Journal of Endocrinological Investigation最新文献

{"title":"Changing face of Cushing's disease over three decades in pituitary center.","authors":"Ilkin Muradov, Serdar Sahin, Serhat Uysal, Cem Sulu, Pelinsu Gunebakan, Ali Tunc, Banu Betul Kocaman, Lala Soltanova, Nurperi Gazioglu, Necmettin Tanriover, Pinar Kadioglu","doi":"10.1007/s40618-025-02702-5","DOIUrl":"https://doi.org/10.1007/s40618-025-02702-5","url":null,"abstract":"<p><strong>Objective: </strong>Cushing Disease (CD) presents with typical clinical findings, even though, there is a wide spectrum of manifestations. Over the years, the sings and symptoms of Cushing's syndrome (CS) have become more subtle and atypical forms of CS have emerged. In this study, we aimed to investigate the changes in the clinical presentation of CD in recent years.</p><p><strong>Materials and methods: </strong>In this study, CD patients followed by our center were examined. A total of 258 patients with CD were included in the study. The clinical findings at the time of presentation, laboratory and imaging findings, treatment modalities and remission status in the first year after treatment were evaluated.</p><p><strong>Results: </strong>The mean age of the patients included in the study was 41.3 ±13.28 years. CD patients diagnosed between 2013 and 2023 were older than those diagnosed between 1990 and 2012 (p < 0.001). There was no difference between the groups in terms of gender. Moon face, purple striae, hirsutism, and menstrual irregularities were statistically significantly less frequent in the last 10 years than in previous years (p < 0.001; p = 0.004; p < 0.001; p < 0.001, respectively). In addition, patients who applied after 2013 had lower baseline cortisol and adrenocorticotropic hormone (ACTH) levels, and a smaller median size of the pituitary adenoma. Limitations of the study include its retrospective design and the subjectivity of clinical data.</p><p><strong>Conclusion: </strong>As the clinical presentation of Cushing's disease changes over time, waiting for the typical Cushing's clinic can delay diagnosis. It is important that clinicians take this into account when they suspect CD.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070782","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":"Early modification of blood glucose levels during teriparatide treatment in postmenopausal women with severe osteoporosis.","authors":"Jessica Pepe, Veronica Cecchetti, Luciano Colangelo, Marco Occhiuto, Rachele Santori, Krenar Malaj, Davide Diacinti, Evaristo Ettore, Giovambattista Desideri, Salvatore Minisola, Cristiana Cipriani","doi":"10.1007/s40618-025-02704-3","DOIUrl":"https://doi.org/10.1007/s40618-025-02704-3","url":null,"abstract":"<p><strong>Purpose: </strong>To analyse the effect on fasting glucose levels after one month of PTH 1-34 treatment in postmenopausal women with osteoporosis.</p><p><strong>Methods: </strong>Twenty-six postmenopausal women treated with PTH 1-34 were enrolled. Patients with glucose ≥ 110 mg/dl and/or glycosylated hemoglobin > 48 mmol/mol were excluded. At baseline and after one month treatment, we measured fasting serum glucose, calcium, creatinine, PTH, 25(OH)vitamin D, OPG, RANKL, and BALP. Standardized questionnaires were administered to assess dietary caloric intake and physical activity.</p><p><strong>Results: </strong>After one month, patients were divided according to the increase (group A) or decrease of glucose (group B). We found no difference between these two groups as regards anthropometric, biochemical evaluation, DXA measurements, dietary caloric intake, physical activity and fractures at baseline. There was no difference between groups in the number of patients treated before with bisphosphonates. Dietary caloric intake and physical activity after one month of therapy were not different in both groups. The mean delta glucose decrease after one month was 7%±4% in group B while the delta increase was 8%±5% in group A, p = 0.001. The only statistically significant difference between these groups, after one month, was an increase in mean delta BALP in group B compared to group A (group B:19 ± 23% vs. group A -0.7 ± 7, p = 0.04). Mean delta vitamin D and OPG increased, while mean delta PTH and RANKL decreased in both groups, without statistically significant differences between groups.