Journal of Endocrinological Investigation最新文献

{"title":"Predicting postoperative hypocortisolism in patients with non-aldosterone-producing adrenocortical adenoma: a retrospective single-centre study","authors":"","doi":"10.1007/s40618-023-02283-1","DOIUrl":"https://doi.org/10.1007/s40618-023-02283-1","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Background</h3> <p>Limited information exists on postoperative hypocortisolism and hypothalamus–pituitary–adrenal axis recovery in patients with adrenal incidentaloma following unilateral adrenalectomy. We evaluated frequency of postoperative hypocortisolism and predictors for recovery in non-aldosterone-producing adrenocortical adenoma patients after unilateral adrenalectomy.</p> </span> <span> <h3>Methods</h3> <p>A retrospective analysis of 32 adrenal incidentaloma patients originally included in the ITACA trial (NCT04127552) with confirmed non-aldosterone-producing adrenocortical adenoma undergoing unilateral adrenalectomy from September 2019 to April 2023 was conducted. Preoperative assessments included adrenal MRI, anthropometrics, evaluation of comorbidities, adrenal function assessed via ACTH, urinary free cortisol, and 1 mg dexamethasone suppression test. ACTH and serum cortisol or Short Synacthen test were performed within 6 days, 6 weeks, 6 months, and a year after surgery.</p> </span> <span> <h3>Results</h3> <p>Six days postoperative, 18.8% of patients had normal adrenal function. Among those with postoperative hypocortisolism, 53.8% recovered by 6 weeks. Patients with earlier adrenal recovery (6 weeks) had lower preoperative 1 mg dexamethasone suppression test (median 1 mg dexamethasone suppression test 76.2 [61.8–111.0] nmol/L vs 260.0 [113.0–288.5] nmol/L, <em>p</em> < 0.001). Univariate analysis showed preoperative 1 mg dexamethasone suppression test negatively related with baseline ACTH levels (<em>r</em> = − 0.376; <em>p</em> = 0.041) and negatively associated with the 6-week baseline (<em>r</em> = − 0.395, <em>p</em> = 0.034) and 30-min cortisol levels during Short Synacthen test (<em>r</em> = − 0.534, <em>p</em> = 0.023). Logistic regression analysis demonstrated preoperative 1 mg dexamethasone suppression test as the only biochemical predictor for 6-week adrenal recovery: ROC curve identified a 1 mg dexamethasone suppression test threshold of 131 nmol/L predicting 6-week recovery with 89.5% sensitivity and 72.7% specificity (AUC 0.87; 95% CI 66.9–98.7, <em>p</em> < 0.001). Other preoperative assessments (tumor size, ACTH levels and anthropometrics) were not associated with postoperative hypothalamus–pituitary–adrenal axis function, but the presence of diabetes was associated with a lower probability of recovery (OR = 24.55, <em>p</em> = 0.036). ACTH levels increased postoperatively in all patients but did not predict hypothalamus–pituitary–adrenal axis recovery.</p> </span> <span> <h3>Conclusions</h3> <p>The preoperative 1 mg dexamethasone suppression test cortisol value and presence of diabetes are the only relevant predictor of hypothalamus–pituitary–adrenal axis recovery in patients with non-aldosterone- producing adrenocortical adenoma undergoing surgery, regardless other clinical and biochemical variables. Notably, pre- and postoperative ACTH levels did not predict hypothalamus–pituitary","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"20 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139926440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel reference range values for serum testosterone: a cross-sectional study of 200,000 males","authors":"Richard J. Fantus, Daniel R. Greenberg, Cecilia Chang, Brian T. Helfand, Jianfeng Xu, Jun Wei, Jonathan E. Shoag, Ajay K. Nangia, Robert E. Brannigan, Joshua A. Halpern","doi":"10.1007/s40618-024-02319-0","DOIUrl":"https://doi.org/10.1007/s40618-024-02319-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To better understand the effects of aging, metabolic syndrome, diurnal variation, and seasonal variation on serum testosterone levels in the context of current guideline statements on testosterone deficiency.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This cross-sectional study utilized the United Kingdom Biobank. Physical examination, anthropomorphic measurements, and laboratory evaluation were performed at the time of enrollment from 2006 to 2010. The primary outcomes were the effect of age, the presence of metabolic syndrome, the time of day, and the month of the year on serum testosterone levels.