volume, bile acid synthesis, and circulating levels of lipase, amylase and triglycerides, while decreasing plasma Na+. Compared to placebo, secretin infusion was associated with 24.0 ± 10.8% (95% CI 0.3 to 1, P = 0.025) more adverse events (headache, nausea, diarrhoea, and vomiting).</p><p><strong>Conclusions: </strong>In healthy men, secretin infusion decreased ad libitum food intake concomitantly with a postprandial increase in BAT activity as assessed by thermal imaging-measured supraclavicular skin temperature.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT04613700.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667631","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}

{"title":"Proof of concept for a superior therapeutic index of corticosterone compared with hydrocortisone in patients with congenital adrenal hyperplasia.","authors":"Catriona J Kyle, Luke D Boyle, Mark Nixon, Natalie Z M Homer, Joanna P Simpson, Alison Rutter, Lynne E Ramage, Alexandra Kelman, Marie Freel, Ruth Andrew, Brian R Walker, Roland H Stimson","doi":"10.1093/ejendo/lvae144","DOIUrl":"https://doi.org/10.1093/ejendo/lvae144","url":null,"abstract":"<p><strong>Objective: </strong>Outcomes are poor for patients with congenital adrenal hyperplasia (CAH), in part due to the supraphysiological glucocorticoid doses required to control adrenal androgen excess. Hydrocortisone (i.e. cortisol) is the recommended glucocorticoid for treatment of CAH. However, the other endogenous glucocorticoid in humans, corticosterone, is actively transported out of metabolic tissues such as adipose tissue and muscle, so we hypothesized that corticosterone could control adrenal androgens while causing fewer metabolic adverse effects than hydrocortisone.</p><p><strong>Methods: </strong>Thirteen patients (8 female, 5 male) with CAH due to 21-hydroxylase deficiency completed a randomised placebo-controlled crossover study comparing 5h intravenous infusions of either hydrocortisone, corticosterone or placebo. 6-6[2H]2-glucose and 1,1,2,3,3-[2H]5-glycerol were infused to measure glucose and glycerol kinetics, and blood samples were collected throughout. Subcutaneous abdominal adipose tissue biopsies were obtained at the end of each infusion.</p><p><strong>Results: </strong>During the infusion, corticosterone and hydrocortisone similarly reduced ACTH, 17α-hydroxyprogesterone, androstenedione, and testosterone (in females only) compared with placebo. Despite achieving circulating corticosterone concentrations ∼2.5-fold higher than hydrocortisone, by T+300 minutes hydrocortisone but not corticosterone increased glucose and insulin concentrations and reduced 6-6-[2H]2-glucose clearance compared with placebo. Hydrocortisone increased mRNA levels of the glucocorticoid regulated transcript PER1 in adipose to a greater extent than corticosterone.</p><p><strong>Conclusions: </strong>Corticosterone acutely controls biochemical markers of androgen excess similarly to hydrocortisone but without inducing markers of glucocorticoid 'toxicity' in CAH. These data demonstrate proof of concept that corticosterone may be a safer glucocorticoid replacement than current medications, although further research is required to assess the longer-term effects of corticosterone replacement.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638604","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}

{"title":"Apelin levels in patients with polyuria-polydipsia syndrome upon copeptin stimulation tests.","authors":"Chiara Angela Bizzozero, Sophie Monnerat, Fiona A Chapman, Neeraj Dhaun, Julie Refardt, Mirjam Christ-Crain","doi":"10.1093/ejendo/lvae138","DOIUrl":"10.1093/ejendo/lvae138","url":null,"abstract":"<p><strong>Objective: </strong>Differentiating between arginine vasopressin deficiency (AVP-D) and primary polydipsia (PP) requires a copeptin stimulation test. We aimed to characterize changes in apelin, an endogenous hormone antagonizing AVP, upon copeptin stimulation tests.</p><p><strong>Design: </strong>Post hoc secondary analysis of a multi-centric cross-over diagnostic study (NCT03572166).</p><p><strong>Setting: </strong>Outpatients included at the University Hospital Basel.</p><p><strong>Participants: </strong>Patients with AVP-D and PP.</p><p><strong>Interventions: </strong>Copeptin stimulation tests with hypertonic saline and arginine infusion.</p><p><strong>Outcomes and measures: </strong>The primary outcome was the absolute difference in apelin between baseline and peak of copeptin stimulation tests. Secondary objectives included the diagnostic ability of apelin.</p><p><strong>Results: </strong>Thirty-eight patients were analysed, 23 (60%) had PP and 15 (40%) had AVP-D. No difference was seen between baseline median (IQR) apelin levels in PP and AVP-D (1079 [912, 1225] and 910 [756, 1039] pmol/L, respectively). Upon hypertonic saline, apelin decreased by -241 (-326, -124) pmol/L in PP and -47.2 (-198, 5.86) pmol/L in AVP-D (P = .022). The area under the curve (AUC) to differentiate PP from AVP-D was 97.1% (95% CI, 90.5-100) for copeptin and 49.3% (95% CI, 30.4-68.1) for apelin (P < .001). Upon arginine, apelin decreased by -39.2 (-96.4, 39.8) pmol/L in PP and increased by 25.8 (2.8, 113.0) pmol/L in AVP-D (P = .1). The AUC was 97.1% (95% CI: 79.6-98.0) for copeptin and 60.5% (95% CI: 39.8-80.0) for apelin (P = .007).</p><p><strong>Conclusions and relevance: </strong>Our findings suggest that apelin decreases to a greater extent in PP compared with AVP-D upon copeptin stimulation tests. However, copeptin remains the best marker to differentiate AVP-D from PP.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"491-498"},"PeriodicalIF":5.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461000","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}