</p><p><strong>Conclusion: </strong>PTH 1-34 decreases mean serum glucose levels when bone formation is increased, as suggested by a significant increase in BALP in this group.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066124","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":"Newborn screening for congenital adrenal hyperplasia due to 21 hydroxylase deficiency: the Italian experience 2006-2019.","authors":"Federico Baronio, Enrica Abrigo, Sara Azzolini, Paolo Cavarzere, Cristina Cereda, Luisa De Sanctis, Silvia Laura Carla Meroni, Jessica Munarin, Francesca Righetti, Gianni Russo, Francesca Teofoli, Antonio Balsamo","doi":"10.1007/s40618-025-02669-3","DOIUrl":"https://doi.org/10.1007/s40618-025-02669-3","url":null,"abstract":"<p><strong>Purpose: </strong>Early identification of classic 21-Hydroxylase Deficiency Congenital Adrenal Hyperplasia (21OH-CAH) through newborn screening (NBS) is vital to prevent morbidity from salt-wasting crises. The aim of the study is to assess the efficacy of 21OH-CAH NBS from 2006 to 2019 in the five Regions of Italy where 21OH-CAH NBS is performed.</p><p><strong>Methods: </strong>Methods included dried blood spot (DBS) tests for 17OH-progesterone (17OHP) within the first 48-72 h, with variable protocols. Dried blood spots have been screened with a time-resolved fluoroimmunoassay for 17OHP determination (DELFIA) as first tier test in all the Italian Regions. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was implemented in the Veneto region starting October 2017 as second-tier test.</p><p><strong>Results: </strong>Among 2,933,074 screened newborns, 161 (86 males, 75 females) had classic 21OH-CAH, with a cumulative incidence of 1 in 17,699. Salt-wasting CAH was the most prevalent form (71.9%). Mean age at blood sampling for true positives was 9 ± 18 days, with 28% suspected before NBS results. In Regions with a second-tier test, the recall rate (RR) was 0.17, and positive predictive value (PPV) was 4.3. No patients had adrenal crisis and 23% of cases were symptomatic before the NBS results were reported.</p><p><strong>Conclusions: </strong>The study confirms the efficacy of NBS in early detection of classic 21OH-CAH, emphasizing the need for timely reporting and second-tier testing to improve outcomes.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066101","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":"Evaluation and comparison of efficacy and safety of mitochondrial modulator (Imeglimin) and DPP-4 inhibitors in patients with type 2 diabetes mellitus: A Bayesian network meta-analysis.","authors":"Junwei Chow, Woonling Lim, Longzhou Li, Qiuxia Yu, Yu Zhong, Zihan Wang, Syed Alfakhar Ali Shah, Chenyang Zhu, Shiwei Yan, Haiyang Liu, Xinyi Hu, Long Gao, Shan Wang, Jun Liu, Guo Ma","doi":"10.1007/s40618-025-02655-9","DOIUrl":"https://doi.org/10.1007/s40618-025-02655-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Imeglimin (Imeg), a novel oral antidiabetic drug that acts as a mitochondrial modulator and targets multiple metabolic pathways, offers a novel therapeutic option for type 2 diabetes mellitus (T2DM). Although both Imeg and dipeptidyl peptidase-4 inhibitors (DPP-4i) enhance glucose-stimulated insulin secretion (GSIS), their comparative clinical benefits remain uncertain. Therefore, we comprehensively evaluated and compared the efficacy and safety of Imeg and DPP-4i in the treatment of T2DM using Bayesian network meta-analysis (BNMA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PubMed, Web of Science, EMBASE, Cochrane Library, and ClinicalTrials.gov were systematically searched from inception to 1 October, 2024. Randomized clinical trials (RCTs) comparing the efficacy and safety of Imeg or DPP-4i with placebo or other antidiabetic drugs in treating T2DM were included. The primary efficacy outcomes included changes in glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and 2-hours postprandial plasma glucose (2h PPG), as well as the proportion of participants