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Pia Burman, André P van Beek, Beverly M K Biller, Cecilia Camacho-Hübner, Anders F Mattsson
Context: De novo brain tumors developing after treatment of pituitary/sellar lesions have been reported, but it is unknown whether this is linked to any of the treatment modalities. Objective: To study the occurrence of malignant brain tumors and meningiomas in a large cohort of patients treated for pituitary/sellar lesions, with special emphasis on the role of radiotherapy (RT). Patients and Methods: Patients (n = 8917) who were hypopituitary due to pituitary adenomas, craniopharyngiomas, and other sellar tumors followed in KIMS (Pfizer International Metabolic Database) from 1994 to 2012 were included...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
Agnethe Berglund, Morten Olsen, Marianne Andersen, Eigil Husted Nielsen, Ulla Feldt-Rasmussen, Caroline Kistorp, Claus Højbjerg Gravholt, Kirstine Stochhholm
OBJECTIVE: Routinely collected health data may be valuable sources for conducting research. This study aimed to evaluate the validity of algorithms detecting hypopituitary patients in the Danish National Patient Registry (DNPR) using medical records as reference standard. STUDY DESIGN AND SETTING: Patients with International Classification of Diseases (10th edition [ICD-10]) diagnoses of hypopituitarism, or other diagnoses of pituitary disorders assumed to be associated with an increased risk of hypopituitarism, recorded in the DNPR during 2000-2012 were identified...
2017: Clinical Epidemiology
Esben T Vestergaard, Niels Jessen, Niels Møller, Jens Otto Lunde Jørgensen
Ghrelin produced in the gut stimulates GH and ACTH secretion from the pituitary and also stimulates appetite and gastric emptying. We have shown that ghrelin also induces insulin resistance via GH-independent mechanisms, but it is unknown if this effect depends on ambient fatty acid (FFA) levels. We investigated the impact of ghrelin and pharmacological antilipolysis (acipimox) on insulin sensitivity and substrate metabolism in 8 adult hypopituitary patients on stable replacement with GH and hydrocortisone using a 2 × 2 factorial design: Ghrelin infusion, saline infusion, ghrelin plus short-term acipimox, and acipimox alone...
February 15, 2017: Scientific Reports
Nigel Glynn, Helena Kenny, Leah Quisenberry, David J Halsall, Paul Cook, Tommy Kyaw Tun, John H McDermott, Diarmuid Smith, Christopher J Thompson, Donal J O'Gorman, Anita Boelen, Joaquin Lado-Abeal, Amar Agha
OBJECTIVE: Alterations in the hypothalamic-pituitary-thyroid axis have been reported following growth hormone (GH) replacement. The aim was to examine the relationship between changes in serum concentration of thyroid hormones and deiodinase activity in subcutaneous adipose tissue, before and after GH replacement. DESIGN: A prospective, observational study of patients receiving GH replacement as part of routine clinical care. PATIENTS: Twenty adult hypopituitary men...
November 3, 2016: Clinical Endocrinology
Mariam Elbornsson, Alexandra Horvath, Galina Götherström, Bengt-Åke Bengtsson, Gudmundur Johannsson, Johan Svensson
OBJECTIVE: Few studies have determined the effects of long-term growth hormone (GH) replacement on quality of life (QoL). This study investigated the effects of 7 years of GH replacement on QoL. DESIGN: A prospective, single-center, open-label study of 95 adults (mean age 52.8 years; 46 men) with adult-onset GH deficiency (GHD). METHODS: QoL was measured using Quality of Life-Assessment for Growth Hormone Deficiency in Adults (QoL-AGHDA) and Psychological General Well-Being (PGWB) scores...
February 2017: European Journal of Endocrinology
Chiara Diazzi, Giulia Brigante, Giulia Ferrannini, Anna Ansaloni, Lucia Zirilli, Maria Cristina De Santis, Stefano Zona, Giovanni Guaraldi, Vincenzo Rochira
Biochemical growth hormone deficiency is prevalent among human immunodeficiency virus-infected patients, but if this condition is clinically relevant remains challenging. The aim is to prospectively compare the growth hormone deficiency/insulin-like growth factor-1 status of 71 human immunodeficiency virus-infected patients with impaired growth hormone response to growth hormone releasing hormone + Arginine with that of 65 hypopituitary patients affected by a true growth hormone deficiency secondary to pituitary disease...
October 11, 2016: Endocrine
Ah Reum Khang, Eu Jeong Ku, Ye An Kim, Eun Roh, Jae Hyun Bae, Tae Jung Oh, Sang Wan Kim, Chan Soo Shin, Seong Yeon Kim, Jung Hee Kim
PURPOSE: Hypopituitary patients have a reduced life expectancy owing to cardiovascular events. We investigated the prevalence of metabolic syndrome in hypopituitary patients for a follow-up period of at least 1 year in comparison with an age- and sex-matched nationwide control group. METHODS: A total of 515 patients with hypopituitarism who visited Seoul National University Hospital between January 2000 and December 2010 were included. Data for an age- and sex-matched control group were obtained from the Korean National Health and Nutrition Examination Surveys (KNHANES) (n = 1545)...
