Vitamins and Hormones最新文献_第2页

Adrenal venous sampling interpretation and molecular imaging as localization tool in primary aldosteronism. 肾上腺静脉取样解释和分子成像作为原发性醛固酮增多症的定位工具。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2025-12-15 DOI: 10.1016/bs.vh.2025.11.002

Sinan Deniz, Matthias Oettle, Markus Kroiss, Friederike Völter, Martin Reincke

{"title":"Adrenal venous sampling interpretation and molecular imaging as localization tool in primary aldosteronism.","authors":"Sinan Deniz, Matthias Oettle, Markus Kroiss, Friederike Völter, Martin Reincke","doi":"10.1016/bs.vh.2025.11.002","DOIUrl":"10.1016/bs.vh.2025.11.002","url":null,"abstract":"Primary aldosteronism (PA) is the leading cause of secondary hypertension. In general, two principal subtypes are distinguished: A lateralized form in which aldosterone hypersecretion originates from a single adrenal gland, and a non-lateralized form characterized by bilateral adrenal involvement. In patients with lateralized PA, adrenalectomy yields more favorable clinical and biochemical outcomes than pharmacological therapy. Accurate subtype classification is therefore essential to guide the optimal treatment. Adrenal venous sampling (AVS) remains the gold standard for localizing aldosterone excess, though its technical difficulty and limited availability pose challenges. In addition, molecular imaging has emerged as a promising non-invasive alternative in recent years, with novel PET tracers showing potential to complement or replace AVS in selected patients. This chapter summarizes the indications, technical aspects, and interpretation of AVS, and reviews current molecular imaging approaches, emphasizing their potential role as complementary tools in the diagnostic work-up of PA.","PeriodicalId":51209,"journal":{"name":"Vitamins and Hormones","volume":"130 ","pages":"255-288"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Diagnosis of primary aldosteronism: Renin activity, renin concentration and aldosterone/renin ratio. 原发性醛固酮增多症的诊断：肾素活性、肾素浓度和醛固酮/肾素比值。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2025-09-27 DOI: 10.1016/bs.vh.2025.08.005

Manuel Morales-Ruiz, María Rodríguez-García, Nerea Sainz-Pastor, Alex Barragán-Muñoz, Gregori Casals

{"title":"Diagnosis of primary aldosteronism: Renin activity, renin concentration and aldosterone/renin ratio.","authors":"Manuel Morales-Ruiz, María Rodríguez-García, Nerea Sainz-Pastor, Alex Barragán-Muñoz, Gregori Casals","doi":"10.1016/bs.vh.2025.08.005","DOIUrl":"10.1016/bs.vh.2025.08.005","url":null,"abstract":"The Renin-Angiotensin-Aldosterone System (RAAS) is a cornerstone of cardiovascular and electrolyte homeostasis, and its dysregulation is central to the pathophysiology of hypertension, heart failure, and chronic kidney disease. This chapter provides a comprehensive overview of the RAAS, from its classical and alternative signaling pathways to its clinical implications. We delve into the pathological consequences of both RAAS overactivation and its suppression. A significant focus is placed on the biochemical evaluation of the RAAS, tracing the chronological progression from early bioassays to modern automated immunoassays and high-resolution mass spectrometry for measuring renin and aldosterone. We critically examine the methodologies for determining plasma renin activity (PRA) and direct renin Concentration (DRC), and the nuances of plasma and urinary aldosterone quantification. The aldosterone-to-renin ratio (ARR) is highlighted as the essential screening tool for PA, with a detailed discussion of assay-specific cut-offs and the imperative of laboratory-specific validation. Furthermore, the chapter outlines the numerous preanalytical and analytical variables that profoundly influence RAAS component measurements, including patient posture, diet, and the significant confounding effects of various medications. Adherence to standardized protocols for sample collection, handling, and analysis is emphasized as critical for accurate diagnosis and management.","PeriodicalId":51209,"journal":{"name":"Vitamins and Hormones","volume":"130 ","pages":"105-140"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Growth hormone and glycemic metabolism. 生长激素和血糖代谢。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2026-02-12 DOI: 10.1016/bs.vh.2025.10.003

Eider Pascual-Corrales, José Manuel Ruiz-Cánovas, Wilfredo Antonio Rivera-Martínez

