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Personality traits in acromegalic patients: Comparison with patients with non-functioning adenomas and healthy controls 肢端肥大症患者的人格特征:与无功能腺瘤患者和健康对照的比较
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2022-02-01 DOI: 10.1016/j.ghir.2021.101439
Elif Kilic Kan , Aysegul Atmaca , Gokhan Sarisoy , Gulcin Cengiz Ecemis , Feyzi Gokosmanoglu

Objectives

Pituitary diseases may cause psychiatric and personality alterations. We aimed to compare the personality traits of acromegalic patients with those of patients with non-functioning pituitary adenomas and a healthy control group.

Design

Fifty-eight acromegalic patients, 45 patients with non-functioning adenoma, and 40 healthy subjects were enrolled in the study. Cloninger's Temperament and Character Inventory (TCI), Beck Depression Inventory, Beck Anxiety Inventory, and Rosenberg Self-Esteem Scale (RSES) were used to assess personality, depression, anxiety, and self-esteem.

Results

Depression score was higher in acromegaly and non-functioning adenoma groups than healthy controls. RSES scores were similar among the three groups. Regarding the scales of TCI, only novelty-seeking was significantly reduced in acromegaly and non-functioning adenoma than the control group. Pairwise comparisons revealed that the difference was due to the difference between acromegalic patients and controls. Scales of TCI were correlated with depression and anxiety in patients with acromegaly and non-functioning adenoma but not in healthy controls.

Conclusion

This study showed that novelty-seeking was reduced in patients with acromegaly. Both the hormonal lack and excess and structural changes can lead to cognitive and personality changes in acromegaly. More studies are needed to be carried out about personality characteristics in pituitary diseases.

目的:肺脏疾病可引起精神和人格改变。我们的目的是比较肢端肥大症患者与无功能垂体腺瘤患者和健康对照组的人格特征。58名肢端肥大症患者、45名无功能腺瘤患者和40名健康受试者被纳入研究。采用Cloninger气质与性格量表(TCI)、Beck抑郁量表、Beck焦虑量表和Rosenberg自尊量表(RSES)评估人格、抑郁、焦虑和自尊。结果肢端肥大症和无功能腺瘤组抑郁评分高于健康对照组。三组患者的RSES评分相似。在TCI量表方面,只有肢端肥大症和无功能腺瘤患者寻求新奇性明显低于对照组。两两比较显示,差异是由于肢端肥大症患者和对照组之间的差异。肢端肥大症和无功能腺瘤患者的TCI量表与抑郁和焦虑相关,但在健康对照中无相关。结论肢端肥大症患者的求新行为有所减少。肢端肥大症患者的激素缺乏和过量以及结构变化都可能导致认知和人格改变。垂体疾病患者的人格特征有待进一步研究。
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引用次数: 3
Effect of a copper intrauterine device on HLA-G and IGF-II levels during pregnancy 铜宫内节育器对妊娠期HLA-G和IGF-II水平的影响
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2022-02-01 DOI: 10.1016/j.ghir.2021.101441
Lili Cao , Xiuying Chen , Lili Huang

Objective

An intrauterine device (IUD) is one of the most effective reversible contraceptive methods currently available. Women who use IUDs may become pregnant, albeit rarely, and many such women continue to use IUDs. Because it is difficult to remove or it may cause miscarriage. This study measured the changes in human leucocyte antigen-G (HLA-G) and insulin-like growth factor II (IGF-II) levels in the decidua and villi to explore the effect of a copper IUD on embryonic development.

Design

A total of 54 samples of decidual and villus tissue were collected from pregnant women with IUDs (27 samples) or without IUDs (27 samples). Hematoxylin-eosin staining was used to identify morphological characteristics. Immunohistochemistry was used to detect HLA-G and IGF-II; the protein expression levels were measured via Western blotting.

Results

HLA-G was expressed on the membranes of trophoblasts of villus tissues and the glandular epithelium, and in stromal cells of decidual tissues, in both the IUD and control groups. IGF-II was expressed in the glandular epithelium and cytoplasm of trophoblasts and decidual cells in both groups. Compared to the control group, IGF-II expression was significantly reduced in villus tissues of the IUD group (p < 0.05). The mean sac diameter was significantly positively correlated with IGF-II expression in the villi (p < 0.05).

