Search Results
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Search for other papers by Theodoros Karampitsakos in
Google Scholar
PubMed
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Search for other papers by Fotini Kanouta in
Google Scholar
PubMed
Search for other papers by Christos Chatzakis in
Google Scholar
PubMed
Search for other papers by Vassilios Bakoulas in
Google Scholar
PubMed
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Search for other papers by Alexandros Gryparis in
Google Scholar
PubMed
Search for other papers by Petros Drakakis in
Google Scholar
PubMed
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Search for other papers by Djuro Macut in
Google Scholar
PubMed
Search for other papers by George Mastorakos in
Google Scholar
PubMed
Introduction
To investigate whether synthetic (s) glucocorticoids (GCs) administered between the 24th and the 34th gestational weeks in pre-term labor might precipitate labor, studies on sGCs administration were reviewed. The physiology of endogenous glucocorticoid-related increase in fetal–maternal circulation and its association with labor, followed by a scoping review of studies on exogenous sGCs administered for fetal lung maturation and the timing of labor, were included.
Materials and methods
The methodology of systematic reviews was followed. MEDLINE, Cochrane Library, and Google Scholar databases were searched until October 2023, for original studies investigating the administration of sGCs in pregnancies risking pre-term labor. Duplicates were removed, and 1867 abstracts were excluded as irrelevant. Six controlled and four non-controlled studies were included. The index group consisted of 6001 subjects and 7691 controls in the former, while in the latter, the index group consisted of 2069 subjects.
Results
In three out of the six controlled studies, gestational age at labor was significantly lower in sGC-treated women than in controls, while in three studies, gestational age at labor was lower in sGC-treated women than in controls, with a trend toward statistical significance. In one study, gestational age at labor was significantly lower in controls than in sGC-treated women. In the non-controlled studies, the majority of women delivered less than 1 week from the day of sGC administration.
Conclusions
In this scoping review, studies lack homogeneity. However, in the controlled studies, a pattern of earlier labor emerges among sGC-treated pregnant women. The use of multiple courses of antenatal sGCs appears to be associated with precipitated labor. Their use should be carefully weighed. Carefully designed trials should examine this ongoing scientific query.
Department of Anatomy and UMIB (Unit for Multidisciplinary Biomedical Research) of ICBAS, Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Department of Endocrinology, University of Porto, Porto, 4050-313, Portugal
Search for other papers by Sofia S Pereira in
Google Scholar
PubMed
Search for other papers by Tiago Morais in
Google Scholar
PubMed
Search for other papers by Madalena M Costa in
Google Scholar
PubMed
Search for other papers by Mariana P Monteiro in
Google Scholar
PubMed
Department of Anatomy and UMIB (Unit for Multidisciplinary Biomedical Research) of ICBAS, Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Department of Endocrinology, University of Porto, Porto, 4050-313, Portugal
Search for other papers by Duarte Pignatelli in
Google Scholar
PubMed
Malignant adrenocortical tumors (ACTs) are rare and highly aggressive; conversely, benign tumors are common and frequently found incidentally (the so-called incidentalomas). Currently, the use of molecular markers in the diagnosis of ACTs is still controversial. The aim of this study was to analyze the molecular profile of different ACTs with the purpose of identifying markers useful for differentiating between these tumors. The ACTs that were studied (n=31) included nonfunctioning adenomas (ACAn)/incidentalomas (n=13), functioning adenomas with Cushing's syndrome (ACAc) (n=7), and carcinomas (n=11); normal adrenal glands (n=12) were used as controls. For each sample, the percentage area stained for the markers StAR, IGF2, IGF1R, p53, MDM2, p21, p27, cyclin D1, Ki-67, β-catenin, and E-cadherin was quantified using a morphometric computerized tool. IGF2, p27, cyclin D1, and Ki-67 were the markers for which the percentage of stained area was significantly higher in carcinoma samples than in adenoma samples. Ki-67 and p27 were the markers that exhibited the highest discriminative power for differential diagnosis between carcinomas and all type of adenomas, while IGF2 and StAR were only found to be useful for differentiating between carcinomas and ACAn and between carcinomas and ACAc respectively. The usefulness of Ki-67 has been recognized before in the differential diagnosis of malignant tumors. The additional use of p27 as an elective marker to distinguish benign ACTs from malignant ACTs should be considered.
Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
Search for other papers by Earn H Gan in
Google Scholar
PubMed
Search for other papers by Wendy Robson in
Google Scholar
PubMed
Search for other papers by Peter Murphy in
Google Scholar
PubMed
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
Search for other papers by Robert Pickard in
Google Scholar
PubMed
Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
Search for other papers by Simon Pearce in
Google Scholar
PubMed
Search for other papers by Rachel Oldershaw in
Google Scholar
PubMed
Background
The highly plastic nature of adrenal cortex suggests the presence of adrenocortical stem cells (ACSC), but the exact in vivo identity of ACSC remains elusive. A few studies have demonstrated the differentiation of adipose or bone marrow-derived mesenchymal stem cells (MSC) into steroid-producing cells. We therefore investigated the isolation of multipotent MSC from human adrenal cortex.
Methods
Human adrenals were obtained as discarded surgical material. Single-cell suspensions from human adrenal cortex (n = 3) were cultured onto either complete growth medium (CM) or MSC growth promotion medium (MGPM) in hypoxic condition. Following ex vivo expansion, their multilineage differentiation capacity was evaluated. Phenotype markers were analysed by immunocytochemistry and flow cytometry for cell-surface antigens associated with bone marrow MSCs and adrenocortical-specific phenotype. Expression of mRNAs for pluripotency markers was assessed by q-PCR.
Results
The formation of colony-forming unit fibroblasts comprising adherent cells with fibroblast-like morphology were observed from the monolayer cell culture, in both CM and MGPM. Cells derived from MGPM revealed differentiation towards osteogenic and adipogenic cell lineages. These cells expressed cell-surface MSC markers (CD44, CD90, CD105 and CD166) but did not express the haematopoietic, lymphocytic or HLA-DR markers. Flow cytometry demonstrated significantly higher expression of GLI1 in cell population harvested from MGPM, which were highly proliferative. They also exhibited increased expression of the pluripotency markers.
Conclusion
Our study demonstrates that human adrenal cortex harbours a mesenchymal stem cell-like population. Understanding the cell biology of adrenal cortex- derived MSCs will inform regenerative medicine approaches in autoimmune Addison’s disease.
Search for other papers by Kush Dev Singh Jarial in
Google Scholar
PubMed
Search for other papers by Anil Bhansali in
Google Scholar
PubMed
Search for other papers by Vivek Gupta in
Google Scholar
PubMed
Search for other papers by Paramjeet Singh in
Google Scholar
PubMed
Search for other papers by Kanchan K Mukherjee in
Google Scholar
PubMed
Search for other papers by Akhilesh Sharma in
Google Scholar
PubMed
Search for other papers by Rakesh K Vashishtha in
Google Scholar
PubMed
Search for other papers by Suja P Sukumar in
Google Scholar
PubMed
Search for other papers by Naresh Sachdeva in
Google Scholar
PubMed
Search for other papers by Rama Walia in
Google Scholar
PubMed
Context
Bilateral inferior petrosal sinus sampling (BIPSS) using hCRH is currently considered the ‘gold standard’ test for the differential diagnosis of ACTH-dependent Cushing’s syndrome (CS). Vasopressin is more potent than CRH to stimulate ACTH secretion as shown in animal studies; however, no comparative data of its use are available during BIPSS.
Objective
To study the diagnostic accuracy and comparison of hCRH and lysine vasopressin (LVP) stimulation during BIPSS.
Patients and methods
29 patients (27-Cushing’s disease, 2-ectopic CS; confirmed on histopathology) underwent BIPSS and were included for the study. Patients were randomized to receive hCRH, 5 U LVP or 10 U LVP during BIPSS for ACTH stimulation. BIPSS and contrast-enhanced magnetic resonance imaging (CEMRI) were compared with intra-operative findings of trans-sphenoidal surgery (TSS) for localization and lateralization of the ACTH source.
