EndocrinesPub Date : 2023-07-28DOI: 10.3390/endocrines4030039
Z. Khan, M. Mauer, M. L. Caramori
{"title":"Effects of Renin–Angiotensin Blockade on the Components of Early Interstitial Expansion in Patients with Type 1 Diabetes","authors":"Z. Khan, M. Mauer, M. L. Caramori","doi":"10.3390/endocrines4030039","DOIUrl":"https://doi.org/10.3390/endocrines4030039","url":null,"abstract":"Interstitial expansion is associated with glomerular filtration rate (GFR) loss in many renal diseases, including diabetic nephropathy. The Renin–Angiotensin System Study (RASS) tested whether a 5-year renin–angiotensin system (RAS) blockade with enalapril or losartan versus placebo slowed progression of early diabetic nephropathy lesions in 285 normoalbuminuric, normotensive, normal/high GFR patients with type 1 diabetes. RASS found no benefit to the RAS blockade on diabetic glomerular lesions but observed an unexpected 50% increase in the fractional volume of the renal cortex which is the interstitium. The effects of the RAS blockade on individual interstitial components––striated collagen, interstitial cells, and peritubular capillaries––were not assessed. We evaluated by electron microscopy changes in fractional volume of each component in seven patients from each group between baseline and five years. At baseline, 49% of the interstitium was collagen, 12% cells, 26% peritubular capillaries, 7% space, and 2% artifact. There was no overall change in the interstitial composition during the RASS. There were no statistically significant effects of treatment group on any interstitial components. Renal volume remained stable in all groups. The RAS blockade affected neither the approximately 50% increase in interstitium fractional volume per cortex nor the parallel increase in all interstitial components that occurred over the five years of the RASS.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44503566","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}
EndocrinesPub Date : 2023-07-23DOI: 10.3390/endocrines4030038
L. Gaspari, F. Paris, N. Kalfa, C. Sultan
{"title":"Primary Amenorrhea in Adolescents: Approach to Diagnosis and Management","authors":"L. Gaspari, F. Paris, N. Kalfa, C. Sultan","doi":"10.3390/endocrines4030038","DOIUrl":"https://doi.org/10.3390/endocrines4030038","url":null,"abstract":"Primary amenorrhea (PA) describes the complete absence of menses by the age of 15 years. It is a devastating diagnosis that can affect the adolescent’s view of her femininity, sexuality, fertility and self-image. A normal menstrual cycle can occur only in the presence of: a properly functioning hypothalamus–pituitary axis, well-developed and active ovaries, outflow tract without abnormalities. Any dysfunction in any of these players can result in amenorrhea. PA evaluation includes the patient’s medical history, physical examination, pelvic ultrasonography and initial hormone evaluation, limited to the serum-follicle-stimulating hormone (FSH) and luteinizing hormone, testosterone and prolactin. A karyotype should be obtained in all adolescents with high FSH serum levels. The main causes of PA, whether or not accompanied by secondary sexual characteristics, include endocrine defects of the hypothalamus–pituitary–ovarian axis, genetic defects of the ovary, metabolic diseases, autoimmune diseases, infections, iatrogenic causes (radiotherapy, chemotherapy), environmental factors and Müllerian tract defects. PA management depends on the underlying causes. Estrogen replacement therapy at puberty has mainly been based on personal experience. PA can be due to endocrine, genetic, metabolic, anatomical and environmental disorders that may have severe implications on reproductive health later in life. In some complex cases, a multidisciplinary team best manages the adolescent, including a pediatrician endocrinologist, gynecologist, geneticist, surgeon, radiologist, and psychologist.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41721040","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}
EndocrinesPub Date : 2023-07-20DOI: 10.3390/endocrines4030037
Laleh Razavi Nematollahi, Caitlin Omoregie
{"title":"Updates on the Management of Hyperglycemia in Hospitalized Adult Patients","authors":"Laleh Razavi Nematollahi, Caitlin Omoregie","doi":"10.3390/endocrines4030037","DOIUrl":"https://doi.org/10.3390/endocrines4030037","url":null,"abstract":"The prevalence of diabetes is rising globally; currently, 537 million people worldwide and 37.3 million people in the US are affected. Patients with diabetes have a four-times-greater risk of hospitalization with longer hospital stays and a greater chance of readmission compared to patients without diabetes. Spending on diabetes care as a proportion of global GDP is also projected to increase from 1.8% in 2015 to 2.2% in 2030. The largest component of this medical expenditure is inpatient care in hospitalized patients, accounting for USD 69.7 billion of the total medical cost. Hospitalized patients can develop hyperglycemia without a history of pre-existing diabetes. It has been shown that hyperglycemia in patients without a history of diabetes is also associated with poor hospital outcome. In this review, we discuss the adverse effects of hyperglycemia and hypoglycemia on hospital outcomes; we review recent glycemic targets, recent guidelines’ recommendations, and landmark trials with a brief review on discharge planning, updates on hyperglycemic emergencies, and the use of newer technologies in hospitalized patients such as continuous glucose monitoring devices.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42818557","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}