Conclusions

A copper IUD may affect embryonic development by regulating the expression of villus IGF-II.

目的宫内节育器(IUD)是目前最有效的可逆避孕方法之一。使用宫内节育器的妇女可能会怀孕,尽管很少,而且许多这样的妇女继续使用宫内节育器。因为它很难取出或可能导致流产。本研究通过测定蜕膜和绒毛中人白细胞抗原g (HLA-G)和胰岛素样生长因子II (IGF-II)水平的变化,探讨铜宫内节育器对胚胎发育的影响。设计共收集有宫内节育器孕妇(27例)和无宫内节育器孕妇(27例)的蜕膜和绒毛组织54份。苏木精-伊红染色鉴定其形态特征。免疫组化检测HLA-G、IGF-II;Western blotting检测蛋白表达水平。结果在节育器组和对照组中,shla - g在绒毛组织、腺上皮滋养细胞膜和蜕膜间质细胞上均有表达。IGF-II在两组的腺上皮及滋养层细胞和蜕细胞的细胞质中均有表达。与对照组相比,IUD组绒毛组织中IGF-II表达显著降低(p <0.05)。平均囊直径与绒毛中IGF-II的表达呈显著正相关(p <0.05)。结论铜宫内节育器可能通过调节绒毛IGF-II的表达影响胚胎发育。
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引用次数: 1
“Subclinical atherosclerosis in acromegaly: Possible association with cardiovascular risk factors rather than disease activity” 肢端肥大症的亚临床动脉粥样硬化:可能与心血管危险因素有关,而不是与疾病活动有关
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2022-02-01 DOI: 10.1016/j.ghir.2021.101442
Maria Cristina Costa de Almeida , Claudia Maria Vilas Freire , Maria do Carmo P. Nunes , Beatriz Santana Soares , Marcia M. Barbosa , Alexandre Varella Giannetti , Giancarlo Pereira Zille , Paulo Augusto Carvalho Miranda , Antonio Ribeiro-Oliveira Jr , Juliana Beaudette Drummond

Objective

Cardiovascular (CV) disease is still a major cause of excessive morbidity and mortality in patients with active acromegaly, which may be attributed to a high prevalence of associated pro-atherosclerotic risk factors. However, a direct effect of GH/IGF-1 excess on the vasculature has been previously suggested, warranting further investigation. The present study was designed to investigate whether chronic GH/IGF-1 excess is associated with an increased prevalence of subclinical atherosclerosis in patients with acromegaly.

Design

We measured carotid intima-media thickness (cIMT) and assessed carotid plaques by ultrasonography along with classical CV risk factors in 54 acromegaly patients (34 females, 50 ± 12 years and compared those with 62 (42 females, 53 ± 13 years) age-, sex- and CV risk factors- matched controls. In order to compare cIMT measurements between patients and controls we analyzed common carotid artery far wall data as well as a combined measurement result, which consisted of the mean value of the six different measurements, three at each side.

Results

mean ± SD serum GH and IGF-1 levels were 2.76 ± 4.65 ng/mL and 1.7 ± 1.25 x ULN, respectively, in all acromegaly patients. Age, body mass index, blood pressure, lipid levels, fasting glucose and Framingham's global cardiovascular risk score classification were similar comparing patients and controls. Combined median [IQR] cIMT measurements were similar in acromegaly patients and matched controls (0.59 [0.52–0.66] mm vs. 0.59 [0.52–0.69] mm; P = 0.872) as well as in acromegaly patients with active and controlled disease (0.59 [0.51–0.68] mm vs. 0.60 [0.54–0.68] mm; P = 0.385). No significant correlations were observed between cIMT measurements and GH (Spearman r = 0.1, P = 0.49) or IGF-1 (Spearman r = 0.13, P = 0.37) levels in patients with acromegaly. Carotid atherosclerotic plaques prevalence was similar in patients and controls (26% vs. 32%; P = 0.54) as well as in patients with active and controlled acromegaly (22% vs. 30%; P = 0.537).

Conclusions

Our data suggest that GH/IGF-1 excess itself is not one of the main drivers of subclinical morphological atherosclerosis changes in patients with acromegaly and that optimal control of acromegaly-associated CV risk factors may preserve vasculature structure even when strict biochemical control is not achieved.

