Acta Endocrinologica-Bucharest最新文献

Primary Pigmented Micronodular Adrenal Disease is a rare cause of Cushing's syndrome, typically observed in children and young adults. It is often associated with the Carney complex. A typical, subclinical, or cyclic Cushing's syndrome clinic can be seen clinically. Treatment options include bilateral-unilateral adrenalectomy or medical treatment. This case presentation aims to draw attention to a rare condition by presenting a patient diagnosed with isolated PPNAD unrelated to the Carney complex.

Objective: Infertility affects an estimated 17.5% of couples worldwide, according to the last report published in 2023 by WHO. A significant cause of this global fertility decline is due to environmental endocrine-disrupting chemicals exposure, which have the ability to interfere with the endocrine system. Bisphenol A (BPA), a synthetic chemical product leads to health concerns for its endocrine-disrupting properties. Jujube honey contains antioxidants and active compounds, has various therapeutic properties. This study aims to determine testicular dysfunction and endocrine imbalance induced by BPA chronic exposure and the possible protective effect of jujube honey in gerbil.

Materials and methods: Eighteen adult male gerbil was either considered as control (n=6, group 1) or exposed to 50 mg BPA/kg/day Group 2, n=6) and the BPA-treated group was given jujube honey at 200 mg/kg/day by oral gavage Group 3, n=6) for six weeks. At the end of the experiment, testicular weight, epididymal sperm count, endocrine status, histopathology of testis tissue and oxidative stress parameters were evaluated.

Results: The results showed a decrease in testicular weight, sperm quality and plasma levels of testosterone and estradiol in the BPA-treated group. Furthermore, histopathological findings revealed germinal epithelium alteration characterized by germ cell degeneration, disordered arrangement of the germ cell layers and vacuolization and decreased number of Ki-67-positive germ cells. The results showed a decrease in testicular levels of superoxide dismutase, catalase and reduced glutathione with an increase of malondialdehyde in the BPA-treated group. However, in the jujube honey+BPA group, histopathological studies revealed a systematic array of germ cells with less vacuolization, improved sperm parameters, restored plasma testosterone and estradiol levels and increased antioxidative capacity of the testes.

Conclusion: These findings suggest a potential protective effect of jujube honey against BPA-induced testicular damage and oxidative stress caused by endocrine-disrupting chemicals.

Introduction: Spontaneous intracranial hypotension (SIH) is defined by reduced CSF pressure without an identifiable cause, hallmarked by acute onset of severe postural headache. Overlapping clinical presentation, MRI appearance, laboratory findings and prevalent risk population, may lead to diagnostic challenges in distinguishing SIH from the more common pituitary adenoma apoplexy (PAA). Cardinal MRI characteristics of SIH may be overlooked if sellar region examination is not coupled with a comprehensive cranial MRI examination. Pituitary enlargement in SIH was described with increased prevalence, but mostly as an incidental observation in neuroradiological series, without detailed functional pituitary assessment or follow-up.

Case report: A young female with SIH presented with an intra-suprasellar mass lesion, imitating PAA. Mildly affected pituitary function, absence of visual impairments, and favourable clinical course influenced the decision against urgent pituitary surgery. Subsequent MRI confirmed spontaneous regression in pituitary size in first 5 months, along with clinical, hormonal and perimetric stability. Her initial mild central hypocortisolism resolved spontaneously, while baseline and follow-up dynamic pituitary assessment revealed no other abnormalities. Subsequent 9 years of endocrinological and neuroradiological follow-up confirmed gradual spontaneous pituitary lesion reduction. Awareness is raised that SIH may constitute a diagnostic pitfall due to clinical, neuroradiologic and laboratory overlapping with PA apoplexy, potentially leading to unnecessary surgery.

Introduction: Pheochromocytomas are rare catecholamine-secreting tumors that may present with nonspecific symptoms or life-threatening crises. Spontaneous adrenal hemorrhage is a rare complication that complicates diagnosis, especially in patients with comorbidities.

Case report: A 68-year-old male presented with severe abdominal pain, a history of hypertensive crises, and episodes of syncope. Imaging revealed a retroperitoneal hematoma originating from the right adrenal gland. Biochemical evaluation confirmed pheochromocytoma, and further imaging showed 75% stenosis of the right internal carotid artery. A multidisciplinary team recommended right adrenalectomy prior to carotid intervention. After alpha-blockade with phenoxybenzamine, the patient underwent successful adrenalectomy and hematoma evacuation. Histopathology confirmed pheochromocytoma with hemorrhagic and degenerative features. Carotid artery stenting was performed postoperatively.

Discussion: Hemorrhagic pheochromocytoma may mimic other acute abdominal or vascular conditions, especially in patients on anticoagulation. Noradrenergic pheochromocytomas are linked to a higher risk of atherosclerosis. In such complex scenarios, surgical sequencing must be individualized.

Conclusion: In patients with hemorrhagic pheochromocytoma and significant vascular disease, early tumor resection followed by vascular intervention can reduce perioperative risks. A multidisciplinary approach is essential for optimal outcomes.

Objective: To explore the correlation between the systemic immunity-inflammation index (SII) and obesity, utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020.

Methods: This cross-sectional study included 137,888 adult participants with complete data on SII and obesity. SII was calculated using the formula: platelet count multiplied by the neutrophil count divided by the lymphocyte count. Obesity was defined as a body mass index (BMI) exceeding 30 kg/m².

