Hormones (Athens, Greece)最新文献

{"title":"Glucagon-like peptide-1 receptor agonists and cognitive function: beyond the metabolic effects.","authors":"Stergios A Polyzos, Michael Doulberis, Nikolaos Zervogiannis, Christos-Alexandros Batakoias, Jannis Kountouras","doi":"10.1007/s42000-026-00827-7","DOIUrl":"https://doi.org/10.1007/s42000-026-00827-7","url":null,"abstract":"","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An illustrative summary of receptor-mediated mechanisms involved in the therapeutic regulation of type 2 diabetes.","authors":"Kawalpreet Kaur, Gurdeep Singh","doi":"10.1007/s42000-026-00819-7","DOIUrl":"https://doi.org/10.1007/s42000-026-00819-7","url":null,"abstract":"<p><p>Type 2 diabetes (T2D) is a chronic metabolic disorder primarily affecting the metabolism of glucose in the body. It is characterized by polyphagia, polydipsia, polyuria, fatigue, and persistent hyperglycemia. It occurs mainly because of two major factors, namely, dysregulated insulin secretion from pancreatic β-cells and/or reduced sensitivity of insulin-responsive tissues to insulin, i.e., insulin resistance. The process of insulin secretion and insulin signaling is complex, requiring the involvement of distinct membrane receptors. Sulfonylureas are a class of antidiabetic drugs which exert their antidiabetic action by stimulating sulfonylurea receptors on the pancreatic β-cells. Other cellular mechanisms mediated by receptors, such as insulin receptor, glucagon-like peptide-1 receptor, free fatty acid receptors, and peroxisome proliferator-activated receptor-γ, also serve as potential therapeutic targets for a number of conventional and novel antidiabetic agents. In this review article, we discuss the significance of these receptors in the therapeutic regulation of T2D. We also lay emphasis on the need for the development of novel antidiabetic agents, several of which are currently advancing through clinical research to determine their potential for antidiabetic mediation through these receptors.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of body composition with all-cause mortality among U.S. adults with osteoporosis or osteopenia: a population-based study.","authors":"Keju Wang, Xuefei Li, Hao Wan, Peng Tian, Chang Lu, Xiaotong Zhang, Xiaolin Ding","doi":"10.1007/s42000-026-00825-9","DOIUrl":"https://doi.org/10.1007/s42000-026-00825-9","url":null,"abstract":"<p><strong>Background: </strong>Adults with osteopenia or osteoporosis have increased risks of adverse outcomes; however, mortality risk varies substantially and may be influenced by body composition. Evidence for the joint impact of low muscle mass and percentage-based adiposity in this population remains limited.</p><p><strong>Objectives: </strong>To examine the independent and combined associations of low muscle mass and obesity with all-cause mortality among U.S. adults with osteopenia or osteoporosis and to characterize the dose-response relationship between total fat mass and mortality.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis of NHANES cycles with concurrent whole-body DXA (appendicular lean mass and total fat mass) and site-specific BMD assessments (1999-2006, 2013-2014, and 2017-2018). Eligible participants with osteopenia or osteoporosis and mortality linkage were included (unweighted n = 3,918). Low muscle mass (LMM) was defined by DXA-derived appendicular lean mass index (ALMI; men < 7.0 kg/m², women < 5.5 kg/m²), while obesity was operationally defined by DXA body fat percentage (FM%; men > 30%, women > 42%) instead of body mass index (BMI). Survey-weighted Cox models and restricted cubic splines were utilized.</p><p><strong>Results: </strong>Over a median follow-up of 14.8 years, 1,095 deaths occurred. In fully adjusted models, low muscle mass was associated with higher mortality (HR = 1.59, 95% CI: 1.30-1.95). Jointly, both low muscle mass alone (HR = 1.70, 95% CI: 1.30-2.23) and low muscle mass with obesity (HR = 1.45, 95% CI: 1.13-1.87) were associated with higher mortality compared with the normal phenotype, whereas obesity alone was not; notably, the isolated low muscle mass phenotype exhibited a higher point estimate than the combined phenotype. For total fat mass, with Q1 as reference, intermediate quartiles exhibited significantly lower risk (Q2: HR = 0.71, 95% CI: 0.57-0.88; Q3: HR = 0.68, 95% CI: 0.54-0.87), while Q4 showed a similar but non-significant downward trend (HR = 0.64, 95% CI: 0.50-1.03).