Reviews in Endocrine & Metabolic Disorders最新文献

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Pituitary adenomas: biology, nomenclature and clinical classification.
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2025-01-25 DOI: 10.1007/s11154-025-09944-x
Ken K Y Ho, Shlomo Melmed
{"title":"Pituitary adenomas: biology, nomenclature and clinical classification.","authors":"Ken K Y Ho, Shlomo Melmed","doi":"10.1007/s11154-025-09944-x","DOIUrl":"https://doi.org/10.1007/s11154-025-09944-x","url":null,"abstract":"<p><p>An 'adenoma' is a benign neoplasm composed of epithelial tissue, and has been standard nomenclature for primary pituitary neoplasms. In 2022, the fifth edition of the WHO Classification of Endocrine Tumours and of Central Nervous System Tumours, renamed pituitary adenomas as neuroendocrine tumours (NETs), assigning an oncology label to pituitary invariably benign neoplasms. Multidisciplinary workshops convened by the Pituitary Society have questioned the process, validity, and merit of this arbitrary change, while addressing the adverse clinical implications of the proposed new nomenclature. Unlike NETs, pituitary adenomas are highly prevalent, indolent and very rarely become malignant, and in general do not affect life expectancy when appropriately managed. A nomenclature change to NET does not advance mechanistic insight, treatment or prognosis but confers a misleading oncology connotation, potentially leading to overtreatment as well as engendering unnecessary patient anxiety. As the majority of pituitary adenomas do not require surgery, exclusion of these disorders is a major shortcoming of the pathology-based WHO classification system which is limited to patients undergoing surgery. Many factors influence prognosis other than histopathology. A new clinical classical classification has been developed for guiding prognosis and therapy of pituitary adenomas by integrating clinical, genetic, biochemical, radiological, pathological, and molecular information for all adenomas arising from anterior pituitary cell lineages. The system uses an evidence-based scoring of risk factors to yield a cumulative grade score that reflects disease severity. It can be used at the bedside to guide pituitary adenoma management. Once validated in prospective studies, this simple classification system could provide a standardised platform for assessing disease severity, prognosis, and effects of therapy on pituitary adenoma outcomes.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041071","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}
引用次数: 0
Poor muscle quality: A hidden and detrimental health condition in obesity. 肌肉质量差:肥胖中隐藏的有害健康状况。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2025-01-21 DOI: 10.1007/s11154-025-09941-0
Flavio T Vieira, Yuanjun Cai, M Cristina Gonzalez, Bret H Goodpaster, Carla M Prado, Andrea M Haqq
{"title":"Poor muscle quality: A hidden and detrimental health condition in obesity.","authors":"Flavio T Vieira, Yuanjun Cai, M Cristina Gonzalez, Bret H Goodpaster, Carla M Prado, Andrea M Haqq","doi":"10.1007/s11154-025-09941-0","DOIUrl":"https://doi.org/10.1007/s11154-025-09941-0","url":null,"abstract":"<p><p>Poor muscle quality (MQ) is a hidden health condition in obesity, commonly disregarded and underdiagnosed, associated with poor health-related outcomes. This narrative review provides an in-depth exploration of MQ in obesity, including definitions, available assessment methods and challenges, pathophysiology, association with health outcomes, and potential interventions. MQ is a broad term that can include imaging, histological, functional, or metabolic assessments, evaluating beyond muscle quantity. MQ assessment is highly heterogeneous and requires further standardization. Common definitions of MQ include 1) muscle-specific strength (or functional MQ), the ratio between muscle strength and muscle quantity, and 2) muscle composition (or morphological MQ), mainly evaluating muscle fat infiltration. An individual with obesity might still have normal or higher muscle quantity despite having poor MQ, and techniques for direct measurements are needed. However, the use of body composition and physical function assessments is still limited in clinical practice. Thus, more accessible techniques for assessing