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 197,883 included men, the 5th, 25th, 50th, 75th and 95th percentile testosterone levels in men without metabolic syndrome were significantly higher than those in men with metabolic syndrome at every decade of life (p &lt; 0.001). The average testosterone level within each group (men without metabolic syndrome vs. men with) was clinically similar across decade of life (12.43 in 40’s 12.29 in 50’s 12.24 in 60’s vs. 10.69 in 40’s 10.56 in 50’s 10.63 in 60’s respectively). Average testosterone levels decreased with blood draws later in the day ranging from 10.91 to 12.74 nmol/L (p &lt; 0.01). Similarly, there was seasonal variation in serum testosterone ranging from 11.86 to 12.18 nmol/L (p &lt; 0.01).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>We found significant variation in serum testosterone according to the presence of metabolic syndrome and time of laboratory draw, but not according to age. These data challenge the prior dogma of age-related hypogonadism and favor an individualized approach towards serum testosterone measurement and interpretation. However, further studies are needed to correlate these population-based data with individuals’ hypogonadal symptoms.</p>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"38 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139926475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting glutamine metabolism exhibits anti-tumor effects in thyroid cancer","authors":"G.-Q. Zhang, C. Xi, N.-T. Ju, C.-T. Shen, Z.-L. Qiu, H.-J. Song, Q.-Y. Luo","doi":"10.1007/s40618-023-02294-y","DOIUrl":"https://doi.org/10.1007/s40618-023-02294-y","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Background&lt;/h3&gt;&lt;p&gt;Effective treatment for patients with advanced thyroid cancer is lacking. Metabolism reprogramming is required for cancer to undergo oncogenic transformation and rapid tumorigenic growth. Glutamine is frequently used by cancer cells for active bioenergetic and biosynthetic needs. This study aims to investigate whether targeting glutamine metabolism is a promising therapeutic strategy for thyroid cancer.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Methods&lt;/h3&gt;&lt;p&gt;The expression of glutaminase (GLS) and glutamate dehydrogenase (GDH) in thyroid cancer tissues was evaluated by immunohistochemistry, and glutamine metabolism-related genes were assessed using real time-qPCR and western blotting. The effects of glutamine metabolism inhibitor 6-diazo-5-oxo-l-norleucine (DON) on thyroid cancer cells were determined by CCK-8, clone formation assay, Edu incorporation assay, flow cytometry, and Transwell assay. The mechanistic study was performed by real time-qPCR, western blotting, Seahorse assay, and gas chromatography–mass spectrometer assay. The effect of DON prodrug (JHU-083) on thyroid cancer in vivo was assessed using xenograft tumor models in BALB/c nude mice.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;GLS and GDH were over-expressed in thyroid cancer tissues, and GLS expression was positively associated with lymph-node metastasis and TNM stage. The growth of thyroid cancer cells was significantly inhibited when cultured in glutamine-free medium. Targeting glutamine metabolism with DON inhibited the proliferation of thyroid cancer cells. DON treatment did not promote apoptosis, but increased the proportion of cells in the S phase, accompanied by the decreased expression of cyclin-dependent kinase 2 and cyclin A. DON treatment also significantly inhibited the migration and invasion of thyroid cancer cells by reducing the expression of N-cadherin, Vimentin, matrix metalloproteinase-2, and matrix metalloproteinase-9. Non-essential amino acids, including proline, alanine, aspartate, asparagine, and glycine, were reduced in thyroid cancer cells treated with DON, which could explain the decrease of proteins involved in migration, invasion, and cell cycle. The efficacy and safety of DON prodrug (JHU-083) for thyroid cancer treatment were verified in a mouse model. In addition to suppressing the proliferation and metastasis potential of thyroid cancer in vivo, enhanced innate immune response was also observed in JHU-083-treated xenograft tumors as a result of decreased expression of cluster of differentiation 47 and programmed cell death ligand 1.