目的:心血管(CV)疾病仍然是活动性肢端肥大症患者高发病率和高死亡率的主要原因,这可能归因于相关的促动脉粥样硬化危险因素的高患病率。然而,GH/IGF-1过量对脉管系统的直接影响已经被提出,需要进一步的研究。本研究旨在探讨慢性GH/IGF-1过量是否与肢端肥大症患者亚临床动脉粥样硬化患病率增加有关。我们测量了54例肢端肥大症患者(34例女性,50±12岁)的颈动脉内膜-中膜厚度(cIMT),并通过超声检查评估了颈动脉斑块以及典型的心血管危险因素,并与62例(42例女性,53±13岁)年龄、性别和心血管危险因素匹配的对照组进行了比较。为了比较患者和对照组之间的cIMT测量结果,我们分析了颈总动脉远壁数据以及联合测量结果,该结果由六种不同测量值的平均值组成,每侧三种。结果所有肢端肥大症患者的平均±SD血清GH和IGF-1水平分别为2.76±4.65 ng/mL和1.7±1.25 x ULN。患者和对照组的年龄、体重指数、血压、血脂水平、空腹血糖和Framingham全球心血管风险评分分类相似。肢端肥大症患者和匹配对照组的中位cIMT测量值相似(0.59 [0.52-0.66]mm vs. 0.59 [0.52-0.69] mm;P = 0.872)以及活动性和控制疾病的肢端肥大症患者(0.59 [0.51-0.68]mm vs. 0.60 [0.54-0.68] mm;p = 0.385)。肢端肥大症患者的cIMT测量与GH (Spearman r = 0.1, P = 0.49)或IGF-1 (Spearman r = 0.13, P = 0.37)水平无显著相关性。患者和对照组的颈动脉粥样硬化斑块患病率相似(26% vs. 32%;P = 0.54)以及活动性和控制性肢端肥大症患者(22% vs. 30%;p = 0.537)。结论GH/IGF-1过量本身并不是肢端肥大症患者亚临床形态动脉粥样硬化改变的主要驱动因素之一,即使没有严格的生化控制,对肢端肥大相关的心血管危险因素的最佳控制也可能保留血管结构。
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引用次数: 1
David B. Dunger: in memoriam 1948–2021 大卫·邓格:纪念1948年至2021年
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101426
KevinC.J. Yuen , Ken Ong , Rakesh Amin , Rachel Williams
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引用次数: 0
Changes in anterior segment parameters and presence of dry eye disease in patients with acromegaly: A Sirius topography study combined with meibography 肢端肥大症患者前段参数的变化和干眼病的存在:一项天狼星地形图研究结合meibography
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101424
Deniz Kilic , Berkay Akmaz , Fahrettin Akay , Yusuf Ziya Guven , Guzide Gonca Oruk

Purpose

To investigate anterior segment parameters (ASPs) and dry eye disease (DED), including the status of the meibomian glands, in patients with acromegaly.

Methods

In this cross-sectional, comparative study, 36 acromegaly patients and 40 healthy sex- and age-matched controls were included. Participants received a comprehensive ophthalmological examination, including intraocular pressure measurements with Goldmann applanation tonometry (IOPGAT) and central corneal thickness corrected intraocular pressure (IOPCCT) measurements, and were evaluated for ASPs and DED. For ASPs, white-to-white (WTW), apical (ACT) and thinnest corneal thickness (TCT), corneal volume (CV), keratometry readings (K1, K2, and Kmean), anterior chamber depth (ACD) and volume (ACV), and iridocorneal angle (ICA) were obtained via Sirius topography. DED was assessed with Schirmer's test, tear breakup time (TBUT), and Ocular Surface Disease Index (OSDI) scores. Meibography scores (MSs) were obtained with the Sirius topography device.

Results

Patients had higher mean IOPGAT (P = .006), IOPCCT (P = .01), ACT (P = .024), and TCT (P = .005) but narrower ICA (P = .014) than controls. Although Schirmer's test did not differ between the groups (P = .442), patients had higher OSDI (P < .001), higher MS (P = .001), and shorter TBUT (P = .002).