strength, muscle mass, and composition should be further explored. Obesity leads to adipocyte dysfunction, generating a low-grade chronic inflammatory state, which leads to mitochondrial dysfunction. Adipocyte and mitochondrial dysfunction result in metabolic dysfunction manifesting clinically as insulin resistance, dyslipidemia, and fat infiltration into organs such as muscle, which in excess is termed myosteatosis. Myosteatosis decreases muscle cell function and insulin sensitivity, creating a vicious cycle of inflammation and metabolic derangements. Myosteatosis increases the risk of poor muscle function, systemic metabolic complications, and mortality, presenting prognostic potential. Interventions shown to improve MQ include nutrition, physical activity/exercise, pharmacology, and metabolic and bariatric surgery.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010810","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}
引用次数: 0
Update on regulation of GHRH and its actions on GH secretion in health and disease. GHRH调控及其在健康和疾病中对GH分泌的作用的最新进展。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2025-01-21 DOI: 10.1007/s11154-025-09943-y
Antonio J Montero-Hidalgo, Mercedes Del Rio-Moreno, Jesús M Pérez-Gómez, Raúl M Luque, Rhonda D Kineman
{"title":"Update on regulation of GHRH and its actions on GH secretion in health and disease.","authors":"Antonio J Montero-Hidalgo, Mercedes Del Rio-Moreno, Jesús M Pérez-Gómez, Raúl M Luque, Rhonda D Kineman","doi":"10.1007/s11154-025-09943-y","DOIUrl":"https://doi.org/10.1007/s11154-025-09943-y","url":null,"abstract":"<p><p>This review focuses on our current understanding of how growth hormone releasing hormone (GHRH): 1) stimulates GH release and synthesis from pituitary growth hormone (GH)-producing cells (somatotropes), 2) drives somatotrope proliferation, 3) is negatively regulated by somatostatin (SST), GH and IGF1, 4) is altered throughout lifespan and in response to metabolic challenges, and 5) analogues can be used clinically to treat conditions of GH excess or deficiency. Although a large body of early work provides an underpinning for our current understanding of GHRH, this review specifically highlights more recent work that was made possible by state-of-the-art analytical tools, receptor-specific agonists and antagonists, high-resolution in vivo and ex vivo imaging and the development of tissue (cell) -specific ablation mouse models, to paint a more detailed picture of the regulation and actions of GHRH.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010811","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}
引用次数: 0
The radiologic spectrum of neuroendocrine tumors in emergent care. 急诊神经内分泌肿瘤的放射谱分析。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2025-01-02 DOI: 10.1007/s11154-024-09940-7
Asutosh Sahu, Michael Patlas, Ankush Jajodia
{"title":"The radiologic spectrum of neuroendocrine tumors in emergent care.","authors":"Asutosh Sahu, Michael Patlas, Ankush Jajodia","doi":"10.1007/s11154-024-09940-7","DOIUrl":"https://doi.org/10.1007/s11154-024-09940-7","url":null,"abstract":"<p><p>Neuroendocrine tumors (NETs) are a diverse group of neoplasms whose prevalence is increasing globally, primarily due to advancements in diagnostic techniques. NETs arise from cells of the diffuse endocrine system and can occur in various locations, with the gastrointestinal tract being the most common. Their diverse clinical presentations, which range from asymptomatic to severe hormone-induced syndromes, pose significant diagnostic challenges. In emergency care, prompt recognition and management of complications such as bowel obstruction, ischemic events, hormonal crises, and metastases are critical. This review discusses the radiologic spectrum of NETs in emergent care, emphasizing the role of imaging in timely diagnosis and intervention.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915543","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}
引用次数: 0
Effects of growth hormone-releasing hormone deficiency in mice beyond growth. 生长激素释放激素缺乏对小鼠生长的影响。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-12-18 DOI: 10.1007/s11154-024-09936-3
Lucia Recinella, Maria Loreta Libero, Luigi Brunetti, Alessandra Acquaviva, Annalisa Chiavaroli, Giustino Orlando, Riccarda Granata, Roberto Salvatori, Sheila Leone
