Frontiers of Hormone Research最新文献

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Secondary and Tertiary Hyperparathyroidism. 继发性和三期甲状旁腺功能亢进。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2018-11-19 DOI: 10.1159/000491041
Piergiorgio Messa, Carlo Maria Alfieri
{"title":"Secondary and Tertiary Hyperparathyroidism.","authors":"Piergiorgio Messa,&nbsp;Carlo Maria Alfieri","doi":"10.1159/000491041","DOIUrl":"https://doi.org/10.1159/000491041","url":null,"abstract":"<p><p>Secondary hyperparathyroidism (SHP) is a frequent complication of kidney diseases. At variance with all the other forms of SHP, which are compensatory conditions, renal SHP has many pathogenetic peculiarities, which have been only in part defined. Furthermore, in the long course of chronic kidney diseases (CKD), SHP sometimes transforms into a hypercalcemic condition resembling the autonomous form of hyperparathyroidism (tertiary hyperparathyroidism; THP). The clinical consequences of SHP in CKD patients are manifold, encompassing not only bone and mineral disorders, but also other metabolic and organic changes which frequently burden these patients. Although the medical therapeutic tools have substantially increased in number and improved in their efficacy in recent decades, we have as yet no demonstration of a clear benefit regarding the major clinical outcomes. Furthermore, some of these patients, particularly when the autonomous THP develops, still require a surgical approach.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"51 ","pages":"91-108"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000491041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36905206","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: 26
Hypoparathyroidism. Hypoparathyroidism。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2018-11-19 DOI: 10.1159/000491042
Yasser Hakami, Aliya Khan
{"title":"Hypoparathyroidism.","authors":"Yasser Hakami,&nbsp;Aliya Khan","doi":"10.1159/000491042","DOIUrl":"https://doi.org/10.1159/000491042","url":null,"abstract":"<p><p>The regulation of plasma calcium levels is essential for the normal physiologic function of every cell. Parathyroid hormone (PTH) is the principal regulator of serum calcium and phosphate homeostasis. PTH is synthesized and secreted by the parathyroid chief cells in the parathyroid glands primarily in response to a decline in serum calcium levels. The causes of hypocalcemia can be broadly classified as inadequate PTH or vitamin D production, PTH resistance, or miscellaneous causes. The term \"hypoparathyroidism\" refers to a metabolic disorder in which hypocalcemia and hyperphosphatemia occur either from a failure of the parathyroid glands to secrete sufficient amounts of biologically active PTH, or from an inability of PTH to appropriately induce a biological response in its target tissues. The most common cause of acquired hypoparathyroidism is surgery, accounting for 75% of all cases. Nonsurgical causes of hypoparathyroidism include autoimmune, genetic variants, infiltrative, metastatic, radiation, mineral deposition, magnesium deficiency or excess or idiopathic. The objective of this chapter is to provide a comprehensive review of the physiology of calcium homeostasis, the causes of hypocalcemia, and the epidemiology of hypoparathyroidism. It is very important to determine the underlying cause of the hypoparathyroidism in order to effectively treat our patients and improve quality of life.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"51 ","pages":"109-126"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000491042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36862641","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: 7
Parathyroid Carcinoma. 甲状旁腺癌。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2018-11-19 DOI: 10.1159/000491039
Filomena Cetani, Elena Pardi, Claudio Marcocci
{"title":"Parathyroid Carcinoma.","authors":"Filomena Cetani,&nbsp;Elena Pardi,&nbsp;Claudio Marcocci","doi":"10.1159/000491039","DOIUrl":"https://doi.org/10.1159/000491039","url":null,"abstract":"<p><p>Parathyroid carcinoma (PC) is a rare endocrine malignancy, accounting for <1% of all cases of sporadic primary hyperparathyroidism (PHPT) and up to 15% in the hereditary hyperparathyroidism-jaw tumor syndrome. Genomic alterations identified in PC are mostly represented by CDC73 gene mutations, codifying for a loss-of-function protein termed parafibromin. Whole exome sequencing identified mutations in other genes, such as mTOR, KMT2D, CDKN2C, THRAP3, PIK3CA, and EZH2 genes, CCND1 gene amplification. The diagnosis of PC is quite difficult due to the lack of reliable clinical diagnostic criteria, and in the majority of cases is made postoperatively at histological examination. The clinical manifestations of PC are primarily due to the excessive secretion of PTH by the tumor rather than spread to local or distant organs. En bloc resection of the parathyroid tumor represents the initial mainstay treatment of patients with PC. Multiple surgical procedures may be required, although surgical morbidity should be taken into account. A 5- and 10-year survival between 77-100 and 49-91%, respectively, has been reported. When the tumor is no more resectable, medical treatment of hypercalcemia has a pivotal role in the management of these patients.