Results
BIPSS correctly localized the source of ACTH excess in 29/29 of the patients with accuracy of 26/26 patients, using any of the agent, whereas sensitivity and PPV for lateralization with hCRH, 5 U LVP and 10 U LVP was seen in 10/10, 6/10; 10/10,8/10 and 7/7,6/7 patients respectively. Concordance of BIPSS with TSS was seen in 20/27, CEMRI with BIPSS in 16/24 and CEMRI with TSS in 18/24 of patients for lateralizing the adenoma. Most of the side effects were transient and were comparable in all the three groups.
Conclusion
BIPSS using either hCRH or LVP (5 U or 10 U) confirmed the source of ACTH excess in all the patients, while 10 U LVP correctly lateralized the pituitary adenoma in three fourth of the patients.
Search for other papers by Carla Scaroni in
Google Scholar
PubMed
Search for other papers by Nora M Albiger in
Google Scholar
PubMed
Search for other papers by Serena Palmieri in
Google Scholar
PubMed
Search for other papers by Davide Iacuaniello in
Google Scholar
PubMed
Search for other papers by Chiara Graziadio in
Google Scholar
PubMed
Search for other papers by Luca Damiani in
Google Scholar
PubMed
Search for other papers by Marialuisa Zilio in
Google Scholar
PubMed
Search for other papers by Antonio Stigliano in
Google Scholar
PubMed
Search for other papers by Annamaria Colao in
Google Scholar
PubMed
Search for other papers by Rosario Pivonello in
Google Scholar
PubMed
Search for other papers by the Altogether to Beat Cushing’s Syndrome (ABC) study group in
Google Scholar
PubMed
The distinction between pseudo-Cushing’s states (PCS) and Cushing’s syndrome (CS) poses a significant clinical challenge even for expert endocrinologists. A patient’s clinical history can sometimes help to distinguish between them (as in the case of alcoholic individuals), but the overlap in clinical and laboratory findings makes it difficult to arrive at a definitive diagnosis. We aim to describe the most common situations that can give rise to a condition resembling overt endogenous hypercortisolism and try to answer questions that physicians often face in clinical practice. It is important to know the relative prevalence of these different situations, bearing in mind that most of the conditions generating PCS are relatively common (such as metabolic syndrome and polycystic ovary syndrome), while CS is rare in the general population. Physicians should consider CS in the presence of additional features. Appropriate treatment of underlying conditions is essential as it can reverse the hormonal abnormalities associated with PCS. Close surveillance and a thorough assessment of a patient’s hormone status will ultimately orient the diagnosis and treatment options over time.
Wildlife Reproductive Centre, School of Life and Environmental Sciences, School of Agriculture and Food Sciences, Taronga Conservation Society Australia, Dubbo, New South Wales, Australia
Search for other papers by Kerry V Fanson in
Google Scholar
PubMed
Wildlife Reproductive Centre, School of Life and Environmental Sciences, School of Agriculture and Food Sciences, Taronga Conservation Society Australia, Dubbo, New South Wales, Australia
Search for other papers by Tamara Keeley in
Google Scholar
PubMed
Search for other papers by Benjamin G Fanson in
Google Scholar
PubMed
In the context of reproduction, glucocorticoids (GCs) are generally considered to have negative effects. However, in well-studied model species, GCs fluctuate predictability across the estrous cycles, and short-term increases promote healthy ovarian function. Reproductive challenges have plagued captive elephant populations, which are not currently self-sustaining. Efforts to understand reproductive dysfunction in elephants have focused on the suppressive effects of cortisol, but the potential permissive or stimulatory effects of cortisol are unknown. In this study, we provide a detailed examination of cortisol patterns across the estrous cycle in Asian elephants (Elephas maximus). Time series analysis was used to analyze cortisol and progesterone data for a total of 73 cycles from eight females. We also compared cortisol profiles between females that successfully conceived and females that failed to conceive despite repeated mating attempts. Our results revealed that cortisol fluctuates predictably across the estrous cycle, with a peak during the second half of the follicular phase followed by low levels throughout the luteal phase. Furthermore, this pattern was significantly altered in nulliparous females; cortisol concentrations did not decline during the luteal phase to the same extent as in parous females. This study highlights the complexity of cortisol signaling and suggests future directions for understanding the role of cortisol in reproductive dysfunction.