</p><p><strong>Conclusions: </strong>Among U.S. adults with osteopenia or osteoporosis, low muscle mass was a robust predictor of all-cause mortality. Adiposity defined by body fat percentage was not independently associated with mortality, and fat mass demonstrated a nonlinear pattern with the lowest risk at intermediate levels. These findings support incorporating muscle assessment and refined adiposity measures into risk stratification beyond BMD alone.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunistic screening for osteoporosis using dental radiographic indices.","authors":"Argyris Dimitrios Kouramas, Antigoni Delantoni, Theodoros Petsas, Sokratis Varitimidis","doi":"10.1007/s42000-026-00820-0","DOIUrl":"https://doi.org/10.1007/s42000-026-00820-0","url":null,"abstract":"<p><strong>Purpose: </strong>Early identification of individuals at risk for osteoporosis is essential for timely intervention and prevention of fragility fractures. This study aimed to assess the diagnostic value of dental radiographic indices obtained from panoramic radiography and cone beam computed tomography (CBCT) for the early detection of osteoporosis, using dual-energy X-ray absorptiometry (DXA) as the reference standard.</p><p><strong>Materials and methods: </strong>Seventy (n = 70) postmenopausal women underwent panoramic radiography, CBCT, and DXA examinations. Images were evaluated by an oral surgeon certified in oral radiology. The Mandibular Cortical Index (MCI), Mental Index (MI), Panoramic Mandibular Index (PMI), and Molar Index (M index) were evaluated using panoramic images. Corresponding computed tomography (CT)-based indices, specifically the Computed Tomography Mandibular Cortical Index (CTMCI), Computed Tomography Mental Index (CTMI), Computed Tomography Panoramic Mandibular Index (CTPMI), and Computed Tomography Molar Index (CTM index), were derived from CBCT measurements.</p><p><strong>Results: </strong>PMI, CTPMI, and the M index demonstrated the highest diagnostic performance for osteoporosis detection. Specifically, the highest areas under the curve (AUC) for distinguishing normal individuals from those with osteoporosis were observed for PMI (AUC = 0.89, 95% CI: 0.77-1.00), CTPMI (AUC = 0.88, 95% CI: 0.75-1.00), and the M index (AUC = 0.86, 95% CI: 0.73-0.99). Optimal cutoff values were approximately 3.5-4.0 for MI and CTMI, 0.32-0.38 for PMI and CTPMI, and 3.1-3.35 for the M index. Diagnostic accuracy was higher for differentiating normal individuals from osteoporotic individuals than from osteopenic individuals.</p><p><strong>Conclusion: </strong>Dental radiographic indices derived from panoramic radiography and CBCT may represent useful opportunistic screening tools for identification of postmenopausal women at risk for osteoporosis. The proposed cutoff values could assist clinicians in recognizing individuals who may benefit from referral for DXA assessment and further evaluation of bone mineral density.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed food consumption and thyroid hormone profiles: a cross-sectional analysis of NHANES 2007-2012.","authors":"Qian Chen, YangCheng Guang, He Jun, Yang Feng, XuYing Jie","doi":"10.1007/s42000-026-00807-x","DOIUrl":"https://doi.org/10.1007/s42000-026-00807-x","url":null,"abstract":"<p><strong>Background: </strong>Ultra-processed foods (UPFs) have been increasingly linked to adverse metabolic outcomes. The aim of this study was to assess the association between UPF consumption and thyroid hormone levels in a nationally representative sample of U.S. adults.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from 5,961 adults aged ≥ 18 years participating in NHANES 2007-2012. Dietary intake was assessed using two 24-hour dietary recall and categorized using the NOVA classification system. UPF intake was expressed as a percentage of total daily energy consumption and divided into tertiles. Serum levels of thyroid-stimulating hormone (TSH), free and total triiodothyronine (FT3, TT3), and thyroxine (FT4, TT4) were measured using standardized immunoassays. Weighted linear regression, adjusting for covariates, was used to evaluate associations.