with HbA1c &lt; 7%. The secondary efficacy outcomes included changes in body weight (BW), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, homeostasis model assessment of β-cell function (HOMA-β), and homeostatic model assessment for insulin resistance (HOMA-IR). The safety outcomes included the proportion of participants with adverse events, infection, and gastrointestinal adverse events (GIAEs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;145 studies with 71,476 participants were included in the BNMA. Imeg 500 mg,1000 mg, 1500 mg and 2000 mg BID all exhibited significant efficacy in reducing HbA1c compared to placebo (mean difference (MD) [95% confidence interval (CI)], -0.29 [-0.51, -0.06] %, -0.67 [-0.83, -0.51] %, -0.73 [-0.90, -0.56] %, and - 0.63 [-0.95, -0.30] %, respectively). Compared to placebo, the majority of DPP-4i (except for Gosogliptin (Goso) 2 mg QD (MD [95% CI], -0.32 [-0.73, 0.09] %), Omarigliptin 0.25 mg QW (-0.26 [-0.54, 0.01] %), and Sitagliptin (Sita) 5 mg BID (-0.24 [-0.50, 0.01] %)) demonstrated significant efficacy in reducing HbA1c. Compared to the FDA-approved DPP-4i, i.e., Sita 100 mg QD, Saxagliptin 5 mg QD, Linagliptin 5 mg QD, and Alogliptin (Alog) 25 mg QD, Imeg showed no significant differences in glycemic control. Compared to placebo, Alog 50 mg QD (MD [95% CI], -11.15 [-19.99, -2.48] mg/dL), Alog 25 mg QD (-6.11 [-10.33, -2.07] mg/dL), and Alog 12.5 mg QD (-5.53 [-9.72, -1.49] mg/dL) exhibited notable total cholesterol-lowering effects. Compared to placebo, only Alog 50 mg QD (OR [95% CI], 1.91 [1.02, 3.28]) and Goso 30 mg QD (2.14 [1.07, 3.86]) exhibited a higher incidence of adverse events. Compared to placebo, only Imeg 500 mg BID was associated with a significantly increased risk of infection (OR [95% CI], 2.30 [1.01, 4.61]). Compared to placebo, Imeg 1500 mg BID (OR","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042018","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":"Pathophysiology and treatment of exercise-associated hyponatremia.","authors":"Barbara Altieri, Irene Aini, Giuseppe Cannavale, Caterina Magnelli, Camilla Mancini, Virginia Zamponi, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano, Alessandro Peri","doi":"10.1007/s40618-025-02673-7","DOIUrl":"https://doi.org/10.1007/s40618-025-02673-7","url":null,"abstract":"<p><p>Exercise associated hyponatremia (EAH) is a medical condition that can occur during physical exertion. Initially, EAH was considered to be restricted to extreme endurance activities, such as ultramarathons and Ironman triathlons. However, it has been more recently recognized in a variety of sports, including team sports and in shorter-duration events. The pathophysiology of EAH is multifactorial and includes excessive fluid intake and non-osmotic arginine vasopressin secretion, which is induced by physical activity. Sodium loss through sweat appears to play a less important role in contributing to EAH. The clinical presentation may vary, depending on the degree of serum sodium reduction. Symptoms, which are due to increased intracranial pressure, may vary from nausea, vomiting, headache, confusion to severe alterations in cognitive functions, decorticate posturing, respiratory distress, coma and even death. It is of pivotal importance to differentiate EAH from other conditions that may present with similar signs/symptoms, such as for instance hypoglycemia, orthostatic hypotension, vasovagal syncope, heat stroke. The treatment of EAH depends on the severity of symptoms. In life-threatening situations intravenous infusion of hypertonic saline solution (3%NaCl) is recommended. In less severe situations oral hypertonic saline solutions can be administered, as an alternative to intravenous hypertonic saline, when tolerated by patients. When symptoms are negligible, the treatment can be limited to fluid restriction. Effective strategies to prevent EAH would be important to reduce the risk of incurring in potentially life-threatening situations. In particular, recommendations to drink in anticipation of thirst during physical exertions should be replaced by the \"drinking when thirsty\" strategy.