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"51 ","pages":"63-76"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000491039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36863660","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: 32
Hyponatremia Is Linked to Bone Loss, Osteoporosis, Fragility and Bone Fractures. 低钠血症与骨质流失、骨质疏松、脆弱和骨折有关。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2019-01-15 DOI: 10.1159/000493237
Julianna Barsony, Lauren Kleess, Joseph G Verbalis
{"title":"Hyponatremia Is Linked to Bone Loss, Osteoporosis, Fragility and Bone Fractures.","authors":"Julianna Barsony,&nbsp;Lauren Kleess,&nbsp;Joseph G Verbalis","doi":"10.1159/000493237","DOIUrl":"https://doi.org/10.1159/000493237","url":null,"abstract":"<p><p>Chronic hyponatremia may not cause overt symptoms, and therefore frequently remains untreated. More recently, growing evidence indicate that this condition is not benign, and can lead to unsteady gait, deterioration of bone mass and strength, increased fragility, and increased all-cause mortality. We provided the first evidence for hyponatremia-induced osteoporosis based on markedly reduced bone mineral density and bone structural changes in hyponatremic rats, which is an experimental model of the syndrome of inappropriate antidiuresis (SIAD). These animal data were supported by results of the analysis of the National Health and Nutrition Examination Survey III dataset showing a 2.5-fold increased OR of osteoporosis in participants with serum sodium concentration [Na+] below 135 mmol/L. A subsequent cross-sectional study from Michigan analyzed data from 25,000 patients and found a strong association between the odds of osteoporosis by bone density and hyponatremia. This study pointed out that age-dependent decline in bone density may mask hyponatremia-induced bone loss. Multiple independent retrospective studies, epidemiological studies, and prospective clinical studies have since confirmed and extended our findings, reporting evidence for increased bone fractures and increased mortality in patients with hyponatremia. Cell culture studies have elucidated some of the adaptive mechanisms by which low extracellular fluid [Na+] increases osteoclast formation and bone resorbing activity, thereby liberating stored sodium from the bone matrix. Studies on older SIAD rats indicated that the damage may not be restricted to bone alone, but may involve other organs, including the heart, testis, kidney, and the brain. Finally, compelling open questions and future research directions about the effect of hyponatremia on bone are outlined.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"52 ","pages":"49-60"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000493237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37677232","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: 10
Euvolemic Hyponatremia Secondary to the Syndrome of Inappropriate Antidiuresis. 不适当抗利尿综合征继发的低钠血症。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2019-01-15 DOI: 10.1159/000493238
Joseph G Verbalis
{"title":"Euvolemic Hyponatremia Secondary to the Syndrome of Inappropriate Antidiuresis.","authors":"Joseph G Verbalis","doi":"10.1159/000493238","DOIUrl":"https://doi.org/10.1159/000493238","url":null,"abstract":"<p><p>Euvolemic hyponatremia is the most common cause of hyponatremia in both hospitalized patients and outpatients. The most common etiology of euvolemic hyponatremia is the syndrome of inappropriate antidiuresis (SIAD). Diagnosis of SIAD involves evaluation of a set of long-standing clinical and laboratory criteria for this diagnosis. Many treatment options for SIAD exist, and choosing among them should be based on the chronicity of the hyponatremia and neurological symptomatology. Importantly, clinical judgment and risk/benefit analysis that is individualized for specific patients should drive therapeutic decisions, because there is no single treatment that represents the \"best\" therapy for all patients with SIAD.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"52 ","pages":"61-79"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000493238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37677329","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: 19
The Diagnostic Approach to the Patient with Hyponatremia: Are the Correct Investigations Being Done? 低钠血症的诊断方法:是否做了正确的调查?
