Non-functional adrenal incidentaloma (NFAI) is associated with an increased risk of adverse cardiometabolic outcome. Identifying predictors of atherosclerotic cardiovascular disease (ASCVD) may enable more appropriate management strategies in patients with NFAI. We aimed to investigate the body composition parameters and ASCVD risk in patients with NFAI.
Methods
Eighty patients with NFAI and 80 controls matched for age, gender and body mass index (BMI) were included. ASCVD risk was assessed on Framingham Risk Score (FRS) and American Heart Association/American College of Cardiology (AHA/ACC) score. Body composition was evaluated using a segmental body composition analyzer.
Results
There were no significant differences in age, gender, blood pressure or body composition parameters between the two groups. Patients with NFAI had higher FRS and AHA/ACC scores than controls (P = 0.017, P = 0.024, respectively). In patients with NFAI, independent predictors for FRS were serum cortisol level after 1 mg dexamethasone suppression test (DST) and waist/hip ratio (WHR), while independent predictors for AHA/ACC score were serum cortisol level after 1 mg DST, WHR and fasting plasma glucose (FPG), in various multivariate linear regression models.
Conclusions
FRS and AHA/ACC scores may be useful in determining ASCVD risk in patients with NFAI, and serum cortisol level after 1 mg DST is an independent predictor of ASCVD in these patients, even in the absence of hypercortisolism.
{"title":"Increased cardiovascular risk despite unchanged body composition in non functional adrenal incidentaloma","authors":"Alperen Boyraz , Burcu Candemir , Şafak Akın , Mustafa Candemir , Neşe Ersöz Gülçelik","doi":"10.1016/j.ando.2025.101687","DOIUrl":"10.1016/j.ando.2025.101687","url":null,"abstract":"<div><h3>Background</h3><div>Non-functional adrenal incidentaloma (NFAI) is associated with an increased risk of adverse cardiometabolic outcome. Identifying predictors of atherosclerotic cardiovascular disease (ASCVD) may enable more appropriate management strategies in patients with NFAI. We aimed to investigate the body composition parameters and ASCVD risk in patients with NFAI.</div></div><div><h3>Methods</h3><div>Eighty patients with NFAI and 80 controls matched for age, gender and body mass index (BMI) were included. ASCVD risk was assessed on Framingham Risk Score (FRS) and American Heart Association/American College of Cardiology (AHA/ACC) score. Body composition was evaluated using a segmental body composition analyzer.</div></div><div><h3>Results</h3><div>There were no significant differences in age, gender, blood pressure or body composition parameters between the two groups. Patients with NFAI had higher FRS and AHA/ACC scores than controls (<em>P</em> <!-->=<!--> <!-->0.017, <em>P</em> <!-->=<!--> <!-->0.024, respectively). In patients with NFAI, independent predictors for FRS were serum cortisol level after 1<!--> <!-->mg dexamethasone suppression test (DST) and waist/hip ratio (WHR), while independent predictors for AHA/ACC score were serum cortisol level after 1<!--> <!-->mg DST, WHR and fasting plasma glucose (FPG), in various multivariate linear regression models.</div></div><div><h3>Conclusions</h3><div>FRS and AHA/ACC scores may be useful in determining ASCVD risk in patients with NFAI, and serum cortisol level after 1<!--> <!-->mg DST is an independent predictor of ASCVD in these patients, even in the absence of hypercortisolism.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101687"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1016/j.ando.2025.101682
Miriam Ladsous , Philippe Caron
{"title":"Key data from the 2024 European Thyroid Association Congress. Graves’ orbitopathy: Old recipes or new cuisine?","authors":"Miriam Ladsous , Philippe Caron","doi":"10.1016/j.ando.2025.101682","DOIUrl":"10.1016/j.ando.2025.101682","url":null,"abstract":"","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101682"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-27DOI: 10.1016/j.ando.2024.101681
Philippe Caron
{"title":"Key data from the 2024 European Thyroid Association annual meeting: “Thyroid and pregnancy”","authors":"Philippe Caron","doi":"10.1016/j.ando.2024.101681","DOIUrl":"10.1016/j.ando.2024.101681","url":null,"abstract":"","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101681"},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-27DOI: 10.1016/j.ando.2024.101680
Lauriane Le Collen , Théo Charnay , Sang Ly , Brigitte Delemer , Arnaud Lagarde , Giuliana Ascone , Adrian F. Daly , Anne Barlier , Pauline Romanet , AURAGEN consortium
We describe for the first time the case of a woman presenting with Tatton-Brown-Rahman syndrome (TBRS) and multiple endocrine neoplasia (MEN). She developed primary hyperparathyroidism at age 13, a pituitary cyst at age 14, adrenal tumor at age 21, and metastatic insulinoma at age 34. In addition, she showed intellectual disability, obesity, multiple lipomas, facial dysmorphia, hemihypertrophy and kyphoscoliosis. At age 35, genome analysis revealed a pathogenic de-novo heterozygous germline DNMT3A variant, while classic MEN syndromes were ruled out by targeted somatic and germline genetic testing. This case highlights not only the importance of genomic analysis in patients with multiple and atypical conditions, but also the need for a multidisciplinary approach for TBRS patients, including in adulthood, involving endocrinologists to enhance understanding and optimize monitoring of this syndrome.