Conclusion

Patients with acromegaly have greater IOP, greater corneal thickness, but narrower ICA than healthy individuals, as well as DED with increased MSs, which suggests meibomian gland dysfunction.

目的探讨肢端肥大症患者前段参数(asp)与干眼症(DED)的关系,包括睑板腺的状态。方法本研究选取36例肢端肥大症患者和40例性别、年龄相匹配的健康对照。参与者接受了全面的眼科检查,包括使用Goldmann眼压计(IOPGAT)测量眼压和中央角膜厚度校正眼压(IOPCCT)测量眼压,并评估asp和DED。对于asp,通过Sirius地形图获得白到白(WTW)、顶(ACT)和最薄角膜厚度(TCT)、角膜体积(CV)、角膜测量读数(K1、K2和Kmean)、前房深度(ACD)和体积(ACV)以及虹膜角膜角(ICA)。采用Schirmer试验、泪液破裂时间(TBUT)和眼表疾病指数(OSDI)评分评估DED。使用Sirius地形仪获得Meibography评分(MSs)。结果患者IOPGAT (P = 0.006)、IOPCCT (P = 0.01)、ACT (P = 0.024)、TCT (P = 0.005)均值高于对照组,ICA (P = 0.014)均值低于对照组。虽然两组间Schirmer检验没有差异(P = .442),但患者的OSDI较高(P <.001), MS较高(P = .001), TBUT较短(P = .002)。结论肢端肥大症患者IOP较大,角膜厚度较大,ICA较正常人窄,且DED伴MSs增高,提示睑板腺功能障碍。
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引用次数: 2
Clinical and epidemiological characteristics, morbidity and treatment based on the registry of acromegalic patients in Colombia: RAPACO 基于哥伦比亚肢端肥大症患者登记的临床和流行病学特征、发病率和治疗:RAPACO
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101425
Rafael Castellanos-Bueno , Alín Abreu-Lomba , Nathalia Buitrago-Gómez , Marcela Patiño-Arboleda , Doly Pantoja-Guerrero , Alex Valenzuela-Rincón , Henry M. Arenas-Quintero , Humberto I. Franco-Betancur , Alejandro Castellanos-Pinedo , Dinett Movilla-Castro , José M. Ocampo-Chaparro , Carlos A. Reyes-Ortiz , Alejandro Pinzón-Tovar

Aims

Describe the local characteristics, methodology and results of the registry of acromegalic patients in Colombia (RAPACO).

Methods

Multicenter, retrospective study based on the registry of acromegalic patients in Colombia: RAPACO. The data collected included: demographics, diagnosis, approximate time of disease evolution, data on weight, height, body mass index (BMI), neck circumference (NC) abdominal circumference (AC) hip circumference (HC) and waist/hip ratio (WHR); clinical and biochemical data at the time of diagnosis, etiology, immunohistochemistry of the tumor and information related to types of treatment. Descriptive analytics were employed.

Results

A total of 201 patients (60% females) with an average age at registration of 49.5 ± 14.6 years and an average time of evolution of the disease of 6.96 ± 4.5 years. Average weight was 75.1 Kg ± 12.98, with an average BMI of 28.11 ± 4.33. The most frequent symptoms mentioned at the time of diagnosis were extremity enlargement and headache. The most frequent comorbidity was arterial hypertension in 50.3% of the cases. 78.6% of cases were caused by macroadenoma. 80.1% received surgical treatment, 77.6% were under medical treatment, of which 95.7% were receiving somatostatin analogues. 26.4% of patients were treated with radiation therapy. Of the patients who received any type of clinical treatment, only 2.5% reported biochemical control at registration.

Conclusion

It is important to recognize the local epidemiological, clinical, biochemical and treatment characteristics in order to assist in further understanding this pathology to implement local measures to improve both the quality of life as well as the prognosis of the patients diagnosed.