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Thyroid cancer exhibited enhanced glutamine metabolism, as evidenced by the glutamine dependence of thyroid cancer cells and high expression of multiple glutamine metabolism-related genes. Targeting glutamine metabolism with DON prodrug could be a promising therapeutic option for advanced thyroid ","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"1 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139926336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel variants ensued genomic imprinting in familial central precocious puberty","authors":"","doi":"10.1007/s40618-023-02300-3","DOIUrl":"https://doi.org/10.1007/s40618-023-02300-3","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Introduction</h3> <p>Central precocious puberty (CPP) is characterized by the early onset of puberty and is associated with the critical processes involved in the pubertal switch. The puberty-related gene pool in the human genome is considerably large though few have been described in CPP. Within those genes, the genomic imprinting features of the <em>MKRN3</em> and <em>DLK1</em> genes add additional complexity to the understanding of the pathologic pathways. This study aimed to investigate the molecular etiology in the CPP cohort.</p> </span> <span> <h3>Methods</h3> <p>Eighteen familial CPP cases were investigated by Sanger sequencing for five CPP-related genes; <em>DLK1</em>, <em>KISS1</em>, <em>KISS1R</em>, <em>MKRN3</em>, and <em>PROKR2</em>. Segregation analysis was performed in all patients with pathogenic variants. Using an ELISA test, the functional pathogenicity of novel variants was also investigated in conjunction with serum delta-like 1 homolog (DLK1) concentrations.</p> </span> <span> <h3>Results</h3> <p>In three probands<strong>,</strong> a known variant in the <em>MKRN3</em> gene (c.982C&gt;T/p.(Arg328Cys)) and two novel variants in the <em>DLK1</em> gene (c.357C&gt;G/p.(Tyr119Ter) and c.67+78C&gt;T) were identified. All three were inherited from the paternal allele. The individuals carrying the <em>DLK1</em> variants had low detectable DLK1 levels in their serum.</p> </span> <span> <h3>Conclusions</h3> <p>The frequencies were 5.5% (1/18) for <em>MKRN3</em> 11% (2/18) for <em>DLK1</em>, and none for either <em>KISS1</em>, <em>KISS1R</em>, and <em>PROKR2</em>. Low serum DLK1 levels in affected individuals supported the relationship between here described novel <em>DLK1</em> gene variants with CPP. Nonsense nature of c.357C&gt;G/p.(Tyr119Ter) and an alteration in the evolutionarily conserved nucleotide c.67+78C&gt;T suggested the disruptive nature of the variant's compatibility with CPP.</p> </span>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"2 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139772229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different tumor growth pattern of clinically nonfunctioning pituitary neuroendocrine tumor according to sex and age: a longitudinal study","authors":"S. S. Park, H. Kang, Y. H. Kim, J. H. Kim","doi":"10.1007/s40618-024-02303-8","DOIUrl":"https://doi.org/10.1007/s40618-024-02303-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Asymptomatic patients with clinically non-functional pituitary neuroendocrine tumors (CNF-PitNETs) are usually followed up. However, the natural course of CNF-PitNETs according to sex and age remains unclear. Therefore, this study assessed growth patterns of CNF-PitNETs according to sex and age.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this longitudinal study, we enrolled 431 consecutive patients with CNF-PitNETs who were treated at Seoul National University Hospital from 1997 to 2021. The patients underwent hormone function testing and visual field testing, and were subsequently followed up with imaging over a median duration of 66 months.