</p><p><strong>Results: </strong>Participants had a mean age of 46.8 years and 51.9% were men. Higher UPF intake was linked to younger age, lower income, and greater obesity prevalence (P < 0.001). In fully adjusted models, higher UPF intake was associated with small decreases in FT4 and TT4 and small increases in TSH. Each tertile increase in UPF intake was associated with lower FT4 (β = -0.01 ng/dL, 95% CI - 0.015 to - 0.007) and TT4 (β = -0.12 µg/dL, 95% CI - 0.16 to - 0.09), alongside a modest increase in TSH (β = 0.02, P = 0.012). FT3 associations were weaker and less consistent.</p><p><strong>Conclusion: </strong>Higher UPF consumption was associated with small differences in thyroid hormone levels in this cross-sectional analysis. Given the modest effect sizes and cross-sectional design, these findings should be interpreted cautiously.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of small fiber neuropathy assessed by corneal confocal microscopy following semaglutide treatment: a case report and literature review.","authors":"Ioanna A Anastasiou, Nikolaos Tentolouris, Eleni Rebelos","doi":"10.1007/s42000-026-00826-8","DOIUrl":"https://doi.org/10.1007/s42000-026-00826-8","url":null,"abstract":"<p><p>Diabetic peripheral neuropathy (DPN) is the most common chronic complication of type 2 diabetes (T2D) and a major predisposing factor for the development of diabetic foot, one of the most devastating diabetes-related conditions associated with substantial morbidity and mortality. To date, no pharmacological therapy has been shown capable of preventing, halting, or reversing neuropathic damage. We report the case of a 57-year-old man with T2D and obesity (BMI 35.2 kg/m²) who presented with symptoms and signs of DPN, including a neuropathy symptom score (NSS) of 3/9, a neuropathy disability score (NDS) of 3/10, and a vibration perception threshold (VPT) of 22 volts (V) bilaterally. In vivo corneal confocal microscopy (CCM) was performed to further evaluate small fiber involvement. Despite adequate glycemic control (HbA_1c 6.6%), semaglutide was initiated to optimize metabolic status and promote weight loss. After 6 months of treatment, both BMI and HbA_1c had improved, while NSS, NDS, and VPT remained unchanged. Repeat CCM demonstrated improvement across all corneal nerve parameters. This case suggests that semaglutide-associated metabolic improvement, or a direct semaglutide effect on small fiber integrity, may contribute to early regeneration of small nerve fibers in DPN. Further studies are urgently needed to determine whether semaglutide has a therapeutic role in the management of DPN.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging findings of the hypothalamus and pituitary gland in children with growth hormone deficiency: a 25-year single-center retrospective study.","authors":"Chrysi-Evangelia Akrivou, Eleni P Kotanidou, Vasiliki Rengina Tsinopoulou, Konstantinos Kouskouras, Assimina Galli-Tsinopoulou","doi":"10.1007/s42000-026-00823-x","DOIUrl":"https://doi.org/10.1007/s42000-026-00823-x","url":null,"abstract":"<p><strong>Purpose: </strong>Growth hormone deficiency (GHD) is a cause of short stature in childhood. Central nervous system imaging, including hypothalamic-pituitary magnetic resonance imaging (MRI) is important for the diagnostic investigation of these patients. The aim of this descriptive study was to examine the MRI findings of the hypothalamus-pituitary area in children with GHD.</p><p><strong>Methods: </strong>Medical records and MRI findings of the hypothalamus and pituitary gland were retrospectively reviewed for all patients diagnosed with GHD and treated with recombinant human GH during the 25-year period 1999-2024.</p><p><strong>Results: </strong>The study included 194 patients (138 boys, mean age at diagnosis 10.34 (4) years). Normal imaging findings were observed in 121/194 patients (62.3%), while abnormal findings were noted in 73/194 (37.6%) patients. Isolated or combined congenital structural anomalies of the hypothalamus-pituitary region, congenital pituitary variants, and tumors were also observed. The most frequent congenital imaging pituitary variants were pituitary hypoplasia, a partially empty sella turcica, and an ectopic posterior pituitary. Regarding tumors, 4/194 (2.1%) patients were diagnosed with craniopharyngiomas and 3/194 (1.5%) participants were diagnosed with germinomas in the hypophysis-hypothalamus region. Brain medulloblastomas were found in 3/194 (1.5%) patients. The 93.2% of the study sample (181/194) was diagnosed with isolated GHD, while in 13 patients (6.7%) multiple pituitary hormone insufficiency was established.