{"title":"Growth hormone and glycemic metabolism.","authors":"Eider Pascual-Corrales, José Manuel Ruiz-Cánovas, Wilfredo Antonio Rivera-Martínez","doi":"10.1016/bs.vh.2025.10.003","DOIUrl":"10.1016/bs.vh.2025.10.003","url":null,"abstract":"Growth hormone (GH) is secreted in a pulsatile pattern and exerts pleiotropic effects on growth and metabolism. Beyond its role in somatic development, GH is a key regulator of glucose homeostasis through its influence on insulin signaling, lipid mobilization, and substrate partitioning. Chronic disturbances of the GH-IGF-1 axis profoundly affect glucose metabolism. In acromegaly, sustained GH and IGF-1 excess induces systemic insulin resistance via direct antagonism of insulin receptor signaling, increased lipolysis, and elevated free fatty acids, ultimately leading to impaired glucose tolerance or overt diabetes in up to half of patients. Conversely, GH deficiency is characterized by visceral adiposity, low IGF-1, and reduced lean mass, changes that also impair insulin sensitivity through distinct mechanisms. These contrasting phenotypes highlight the dual role of GH in modulating insulin action and glucose control. Notably, insulin resistance in acromegaly is paradoxical in that it occurs despite reduced adipose tissue mass, whereas in GH deficiency it is driven by increased fat accumulation. Therapeutic interventions targeting the GH axis -such as transsphenoidal surgery, somatostatin analogues, GH receptor antagonists, and dopamine agonists- have differential effects on glucose homeostasis, ranging from improvement of insulin sensitivity to further impairment depending on the agent. Recognition of these divergent metabolic consequences is critical for personalized management of patients with acromegaly or GH deficiency. Looking ahead, advances in understanding GH-IGF-1-insulin cross-talk and the molecular drivers of insulin resistance may guide the development of novel therapies aimed at optimizing metabolic outcomes in disorders of the GH axis.","PeriodicalId":51209,"journal":{"name":"Vitamins and Hormones","volume":"131 ","pages":"59-82"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Co-secreting pituitary adenomas in acromegaly: Classification, diagnosis, and treatment strategies. 肢端肥大症并发垂体腺瘤：分类、诊断和治疗策略。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI: 10.1016/bs.vh.2025.06.002

Betina Biagetti, Marta Araujo-Castro

引用次数: 0

Acromegaly-Physiopathology and etiology. 肢端肥大——生理病理和病因学。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2026-01-28 DOI: 10.1016/bs.vh.2026.01.001

Frederic Castinetti

引用次数: 0

Pathogenesis of primary aldosteronism. 原发性醛固酮增多症的发病机制。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI: 10.1016/bs.vh.2025.08.004

Paola Parra Ramírez, Patricia Martín Rojas-Marcos

{"title":"Pathogenesis of primary aldosteronism.","authors":"Paola Parra Ramírez, Patricia Martín Rojas-Marcos","doi":"10.1016/bs.vh.2025.08.004","DOIUrl":"10.1016/bs.vh.2025.08.004","url":null,"abstract":"Primary aldosteronism (PA) is the most common cause of endocrine hypertension, characterized by autonomous aldosterone production, unregulated by sodium balance or renin-angiotensin system activity. Once considered a rare, PA is now recognized as a spectrum that includes subclinical forms in normotensive individuals. Aldosterone synthesis, normally regulated by angiotensin II, extracellular potassium, and adrenocorticotropic hormone (ACTH), undergoes dysregulated in PA, often due to somatic or germline mutations affecting ion channels or intracellular signaling pathways. This disruption promotes morphological alteration in the adrenal cortex, including aldosterone-producing cell clusters (APCCs), micronodules, and aldosterone-producing adenomas (APAs). These lesions contribute to renin-independent aldosterone secretion and inappropriate ACTH sensitivity. Aldosterone acts through the mineralocorticoid receptor (MR), triggering both genomic and non-genomic effects. MR activation in multiple tissues promotes cardiovascular and metabolic damage, often independent of blood pressure. These insights support early detection and a broader clinical approach to PA, incorporating its genetic, structural, and molecular basis.","PeriodicalId":51209,"journal":{"name":"Vitamins and Hormones","volume":"130 ","pages":"27-41"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

New tools for the diagnosis of hypercortisolism. 诊断高皮质醇血症的新工具。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2026-03-11 DOI: 10.1016/bs.vh.2026.02.007