{"title":"Tatton-Brown-Rahman syndrome: A new multiple endocrine neoplasia syndrome with intellectual disability?","authors":"Lauriane Le Collen , Théo Charnay , Sang Ly , Brigitte Delemer , Arnaud Lagarde , Giuliana Ascone , Adrian F. Daly , Anne Barlier , Pauline Romanet , AURAGEN consortium","doi":"10.1016/j.ando.2024.101680","DOIUrl":"10.1016/j.ando.2024.101680","url":null,"abstract":"<div><div>We describe for the first time the case of a woman presenting with Tatton-Brown-Rahman syndrome (TBRS) and multiple endocrine neoplasia (MEN). She developed primary hyperparathyroidism at age 13, a pituitary cyst at age 14, adrenal tumor at age 21, and metastatic insulinoma at age 34. In addition, she showed intellectual disability, obesity, multiple lipomas, facial dysmorphia, hemihypertrophy and kyphoscoliosis. At age 35, genome analysis revealed a pathogenic de-novo heterozygous germline <em>DNMT3A</em> variant, while classic MEN syndromes were ruled out by targeted somatic and germline genetic testing. This case highlights not only the importance of genomic analysis in patients with multiple and atypical conditions, but also the need for a multidisciplinary approach for TBRS patients, including in adulthood, involving endocrinologists to enhance understanding and optimize monitoring of this syndrome.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101680"},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-19DOI: 10.1016/j.ando.2024.101678
Cecilia Piazzola , Thomas Graillon , Nadine Girard , Henry Dufour , Thierry Brue , Frederic Castinetti
Purpose
Bilateral inferior petrosal sinus sampling (BIPSS) with corticotropin-releasing hormone (CRH) was the gold standard for distinguishing Cushing disease (CD) from ectopic ACTH secretion (EAS). CRH, however, is no longer available.
Objective
To assess the reliability of BIPSS with desmopressin to differentiate CD from EAS.
Methods
A retrospective study included patients who underwent BIPSS with desmopressin for ACTH-dependent hypercortisolism, with the whole diagnostic procedure in a single center.
Results
Fifty-eight patients with confirmed etiological diagnosis were included: 51 CD, 7 EAS. Forty-three CD patients (84.3%) had post-stimulation ratio ≥ 2 before stimulation and 6 of the other 8 (75%) had a ratio ≥ 3. All EAS patients were correctly diagnosed before and after stimulation. Sensitivity was 84.3% before stimulation and 92.2% combining pre- and post-stimulation results; specificity reached 100%. A ROC curve established optimal thresholds at 1.4 before stimulation and 1.7 after.
Conclusion
Desmopressin is a good substitute for CRH, correcting diagnosis compared to baseline BIPSS in 12% of cases.
{"title":"Desmopressin is a safe and effective secretagogue to replace corticotropin-releasing hormone in petrosal sinus sampling","authors":"Cecilia Piazzola , Thomas Graillon , Nadine Girard , Henry Dufour , Thierry Brue , Frederic Castinetti","doi":"10.1016/j.ando.2024.101678","DOIUrl":"10.1016/j.ando.2024.101678","url":null,"abstract":"<div><h3>Purpose</h3><div>Bilateral inferior petrosal sinus sampling (BIPSS) with corticotropin-releasing hormone (CRH) was the gold standard for distinguishing Cushing disease (CD) from ectopic ACTH secretion (EAS). CRH, however, is no longer available.</div></div><div><h3>Objective</h3><div>To assess the reliability of BIPSS with desmopressin to differentiate CD from EAS.</div></div><div><h3>Methods</h3><div>A retrospective study included patients who underwent BIPSS with desmopressin for ACTH-dependent hypercortisolism, with the whole diagnostic procedure in a single center.</div></div><div><h3>Results</h3><div>Fifty-eight patients with confirmed etiological diagnosis were included: 51 CD, 7 EAS. Forty-three CD patients (84.3%) had post-stimulation ratio ≥<!--> <!-->2 before stimulation and 6 of the other 8 (75%) had a ratio ≥<!--> <!-->3. All EAS patients were correctly diagnosed before and after stimulation. Sensitivity was 84.3% before stimulation and 92.2% combining pre- and post-stimulation results; specificity reached 100%. A ROC curve established optimal thresholds at 1.4 before stimulation and 1.7 after.</div></div><div><h3>Conclusion</h3><div>Desmopressin is a good substitute for CRH, correcting diagnosis compared to baseline BIPSS in 12% of cases.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101678"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prolactin measurement is essential in endocrine diagnostics. Challenges such as the hook effect and reactivity to macroprolactin, which varies according to the reagent, complicate accurate measurement. The present study evaluated a newly marketed reagent to detect prolactin, IDS Prolactin, comparing it to an established reagent, Roche Elecsys Prolactin, assessing its behavior toward macroprolactin and polyethylene glycol (PEG) treatment, and establishing reference intervals.