目的描述哥伦比亚肢端肥大症患者(RAPACO)登记的地方特点、方法和结果。方法基于哥伦比亚肢端肥大症患者的多中心回顾性研究:RAPACO。收集的资料包括:人口统计学、诊断、疾病演变的大致时间、体重、身高、体重指数(BMI)、颈围(NC)、腹围(AC)、臀围(HC)和腰臀比(WHR);诊断时的临床生化资料、病因、肿瘤免疫组织化学及治疗类型相关信息。采用描述性分析。结果201例患者(女性占60%),登记时平均年龄49.5±14.6岁,平均发病时间6.96±4.5年。平均体重75.1 Kg±12.98,平均BMI 28.11±4.33。诊断时最常见的症状是四肢肿大和头痛。最常见的合并症是动脉高血压,占50.3%。78.6%的病例由大腺瘤引起。80.1%接受手术治疗,77.6%接受内科治疗,其中95.7%接受生长抑素类似物治疗。26.4%的患者接受了放射治疗。在接受任何类型临床治疗的患者中,只有2.5%在登记时报告生化控制。结论认识当地的流行病学、临床、生化和治疗特点,有助于进一步了解本病,实施当地措施,提高患者的生活质量和预后。
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引用次数: 2
Illness-related burden, personal resources and need for support in patients with acromegaly: Results of a focus group analysis 肢端肥大症患者的疾病相关负担、个人资源和支持需求:焦点小组分析的结果
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101422
Sonja Siegel , Cedric Fabian Kirstein , Bernadette Schröder , Nicole Unger , Ilonka Kreitschmann-Andermahr

Objective

It was the aim of this study to evaluate illness-related burdens and support needs of patients with acromegaly to identify hitherto unadressed research questions and to open up avenues for improvements in patient care. This was done by using the focus group approach as a qualitative research method.

Design

Seven patients with acromegaly took part in a focus group moderated by an external medical communication specialist. The discourse focused on topics such as impact of the illness on everyday life, support needs and personal resources. The discussion was recorded and transcribed and analyzed by qualitative content analysis.

Results

Participants reported a huge impact of acromegaly on daily life, ranging from time expenditure for managing their illness, to bodily and mental sequelae and strain caused by physical disfigurement. Patients' coping strategies included family support, physical activities and humor. The participants wished for a sound patient-doctor relationship, more interdisciplinary and holistic treatment, medical rehabilitation services with special knowledge on acromegaly-related morbidity, a stable contact person in the medical process and reliable information material for themselves and their relatives.

Conclusions

The results provide multi-facetted impressions of the overwhelming impact of acromegaly and unmet support needs of the afflicted patients. Further quantitative research is necessary to examine the generalisibility of the present results in order to implement tailored support measures. We suggest to develop standardized questionnaires to explore the prevalence and severity of the addressed problems in a large patient sample and to establish screening instruments to monitor disease burden in clinical practice.