Search for other papers by Yue-Yue Wang in
Google Scholar
PubMed
Search for other papers by Qian Wu in
Google Scholar
PubMed
Search for other papers by Lu Chen in
Google Scholar
PubMed
Search for other papers by Wen Chen in
Google Scholar
PubMed
Search for other papers by Tao Yang in
Google Scholar
PubMed
Search for other papers by Xiao-Quan Xu in
Google Scholar
PubMed
Search for other papers by Fei-Yun Wu in
Google Scholar
PubMed
Search for other papers by Hao Hu in
Google Scholar
PubMed
Search for other papers by Huan-Huan Chen in
Google Scholar
PubMed
Purpose
To evaluate the value of MRI-based texture analysis of extraocular muscle (EOM) and orbital fat (OF) in monitoring and predicting the response to glucocorticoid (GC) therapy in patients with thyroid-associated ophthalmopathy (TAO).
Methods
Thirty-seven active and moderate-to-severe TAO patients (responders, n = 23; unresponders, n = 14) were retrospectively enrolled. MRI-based texture parameters (entropy, uniformity, skewness and kurtosis) of EOM and OF were measured before and after GC therapy, and compared between groups. Correlations between the changes of clinical activity score (CAS) and imaging parameters before and after treatment were assessed. Receiver operating characteristic curves were used to evaluate the predictive value of identified variables.
Results
Responsive TAOs showed significantly decreased entropy and increased uniformity at EOM and OF after GC therapy (P < 0.01), while unresponders showed no significance. Changes of entropy and uniformity at EOM and OF were significantly correlated with changes of CAS before and after treatment (P < 0.05). Responders showed significantly lower entropy and higher uniformity at EOM than unresponders before treatment (P < 0.01). Entropy and uniformity of EOM and disease duration were identified as independent predictors for responsive TAOs. Combination of all three variables demonstrated optimal efficiency (area under curve, 0.802) and sensitivity (82.6%), and disease duration alone demonstrated optimal specificity (100%) for predicting responsive TAOs.
Conclusion
MRI-based texture analysis can reflect histopathological heterogeneity of orbital tissues. It could be useful for monitoring and predicting the response to GC in TAO patients.
Search for other papers by Iulia Soare in
Google Scholar
PubMed
Department of Endocrinology, Diabetes and Metabolic diseases, Elias Hospital, Bucharest, Romania
Search for other papers by Anca Sirbu in
Google Scholar
PubMed
Department of Gastroenterology, Fundeni Clinical Institute, Bucharest, Romania
Search for other papers by Mihai Mircea Diculescu in
Google Scholar
PubMed
Department of Gastroenterology, Colentina Hospital, Bucharest, Romania
Search for other papers by Bogdan Radu Mateescu in
Google Scholar
PubMed
Department of Gastroenterology, Elias Hospital, Bucharest, Romania
Search for other papers by Cristian Tieranu in
Google Scholar
PubMed
Department of Endocrinology, Diabetes and Metabolic diseases, Elias Hospital, Bucharest, Romania
Search for other papers by Sorina Martin in
Google Scholar
PubMed
Department of Endocrinology, Diabetes and Metabolic diseases, Elias Hospital, Bucharest, Romania
Search for other papers by Carmen Gabriela Barbu in
Google Scholar
PubMed
Department of Gastroenterology, Elias Hospital, Bucharest, Romania
Search for other papers by Mirela Ionescu in
Google Scholar
PubMed
Department of Endocrinology, Diabetes and Metabolic diseases, Elias Hospital, Bucharest, Romania
Search for other papers by Simona Fica in
Google Scholar
PubMed
Background and aim
Low bone mineral density (BMD) is a common complication in patients with inflammatory bowel disease (IBD). However, debates are ongoing with regard to the other involved factors, especially in younger patients. This study aimed to evaluate the parameters that contribute to decreased BMD, focusing on premenopausal women and men aged <50 years.
Methods
This study included 81 patients with IBD and 81 age-, sex- and BMI-matched controls. Blood tests were conducted on IBD patients, and a dual-energy X-ray absorptiometry (DXA) scan was performed on both groups.