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The median age of the patients was 53.0 years, and 37.1% (<i>n</i> = 160) were men. Men were older and harbored more macroadenomas than women. The annual tumor volume change was higher in men than in women (0.21 vs. 0.04 cm³/year, <i>P</i> &lt; 0.001). The estimated cutoff value of age for significant tumor growth was 51 years. In men, the annual tumor volume change was similar across all age groups. In women, those aged ≤ 50 years showed significantly lower annual tumor volume change than those aged &gt; 50 years (0.01, 0.11, and 0.17 cm³/year, <i>P</i> = 0.001). When comparing sexes within the same age group, the annual tumor volume changes was significantly lower for women than for men, only in patients aged ≤ 50 years (0.01 vs. 0.15 cm³/year, <i>P</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Among patients with CNF-PitNET, tumor growth was slower in women aged ≤ 50 years than in men and women aged &gt; 50. These findings may guide the customization of surveillance strategies for CNF-PitNETs according to sex and age.</p>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"28 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139678564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid-induced adrenal insufficiency after therapy with intravenous methylprednisolone in patients with moderate-to-severe and active Graves’ orbitopathy: assessment with a low-dose corticotropin test","authors":"K. Pelewicz, P. Miśkiewicz","doi":"10.1007/s40618-024-02304-7","DOIUrl":"https://doi.org/10.1007/s40618-024-02304-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>We aimed to assess adrenal function following treatment of moderate-to-severe and active Graves’ orbitopathy (GO) with intravenous methylprednisolone (IVMP) in weekly pulses in a cumulative dose of 4.5 or 7.5 g. We evaluated the impact of IVMP pulses on adrenal reserve using a low-dose (1 μg) ACTH stimulation test (LDT) for the first time.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this prospective study we evaluated adrenal function in 21 patients with moderate-to-severe and active GO treated with 12 weekly IVMP pulses according to the European Group on Graves’ Orbitopathy (EUGOGO) recommendations. We assessed serum cortisol, plasma adrenocorticotropic hormone (ACTH), and dehydroepiandrosterone sulfate (DHEA-S) levels before the 1st and 12th IVMP pulse. We performed dynamic testing using LDT before the 12th IVMP pulse in all patients. In those who failed LDT, adrenal function was reassessed with LDT and the overnight metyrapone test after 4–7 weeks.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Two patients failed to achieve serum cortisol levels ≥ 18.1 μg/dL at 30 and 60 min in LDT and were diagnosed with glucocorticoid-induced adrenal insufficiency (GC-induced AI). They were recommended to take hydrocortisone in situations of acute stress. Both patients were reassessed within 4–7 weeks after treatment cessation and showed an adequate response in LDT and overnight metyrapone test. We observed a statistically significant decrease in DHEA-S levels (p = 0.004) before the 12th IVMP pulse compared to baseline in all patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>For the first time, our research shows that administering IVMP in 12 weekly pulses can result in GC-induced AI. We suggest that patients should undergo careful evaluation for GC-induced AI, including LDT, after therapy with IVMP according to EUGOGO guidelines. Screening for altered adrenal reserve could prevent life-threatening complications, particularly during acute stress situations.</p>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"3 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139678629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrine manifestations in adults with 22q11.2 deletion syndrome: a retrospective single-center cohort study","authors":"","doi":"10.1007/s40618-023-02276-0","DOIUrl":"https://doi.org/10.1007/s40618-023-02276-0","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Introduction and objective</h3> <p>Patients with the 22q11.2 deletion syndrome (22q11DS) frequently display cardiological and psychiatric diseases, but are also at increased risk for endocrine manifestations. The aim of this study was to evaluate the screening, prevalence, and management of hypoparathyroidism and thyroid disease in patients with 22q11DS, to evaluate the metabolic profile, and to compare these results with current literature and guidelines.