Methods
The IDS Prolactin and Roche Elecsys Prolactin assays were compared using 44 samples containing macroprolactin confirmed on gel filtration chromatography (macroprolactin: BBPRL) and 104 samples for which the diagnosis of macroprolactin was excluded (monomeric prolactin: MNPRL). Analytic performance of the IDS Prolactin assay was also assessed.
Results
The new reagent showed satisfactory analytic performance, meeting EFLM standards for repeatability and intermediate imprecision. Comparison between the two methods found robust correlation for monomeric samples (y = 1.060x–18.28; r2 = 0.993). Compared to the Roche assay, which is particularly low in its reaction to macroprolactin, the IDS assay displayed a higher level of detection. PEG precipitation effectively separated monomeric and macroprolactin samples when a cut-off of 65% recovery was used or at the threshold of 444 mIU/L (20.9 μg/L) for post-PEG monomeric prolactin upper limit of normal. Reference intervals were established for women, with ROC curve analysis demonstrating high sensitivity and specificity.
Conclusion
The IDS Prolactin assay showed excellent analytic performance and satisfactory characteristics on macroprolactinemic samples.
{"title":"Evaluation of the analytic performance and macroprolactin sensitivity of a new prolactin immunoassay","authors":"Guillaume David , Pauline Perrin , Camille Sergeant , Gérald Raverot , Véronique Raverot","doi":"10.1016/j.ando.2024.101677","DOIUrl":"10.1016/j.ando.2024.101677","url":null,"abstract":"<div><h3>Purpose</h3><div>Prolactin measurement is essential in endocrine diagnostics. Challenges such as the hook effect and reactivity to macroprolactin, which varies according to the reagent, complicate accurate measurement. The present study evaluated a newly marketed reagent to detect prolactin, IDS Prolactin, comparing it to an established reagent, Roche Elecsys Prolactin, assessing its behavior toward macroprolactin and polyethylene glycol (PEG) treatment, and establishing reference intervals.</div></div><div><h3>Methods</h3><div>The IDS Prolactin and Roche Elecsys Prolactin assays were compared using 44 samples containing macroprolactin confirmed on gel filtration chromatography (macroprolactin: BBPRL) and 104 samples for which the diagnosis of macroprolactin was excluded (monomeric prolactin: MNPRL). Analytic performance of the IDS Prolactin assay was also assessed.</div></div><div><h3>Results</h3><div>The new reagent showed satisfactory analytic performance, meeting EFLM standards for repeatability and intermediate imprecision. Comparison between the two methods found robust correlation for monomeric samples (y<!--> <!-->=<!--> <!-->1.060x–18.28; r<sup>2</sup> <!-->=<!--> <!-->0.993). Compared to the Roche assay, which is particularly low in its reaction to macroprolactin, the IDS assay displayed a higher level of detection. PEG precipitation effectively separated monomeric and macroprolactin samples when a cut-off of 65% recovery was used or at the threshold of 444 mIU/L (20.9<!--> <!-->μg/L) for post-PEG monomeric prolactin upper limit of normal. Reference intervals were established for women, with ROC curve analysis demonstrating high sensitivity and specificity.</div></div><div><h3>Conclusion</h3><div>The IDS Prolactin assay showed excellent analytic performance and satisfactory characteristics on macroprolactinemic samples.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101677"},"PeriodicalIF":2.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-04DOI: 10.1016/j.ando.2024.101676
Omolara Khadijat Tijani, Maria Moreno-Lopez, Isaline Louvet, Ana Acosta-Montalvo, Anaïs Coddeville, Valery Gmyr, Julie Kerr-Conte, François Pattou, Marie-Christine Vantyghem, Chiara Saponaro, Caroline Bonner, Stéphanie Espiard
Introduction
Glucocorticoid-induced diabetes (GCID) is a prevalent health issue, generally attributed to insulin resistance. High doses of dexamethasone (DEX) are known to inhibit glucose-stimulated insulin secretion (GSIS), but the effects of lower doses, commonly used in chronic therapy, and equipotent doses of other glucocorticoids (GCs) such as hydrocortisone (HC) and prednisone (PRED) remain underexplored. This study aimed to investigate these effects in vitro, and explore variations between patients.