EndocrinesPub Date : 2023-07-19DOI: 10.3390/endocrines4030036
Cherlie Magny-Normilus, S. Griggs, Julie A Sanders, Youri Hwang, Catrina Longhurst
{"title":"Sleep Characteristics in Adults of African Descent at Risk for and with Cardiometabolic Conditions: A Systematic Review","authors":"Cherlie Magny-Normilus, S. Griggs, Julie A Sanders, Youri Hwang, Catrina Longhurst","doi":"10.3390/endocrines4030036","DOIUrl":"https://doi.org/10.3390/endocrines4030036","url":null,"abstract":"The purpose of this systematic review is to synthesize available studies on sleep health characteristics in adults of African descent with or at risk for cardiometabolic conditions. PubMed, PsycINFO, CINAHL, and Web of Science were searched for original research studies on subgroups of African descent with at least one cardiometabolic risk factor. Studies published in English with measured sleep characteristics were included. Studies focused on participants with severe psychiatric illness, night shift workers, or with a pharmacologic sleep treatment focus were excluded. The risk for bias was assessed using the NHLBI 2021 Quality Assessment Tool. Two reviewers independently synthesized the results before reaching a consensus. Out of 340 studies screened, 35 studies were included. There were 631,756 participants with an average age of 44.3 combined (SD = 16.5) (53% female and 22% Black). Disparities in sleep health characteristics and cardiometabolic health among African American adults were found. Markers of poor cardiometabolic health were associated with disordered sleep. While the studies in this review captured key factors, the study measurement methods were inconsistent, and African Caribbean Americans were underrepresented. The studies demonstrated the intersectionality of poor sleep characteristics, cardiometabolic risk factors, and racial/ethnic groupings. Clinicians should consider these findings when providing care.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42111960","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}
EndocrinesPub Date : 2023-07-06DOI: 10.3390/endocrines4030035
Andrew Shahidehpour, Mudassir M. Rashid, Mohammad-Reza Askari, Mohammad Ahmadasas, A. Cinar
{"title":"Identification of Glucagon Secretion Patterns during an Oral Glucose Tolerance Test","authors":"Andrew Shahidehpour, Mudassir M. Rashid, Mohammad-Reza Askari, Mohammad Ahmadasas, A. Cinar","doi":"10.3390/endocrines4030035","DOIUrl":"https://doi.org/10.3390/endocrines4030035","url":null,"abstract":"Impaired glucagon secretion is a major component of glucose intolerance in type 2 diabetes mellitus (T2D). Glucagon secretion exhibits heterogenous patterns in individuals and across glucose tolerance diagnoses. Characterization of the range of glucagon secretion patterns can help clinicians personalize diabetes care based on glucagon characteristics in addition to glucose and insulin profiles. A total of 102 subjects with normal glucose tolerance, impaired glucose tolerance, and T2D had their glucagon profiles recorded in response to an oral glucose tolerance test. Shapelet analysis was used to identify the most descriptive patterns of early glucagon secretion, and spectral biclustering was employed to identify biclusters of associated subjects and shapelets. The dynamics of glucose, insulin, and glucagon secretion in each cluster were evaluated to identify overall patterns, and the characteristics of the subjects in each cluster were compared. Three clusters were chosen to represent the glucagon patterns. Membership in these three clusters was interpreted based on the presence or lack of extrema in the first 30 min after oral carbohydrate intake. Cluster 1 (n = 23) had a minimum at 30 min and only negative trends. Cluster 2 had a minimum at 10 min and a maximum at 20 min (n = 25). Cluster 3 (n = 40) had a maximum at 10 min and a minimum at 20 min. Subjects in cluster 1 had the lowest average fasting plasma glucose (90.17 mg/dL) and average age (41.39 years) and the highest HOMA-beta score (87.5%), while subjects in cluster 2 had the highest average fasting plasma glucose (102.56 mg/dL) and average age (53.16 years) and the lowest HOMA-beta score (55.77%). Characterization of glucagon dynamics, in addition to glucose and insulin, can aid in personalized treatment approaches and provide greater insight about the underlying dysfunction in glucose regulation.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47129082","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}
EndocrinesPub Date : 2023-06-20DOI: 10.3390/endocrines4020034
A. Petrescu, Suyeon An, J. Venter, Matthew McMillin, S. DeMorrow