目的本研究的目的是评估肢端肥大症患者的疾病相关负担和支持需求,以确定迄今为止尚未解决的研究问题,并为改善患者护理开辟途径。这是通过使用焦点小组方法作为定性研究方法来完成的。设计7例肢端肥大症患者参加由外部医学交流专家主持的焦点小组。讨论的重点是疾病对日常生活的影响、支持需求和个人资源等主题。对讨论内容进行记录和转录,并进行定性内容分析。结果参与者报告了肢端肥大症对日常生活的巨大影响,从控制疾病的时间花费到身体和精神的后遗症以及由身体毁容引起的紧张。患者的应对策略包括家庭支持、体育活动和幽默。与会者希望有良好的医患关系,更多的跨学科和整体治疗,具有肢端肥大症相关疾病专门知识的医疗康复服务,在医疗过程中有稳定的联系人,并为自己和亲属提供可靠的信息材料。结论本研究结果从多个方面反映了肢端肥大症的压倒性影响和患者未得到满足的支持需求。有必要进行进一步的定量研究,以审查目前结果的普遍性,以便实施有针对性的支助措施。我们建议在大量患者样本中制定标准化问卷,以探讨所解决问题的患病率和严重程度,并建立筛查工具以监测临床实践中的疾病负担。
{"title":"Illness-related burden, personal resources and need for support in patients with acromegaly: Results of a focus group analysis","authors":"Sonja Siegel ,&nbsp;Cedric Fabian Kirstein ,&nbsp;Bernadette Schröder ,&nbsp;Nicole Unger ,&nbsp;Ilonka Kreitschmann-Andermahr","doi":"10.1016/j.ghir.2021.101422","DOIUrl":"10.1016/j.ghir.2021.101422","url":null,"abstract":"<div><h3>Objective</h3><p><span>It was the aim of this study to evaluate illness-related burdens and support needs of patients with acromegaly to identify hitherto unadressed research questions and to open up avenues for improvements </span>in patient care. This was done by using the focus group approach as a qualitative research method.</p></div><div><h3>Design</h3><p>Seven patients with acromegaly took part in a focus group moderated by an external medical communication specialist. The discourse focused on topics such as impact of the illness on everyday life, support needs and personal resources. The discussion was recorded and transcribed and analyzed by qualitative content analysis.</p></div><div><h3>Results</h3><p>Participants reported a huge impact of acromegaly on daily life, ranging from time expenditure for managing their illness, to bodily and mental sequelae<span><span> and strain caused by physical disfigurement. Patients' coping strategies included family support, physical activities and humor. The participants wished for a sound patient-doctor relationship, more interdisciplinary and holistic </span>treatment, medical rehabilitation services with special knowledge on acromegaly-related morbidity, a stable contact person in the medical process and reliable information material for themselves and their relatives.</span></p></div><div><h3>Conclusions</h3><p>The results provide multi-facetted impressions of the overwhelming impact of acromegaly and unmet support needs of the afflicted patients. Further quantitative research is necessary to examine the generalisibility of the present results in order to implement tailored support measures. We suggest to develop standardized questionnaires to explore the prevalence and severity of the addressed problems in a large patient sample and to establish screening instruments to monitor disease burden in clinical practice.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101422"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39332552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors associated with thyroid nodular disease in acromegalic patients: A case-cohort study in a tertiary center 肢端肥大症患者甲状腺结节疾病相关的危险因素:三级中心的病例队列研究
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101431
Guadalupe Vargas-Ortega , Carlos Alfonso Romero-Gameros , Mario Enrique Rendón-Macias , Lourdes Balcázar-Hernández , Ernesto Sosa-Eroza , Moises Mercado , Ana L. Espinosa de los Monteros-Sánchez , Barbara Pérez-Aguilar , Carlos Paredes-Manjarrez , Fernando Bernardo Reyes-Olhagaray , Diana Laura Serrano-Ramírez , Erick Vladimir Martínez-De la Cruz , Baldomero González-Virla

Introduction

Goiter is very common in patients with acromegaly; its development is correlated to the duration of the disease. Thyroid cells express the IGF-1 receptor and the TSH/IGF-1 interaction has been demonstrated to have a synergistic effect in thyroid cell growth. There is a correlation between IGF-1 levels and the thyroid volume of patients with acromegaly. The aim of this study was to evaluate, in a retrospective case-cohort study of patients with acromegaly, the associated risk factors for thyroid nodules disease in this population.

Methods

This was a case-cohort study matched by age, gender, and growth hormone at diagnosis. Cases consisted of acromegalic patients that developed thyroid nodules during the follow up, and controls consisted in acromegalic patients without thyroid nodules. A Cox proportional hazard estimation was carried out for measure the associated risk factors for thyroid nodules disease in acromegalic patients. A nodular thyroid disease-free survival analysis was estimated using the Kaplan-Meier analysis.

Results

We recruited 49 cases and 56 controls. In a multivariate Cox proportional hazard analysis age and IGF-1 ≥ 2.2 x ULN were significantly related with the presence of thyroid nodules [HR of 2.21 (95% CI; 1.15–4.25, p = 0.01)]. Nodularity-free survival rates in patients who had an IGF-1 X ULN ≥ 2.2 was found to be lower in comparison to those who had IGF-1 X ULN < 2.2, according to a Kaplan-Meier survival analysis.

Conclusions

Our findings support that exist more probability to develop thyroid nodular disease in patients with acromegaly that present IGF-1 X ULN ≥ 2.2, suggesting a possible direct effect between the time of exposure to the IGF-1 axis hyperactivity and the genesis of thyroid nodules.