Results
Low BMD and fragility fracture were found to be more prevalent in IBD patients than in healthy subjects (49.3% vs 23.4%, P = 0.001 and 9.8% vs 1.2%, P = 0.01, respectively). Patients with low BMD were older, with a longer disease duration, higher faecal calprotectin (FC) levels and lower magnesium and lean mass (appreciated as appendicular skeletal muscle index (ASMI)). Multiple regression analysis revealed that ASMI, age and use of glucocorticoids were the independent parameters for decreased BMD. Although 91.3% of the patients had a 25-hydroxy vitamin D level of <30 ng/mL, it was not a statistically significant factor for decreased BMD.
Conclusion
In our study, the levels of vitamin D did not seem to have an important impact on BMD. Conversely, FC, magnesium and lean mass are important factors, suggesting that good control of disease, adequate magnesium intake and increased lean mass can have a good impact on bone metabolism in patients with IBD.
The Center for Biomedical Research, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for other papers by Chunliang Yang in
Google Scholar
PubMed
Search for other papers by Junyi Li in
Google Scholar
PubMed
Search for other papers by Fei Sun in
Google Scholar
PubMed
Search for other papers by Haifeng Zhou in
Google Scholar
PubMed
Search for other papers by Jia Yang in
Google Scholar
PubMed
Search for other papers by Chao Yang in
Google Scholar
PubMed
Hyperglycemia is the consequence of blood glucose dysregulation and a driving force of diabetic complications including retinopathy, nephropathy and cardiovascular diseases. The serum and glucocorticoid inducible kinase-1 (SGK1) has been suggested in the modulation of various pathophysiological activities. However, the role of SGK1 in blood glucose homeostasis remains less appreciated. In this review, we intend to summarize the function of SGK1 in glucose level regulation and to examine the evidence supporting the therapeutic potential of SGK1 inhibitors in hyperglycemia. Ample evidence points to the controversial roles of SGK1 in pancreatic insulin secretion and peripheral insulin sensitivity, which reflects the complex interplay between SGK1 activation and blood glucose fluctuation. Furthermore, SGK1 is engaged in glucose absorption and excretion in intestine and kidney and participates in the progression of hyperglycemia-induced secondary organ damage. As a net effect, blockage of SGK1 activation via either pharmacological inhibition or genetic manipulation seems to be helpful in glucose control at varying diabetic stages.
Search for other papers by Karim Gariani in
Google Scholar
PubMed
Search for other papers by Pedro Marques-Vidal in
Google Scholar
PubMed
Search for other papers by Gérard Waeber in
Google Scholar
PubMed
Search for other papers by Peter Vollenweider in
Google Scholar
PubMed
Search for other papers by François R Jornayvaz in
Google Scholar
PubMed
Background
Excessive glucocorticoid secretion has been associated with type 2 diabetes mellitus (T2DM) and other features of the metabolic syndrome. We aimed to evaluate whether basal or evening salivary cortisol may predict the occurrence of incident insulin resistance (IR) or T2DM.
Method
This was a prospective, population-based study derived from the CoLaus/PsyCoLaus study including 1525 participants (aged 57.7 ± 10.3 years; 725 women). A total of 1149 individuals were free from T2DM at baseline. Fasting plasma glucose and insulin were measured after a follow-up of 5.3 years. Basal and evening salivary cortisol were measured at baseline. The association between basal or evening salivary cortisol level and incidence of IR or T2DM were analyzed by logistic regression, and the results were expressed for each independent variable as ORs and 95% CI.
Results
After a median follow-up of 5.3 years, a total of 376 subjects (24.7%) developed IR and 32 subjects (2.1%) developed T2DM. Basal and evening salivary cortisol divided in quartiles were not associated with incidence of IR or T2DM. Multivariable analysis for age, gender, body mass index, physical activity and smoking status showed no association between basal or evening salivary cortisol and incidence of IR or T2DM.
Conclusion
In the CoLaus/PsyCoLaus study of healthy adults, neither basal nor evening salivary cortisol was associated with incident IR or T2DM.
