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European Journal of Endocrinology

Przemyslaw Rys, Agnieszka H Ludwig-Słomczyńska, Katarzyna Cyganek, Maciej T Malecki
BACKGROUND: Randomised controlled trials (RCTs) have shown an advantage of continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) in the general type 1 diabetes mellitus (T1DM) population. RCT data on T1DM management in pregnancy remain limited. OBJECTIVE: We performed a systematic review of both RCTs and non-RCTs evaluating CSII versus MDI in T1DM-complicated pregnancy. STUDY DESIGN: Electronic databases were searched for studies comparing CSII with MDI in T1DM-complicated pregnancy...
March 15, 2018: European Journal of Endocrinology
Omar Yaxmehen Bello-Chavolla, Paloma Almeda-Valdes, Donaji Gomez-Velasco, Tannia Viveros-Ruiz, Ivette Cruz-Bautista, Alonso Romo-Romo, Daniel Sánchez-Lázaro, Dushan Meza-Oviedo, Arsenio Vargas-Vazquez, Olimpia Arellano Campos, Magdalena Del Rocío Sevilla-González, Alexandro J Martagón, Liliana Muñoz Hernández, Roopa Pravin Mehta, César Rodolfo Caballeros-Barragán, Carlos Aguilar-Salinas
OBJECTIVE: We developed a novel non-insulin based fasting score to evaluate insulin sensitivity validated against the EHC. We also evaluated its correlation with ectopic fact accumulation and its capacity to predict incident T2D cases. DESIGN & METHODS: The discovery sample was composed by 125 subjects (57 without and 68 with T2D) that underwent an EHC. We defined METS-IR as Ln[(2*G0)+TG0]*BMI)/(Ln[HDL-c]) and compared its diagnostic performance against the MFFM obtained by an EHC...
March 13, 2018: European Journal of Endocrinology
Miikka-Juhani Honka, Aino Latva-Rasku, Marco Bucci, Kirsi A Virtanen, Jarna C Hannukainen, Kari K Kalliokoski, Pirjo Nuutila
OBJECTIVE: Insulin resistance is reflected by the rates of reduced glucose uptake (GU) into the key insulin-sensitive tissues, skeletal muscle, liver and adipose tissue. It is unclear whether insulin resistance occurs simultaneously in all these tissues or whether insulin resistance is tissue specific. DESIGN AND METHODS: We measured GU in skeletal muscle, adipose tissue and liver and endogenous glucose production (EGP), in a single session using 18F-fluorodeoxyglucose with positron emission tomography (PET) and euglycemic-hyperinsulinemic clamp...
March 13, 2018: European Journal of Endocrinology
Sung Keun Park, Jae-Hong Ryoo, Chang-Mo Oh, Joong Myung Choi, Ju Young Jung
BACKGROUND: Body fat plays the significant role in maintaining glucose homeostasis. However, it is not fully identified how body fat percentage (BF%) has an impact on the development of type 2 diabetes mellitus (T2DM). Thus, this study was to evaluate the incidental risk for T2DM according to BF% level. METHODS: In a community based Korean cohort, 5,972 Korean adults were divided into quintile groups by BF% and followed-up for 10 years to monitor the development of T2DM...
March 9, 2018: European Journal of Endocrinology
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
Emilia Sbardella, Marianna Minnetti, Denise D'Aluisio, Laura Rizza, Maria Rosaria Di Giorgio, Fabio Vinci, Riccardo Pofi, Elisa Giannetta, Mary Anna Venneri, Annarita Vestri, Sergio Morelli, Andrea Lenzi, Andrea M Isidori
BACKGROUND: Low-grade incomplete post-dexamethasone cortisol suppression in patients with adrenal incidentalomas -recently defined as possible autonomous cortisol secretion (pACS)- has been associated with increased cardiovascular events and mortality. However, prospective studies documenting cardiac abnormalities in these patients are lacking. SUBJECTS AND METHODS: Between July 2016 and September 2017, 71 consecutive patients with adrenal lesions were prospectively screened for hypercortisolism by dexamethasone suppression test (NCT02611258)...
March 6, 2018: European Journal of Endocrinology
Gudmundur Johannsson, Ulla Feldt-Rasmussen, Ida Holme Håkonsson, Henrik Biering, Patrice Rodien, Shigeyuki Tahara, Andrew A Toogood, Michael Højby Rasmussen
OBJECTIVE: Somapacitan is a reversible albumin-binding growth hormone (GH) derivative, developed for once-weekly administration. This study aimed to evaluate the safety of once-weekly somapacitan vs once-daily Norditropin® Local tolerability and treatment satisfaction were also assessed. DESIGN: 26-week randomized, controlled phase 3 safety and tolerability trial in six countries (NCT02382939). METHODS: Male or female patients aged 18-79 years with adult GH deficiency (AGHD), treated with once-daily GH for ≥6 months, were randomized to once-weekly somapacitan (n = 61) or once-daily Norditropin® (n = 31) administered subcutaneously by pen...