甲状腺肿在肢端肥大症患者中很常见;它的发展与疾病的持续时间有关。甲状腺细胞表达IGF-1受体,TSH/IGF-1相互作用已被证明在甲状腺细胞生长中具有协同作用。肢端肥大症患者IGF-1水平与甲状腺体积之间存在相关性。本研究的目的是通过对肢端肥大症患者的回顾性病例队列研究来评估该人群中甲状腺结节疾病的相关危险因素。方法采用病例队列研究,根据年龄、性别和诊断时的生长激素进行匹配。病例包括在随访中出现甲状腺结节的肢端肥大症患者,对照组包括没有甲状腺结节的肢端肥大症患者。对肢端肥大症患者甲状腺结节病的相关危险因素进行Cox比例风险估计。使用Kaplan-Meier分析估计甲状腺结节无病生存分析。结果纳入病例49例,对照组56例。在多变量Cox比例风险分析中,年龄和IGF-1 ≥ 2.2 x ULN与甲状腺结节的存在显著相关[HR为2.21 (95% CI;1.15 - -4.25, p = 0.01)]。Kaplan-Meier生存分析显示,IGF-1 X ULN ≥ 2.2患者的无结节生存率低于IGF-1 X ULN < 2.2患者。结论IGF-1 X ULN ≥ 2.2的肢端肥大症患者发生甲状腺结节病的可能性更大,提示暴露于IGF-1轴高活动的时间与甲状腺结节的发生可能存在直接影响。
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引用次数: 5
Cardiac functions in children with growth hormone deficiency: Effects of one year of GH replacement therapy 生长激素缺乏症儿童的心功能:一年生长激素替代治疗的影响
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101432
Fatos Alkan , Betul Ersoy , Deniz Ozalp Kızılay , Senol Coskun

Introduction

Children with Growth Hormone deficiency (GHD) are prone to heart dysfunction and, if left untreated, will result in marked cardiac dysfunction in adulthood. The aim was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiac structure in children and adolescents, and to investigate the role of insulin like growth factor-1 (IGF-1) in this.

Methods

M-mode, pulse-wave Doppler echocardiography and tissue Doppler imaging (TDI) were performed in 49 children with GHD who were divided into those with a peak GH response < 7 μg/L and 7–10 μg/L after two GH stimulation tests, aged 8–16 years at baseline and at six and 12 months after GH initiation, and 49 healthy peers. IGF-1 concentration was measured.

Results

Although the left ventricular end diastolic and systolic diameters in both GH deficient groups were significantly lower than controls (p < 0.01), both diameters increased significantly with one year of treatment and achieved normal values (p > 0.05). Using TDI in both two patients group revealed increased E/A, prolonged isovolumic relaxation time, shortened ejection time, and a significant increase in myocardial performance index compared to controls (p < 0.001). Significant improvement was observed in these parameters from the sixth month of GH treatment (p < 0.001), this improvement does not match parameters measured in healthy peers, even after one year of treatment in both patients group. (p < 0.001). No correlation was found between IGF-1 concentration and any echocardiographic parameter.

Conclusion

Echocardiographic parameters were similar in children with a GH peak < 7 μg/L and 7–10 μg/L. In TDI, both systolic and diastolic function was impaired in GHD children compared to controls. These parameters improved after one year of GH therapy but did not recover to healthy control levels.

患有生长激素缺乏症(GHD)的儿童容易出现心功能障碍,如果不及时治疗,将导致成年后明显的心功能障碍。目的是评估GHD和生长激素(GH)治疗对儿童和青少年心脏结构的影响,并探讨胰岛素样生长因子-1 (IGF-1)在其中的作用。方法对49例GHD患儿进行sm模式、脉冲波多普勒超声心动图和组织多普勒成像(TDI)检查。年龄为8-16岁,基线时为7 μg/L,生长激素启动后6和12个月为7 - 10 μg/L, 49名健康同龄人。测定IGF-1浓度。结果两组患者左心室舒张末期和收缩末期直径均显著低于对照组(p <0.01),治疗一年后,两种直径均显著增加,达到正常值(p >0.05)。与对照组相比,两组患者经TDI后E/A增加,等容松弛时间延长,射血时间缩短,心肌功能指数显著增加(p <0.001)。从生长激素治疗的第6个月开始,观察到这些参数有显著改善(p <0.001),即使在两组患者治疗一年后,这种改善与健康同龄人的测量参数不符。(p & lt;0.001)。IGF-1浓度与超声心动图参数无相关性。结论:GH峰值患儿超声心动图参数相似;7 μg/L和7 - 10 μg/L。在TDI中,与对照组相比,GHD儿童的收缩和舒张功能均受损。经过一年的生长激素治疗,这些参数有所改善,但没有恢复到健康控制水平。
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引用次数: 3
Growth hormone secreting pituitary carcinomas: Case report and review of literature 分泌生长激素的垂体癌:1例报告及文献复习
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101430
Shivani Vekaria , Fei Chen , Elcin Zan , Christopher William , Chandra Sen , Richard Lebowitz , David Zagzag , Floyd A. Warren , Tamar C. Brandler , Nidhi Agrawal