Results: Multivariate linear regression analysis showed a significant positive correlation between SII and obesity (β = 0.19, 95% CI: 0.18, 0.20). Factors such as age, sex, education level, and smoking status significantly influenced this correlation. However, race, income-to-poverty ratio, hypertension, and diabetes did not significantly interact with the observed relationship (interaction p-value > 0.05).

Conclusion: The study highlights a substantial link between elevated SII levels and the prevalence of obesity, indicating the potential of SII as a biomarker in obesity research. Further large-scale prospective studies are needed to better understand the role of SII in the pathophysiology of obesity.

Background: This study aimed to assess the impact of oral iron replacement treatment on glucose metabolism and anthropometric measures in premenopausal women with iron deficiency anemia.

Material and methods: This was a prospective study recruiting 30 premenopausal women diagnosed with iron deficiency anemia. The participants received standard oral iron (ferrous gluconate) at a dose of 567.7 mg/day for three months. After three months of iron treatment, the participants' height, weight, and waist circumference were measured again, and fasting blood tests and oral glucose tolerance tests were repeated.

Results: The study included 30 premenopausal women with a median age of 24 years and a median BMI of 21.9 kg/m². After three months of oral iron treatment, there was a significant increase in serum ferritin, hemoglobin, transferrin saturation, body weight, BMI, and waist circumference (p<0.001 for all). Fasting glucose levels decreased, and first-hour glucose at 75g OGTT increased significantly after treatment. Notably, HOMA-IR decreased significantly (1.46 vs. 1.15, p = 0.039).

Conclusions: The findings indicate that after three months of treatment, there was a significant improvement in glucose metabolism as evidenced by the decrease in HOMA-IR scores, despite an increase in weight, BMI, and waist circumference.

Aim: We aimed to determine styles of coping with stress, emotion regulation skills, eating attitudes and quality of life in children with DM type-1 and comparison of findings with healthy children. In addition, it was aimed to investigate the relationship between this findings and the presence of psychopathology, emotion regulation skills and styles of coping with stress in their mothers.

Method: The study included 70 diabetic,70 healthy children and their mothers. During the evaluation, the Children's Depression Inventory, the Screen for Children Anxiety Related Disorders (SCARED), the Difficulties in Emotion Regulation Scale (DERS), the Eating Attitudes Test(EAT), the Pediatric Quality of Life Inventory(PedsQL) and Ways of Coping Inventory (COPE) were applied to all children. In addition, DERS, COPE, Beck depression and Beck anxiety scales were applied to all mothers.

Results: It was found significantly more problems in diabetic group in the DERS-impulse subscale, COPE-helplessness, PedsQL-physical subgroup, EAT, SCARED scores experienced than the control group. In the scales applied to mothers of diabetic children, significantly higher scores were found in the DERS-nonacceptance subscale, deficits in emotional clarity subscale and impulse subscale, COPE-helplessness subgroup,and Beck Depression Scale.

Conclusions: DM creates problems in patients' and mothers' emotional regulation skills and coping styles with stress; it also negatively affects the quality of life and eating attitudes of children.

Differentiated thyroid cancer (DTC) generally has an excellent prognosis, yet treatment strategies have traditionally been aggressive, often involving total thyroidectomy followed by radioactive iodine (RAI) ablation and long-term suppressive levothyroxine therapy even in cases considered to be low- or intermediate-risk. In recent years, several guidelines have recommended a more individualized, risk-based approach aiming for a more conservative treatment plan. Despite this paradigm shift, there is a gap between recommendations and actual clinical practice as many centers continue to advocate the more aggressive treatment model. De-escalating the care of selected patients with thyroid cancer include the avoidance of surgery in tumours < 10 mm, the recommendation for thyroid lobectomy for tumours < 4cm, the avoidance of prophylactic lymph node dissection. Evidence based studies show that such strategies do not worsen long-term outcomes, can reduce complications and can lead to better quality of life. Such studies will be summarised in this editorial with the aim of encouraging clinicians to reconsider established treatment protocols and empowering patients to make informed decisions for their care.

Context: Osteopenia and osteoporosis are medical terms commonly used for a defect in compact bone. Diabetes has a complex effect on the degree of bone mineral density (BMD).

Objective: Evaluation of the effect of type 2 diabetes mellitus (T2DM) on osteopenia and osteoporosis concerning body mass is the aim of this study.

Design: A case-control study, including 400 patients with type 2 diabetes mellitus (T2DM) and 200 healthy individuals, was designed.

Subjects and methods: BMD T-score measured by dual X-ray absorptiometry (DXA) was used as an indicator for osteopenia and osteoporosis, while body mass index (BMI) was used for determining obesity.

Results: The BMD value of osteoporosis was observed in most females of both groups, compared to males with osteopenia with no supported by statistical analysis. The BMI value indicated that obese individuals are more likely to develop osteopenia in both groups, although there were no significant differences. Subjects aged 40 and over showed high osteopenia, which is associated with obesity.

Conclusion: There is no significant effect of gender, diabetes, or obesity on the BMD. Osteopenia is more prevalent in age groups over 40. The obese women remain at risk of osteoporosis and men are at risk of osteopenia.