{"title":"Effects of growth hormone-releasing hormone deficiency in mice beyond growth.","authors":"Lucia Recinella, Maria Loreta Libero, Luigi Brunetti, Alessandra Acquaviva, Annalisa Chiavaroli, Giustino Orlando, Riccarda Granata, Roberto Salvatori, Sheila Leone","doi":"10.1007/s11154-024-09936-3","DOIUrl":"https://doi.org/10.1007/s11154-024-09936-3","url":null,"abstract":"<p><p>This paper provides a critical overview on GHRH and its deficiency, discussing its multiple roles in both central and peripheral tissues. Genetically engineered mice have been instrumental in elucidating the multifaceted roles of GHRH and GH, each offering unique insights into the physiological and pathological roles of these hormones, although in many of these models dissecting the direct effect of GHRH from the effect of GH is not possible. Key findings highlight the effects of GHRH deficiency on emotional behavior, including anxiety and depression, its impact on memory and learning capabilities, as well as on adipose tissue, immune system, inflammation and pain.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855264","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}
引用次数: 0
The history of an effective, specific and sensitive diagnostic test: the GHRH test in clinical practice. 一种有效、特异和敏感的诊断测试的历史:临床实践中的 GHRH 测试。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-12-17 DOI: 10.1007/s11154-024-09938-1
Marina Caputo, Stella Pigni, Chiara Mele, Rosa Pitino, Paolo Marzullo, Flavia Prodam, Gianluca Aimaretti
{"title":"The history of an effective, specific and sensitive diagnostic test: the GHRH test in clinical practice.","authors":"Marina Caputo, Stella Pigni, Chiara Mele, Rosa Pitino, Paolo Marzullo, Flavia Prodam, Gianluca Aimaretti","doi":"10.1007/s11154-024-09938-1","DOIUrl":"https://doi.org/10.1007/s11154-024-09938-1","url":null,"abstract":"<p><p>Growth hormone (GH) secretion is pulsatile, entropic, and nycthemeral and is mainly controlled by the hypothalamus through two neurohormones, the stimulating growth hormone releasing hormone (GHRH) and the inhibiting somatostatin. Shortly after its discovery and synthesis, GHRH was intensely investigated diagnostically to define GH secretion. The nascent enthusiasm for using GHRH as a single diagnostic tool to investigate GH deficiency (GHD) dropped down quickly due to a flawed reproducibility. The subsequent combinatory use of molecules implicated in GH secretion through inhibition of the somatostatinergic tone, such as arginine (ARG), or the synthesis of receptor-orphan pharmaceutical compounds capable of stimulating pituitary somatotrophs to release GH, such as the GH secretagogues (GHSs), improved the reproducibility of GH response to GHRH alone, thus gaining access into the clinical practice by means of different diagnostic approaches. This review will focus on the history of the GHRH test, with main emphasis on GHRH plus ARG as a dynamic testing for the diagnosis of GHD. Our attention will extend crosswise from studies aimed at validating GHRH-based tests for the clinical practice, to address main pitfall conditions capable of affecting per se GH secretion, such as obesity, hypothalamic damage, and ageing. The history of GHRH test has been progressively dismantled due to the cease of its production for business reasons, opening a gap in the diagnostic workup of patients with GHD. In the urgency to seek further robust, safe, and validated diagnostic tests or tools, we hope to stimulate attention on a so important peptide for the health of our patients suffering from pituitary diseases.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839091","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}
引用次数: 0
Nutritional status and gastroenteropancreatic neuroendocrine neoplasms: lights and shadows with a clinical guide from the NIKE Group. 营养状况与胃肠胰神经内分泌肿瘤:NIKE 集团临床指南的光与影。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-12-09 DOI: 10.1007/s11154-024-09937-2
Giovanni Vitale, Germano Gaudenzi, Monica Oldani, Carla Pandozzi, Alessia Filice, Simona Jaafar, Luigi Barrea, Annamaria Colao, Antongiulio Faggiano