Objective

Pituitary carcinoma is a rare tumor, defined as a tumor of adenohypophyseal cells with systemic or craniospinal metastasis. We present a case of a growth hormone (GH)-secreting pituitary carcinoma with a review of literature to better characterize this disease.

Design

Case report and literature review of 25 cases of GH-secreting pituitary carcinomas

Results

The age of diagnosis of GH-secreting carcinomas ranged 24–69 years old with a mean age of 44.4 with 52% of cases present in females. Mean latency period between diagnosis of acromegaly and transition to pituitary carcinoma was 11.4 years with mean survival being 3.4 years.

Conclusion

Growth hormone (GH)-secreting pituitary carcinomas are rare and hard to distinguish from aggressive pituitary adenomas. From review of literature, treatment options include debulking surgery, radiotherapy, or chemotherapy with dismal outcomes. There are no diagnostic markers or features which can predict metastatic progression of these tumors. Future studies with genomic landscapes and relevant tumor markers are needed to identify pituitary tumors most likely to metastasize.

目的垂体癌是一种少见的肿瘤,定义为腺垂体细胞的肿瘤伴全身或颅脊髓转移。我们提出一个病例生长激素(GH)分泌垂体癌与文献回顾,以更好地表征这种疾病。25例垂体gh分泌癌病例报告及文献复习结果gh分泌癌的诊断年龄为24 ~ 69岁,平均年龄44.4岁,女性占52%。从诊断肢端肥大症到转变为垂体癌的平均潜伏期为11.4年,平均生存期为3.4年。结论垂体生长激素(GH)分泌型垂体腺瘤罕见,难以与侵袭性垂体腺瘤鉴别。从文献综述来看,治疗选择包括减脂手术、放疗或化疗,但结果不佳。没有诊断标记物或特征可以预测这些肿瘤的转移进展。未来需要通过基因组图谱和相关肿瘤标志物的研究来确定最有可能转移的垂体肿瘤。
{"title":"Growth hormone secreting pituitary carcinomas: Case report and review of literature","authors":"Shivani Vekaria ,&nbsp;Fei Chen ,&nbsp;Elcin Zan ,&nbsp;Christopher William ,&nbsp;Chandra Sen ,&nbsp;Richard Lebowitz ,&nbsp;David Zagzag ,&nbsp;Floyd A. Warren ,&nbsp;Tamar C. Brandler ,&nbsp;Nidhi Agrawal","doi":"10.1016/j.ghir.2021.101430","DOIUrl":"10.1016/j.ghir.2021.101430","url":null,"abstract":"<div><h3>Objective</h3><p>Pituitary carcinoma is a rare tumor, defined as a tumor of adenohypophyseal cells with systemic or craniospinal metastasis. We present a case of a growth hormone (GH)-secreting pituitary carcinoma with a review of literature to better characterize this disease.</p></div><div><h3>Design</h3><p>Case report and literature review of 25 cases of GH-secreting pituitary carcinomas</p></div><div><h3>Results</h3><p>The age of diagnosis of GH-secreting carcinomas ranged 24–69 years old with a mean age of 44.4 with 52% of cases present in females. Mean latency period between diagnosis of acromegaly and transition to pituitary carcinoma was 11.4 years with mean survival being 3.4 years.</p></div><div><h3>Conclusion</h3><p><span>Growth hormone (GH)-secreting pituitary carcinomas are rare and hard to distinguish from aggressive pituitary adenomas<span><span>. From review of literature, treatment options include </span>debulking surgery, radiotherapy, or chemotherapy with dismal outcomes. There are no diagnostic markers or features which can predict metastatic progression of these tumors. Future studies with genomic landscapes and relevant tumor markers are needed to identify </span></span>pituitary tumors most likely to metastasize.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101430"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39484904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
期刊
Growth Hormone & Igf Research
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