{"title":"The Role of Hypothalamic Neuropeptides in Regulation of Liver Functions in Health and Disease","authors":"A. Petrescu, Suyeon An, J. Venter, Matthew McMillin, S. DeMorrow","doi":"10.3390/endocrines4020034","DOIUrl":"https://doi.org/10.3390/endocrines4020034","url":null,"abstract":"The communication between brain and peripheral tissues is mediated by neuropeptides that coordinate the functions of each organ with the activities of the entire body in specific environmental conditions. Hypothalamic neuropeptides act as neurotransmitters and hormones to regulate the physiology of food intake, digestion, and metabolism, having a direct or indirect impact on the liver. Investigations on liver pathologies found that dysfunctions of neuropeptides and their receptors are associated with liver disorders such as non-alcoholic fatty liver disease, steatohepatitis, cholestasis, cirrhosis, and liver cancer. In this article, we reviewed neuropeptides that regulate energy homeostasis and lipid and glucose metabolism in the liver and are associated with liver injuries. Firstly, peptides involved in regulatory processes in the brain and liver, such as neuropeptide Y, agouti-related protein, and the galanin family, are related to obesity and its comorbidities, including type 2 diabetes and metabolic syndrome, are presented. Secondly, a comprehensive review of neuropeptides such as secretin, vasoactive intestinal peptide, substance P, and somatostatin, which are involved in liver injuries unrelated to obesity; i.e., cholestasis-induced biliary hyperplasia, cirrhosis, hepatocellular carcinoma, and cholangiocarcinoma, is also presented. The cellular and molecular mechanisms underlining liver injuries related to the dysfunction of these neuropeptides and receptors are also described.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43666221","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}
EndocrinesPub Date : 2023-06-15DOI: 10.3390/endocrines4020032
M. Greco, M. Mirabelli, Vera Tocci, Yelyzaveta Mamula, Alessandro Salatino, F. Brunetti, Francesco Dragone, Luciana Sicilia, Omar Tripolino, E. Chiefari, D. Foti, A. Brunetti
{"title":"Prothymosin-Alpha, a Novel and Sensitive Biomarker of the Inflammatory and Insulin-Resistant Statuses of Obese Individuals: A Pilot Study Involving Humans","authors":"M. Greco, M. Mirabelli, Vera Tocci, Yelyzaveta Mamula, Alessandro Salatino, F. Brunetti, Francesco Dragone, Luciana Sicilia, Omar Tripolino, E. Chiefari, D. Foti, A. Brunetti","doi":"10.3390/endocrines4020032","DOIUrl":"https://doi.org/10.3390/endocrines4020032","url":null,"abstract":"Background: Obesity constitutes a chronic, low-grade inflammatory status that predisposes people to the development of insulin resistance and cardiometabolic complications. Hypoxia, a main pathological feature of visceral fat in obese individuals, has been shown to affect the secretome of murine 3T3-L1 adipose cells, causing the upregulation of prothymosin-alpha (ProT-α), which is a protein with immunomodulatory functions that was originally found in the thymus. The aim of this case–control observational study was to measure the circulating levels of ProT-α in obese and lean individuals and determine whether such levels are correlated with inflammatory and metabolic parameters. Methods: Sixty-one obese patients (BMI ≥ 30 Kg/m2) and fifty-one age-matched, lean controls (BMI 18.5–24.9 Kg/m2) were recruited in the Endocrinology Unit (“Mater-Domini”) of the University Hospital of Catanzaro, Italy. The exclusion criteria included affliction with acute and systemic inflammatory states (i.e., leukocytosis), recent infectious diseases or vaccinations, obesity complications (i.e., type 2 diabetes mellitus and cardiovascular diseases), hepatic or renal failure, pregnancy and lactation, cancer, use of drugs or alcohol, and smoking. Apart from routine biochemical determinations, serum samples were screened for the presence of ProT-α using an ELISA method and for the presence of a panel of inflammatory cytokines and growth factors via a multiparametric chemiluminescence micro-array. Results: Between the age-matched groups, no statistically significant differences were shown in relation to fasting glucose, HbA1c, liver function tests, lipid profiles, circulating interleukins (IL)-1α, -1β, -2, -4, -8, and -10, MCP-1, TNF-α, VEGF and EGF. Instead, significantly higher median levels were observed in obese patients vs. lean controls with respect to fasting insulin levels (p < 0.001), a classic insulin resistance marker, and IL-6 (p = 0.004). In addition, ProT-α levels were significantly and considerably higher in obese patients compared to lean controls (median ProT-α, 600.0 vs. 411.5 pg/mL, p = 0.004) and showed a moderate to strong positive relationship with fasting insulin levels and selected cytokines (i.e., TNF-α and IL-8). Conclusions: An increase in circulating levels of ProT-α is linked with obesity and can be detected before any clinical cardiometabolic complications develop. ProT-α may represent a novel and sensitive biomarker for inflammation and insulin resistance in obese individuals.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48730362","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}