Materials and methods
Dynamic perifusion assays were conducted on human islets to evaluate the impact of different GCs on GSIS. The islets were treated for 24 h with 250 nM PRED and other GCs at equipotent anti-inflammatory doses (HC: 1 μM; DEX: 38 nM).
Results
In 11 human islet donor preparations, 250 nM PRED, corresponding to a clinical oral dose of 5 mg/day, significantly inhibited the first and second phase of GSIS: area under the curve (AUC) decreased by 32.3% (P < 0.001), first phase by 41.5% (P < 0.001), and second phase by 38.4% (P < 0.001). Despite interindividual differences in GSIS response to PRED, no significant differences were observed according to body mass index, gender or age. Comparing the effects of GCs at equipotent anti-inflammatory doses, DEX had a more pronounced inhibitory effect on GSIS than HC or PRED.
Conclusions
In vitro, low-dose PRED treatment significantly impacted GSIS. DEX had a more unfavorable impact on GSIS than HC or PRED, indicating that metabolic effects do not align with anti-inflammatory potency.
{"title":"Impact of therapeutic doses of prednisolone and other glucocorticoids on insulin secretion from human islets","authors":"Omolara Khadijat Tijani, Maria Moreno-Lopez, Isaline Louvet, Ana Acosta-Montalvo, Anaïs Coddeville, Valery Gmyr, Julie Kerr-Conte, François Pattou, Marie-Christine Vantyghem, Chiara Saponaro, Caroline Bonner, Stéphanie Espiard","doi":"10.1016/j.ando.2024.101676","DOIUrl":"10.1016/j.ando.2024.101676","url":null,"abstract":"<div><h3>Introduction</h3><div>Glucocorticoid-induced diabetes (GCID) is a prevalent health issue, generally attributed to insulin resistance. High doses of dexamethasone (DEX) are known to inhibit glucose-stimulated insulin secretion (GSIS), but the effects of lower doses, commonly used in chronic therapy, and equipotent doses of other glucocorticoids (GCs) such as hydrocortisone (HC) and prednisone (PRED) remain underexplored. This study aimed to investigate these effects in vitro, and explore variations between patients.</div></div><div><h3>Materials and methods</h3><div>Dynamic perifusion assays were conducted on human islets to evaluate the impact of different GCs on GSIS. The islets were treated for 24<!--> <!-->h with 250<!--> <!-->nM PRED and other GCs at equipotent anti-inflammatory doses (HC: 1<!--> <!-->μM; DEX: 38<!--> <!-->nM).</div></div><div><h3>Results</h3><div>In 11 human islet donor preparations, 250<!--> <!-->nM PRED, corresponding to a clinical oral dose of 5<!--> <!-->mg/day, significantly inhibited the first and second phase of GSIS: area under the curve (AUC) decreased by 32.3% (<em>P</em> <!--><<!--> <!-->0.001), first phase by 41.5% (<em>P</em> <!--><<!--> <!-->0.001), and second phase by 38.4% (<em>P</em> <!--><<!--> <!-->0.001). Despite interindividual differences in GSIS response to PRED, no significant differences were observed according to body mass index, gender or age. Comparing the effects of GCs at equipotent anti-inflammatory doses, DEX had a more pronounced inhibitory effect on GSIS than HC or PRED.</div></div><div><h3>Conclusions</h3><div>In vitro, low-dose PRED treatment significantly impacted GSIS. DEX had a more unfavorable impact on GSIS than HC or PRED, indicating that metabolic effects do not align with anti-inflammatory potency.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101676"},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.ando.2024.11.001
Yann Bertolani, Claudia García-Arumí, Tetiana Goncharova, Albert Arnaiz-Camacho, Jose García-Arumí
{"title":"Choroidal metastasis secondary to follicular thyroid carcinoma successfully managed with larotrectinib: A case report and review of the literature","authors":"Yann Bertolani, Claudia García-Arumí, Tetiana Goncharova, Albert Arnaiz-Camacho, Jose García-Arumí","doi":"10.1016/j.ando.2024.11.001","DOIUrl":"10.1016/j.ando.2024.11.001","url":null,"abstract":"","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101675"},"PeriodicalIF":2.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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