December 2016: Pituitary
Ermina Bach, Andreas B Møller, Jens O L Jørgensen, Mikkel H Vendelbo, Niels Jessen, Steen B Pedersen, Thomas S Nielsen, Niels Møller
OBJECTIVE: Acute and chronic inflammatory and metabolic responses are generated by lipopolysaccharide (LPS) during acute illness and in the pathogenesis of the metabolic syndrome, type 2 diabetes and cardiovascular disease, but whether these responses depend on intact pituitary release of hormones are not clearly identified. We compared the metabolic effects of LPS in hypopituitary patients (HPs) (in the absence of growth hormone (GH) and ACTH responses) and healthy control subjects (CTR) (with normal pituitary hormone responses)...
November 2016: European Journal of Endocrinology
Lara Pena-Bello, Sonia Pértega-Diaz, Susana Sangiao-Alvarellos, Elena Outeiriño-Blanco, Raquel Eiras-Leal, Bárbara Varela-Rodriguez, Paula Juiz-Valiña, Miguel Pérez-Fontán, María Cordido, Fernando Cordido
CONTEXT: The recently identified myokine irisin conveys some of the benefits of exercise. Hypopituitarism with adult growth hormone deficiency (HP) is a situation characterized by decreased GH secretion and an altered body composition. OBJECTIVE: Our aim was to study the skeletal muscle hormone irisin in HP, and compare the results with a similar group of normal subjects. PARTICIPANTS AND METHODS: Seventeen HP patients and fifty-one normal subjects of similar age and sex were studied...
2016: PloS One
M Mormando, S Chiloiro, A Bianchi, A Giampietro, F Angelini, L Tartaglione, L Nasto, D Milardi, A M Formenti, A Giustina, L De Marinis
INTRODUCTION: Growth hormone deficiency is considered the most important factor determining skeletal fragility in hypopituitary patients. Osteoblasts and chondrocytes express growth hormone (GH) receptor. Two GH receptor isoforms (GHRi) have been identified: they differ for the presence/absence of a protein fragment encoded by exon 3 of GHR gene. Consequently, three genotypes were identified: carriers of both the full-length proteins (flfl-GHR), carriers of one full-length protein and one deleted protein (fld3-GHR) and carriers of both deleted proteins (d3d3-GHR)...
November 2016: Clinical Endocrinology
Leonardo Rinaldi, Helmy Selman
A severe gonadotropin deficiency together with chronic estradiol deficiency leading to amenorrhea characterizes patients suffering from hypogonadotropic hypogonadism. Administration of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to these patients has been shown to be essential in achieving successful stimulation of follicular development, ovulation, and rescue of fertility. In recent years, the availability of both recombinant FSH (rFSH) and recombinant LH (rLH) has provided a new therapeutic option for the stimulation of follicular growth in hypopituitary-hypogonadotropic women (World Health Organization Group I)...
2016: International Journal of Women's Health
Hidetaka Suga
The hypothalamic-pituitary system is essential for maintaining life and controlling systemic homeostasis. The functional disorder makes patients suffer from various symptoms all their lives. Pluripotent stem cells, such as embryonic stem (ES) cells and induced pluripotent stem (iPS) cells, differentiate into neuroectodermal progenitors when cultured as floating aggregates under serum-free conditions. Recent results have shown that strict removal of exogenous patterning factors during the early differentiation period induces rostral hypothalamic-like progenitors from mouse ES cells...
August 31, 2016: Endocrine Journal
Pavel Polák, Petr Husa, Hana Matějovská Kubešová
The authors present a case-report of a 73 years old woman treated for arterial hypertension within past 15 years with diuretics (thiazides, amiloride and indapamide) and concomitantly with antidepressive trazodone. The patient developed severe osteoporosis after 6 years of such a treatment with multiple fractures even after minor trauma; during whole this period severe hyponatremia without adequate supplementation was documented. Most probably, there exists tight relationship of osteoporosis and hyponatremia in this patient - the authors discuss possible pathophysiological mechanisms at the level of renal tubules, osteoblasts and osteoclasts, hypopituitary-skeletal axis, syndrome of inadequate adiuretin secretion (SIADH) and possible influence of acid-base balance disturbances...