{"title":"Nutritional status and gastroenteropancreatic neuroendocrine neoplasms: lights and shadows with a clinical guide from the NIKE Group.","authors":"Giovanni Vitale, Germano Gaudenzi, Monica Oldani, Carla Pandozzi, Alessia Filice, Simona Jaafar, Luigi Barrea, Annamaria Colao, Antongiulio Faggiano","doi":"10.1007/s11154-024-09937-2","DOIUrl":"https://doi.org/10.1007/s11154-024-09937-2","url":null,"abstract":"<p><p>Neuroendocrine neoplasms (NENs) originating in the gastroenteropancreatic (GEP) tract are rare tumors often associated with significant metabolic disturbances and nutritional challenges. This review explores the intricate relationship between nutritional status and the development, progression, and prognosis of GEP-NENs. Through an extensive literature search encompassing studies up to April 2024, we examined various factors, including obesity, malnutrition, metabolic syndrome and type 2 diabetes mellitus, and their roles in the development and progression of GEP-NENs. The review highlights the dual role of obesity, both as a risk factor and a potential prognostic indicator, drawing attention to the 'obesity paradox' observed in cancer research. Additionally, we discuss the impact of malnutrition on patient outcomes and emphasize the need for comprehensive nutritional assessments beyond BMI. This analysis highlights the importance of incorporating nutritional interventions into preventive and therapeutic strategies for GEP-NEN patients. Future research should further clarify these associations and develop personalized nutritional management protocols to improve patient prognosis and quality of life. Acronyms adopted in the text and tables: AOR: adjusted odd ratio, BIA: Bioelectrical Impedance Analysis, BMI: Body Mass Index, CI: confidence interval, CLARINET: Controlled Study of Lanreotide Antiproliferative Response in Neuroendocrine Tumor, FLI: fatty liver index, GEP: gastroenteropancreatic, GLIM: global leadership into malnutrition, HR: hazard ratio, MS: metabolic syndrome, MUST: malabsorption universal screening tool, NEC: neuroendocrine carcinoma, NENs: Neuroendocrine neoplasms, NETs: Neuroendocrine tumors, NRS: Nutritional Risk Screening, OR: odd ratio, OS: overall survival, PFS: progression-free survival, RR: risk ratio, SGA: Subjective Global Assessment, T2DM: type 2 diabetes mellitus, VAI: visceral adiposity index, WD: well-differentiated.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802150","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}
引用次数: 0
Prolactin deficiency in the context of other pituitary hormone abnormalities : Special issue: hypoprolactinemia: a neglected endocrine disorder. 其他垂体激素异常背景下的催乳素缺乏症 :特刊:低泌乳素血症:一种被忽视的内分泌疾病。
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-12-01 Epub Date: 2024-10-02 DOI: 10.1007/s11154-024-09902-z
Ilan Shimon
{"title":"Prolactin deficiency in the context of other pituitary hormone abnormalities : Special issue: hypoprolactinemia: a neglected endocrine disorder.","authors":"Ilan Shimon","doi":"10.1007/s11154-024-09902-z","DOIUrl":"10.1007/s11154-024-09902-z","url":null,"abstract":"<p><p>Prolactin deficiency is rare. It generally occurs when pituitary disorders, such as large pituitary tumors, pituitary apoplexy, and other conditions associated with sellar mass effect lead to global failure of pituitary function and hypopituitarism. In these situiations, prolactin is commonly the last pituitary hormone affected, after growth hormone and gonadotropins are lost and thyroid-stimulating hormone and adrenocorticotopic hormone secretion is impaired. Prolactin deficiency accompanies several congenital syndromes due to mutations in PROP1 and Pit1/ POU1F and in X-linked IGSF1 deficiency syndrome, and several aqcuired conditions including Sheehan syndrome, IgG4-related hypophysitis, and immune checkpoint-inhibitor-induced hypophysitis. In women, prolactin deficiency prevents lactation following childbirth among other symptoms associated with hypopituitarism. Human prolactin is not available commercially as replacement therapy. However, recombinant human prolactin administered daily to women with hypoprolactinemia and alactogenesis was found to lead to the production of significant milk volume sufficient for lactation.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"1041-1046"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 homeo-FIT-prolactin hypothesis: the role of prolactin in metabolic homeostasis - association or causality? 同化-FIT-泌乳素假说:泌乳素在代谢平衡中的作用--关联还是因果关系?