</p> </span> <span> <h3>Design</h3> <p>We performed a retrospective study of patients with genetically confirmed 22q11DS, followed at the center for human genetics of the University Hospitals Leuven, resulting in a cohort of 75 patients. Medical history, medication, and laboratory results concerning hypoparathyroidism, thyroid dysfunction, and the metabolic profile were collected.</p> </span> <span> <h3>Results</h3> <p>Of the total cohort, 26 patients (35%) had at least one hypocalcaemic episode. During hypocalcaemia, parathyroid hormone (PTH) was measured in only 12 patients with 11 having normal or low PTH, confirming a diagnosis of hypoparathyroidism. Recurrent episodes of hypocalcaemia occurred in seventeen patients (23%). Adherence to the guidelines was low, with 13% of patients having a yearly serum calcium evaluation, 12% receiving daily calcium supplements, and 20% receiving non-active vitamin D. Hypothyroidism was present in 31 patients (44%) and hyperthyroidism in 6 patients (8%). Information on body mass index (BMI) was available in 52 patients (69%), of which 38% were obese (BMI ≥ 30 kg/m²).</p> </span> <span> <h3>Conclusion</h3> <p>Hypoparathyroidism, hypothyroidism, and obesity are common endocrine manifestations in patients with 22q11DS but are probably underdiagnosed and undertreated, indicating the need for multidisciplinary follow-up including an endocrinologist.</p> </span>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"63 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139678567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are sonographic characteristics of Hashimoto’s thyroiditis related with immunologic parameters? A cross-sectional study","authors":"K. Kenarlı, A. B. Bahçecioğlu, Ö. B. Aksu, S. Güllü","doi":"10.1007/s40618-023-02286-y","DOIUrl":"https://doi.org/10.1007/s40618-023-02286-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The clinical, laboratory, and imaging characteristics of Hashimoto’s thyroiditis are widely recognized. However, there is a dearth of information concerning the relationship between these aspects. The primary objective of this study was to investigate the correlation between sonographic features and immunologic parameters in individuals with Hashimoto’s thyroiditis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This cross-sectional study enrolled a cohort of 100 consecutive patients diagnosed with Hashimoto’s thyroiditis. Ultrasonography was performed to classify thyroid gland characteristics, including parenchymal heterogeneity (mild/moderate-to-high), extent of fibrosis (none-to-mild/moderate-to-high), and volume (atrophic/non-atrophic). As for immunologic parameters, thyroid autoantibodies (TOA; anti-TPO and anti-Tg), along with IG (immunoglobulin) G4 levels and lymphocyte subsets, were assessed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of the 100 patients evaluated, 88 were female (88%) and 12 were male (12%). IgG4/IgG ratio and weekly levothyroxine (LT4) dose were significantly higher in the group with moderate-to-high heterogeneity than the group with mild parenchymal heterogeneity (<i>p</i> = 0.043 and <i>p</i> &lt; 0.001, respectively). Compared to the group with none-to-mild fibrosis, the anti-TPO, IgG4, IgG4/IgG ratio and LT4 dose were significantly higher in the moderate-to-high fibrosis group. Anti-TPO and IgG levels were significantly lower in the atrophic thyroid group compared to the non-atrophic thyroid group. Although not reaching statistical significance, the proportion of plasma cells in the moderate/high fibrosis group was higher than in the non-fibrosis/mild fibrosis group. There was a moderate positive correlation between fibrosis with Anti-TPO, and a low positive correlation between anti-Tg, IgG4 levels with IgG4/IgG ratio.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>TOA, Ig G4 levels and severity of hypothyroidism were associated with ultrasonographic features such as parenchymal heterogeneity and fibrosis in Hashimoto’s thyroiditis.</p>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"197 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139506146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma knife radiosurgery is effective in patients with thyrotropin-secreting pituitary adenomas","authors":"M. Losa, L. Albano, L. R. Barzaghi, M. Bailo, P. Mortini","doi":"10.1007/s40618-023-02291-1","DOIUrl":"https://doi.org/10.1007/s40618-023-02291-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Thyrotropin <b>(</b>TSH)-secreting pituitary adenoma (TSHoma) is a rare cause of TSH-dependent hyperthyroidism. The first therapeutic option is surgery. Medical treatment with somatostatin analogs is also effective. To obviate the need for lifelong drug therapy, gamma knife radiosurgery (GKRS) might be considered in selected patients. We report the largest series of patients with TSHoma treated by GKRS at a single center.