Qiang Zhao, Oana C Sima, Mariona Estape, Gregori Casals, Felicia A Hanzu

引用次数: 0

ACTH independent Cushing's syndrome: Diagnosis and etiology. ACTH独立库欣综合征：诊断和病因学。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2026-05-11 DOI: 10.1016/bs.vh.2026.02.001

Andrés E Ortiz-Flores

{"title":"ACTH independent Cushing's syndrome: Diagnosis and etiology.","authors":"Andrés E Ortiz-Flores","doi":"10.1016/bs.vh.2026.02.001","DOIUrl":"10.1016/bs.vh.2026.02.001","url":null,"abstract":"Cushing´s syndrome (CS) is a heterogeneous disorder characterized by chronic exposure to cortisol excess, leading to significant metabolic and cardiovascular complications. Timely diagnosis is crucial to reduce morbidity and mortality in these patients. Approximately 20 percent of endogenous CS cases are adrenocorticotropic hormone (ACTH)-independent and arise from primary adrenal disease. This review focuses on the diagnostic work-up and etiological spectrum of ACTH-independent CS. ACTH-independent CS most frequently results from unilateral adrenal adenomas, whereas adrenocortical carcinomas represent a less common but aggressive cause. Bilateral forms include primary pigmented nodular adrenocortical disease and primary bilateral macronodular adrenal hyperplasia, which present micronodular or macronodular adrenal enlargement, respectively, often with subtle or cyclic cortisol excess and characteristic imaging patterns. Recognizing these entities and integrating hormonal data with detailed radiological findings is essential for accurate etiological diagnosis and appropriate therapeutic planning in ACTH-independent CS. Radiological assessment with adrenal computed tomography, complemented by magnetic resonance imaging when needed, is crucial to distinguish unilateral from bilateral disease, characterize lesion morphology, and suggest specific etiologies, using unenhanced attenuation values in Hounsfield units to differentiate lipid-rich adenomas from non-adenomatous or potentially malignant lesions.","PeriodicalId":51209,"journal":{"name":"Vitamins and Hormones","volume":"132 ","pages":"79-92"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Cushing's syndrome and pregnancy: Clinical presentation and diagnosis. 库欣综合征与妊娠：临床表现和诊断。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2026-04-24 DOI: 10.1016/bs.vh.2025.11.003

Betina Biagetti

{"title":"Cushing's syndrome and pregnancy: Clinical presentation and diagnosis.","authors":"Betina Biagetti","doi":"10.1016/bs.vh.2025.11.003","DOIUrl":"10.1016/bs.vh.2025.11.003","url":null,"abstract":"Cushing's syndrome (CS) during pregnancy is an exceptionally rare but high-risk condition that poses major diagnostic and therapeutic challenges. Its low prevalence is mainly due to cortisol-induced infertility. Although its low prevalence stems primarily from cortisol-induced infertility, an increasing number of cases are being recognized due to enhanced clinical awareness and expanded use of assisted reproductive technologies. In contrast to the general population where pituitary adenomas predominate, pregnancy-associated CS demonstrates a distinct etiology pattern, with ACTH-independent causes accounting for the majority of cases, particularly benign adrenal adenomas. The physiological hypercortisolism of gestation complicates diagnostic testing, as urinary free cortisol and late-night salivary cortisol rise up to threefold, although circadian rhythmicity is usually preserved. Clinical features overlapping with normal pregnancy delay recognition, but specific signs such as wide violaceous striae, proximal myopathy, and easy bruising should raise suspicion. Untreated CS carries a markedly increased risk of maternal morbidity, including preeclampsia, diabetes, infections, and thromboembolic events, and adverse fetal outcomes such as prematurity, growth restriction, and fetal loss. Management requires a multidisciplinary team. Surgery in the second trimester, remains the treatment of choice. Medical therapy, mainly with metyrapone, may be considered in selected severe cases, whereas ketoconazole and cabergoline have more limited roles. Drugs such as mitotane and mifepristone are contraindicated during pregnancy, while osilodrostat lacks clinical evidence. In summary, early recognition and individualized management are essential to optimize maternal and fetal outcomes in this rare but high-risk condition.","PeriodicalId":51209,"journal":{"name":"Vitamins and Hormones","volume":"132 ","pages":"273-289"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Gigantism. 巨人症。

4区医学

Vitamins and Hormones Pub Date : 2026-01-01 Epub Date: 2026-02-16 DOI: 10.1016/bs.vh.2025.10.005

Sara Donato, Catarina Regala, Pedro Marques

引用次数: 0