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI: 10.1007/s11154-024-09916-7
Jesper Krogh
{"title":"The homeo-FIT-prolactin hypothesis: the role of prolactin in metabolic homeostasis - association or causality?","authors":"Jesper Krogh","doi":"10.1007/s11154-024-09916-7","DOIUrl":"10.1007/s11154-024-09916-7","url":null,"abstract":"<p><p>The homeo-fit-prolactin hypothesis proposes a causal metabolic role for prolactin with hypoprolactinemia and hyperprolactinemia leading to adverse metabolic alterations. However, prolactin within the normal range and up to four times the upper reference limit may be a consequence of metabolic adaption and have a positive metabolic role similar to increased insulin in pre-diabetes. As a consequence, drugs that would increase prolactin levels within this threshold may hold promising effects, particularly for patients with type 2 diabetes. A documented positive metabolic effect of prolactin just above the normal threshold would not just be of benefit to patients with diabetes but assist in the decision to treat mild hyperprolactinemia in other patient groups as well, e.g. drug-induced hyperprolactinemia or idiopathic hyperprolactinemia. Prolactin receptors are present in the pancreas, liver, and adipose tissue, and pre-clinical studies suggest a positive and causal effect of prolactin on the gluco-insulinemic profile and lipid metabolism. This narrative review examines the evidence for the homeo-fit-prolactin hypothesis with a particular focus on results from human studies.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"1077-1086"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401129","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}
引用次数: 0
Could low prolactin levels after radiotherapy predict the onset of hypopituitarism? 放疗后催乳素水平低能否预测垂体功能减退症的发生?
IF 6.9 2区 医学
Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-12-01 Epub Date: 2024-08-22 DOI: 10.1007/s11154-024-09900-1
Chiara Mele, Stella Pigni, Marina Caputo, Maria Francesca Birtolo, Carola Ciamparini, Gherardo Mazziotti, Andrea Gerardo Antonio Lania, Paolo Marzullo, Flavia Prodam, Gianluca Aimaretti
{"title":"Could low prolactin levels after radiotherapy predict the onset of hypopituitarism?","authors":"Chiara Mele, Stella Pigni, Marina Caputo, Maria Francesca Birtolo, Carola Ciamparini, Gherardo Mazziotti, Andrea Gerardo Antonio Lania, Paolo Marzullo, Flavia Prodam, Gianluca Aimaretti","doi":"10.1007/s11154-024-09900-1","DOIUrl":"10.1007/s11154-024-09900-1","url":null,"abstract":"<p><p>Both local and external cranial radiotherapy (RT) can induce neurotoxicity and vascular damage of the hypothalamic-pituitary area, which can promote neuroendocrine alterations. While anterior pituitary insufficiency after RT has been extensively characterized, data on the effect of RT on prolactin (PRL) secretion are limited and heterogeneous, with different patterns of PRL behavior described in the literature. A progressive decline in PRL levels, reflecting a time-dependent, slowly evolving radiation-induced damage to the pituitary lactotroph cells has been reported. To date, the association between hypopituitarism and hypoprolactinemia in patients undergoing RT has not yet been fully investigated. The few available data suggest that lower PRL levels can predict an extent damage of the pituitary tissue and a higher degree of hypothalamic dysfunction. However, most studies on the effect of RT on pituitary function do not properly assess PRL secretion, as PRL deficiency is usually detected as part of hypopituitarism and not systematically investigated as an isolated disorder, which may lead to an underestimation of hypoprolactinemia after RT. In addition, the often-inadequate follow-up over a long period of time may contribute to the non-recognition of PRL deficiency after RT. Considering that hypoprolactinemia is associated with various metabolic complications, there is a need to define appropriate diagnostic and management criteria. Therefore, hypoprolactinemia should enter in the clinical investigation of patients at risk for hypopituitarism, mainly in those patients who underwent RT.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"1013-1025"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
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