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This study was a retrospective analysis of 18 consecutive patients with TSHoma treated by GKRS between 1994 and 2022. Normalization of hyperthyroidism, when present at the time of surgery, and control of tumor growth were the main outcomes of the study.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The median follow-up after GKRS treatment was 114 months (IQR, 57–213 months; range 17–285 months). No patients had growth of the residual tumor after GKRS. Remission of hyperthyroidism occurred in 9 of the 11 (81.8%) patients who were hyperthyroid before GKRS. The probability of hyperthyroidism remission three years after GKRS was 59.1% (95% CI 27.9–90.3%). No major side effects occurred after GKRS. One patient out of the 15 patients (6.7%) with normal baseline adrenal function and follow-up longer than 3 years developed new onset hypoadrenalism, while hypogonadism did not occur in the 13 patients with baseline normal function.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our study shows that GKRS is an effective and safe adjuvant treatment for selected patients with residual or recurring TSHoma. The option of GKRS as an alternative treatment to lifelong medical treatment with somatostatin analogs should be thoroughly discussed with the patients.</p>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"47 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139506105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-life data of Pasireotide LAR in acromegaly: a long-term follow-up","authors":"C. Urbani, F. Dassie, B. Zampetti, R. Mioni, P. Maffei, R. Cozzi, F. Bogazzi","doi":"10.1007/s40618-023-02275-1","DOIUrl":"https://doi.org/10.1007/s40618-023-02275-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>Pasireotide LAR (PAS-LAR) was released in Italy in 2017 to treat acromegaly patients resistant to SRLs (Somatostatin Receptors Ligands). The long-term follow-up data of PAS-LAR therapy in Italy are limited. This study aimed to evaluate the efficacy and safety of PAS-LAR in acromegaly.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>Patients with acromegaly in PAS-LAR treatment were enrolled in three tertiary Italian endocrinological centers and evaluated by a retrospective observational real-life multicentre study.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patients have been studied before (baseline) and 1, 6, 12, 24 and &gt; 36 months after PAS-LAR start. Clinical, biochemical, and pituitary magnetic resonance data were collected, along with information on adverse events. Acromegaly disease activity was classified according to the IGF-1 index (normal value &lt; 1.0).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Fifty patients (female 23) were enrolled. PAS-LAR treatment (mean follow-up 24 ± 16 months) significantly decreased IGF-1 levels (IGF-1 index baseline vs last visit: 1.9 ± 0.6 vs 1.2 ± 0.6, <i>p</i> &lt; 0.0001). At the last visit, 67% of patients had controlled disease, and 44% showed a decrease in tumor volume. Clinical and biochemical efficacy was observed as early as after 1-month of PAS-LAR treatment (IGF-1 index baseline vs 1-month: 1.9 ± 0.6 vs 1.4 ± 0.7, <i>p</i> &lt; 0.0001). Also, 50% of patients referred headache improvement or disappearance. Fifteen patients discontinued PAS-LAR due to failure of treatment and poor glycaemic control. The prevalence of diabetes increased from 33% at the baseline to 54% at the last visit (<i>p</i> = 0.0072).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In real-life settings, PAS-LAR significantly decreases symptoms, IGF-1 levels, and the size of adenoma in patients with acromegaly resistant to SRLs. Beneficial effects may occur early after the first injection.</p>","PeriodicalId":15651,"journal":{"name":"Journal of Endocrinological Investigation","volume":"40 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139506348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}