</p><p><strong>Conclusions: </strong>Imaging of the hypothalamus and pituitary in children with GHD is essential and often reveals benign findings/variants in the region, which should be taken into account during long-term follow-up for possible deficiency of other hormones. Craniopharyngiomas remain the most common tumor causing GHD.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrafollicular activin-A, inhibin-B, and follistatin are associated with in vitro fertilization outcomes in subfertile women.","authors":"Dimitrios Karayiannis, Roxane Tenta, Meropi D Kontogianni, Minas Mastrominas, Nikos Yiannakouris","doi":"10.1007/s42000-026-00818-8","DOIUrl":"https://doi.org/10.1007/s42000-026-00818-8","url":null,"abstract":"<p><strong>Purpose: </strong>The follicular microenvironment strongly influences oocyte and embryo quality and therefore plays a critical role in assisted reproduction therapy outcomes. This study prospectively evaluated the association between follicular fluid (FF) concentrations of activin-A, follistatin, and inhibin-B and in vitro fertilization (IVF) outcome parameters.</p><p><strong>Methods: </strong>Couples with primary infertility attending an Assisted Conception Unit in Athens, Greece, were recruited as part of an ongoing prospective cohort study evaluating the impact of dietary and lifestyle patterns on fertility. FF levels of activin-A, follistatin, and inhibin-B were measured in 86 women undergoing IVF/ICSI cycles, along with assessments of oocyte yield and quality, embryo number and quality, implantation success, clinical pregnancy, and live birth rates. FF samples were collected at oocyte retrieval from follicles ≥ 18 mm in diameter and analyzed using the enzyme-linked immunosorbent assay. Associations between FF biomarkers and IVF outcomes were assessed using correlation analyses and multivariable-adjusted regression models.</p><p><strong>Results: </strong>FF activin-A concentrations were positively correlated with both follistatin and inhibin-B levels (p < 0.001), while FF follistatin and inhibin-B levels were significantly associated with oocyte and embryo number and quality (p < 0.05). Multivariable-adjusted relative risk analyses demonstrated that FF activin-A levels were independently and inversely associated with primary clinical endpoints. Specifically, each 10 pg/mg increase in protein-normalized FF activin-A was independently and inversely associated with successful implantation [RR (95% CI) = 0.82 (0.69-0.96), p = 0.016], clinical pregnancy [RR (95% CI) = 0.76 (0.66-0.86), p < 0.001], and live birth [RR (95% CI) = 0.79 (0.64-0.97), p = 0.023]; however, none of these associations met the Benjamini-Hochberg adjusted significance threshold and all attenuated to marginal non-significance upon adjustment for family subfertility history.</p><p><strong>Conclusion: </strong>Follicular fluid follistatin and inhibin-B were associated with favorable intermediate IVF outcomes, whereas activin-A showed an exploratory inverse association with implantation, clinical pregnancy, and live birth. These findings warrant prospective validation in larger, independent cohorts before any clinical translation can be considered.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GnRH pulse frequency is decoded by distinct Gα_s- and Gα_q/11-mediated signaling pathways in gonadotropes in vitro.","authors":"George A Stamatiades, Iain R Thompson, Han Kyeol Kim, Rona S Carroll, Ursula B Kaiser","doi":"10.1007/s42000-026-00815-x","DOIUrl":"https://doi.org/10.1007/s42000-026-00815-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pulsatile gonadotropin-releasing hormone (GnRH) secretion differentially regulates follicle-stimulating hormone β-subunit (Fshb) expression according to pulse frequency; however, the mechanisms by which pituitary gonadotropes decode GnRH pulsatility remain incompletely understood. GnRH activates both Gα_s- and Gα_q/11-mediated signaling pathways, and the transcriptional regulators cAMP response element-binding protein (Creb) and inducible cAMP early repressor (Icer) have been implicated in Fshb regulation. This study examined whether distinct G protein-dependent pathways regulate Creb and Icer in a GnRH pulse frequency-dependent manner.