School of Women’s & Children’s Health, Discipline of Obstetrics and Gynaecology, University of New South Wales, Sydney, Australia
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). The key ovarian factors believed responsible are the steroids, oestradiol and progesterone, and the protein hormones, inhibin A and B. However, their respective roles are not clearly understood. In a previous study (( 2 ), and ( 3 ) designated in
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morbid obesity and the fear of sex steroid replacement exacerbating existing behavioural problems. Regarding the concern over obesity, our study shows the significant mortality in PWS and that, consistent with data from France ( 29 ) and the United
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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alterations. Importantly, in MPHDs other major confounders must be taken into account. Both estrogens and GH influence thyroid hormone transport and/or metabolism and consequently interfere CeH management ( 33 , 60 ). Sex steroid and GH deficiencies can
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. However, other studies suggest that T2DM is a risk factor for testosterone deficiency and impaired sex steroid status ( 73 ). One large prospective study showed that the development of T2DM is a major driver of the age-related testosterone decline ( 74
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variants. The verification test results showed that 21.79% variants (17/78) were found to be de novo mutations. In primary gonadal/genital disorders subjects ( n = 48), SRD5A2 (steroid 5-alpha-reductase 2) and AR (androgen receptor) were the most
Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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-type. In recent years, a few studies have demonstrated that adenovirus-mediated forced expression of SF1 could transform rodent and human adipose tissue or bone marrow-derived MSCs into steroidogenic cells, with the ability to produce multiple steroid
The Clatterbridge Cancer Centre, Wirral, UK
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Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
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Introduction
Immune checkpoint inhibitors can lead to thyroid dysfunction. However, the understanding of the clinical phenotype of ICI-induced thyroid dysfunction in the real-world population is limited. The purpose of this study was to characterise the clinical patterns of dysfunction and evaluate the demographic, biochemical and immunological features associated with this patient cohort.
Materials and methods
To characterise the longitudinal clinical course of thyroid dysfunction in patients from a single, UK regional cancer centre, a retrospective review of patients was conducted. Inclusion criteria included all patients treated with antiPD-1 checkpoint inhibitors (ICI), either as monotherapy (pembrolizumab/nivolumab) or in combination with a CTLA-4 inhibitor (ipilimumab). Patterns of toxicity were evaluated together with assessment of antibody titres.
Results
Over 16 months, thyroid dysfunction was seen in 13/90 and 3/13 patients treated with anti-PD1 monotherapy and in combination with ipilimumab, respectively. Patients either developed hyperthyroidism followed by hypothyroidism (12/16) or de novo hypothyroidism (4/16). Most patients were female (n = 11). All patients required thyroid replacement therapy. There was no relationship between clinical pattern of dysfunction and the presence of thyroid autoantibodies.
Conclusions
There are two distinct patterns of thyroid dysfunction in ICI-treated patients. Patients with thyroiditis develop subsequent hypothyroidism in the vast majority of cases. The potential benefit from steroids or other therapy to manage the hyperthyroid phase remains unclear. Early detection of these patients through appropriate monitoring will improve clinical management and early hormone replacement, reducing the symptomatic burden of hypothyroidism.
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Purpose: Our study aimed to assess the relationship between serum adipokines and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS), as well as explore the predictive value of adipokines on IR in PCOS.
Methods: This was a prospective cross-sectional study. 154 women with PCOS were included from July 2021 to September 2022 who underwent gonadal steroid hormone measurement, lipid profile, oral glucose tolerance test and homeostasis model assessment (HOMA)-IR. Adiponectin (APN), leptin and secreted frizzled-related protein (Sfrp5) were measured by immunoturbidimetry and enzyme-linked immunosorbent assay. Women with PCOS were categorised based on the presence of IR.
Results: Women with PCOS with IR (n=99) had significantly lower APN level and APN to leptin ratio (A/L ratio) than those without IR (n=55), whereas serum levels of leptin and Sfrp5 were similar between the two groups. In multivariable linear regression analysis, serum log (APN) and log (A/L ratio) were associated with log(HOMA-IR), the association was statistically significant after adjusting for body mass index (BMI) and free androgen index. The area under the ROC curve (95% CI) for APN and A/L ratio were 0.726 (0.644–0.807; P<0.001) and 0.660(0.569–0.751; P<0.01), with cutoff values of 5.225 mg/L (Youden index ¼ 0.364) and 1.438 (Youden index ¼ 0.265) respectively.
Conclusion: Our study demonstrated that serum APN was negatively related to IR. Serum APN may be useful as a clinical marker for IR in women with PCOS. Our findings warrant further investigations into the function of APN in the pathogenesis of IR in women with PCOS.
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Université Pierre et Marie Curie, Sorbonne Université, Paris, France
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INSERM UMR_S933, Paris, France
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Université Pierre et Marie Curie, Sorbonne Université, Paris, France
INSERM UMR_S933, Paris, France
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isoenzyme 3b-HSD2 is an essential step for the biosynthesis of all steroids. Therefore, it plays a crucial role in aldosterone, cortisol and sex hormones production ( Fig. 1 ). Phenotypes encompass a continuum from mild-to-severe enzymatic deficiency. In the
National Hospital for Neurology and Neurosurgery, London, UK
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National Hospital for Neurology and Neurosurgery, London, UK
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function tests, clotting profile Indications for empirical steroid therapy in patients with pituitary apoplexy are haemodynamic instability, altered consciousness level, reduced visual acuity and severe visual field defects. Steroid replacement is