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2019-01-15 DOI: 10.1159/000493248
Ploutarchos Tzoulis, Isabelle Runkle-De la Vega
{"title":"The Diagnostic Approach to the Patient with Hyponatremia: Are the Correct Investigations Being Done?","authors":"Ploutarchos Tzoulis,&nbsp;Isabelle Runkle-De la Vega","doi":"10.1159/000493248","DOIUrl":"https://doi.org/10.1159/000493248","url":null,"abstract":"<p><p>Numerous observational studies have confirmed that inadequate investigation of hyponatremia leads to diagnostic errors and incorrect treatment. In fact, only one out of five patients diagnosed as having syndrome of inappropriate antidiuresis (SIAD) have had all the tests necessary to meet the diagnostic criteria. Diagnostic errors could help explain why a majority of patients presenting hyponatremia during hospitalization are discharged while still hyponatremic. The correct differentiation of hypovolemic from euvolemic patients is a clinical diagnostic challenge. Yet the value of the physical examination in the volemic classification of the patient with hyponatremia has been reinforced by ultrasound studies revalidating the utility of the measurement of internal jugular vein pulse height in the clinical evaluation of intravascular volume. In this chapter, we review the data available on current approaches to the diagnosis of hyponatremia, and suggest our recommended approach to the evaluation of patients with hyponatremia, and more specifically, patients with SIAD. In addition, we will explore how specialized input from multidisciplinary hospital \"hyponatremia teams,\" supported by technologies such as automated electronic alert systems, and computerized physician-support systems can aid the diagnostic pathway and clinical care delivery for patients with hyponatremia.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"52 ","pages":"190-199"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000493248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37675739","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: 7
Inactivating PTH/PTHrP Signaling Disorders. PTH/PTHrP信号失活障碍。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2018-11-19 DOI: 10.1159/000491045
Giovanna Mantovani, Francesca M Elli
{"title":"Inactivating PTH/PTHrP Signaling Disorders.","authors":"Giovanna Mantovani,&nbsp;Francesca M Elli","doi":"10.1159/000491045","DOIUrl":"https://doi.org/10.1159/000491045","url":null,"abstract":"<p><p>Pseudohypoparathyroidism (PHP), pseudo-PHP, acrodysostosis, and progressive osseous heteroplasia are heterogeneous disorders characterized by physical findings, differently associated in each subtype, including short bones, short stature, a stocky build, ectopic ossifications (features associated with Albright's hereditary osteodystrophy), as well as laboratory abnormalities consistent with hormone resistance, such as hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH) and thyroid-stimulating hormone levels. All these disorders are caused by impairments in the cAMP-mediated signal transduction pathway and, in particular, in the PTH/PTHrP signaling pathway: the main subtypes of PHP and related disorders are caused by de novo or autosomal dominantly inherited inactivating genetic mutations, and/or epigenetic, sporadic, or genetic-based alterations within or upstream of GNAS, PRKAR1A, PDE4D, and PDE3A. Here we will review the impressive progress that has been made over the past 30 years on the pathophysiology of these diseases and will describe the recently proposed novel nomenclature and classification. The new term \"inactivating PTH/PTHrP signaling disorder,\" iPPSD: (1) defines the common mechanism responsible for all diseases, (2) does not require a confirmed genetic defect, (3) avoids ambiguous terms like \"pseudo,\" and (4) eliminates the clinical or molecular overlap between diseases.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"51 ","pages":"147-159"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000491045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36862644","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: 16
Androgens in Congenital Adrenal Hyperplasia. 先天性肾上腺增生中的雄激素。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 DOI: 10.1159/000494903
D. Pignatelli, S. Pereira, R. Pasquali