March 2, 2018: European Journal of Endocrinology
Sumana Chatterjee, Lucy Shapiro, Stephen J Rose, Talat Mushtaq, Peter E Clayton, Svetlana Ten, Amrit Bhangoo, Uma Kumbattae, Renuka Dias, Martin O Savage, Louise A Metherell, Helen L Storr
BACKGROUND: Patients with homozygous intronic pseudoexon GH receptor(GHR) mutations(6Ψ) have growth hormone Insensitivity(GHI) (growth failure, IGF1 deficiency and normal/elevated serum GH). We report 9 patients in addition to previously described 11 GHR 6Ψ patients and their responses to rhIGF1 therapy. METHODS: 20 patients (12 males, 11 families, mean age 4.0±2.2yrs) were diagnosed genetically in our centre. Phenotypic data and responses to rhIGF1 treatment were provided by referring clinicians...
March 2, 2018: European Journal of Endocrinology
Juliane Leger, Anne Forhan, Sophie Dos Santos, Beatrice Larroque, Emmanuel Ecosse, Marie Aline Charles, Barbara Heude
OBJECTIVE: Maternal thyroid dysfunction during pregnancy is associated with neurodevelopmental impairment in the offspring. No data are currently available for the offspring of patients treated early for congenital hypothyroidism(CH). The aim of this study was to investigate motor and language milestones at one year of age in a population-based registry of children born to young women with CH. DESIGN AND METHODS: We assessed 110 children born to mothers with CH, and 1367 children from the EDEN French population-based birth cohort study prospectively, at the age of one year, with identical questionnaires...
March 2, 2018: European Journal of Endocrinology
Gisah Amaral Carvalho, Gilberto Paz-Filho, Cleo Otaviano Mesa Junior, Hans Graf
Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH...
February 28, 2018: European Journal of Endocrinology
Daniela Esposito, Oskar Ragnarsson, Daniel Granfeldt, Tom Marlow, Gudmundur Johannsson, Daniel S Olsson
OBJECTIVE: New therapeutic strategies have developed for the management of acromegaly over recent decades. Whether this has improved mortality has not been fully elucidated. The primary aim was to investigate mortality in a nationwide unselected cohort of patients with acromegaly. Secondary analyses included time trends in mortality and treatment patterns. DESIGN: A total of 1089 patients with acromegaly were identified in Swedish National Health Registries between 1987-2013...
February 26, 2018: European Journal of Endocrinology
Anne Jouinot, Jerome Bertherat
Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis, the five-years overall survival being below 40%. However there is great variability of outcomes and we have now a better view of the heterogeneity of tumor aggressiveness. The extent of the disease at the time of diagnosis, best assayed by the European Network for the Study of Adrenal Tumors (ENSAT) staging score, is a major determinant of survival. The tumor grade, including the mitotic count and the Ki67 proliferation index, also appears as a strong prognostic factor...
February 23, 2018: European Journal of Endocrinology
Dimitra Argyro Vassiliadi, Stylianos Tsagarakis
Desmopressin is a vasopressin analogue selective for type 2 vasopressin receptors that mediate renal water retention. In contrast to the native hormone arginine-vasopressin, a well-known ACTH secretagogue, desmopressin exerts minimal or no activity on ACTH excretion. However, in a substantial proportion of patients with ACTH-dependent Cushing's syndrome (CS), desmopressin elicits an ACTH and cortisol response, which contrasts with the minimal responses obtained in healthy subjects. The mechanism underlying this paradoxical response involves upregulation of vasopressin type 3 and/or the aberrant expression of type 2 receptors by neoplastic ACTH-producing cells...
February 22, 2018: European Journal of Endocrinology
Jacques Young, Jerome Bertherat, Marie Christine Vantyghem, Olivier Chabre, Salima Senoussi, Rita Chadarevian, Frédéric Castinetti
OBJECTIVE: Ketoconazole (KTZ) is one of few available treatments for Cushing's syndrome (CS). Although KTZ has been associated with severe hepatotoxicity, little information is available about hepatic safety in CS. The aim of this study was to document changes in liver function in patients with CS treated with KTZ. DESIGN: An observational prospective French cohort study (compassionate use programme). METHODS: Enrolled patients were stratified into a KTZ-naive cohort and a cohort already treated by another formulation of ketoconazole (KTZ-switch cohort)...