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006613","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":"Mineralocorticoid effects of fludrocortisone and hydrocortisone in primary adrenal insufficiency: EU-AIR patient data.","authors":"Bertil Ekman, Marcus Quinkler, Pinggao Zhang, Andrea M Isidori, Robert D Murray, Jeanette Wahlberg","doi":"10.1007/s40618-025-02657-7","DOIUrl":"https://doi.org/10.1007/s40618-025-02657-7","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with primary adrenal insufficiency (PAI) require mineralocorticoid replacement therapy in addition to glucocorticoids. These therapies should be considered in combination because most glucocorticoids also possess mineralocorticoid activity. We aimed to investigate the relationship between fludrocortisone and hydrocortisone-equivalent dosing in patients with PAI.</p><p><strong>Methods: </strong>Data were obtained from the European Adrenal Insufficiency Registry (EU-AIR), a multinational, multicenter, observational study conducted between August 7, 2012, and October 31, 2020, in endocrinology centers in Germany, Italy, the Netherlands, Sweden, and the UK. Patients with PAI (excluding congenital adrenal hyperplasia or known hypertension) and treated with immediate-release hydrocortisone (IRHC), modified-release hydrocortisone (MRHC), or cortisone acetate were included. The relationship between hydrocortisone-equivalent and fludrocortisone doses and mineralocorticoid potency corrected for body surface area (BSA) was examined.</p><p><strong>Results: </strong>Overall, 670 (mean age: 46.2 years; 453 [67.6%] women) of 924 patients with PAI in EU-AIR were analyzed. Of those who received at least one dose of fludrocortisone (n = 350), 45 patients (12.9%) were receiving hydrocortisone-equivalent doses/BSA of ≤ 10 mg/day/m², 170 patients (48.6%) > 10-15 mg/day/m², and 133 patients (38.0%) > 15 mg/day/m². No clear associations were found between total daily fludrocortisone dose/BSA and hydrocortisone-equivalent dose/BSA, or between combined mineralocorticoid potency/BSA and systolic or diastolic blood pressure and sodium or potassium levels. Higher systolic blood pressure was found in IRHC than MRHC groups.</p><p><strong>Conclusions: </strong>Fludrocortisone prescription in PAI appears to be independent of glucocorticoid replacement therapy. IRHC and MRHC might differ in mineralocorticoid effect owing to different pharmacokinetic profiles.</p><p><strong>Clinical trial registration: </strong>NCT01661387.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006656","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":"Effects of non-nutritive sweeteners on body weight: a systematic review and meta-analysis of randomized controlled trial (RCT) studies.","authors":"Dongxu Li, Lingyu Han, Zhihong Yu, Xiaoyu Teng, Yanjie Ma, Dong Wang","doi":"10.1007/s40618-025-02654-w","DOIUrl":"https://doi.org/10.1007/s40618-025-02654-w","url":null,"abstract":"<p><strong>Purposes: </strong>Controversy has emerged regarding the impact of non-nutritive sweeteners (NNS) on body weight. This systematic review and meta-analysis of randomized controlled trials aims to assess the effect of NNS intake on body weight change.</p><p><strong>Results: </strong>Of the 3327 studies retrieved, 19 met the eligibility criteria for inclusion in the meta-analysis. Compared to the control group, the experimental group that replaced daily caloric sugars with NNS showed significant weight change (MD = -0.79 kg; 95% CI: [-1.55, -0.04]; P = 0.04; I² = 84) When grouped by study duration, the effect of NNS intervention on weight change was significant in studies lasting less than 18 weeks (MD = -0.91 kg; 95% CI: [-1.70, -0.12]; P = 0.02), but minimal in studies longer than 18 weeks (P = 0.51). According to the weight status of the participants, the effect of NNS on body weight was statistically significant only in the normal weight group (MD = -0.97 kg; 95% CI: [-1.40, -0.54]; P < 0.01) and the mixed weight group (comprising normal and overweight individuals) (MD= -1.59 kg, 95% CI: [-2.62, -0.57]; P < 0.01), not in the obese group (MD = -0.646 kg; 95% CI: [-1.839, 0.546]; P = 0.29). In the comparator group, NNS had a greater effect only when compared with caloric sugars (MD= -0.94 kg, P = 0.04). Significant weight differences were also observed in the population with diabetes (MD = -1.56 kg, P < 0.01), but not in the nondiabetic population.