{"title":"Androgens in Congenital Adrenal Hyperplasia.","authors":"D. Pignatelli, S. Pereira, R. Pasquali","doi":"10.1159/000494903","DOIUrl":"https://doi.org/10.1159/000494903","url":null,"abstract":"Congenital Adrenal Hyperplasias (CAH) are genetic diseases transmitted in an autosomal recessive way and these diseases affect many aspects of human health. The majority of CAH cases is due to a deficiency in 21-hydroxylase as a result of the existence of mutations in both alleles of the CYP21A2 gene. Since the identification of mild, non-classic forms of this disease, CAH has been recognized to be one of the most common genetic diseases in human beings. This disease is generally associated with elevated secretion of androgens, sometimes resulting in virilizing syndromes, including genital ambiguity, precocious puberty in both sexes, or milder syndromes of androgen excess like precocious pubarche or the occurrence of hirsutism and oligomenorrhea in women. Accumulating precursors like 17-hydroxypregnenolone and 17-hydroxyprogesterone (17OHP) are directed to the synthesis of androgens through the enzyme 17-hydroxylase/17,20 lyase leading to the production of dehydroepiandrosterone that is then converted to testosterone and dihydrotestosterone (DHT) at the gonads and at other peripheral tissues. 17OHP, the hallmark of 21-hydroxylase deficiency, can be converted to androstenedione (in a low efficiency molecular process) but can also be converted to DHT through an alternative pathway that becomes active due to the large amounts of accumulated 17OHP - the backdoor pathway. Another important pathway that becomes significant in this disease is the 11-oxyandrogens pathway through which androstenedione is converted to 11β-hydroxyandrostenedione at the adrenal and from there to 11-ketotestosterone and 11-ketoDHT. The elevated androgens levels affect the hypothalamic-pituitary-gonadal axis and, in some cases, the ovary resulting in chronic anovulation and infertility.","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"53 1","pages":"65-76"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000494903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65285074","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: 16
Androgens, Body Composition, and Their Metabolism Based on Sex. 基于性别的雄激素、身体成分及其代谢。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 DOI: 10.1159/000494900
V. Giagulli, M. Castellana, C. Pelusi, V. Triggiani
{"title":"Androgens, Body Composition, and Their Metabolism Based on Sex.","authors":"V. Giagulli, M. Castellana, C. Pelusi, V. Triggiani","doi":"10.1159/000494900","DOIUrl":"https://doi.org/10.1159/000494900","url":null,"abstract":"Differences between males and females are commonly attributed to sexual hormones. Androgens are responsible for the development of primary and secondary sexual characteristics in males, whereas they influence sexual behaviour, glycaemic control, lipid profile, bone metabolism and erythropoiesis in both sexes. In this chapter, we discuss preclinical and clinical data on sex-specific androgen metabolism and androgen effect on body composition.","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"53 1","pages":"18-32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000494900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65284904","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: 10
Morbidity and Mortality of Hyponatremia. 低钠血症的发病率和死亡率。
2区 医学
Frontiers of Hormone Research Pub Date : 2019-01-01 Epub Date: 2019-01-15 DOI: 10.1159/000493235
Alessandro Peri
{"title":"Morbidity and Mortality of Hyponatremia.","authors":"Alessandro Peri","doi":"10.1159/000493235","DOIUrl":"https://doi.org/10.1159/000493235","url":null,"abstract":"<p><p>In hypotonic hyponatremia, which is the most common form of hyponatremia, clinical manifestations are largely due to brain swelling caused by entry of water into the cells. In acute and severe hyponatremia, dramatic symptoms, such as seizures, acute psychosis, permanent brain damage, brain-stem herniation, leading to coma and death may occur. In chronic hyponatremia, symptoms are generally less dramatic and may include headache, nausea, vomiting, gait alterations, muscle cramps, restlessness, and disorientation. It has become evident in recent years that mild forms of chronic hyponatremia may also be associated with clinical signs, if carefully investigated. Several studies also reported an increased length of stay in the hospital of patients with hyponatremia in different clinical settings, leading to increased costs. Most important, this condition has been clearly associated with a significantly increased risk of death, even when serum [Na+] is slightly reduced. On the contrary, there is convincing evidence that the mortality risk is reduced when hyponatremia improves.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"52 ","pages":"36-48"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000493235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37676591","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: 25
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