February 2016: Vnitr̆ní Lékar̆ství
Dongmei Cao, Xianhua Ma, Jiao Cai, Jing Luan, An-Jun Liu, Rui Yang, Yi Cao, Xiaotong Zhu, Hai Zhang, Yu-Xia Chen, Yuguang Shi, Guang-Xia Shi, Dajin Zou, Xuetao Cao, Michael J Grusby, Zhifang Xie, Weiping J Zhang
The anterior pituitary harbours five distinct hormone-producing cell types, and their cellular differentiation is a highly regulated and coordinated process. Here we show that ZBTB20 is essential for anterior pituitary development and lactotrope specification in mice. In anterior pituitary, ZBTB20 is highly expressed by all the mature endocrine cell types, and to some less extent by somatolactotropes, the precursors of prolactin (PRL)-producing lactotropes. Disruption of Zbtb20 leads to anterior pituitary hypoplasia, hypopituitary dwarfism and a complete loss of mature lactotropes...
April 15, 2016: Nature Communications
Lucy-Ann Behan, David Carmody, Bairbre Rogers, Mark J Hannon, Colin Davenport, William Tormey, Diarmuid Smith, Christopher J Thompson, Alice Stanton, Amar Agha
OBJECTIVE: Increased cardiovascular and cerebrovascular morbidity and mortality in hypopituitary subjects may be linked to inappropriate glucocorticoid exposure; however, the pathophysiology remains unclear. We aimed to examine the effect of three commonly prescribed hydrocortisone (HC) regimens on vascular risk factors. DESIGN: An open crossover study randomising ten hypopituitary men with severe adrenocorticotrophic hormone deficiency to three HC dose regimens: dose A (20mg mane and 10mg tarde), dose B (10mg mane and 10mg tarde) and dose C (10mg mane and 5mg tarde)...
June 2016: European Journal of Endocrinology
Jorien Werumeus Buning, Jenny E Kootstra-Ros, Pauline Brummelman, Gerrit van den Berg, Melanie van der Klauw, Bruce H R Wolffenbuttel, André P van Beek, Robin P F Dullaart
BACKGROUND: Bilirubin has anti-oxidative and anti-inflammatory properties, which may explain its proposed protective effects on the development of cardiometabolic disorders. Glucocorticoids affect heme oxygenase regulation in vitro, which plays a key role in bilirubin production. Effects of variations in glucocorticoid exposure on circulating bilirubin levels in humans are unknown. Here we tested whether a higher hydrocortisone replacement dose affects circulating bilirubin in hypopituitary patients...
May 2016: European Journal of Clinical Investigation
Cristal M Hill, Yimin Fang, Johanna G Miquet, Liou Y Sun, Michal M Masternak, Andrzej Bartke
Growth hormone (GH) signaling stimulates the production of IGF-1; however, increased GH signaling may induce insulin resistance and can reduce life expectancy in both mice and humans. Interestingly, disruption of GH signaling by reducing plasma GH levels significantly improves health span and extends lifespan in mice, as observed in Ames dwarf mice. In addition, these mice have increased adiposity, yet are more insulin sensitive compared to control mice. Metabolic stressors such as high-fat diet (HFD) promote obesity and may alter longevity through the GH signaling pathway...
June 2016: Aging Cell
Hugo L Fideleff, Gabriel Fideleff, Hugo R Boquete, Martha Suárez, Miriam Azaretzky
OBJECTIVE: To evaluate melatonin secretion in adult hypopituitary patients with Growth Hormone deficiency (AGHD) on and off replacement therapy. SUBJECTS AND METHODS: We studied 48 subjects: 12 (6 males) untreated AGHD (AGHDnt), 20 (10 males) treated AGHD (AGHDt) and 16 healthy subjects (8 males) as control group (CG). We measured urinary 6-sulfatoxymelatonin (6-SM) in total (24 h samples), nocturnal (6-SMn): 1800-0800 and diurnal samples (6-SMd): 0800-1800. RESULTS: Significant differences were observed among the 3 groups of male subjects, in total 6-SM (p < 0...
February 16, 2016: Archives of Endocrinology and Metabolism
Seong Yeon Kim
Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. Clinical manifestations of hypopituitarism are variable, often insidious in onset and dependent on the degree and severity of hormone deficiency. However, it is associated with increased mortality and morbidity. Therefore, early diagnosis and prompt treatment is necessary. Hypopituitarism can be easily diagnosed by measuring basal pituitary and target hormone levels except growth hormone (GH) and adrenocorticotropic hormone (ACTH) deficiency...
December 2015: Endocrinology and Metabolism
Chikafumi Ozone, Hidetaka Suga, Mototsugu Eiraku, Taisuke Kadoshima, Shigenobu Yonemura, Nozomu Takata, Yutaka Oiso, Takashi Tsuji, Yoshiki Sasai
Anterior pituitary is critical for endocrine systems. Its hormonal responses to positive and negative regulators are indispensable for homeostasis. For this reason, generating human anterior pituitary tissue that retains regulatory hormonal control in vitro is an important step for the development of cell transplantation therapy for pituitary diseases. Here we achieve this by recapitulating mouse pituitary development using human embryonic stem cells. We find that anterior pituitary self-forms in vitro following the co-induction of hypothalamic and oral ectoderm...
2016: Nature Communications
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