</p><p><strong>Conclusion: </strong>Our study indicates that replacing sugar with NNS leads to weight loss, particularly in normal-weight participants who received the intervention for less than 18 weeks and those with diabetes. For the overweight, it is still advisable to focus on active weight intervention strategies, using NNS only as an auxiliary measure to replace the caloric sugars in the daily diet during weight intervention. This information can inform evidence-based clinical decision-making.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006634","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":"European survey on metabolic and cardiovascular risk in Cushing syndrome.","authors":"Alessandro Mondin, Mattia Barbot, Filippo Ceccato, Alberto M Pereira, Anna Angelousi, Atanaska Elenkova, Birute Zilaitiene, Camilla Schalin-Jäntti, Carlien De Herdt, Christina Kanaka-Gantenbein, Dominique Maiter, Federico Gatto, Gudmundur Johannsson, Kirstine Stochholm, Maria João Bugalho, Mario Detomas, Martin Reincke, Meropi Toumba, Roberta Giordano, Stylianos Tsagarakis, Susan M Webb, Nienke R Biermasz, Carla Scaroni","doi":"10.1007/s40618-025-02663-9","DOIUrl":"https://doi.org/10.1007/s40618-025-02663-9","url":null,"abstract":"<p><strong>Background: </strong>Cushing's syndrome (CS) is associated with increased metabolic and cardiovascular (CV) risk factors and morbidities. Evidence-based guidelines for the management of these issues in active or remitted CS are not available, so best practice is derived from guidelines developed for the general population. We aimed to evaluate the awareness and practice variation for CV comorbidities of CS across Reference Centres (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN).</p><p><strong>Methods: </strong>A dedicated online survey was distributed from June 2022 to December 2022 to Endo-ERN RCs with recognized expertise in adrenal and/or pituitary diseases.</p><p><strong>Results: </strong>19 centres provided complete responses to the survey, accounting for an estimated pool of around one thousand chronically cared CS patients across Europe. Most ERN experts consider patients with CS at high CV risk irrespectively of remission status. Preoperative cortisol-lowering treatment was a common practice, especially for severe cases, and deemed effective in reducing CV risk by many. Most comorbidities were regularly evaluated at diagnosis and during follow-up, although a lack of provocative testing to diagnose diabetes (used only in 26% of RCs) was evidenced. A strict glycaemic control was encouraged although its target differed. On the contrary, a less stringent approach to dyslipidaemia and overweight emerged. Preferred initial compounds for patients presenting comorbidities were angiotensin converting enzyme inhibitors, metformin and statins; lifestyle changes were preferred over drugs to control weight excess after cure. Screening for asymptomatic vascular disease was performed routinely and regularly repeated during follow-up by only half of the centres. Important heterogeneity in some responses emerged, especially regarding the effect of remission or medical treatment on comorbidities and CV risk.</p><p><strong>Discussion: </strong>Our survey highlights the awareness of ERN experts on management of metabolic and CV risk factors or disease in CS. Most of them use the current European guidelines and apply strategies for high CV risk patients, although not all these recommendations were fully followed. Since several CV risk factors seem to persist after disease remission, they should be adequately and promptly addressed. Population-specific studies are required to identify the optimal management of CV and metabolic comorbidities of CS patients.