</p><p><strong>Methods: </strong>Murine gonadotrope-derived LβT2 cells were transduced with lentiviral shRNA targeting Gnas (Gα_s), Gnaq/Gna11 (Gα_q/11), or scrambled controls. Cells were perifused and stimulated with pulsatile GnRH (10 nM) at low (every 120 min) or high (every 30 min) pulse frequencies for 20 h. Creb and Erk1/2 phosphorylation were assessed by immunoblotting and Icer and Egr1 mRNA levels were measured by real-time PCR.</p><p><strong>Results: </strong>GnRH induced pulse frequency-dependent signaling, with enhanced Creb phosphorylation at low pulse frequency and preferential Icer induction at high frequency. Gnas knockdown selectively attenuated Creb phosphorylation at low pulse frequency without affecting Icer expression. In contrast, Gnaq/Gna11 knockdown reduced Icer induction at high pulse frequency and markedly attenuated Erk1/2 phosphorylation and Egr1 expression at both frequencies.</p><p><strong>Conclusion: </strong>GnRH pulse frequency is decoded in gonadotropes through differential engagement of G protein-dependent signaling pathways. Gα_s-mediated signaling pathways preferentially activate Creb at low pulse frequencies, whereas Gα_q/11-mediated pathways promote Erk-dependent Icer and Egr1 induction at higher pulse frequencies, providing a mechanism for differential regulation of FSH and LH synthesis.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of pheochromocytoma-induced reverse Takotsubo cardiomyopathy presenting as a catecholaminergic crisis.","authors":"Foteini Petrea, Ioannis Petropoulos, Foteini Thanasoula, Polyxeni Manifava, Marina Mitropoulou, Anna Dimoula, Evangelos Repasos, Nikolaos Aggelis, Athanasios Kallis, Ektor Anninos, Kimon Stamatelopoulos, Vasiliki Vasileiou","doi":"10.1007/s42000-026-00817-9","DOIUrl":"https://doi.org/10.1007/s42000-026-00817-9","url":null,"abstract":"<p><strong>Purpose: </strong>Pheochromocytoma is a rare neuroendocrine tumor that may present with atypical and potentially life-threatening cardiovascular manifestations due to catecholamine excess. Reverse Takotsubo cardiomyopathy, a distinct form of stress-induced cardiomyopathy, has been strongly associated with catecholamine crisis but remains underrecognized. The purpose of this report is to describe a rare case of pheochromocytoma-induced reverse Takotsubo cardiomyopathy complicated by acute severe mitral regurgitation and to emphasize the importance of early endocrine recognition.</p><p><strong>Case presentation: </strong>A 40-year-old woman presented with hypertensive emergency, acute chest pain, electrocardiographic changes suggestive of acute coronary syndrome, and markedly elevated cardiac biomarkers. Transthoracic echocardiography revealed reduced left ventricular ejection fraction with basal and mid-ventricular akinesis, apical hyperkinesis, and acute severe mitral regurgitation consistent with reverse Takotsubo cardiomyopathy. Emergency coronary angiography demonstrated normal coronary arteries.</p><p><strong>Clinical findings and outcome: </strong>Recurrent stress-induced cardiomyopathy in a young patient without conventional cardiovascular risk factors, accompanied by autonomic symptoms, hyperglycemia, and lactic acidosis, raised suspicion of pheochromocytoma-related catecholamine crisis. Cross-sectional imaging identified a left adrenal mass and biochemical testing confirmed markedly elevated plasma metanephrines. After appropriate preoperative α-adrenergic blockade, laparoscopic adrenalectomy resulted in complete clinical and biochemical remission with full recovery of cardiac function.</p><p><strong>Conclusion: </strong>Pheochromocytoma should be considered in younger patients presenting with recurrent or atypical Takotsubo cardiomyopathy, particularly in the case of reverse pattern and when associated with acute mitral regurgitation or hypertensive emergency. Early endocrine diagnosis is critical as definitive surgical treatment leads to complete resolution and prevents recurrence of severe cardiovascular complications.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}