February 22, 2018: European Journal of Endocrinology
Marie Marty, Delphine Gaye, Paul Perez, Claire Auder, Marie-Laure Nunes, Amandine Ferriere, Magalie Haissaguerre, Antoine Tabarin
CONTEXT: the recent recommendations of the European endocrine society states that the performance of computed tomography (CT) to characterize true adrenal incidentalomas (AIs) remains debatable. OBJECTIVE: to determine relevant thresholds for usual CT parameters for the diagnosis of benign tumors using robust reference standard amongst a large series of "true" AIs recruited in an endocrinological setting. DESIGN: retrospective study of 253 AIs in 233 consecutive patients explored in a single university hospital: 183 adenomas, 33 pheochromocytomas, 23 adrenocortical carcinomas, 5 other malignant tumors and 9 other benign tumors...
February 21, 2018: European Journal of Endocrinology
Edward Buitenwerf, Tijmen Korteweg, Anneke Visser, Charlotte Msc Haag, Richard A Feelders, Henri J Timmers, Letizia Canu, H R Haak, Peter H Bisschop, E Marelise W Eekhoff, Eleonora Pm van der Kleij-Corssmit, Nanda C Krak, Elise Rasenberg, Janneke van den Bergh, Jaap Stoker, Marcel Jw Greuter, Robin P F Dullaart, Thera P Links, Michiel N Kerstens
BACKGROUND: A substantial proportion of all pheochromocytomas is currently detected during the evaluation of an adrenal incidentaloma. Recently it has been suggested that biochemical testing to rule out pheochromocytoma is unnecessary in case of an adrenal incidentaloma with an unenhanced attenuation value ≤10 Hounsfield Units (HU) at computed tomography (CT). OBJECTIVES: We aimed to determine the sensitivity of the 10 HU threshold value to exclude a pheochromocytoma...
February 21, 2018: European Journal of Endocrinology
Xavier Bertagna
One of today's challenges in endocrinology is the treatment of Cushing's disease: Whereas pituitary surgery has the potential to "cure" the patient and restore a completely normal pituitary adrenal axis, there are immediate failures and late recurrences that will ultimately require alternate therapeutic approaches. Their high number is in direct correlation with their serious limitations and they all appear to be "default options". This "personal view" tries to shed some light on the inescapable difficulties of the current treatments of Cushing's disease, and to provide some optimistic view for the future where the pituitary adenoma should be the "reasonable obsession" of a successful therapeutist…...
February 21, 2018: European Journal of Endocrinology
Reetobrata Basu, Yanrong Qian, John J Kopchick
Growth hormone (GH) is produced primarily by anterior pituitary somatotroph cells. Numerous acute human (h) GH treatment and long-term follow-up studies and extensive use of animal models of GH action have shaped the body of GH research over the past 40-50 years. Work on the GH receptor (R) knock-out (GHRKO) mice and results of studies on GH resistant Laron Syndrome (LS) patients have helped define many physiological actions of GH including those dealing with metabolism, obesity, cancer, diabetes, cognition, and aging/longevity...
February 19, 2018: European Journal of Endocrinology
Michel Pugeat, Ingrid Plotton, Aude Brac de la Perrière, Gerald Raverot, Henri Déchaud, Véronique Raverot
Measuring total testosterone level is the first-line approach in assessing androgen excess in women. The main pitfalls in measuring testosterone relate to its low concentration and to the structural similarity between circulating androgens and testosterone, requiring accurate techniques with high specificity and sensitivity. These goals can be achieved by immunoassay using a specific anti-testosterone monoclonal antibody, ideally after an extraction step. Liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) will be commonly used for measuring testosterone, providing optimal accuracy with a low limit of detection...
February 16, 2018: European Journal of Endocrinology
Niranjan Tachamo, Anthony Donato, Bidhya Timilsina, Salik Nazir, Saroj Lohani, Rashmi Dhital, Sijan Basnet
Cosmetic injections with silicone and polymethylmethacrylate are not FDA-approved for augmentation of body parts such as breast, buttock or legs, but they have been widely used for decades. Cosmetic injections can cause foreign body granulomas and occasionally severe and life-threatening hypercalcemia. We aimed to systematically analyze the published literature on cosmetic injection-associated hypercalcemia. Methods We searched relevant articles on hypercalcemia associated with various cosmetic injections and extracted relevant data on demographics, cosmetic injections used, severity of hypercalcemia, management and outcomes...
February 16, 2018: European Journal of Endocrinology
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