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006624","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":"Evolutionary and anthropological perspectives on the sella turcica: from vertebrate origins to neurosurgical relevance.","authors":"M Vaccarezza, S Taurone, M Palmieri, F M Galassi, L Cofone, M Artico, V Papa","doi":"10.1007/s40618-025-02698-y","DOIUrl":"https://doi.org/10.1007/s40618-025-02698-y","url":null,"abstract":"<p><p>The sella turcica, a saddle-shaped depression of the sphenoid bone, serves as a critical anatomical structure housing the pituitary gland and holds significant evolutionary, clinical, and anthropological importance. This review traces the evolutionary origins of the sella turcica from early vertebrates through mammalian and primate evolution, emphasizing its role in the stabilization and protection of neuroendocrine functions. Morphological stability of the sella turcica across hominin evolution highlights strong selective pressures on cranial base anatomy, despite broader craniofacial diversification. Anthropologically, the sella turcica provides a durable landmark for craniometric analyses, forensic reconstructions, and paleoanthropological investigations, revealing patterns of sex-based dimorphism, population variation, and disease prevalence. Developmental anomalies such as empty sella syndrome and pituitary hypoplasia illustrate the evolutionary trade-offs between increased encephalization and cranial vulnerability. Integrating historical, paleopathological, and clinical perspectives, this article underscores the sella turcica's significance as a nexus of evolutionary innovation, structural resilience, and biological fragility.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994265","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":"Prolactin serum concentrations in childhood-onset craniopharyngioma patients.","authors":"Panjarat Sowithayasakul, Julia Beckhaus, Jale Özyurt, Brigitte Bison, Carsten Friedrich, Hermann L Müller","doi":"10.1007/s40618-025-02622-4","DOIUrl":"10.1007/s40618-025-02622-4","url":null,"abstract":"<p><strong>Introduction: </strong>Adamantinomatous craniopharyngiomas (CPs) are rare embryonic tumors originating from the sellar area. Neuroendocrine deficiencies affecting the hypothalamic-pituitary axes are well-known but the mechanisms underlying prolactin secretion in CP patients are unclear. This study analyzed the factors associated with prolactin serum concentrations in CP patients.</p><p><strong>Methods: </strong>Patients with adamantinomatous CP, diagnosed as children, adolescents or young adults (< 26 years) were included in this study. In 98 cases, serum prolactin concentrations were measured before breakfast after fasting for at least 10 h, using an electrochemiluminescence assay, with concentrations analyzed for associations with diagnostic, clinical, and therapeutic parameters.</p><p><strong>Results: </strong>Serum prolactin concentrations were within normal, age- and gender-specific ranges in 39 cases (38%), with decreased concentrations in 22 cases (21%) and elevated concentrations in 37 cases (36%). Factors positively associated with increased prolactin levels were age at CP diagnosis, degree of surgical resection, and suprasellar tumor location. Decreased prolactin levels correlated with irradiation and pituitary deficiencies of thyroid-stimulating hormone and vasopressin. Patients with decreased prolactin concentrations exhibited lower event-free survival. Prolactin concentrations were not associated with functional capacity, tumor volume, calcifications, or anthropometric parameters at diagnosis or at the time of study.</p><p><strong>Conclusions: </strong>Prolactin levels in CP patients are influenced by the impact of the tumor on the hypothalamic-pituitary axes, resulting in either increased or decreased serum concentrations. Prolactin levels could serve as a clinical marker for certain sequelae after CP diagnosis. Patients with abnormal prolactin levels should be monitored for signs of hypothalamic syndrome.</p><p><strong>Clinical trial registration numbers: </strong>NCT00258453; NCT01272622; NCT04158284.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2041-2051"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250452","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}