EndocrinesPub Date : 2023-06-15DOI: 10.3390/endocrines4020033
D. Dubois-Laforgue, J. Timsit
{"title":"The Etiological Diagnosis of Diabetes: Still a Challenge for the Clinician","authors":"D. Dubois-Laforgue, J. Timsit","doi":"10.3390/endocrines4020033","DOIUrl":"https://doi.org/10.3390/endocrines4020033","url":null,"abstract":"The etiological diagnosis of diabetes conveys many practical consequences for the care of patients, and often of their families. However, a wide heterogeneity in the phenotypes of all diabetes subtypes, including Type 1 diabetes, Type 2 diabetes, and monogenic diabetes, has been reported and contributes to frequent misdiagnoses. The recently revised WHO classification of diabetes mellitus includes two new classes, namely “hybrid forms” and “unclassified diabetes”, which also reflect the difficulties of this etiological diagnosis. During the last years, many studies aiming at identifying homogenous subgroups on refined phenotypes have been reported. Ultimately, such subtyping may improve the diagnosis, prognosis, and treatment of patients on a pathophysiological basis. Here, we discuss the concepts of typical vs. atypical diabetes in the context of autoimmune Type 1 diabetes, Type 2 diabetes, and its monogenic forms. We discuss the contributions of clinical markers, biological tests, particularly islet cell auto-antibodies, and genetics to improving accurate diagnoses. These data support a systematic evaluation of all newly diagnosed diabetes cases.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43654715","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}
EndocrinesPub Date : 2023-06-01DOI: 10.3390/endocrines4020030
I. Tomada, N. Tomada
{"title":"Mediterranean Diet and Male Fertility","authors":"I. Tomada, N. Tomada","doi":"10.3390/endocrines4020030","DOIUrl":"https://doi.org/10.3390/endocrines4020030","url":null,"abstract":"Diet has an impact on male reproductive potential, but few studies have focused on the specific impact of food groups or dietary patterns on fertility. Male reproductive health, as indicated by improved semen parameters and increased chances of conceiving, is associated with the Mediterranean diet, while the Western diet is considered a risk factor for male infertility. The potential mechanisms that may explain the impact of these diets on semen quality are still largely unknown. However, numerous studies suggest that nutritional interventions are crucial for the preservation and improvement of male fertility. This review aims to summarize the most recent evidence on the influence of components of the Mediterranean diet on sperm parameters. Unlike other risk factors, dietary modulation represents a great opportunity for improving overall health and can also be an important tool in recommendations for male reproductive health.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49321297","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}
EndocrinesPub Date : 2023-06-01DOI: 10.3390/endocrines4020031
Emilia Sabbatino, Viviana Tutino, F. Licitra, M. Di Donato, G. Castoria, A. Migliaccio, P. Giovannelli
{"title":"Role of the Androgen Receptor in Gender-Related Cancers","authors":"Emilia Sabbatino, Viviana Tutino, F. Licitra, M. Di Donato, G. Castoria, A. Migliaccio, P. Giovannelli","doi":"10.3390/endocrines4020031","DOIUrl":"https://doi.org/10.3390/endocrines4020031","url":null,"abstract":"The androgen receptor (AR) is expressed in many cell types, and its related signaling is widely investigated in hormone-dependent cancers such as prostate and breast. The significance of the AR, however, has been detected even in other cancers, including gastric, bladder, kidney, lung, hepatic, and pancreatic, in which growth and spreading are not strictly or notoriously dependent on sex steroid hormone action. The incidence and mortality of these cancers are, however, somewhat related to gender and, specifically, are higher in men than in women, with the ratio reaching 3–4:1 for bladder cancer. This direct correlation between cancer incidence, mortality, and gender makes sex one of the most important risk factors for these cancers and has incited investigation about the role of sex steroid receptors and their activating hormones in gender-related cancers. In these cancers, the AR is often expressed and seems to play a pivotal role in different processes contributing to cancer onset and progression such as growth, spreading, and epithelial to mesenchymal transition (EMT). This manuscript will offer an overview of the role of the AR in many cancers of the respiratory and gastrointestinal systems wherein its role has been at least partially analyzed. Understanding the role of the AR in these tumors could help us to identify a new biomarker for early diagnostic guidance and to develop better therapeutic approaches by directly targeting the AR or its downstream signaling in individual cells of hormone-related cancers at different stages.","PeriodicalId":72908,"journal":{"name":"Endocrines","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42094352","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}