Issue 1 (January- March)151 – HORMONES (Archive)

More news from IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial)

Posted on by

Niki Katsiki, Vasilios G. Athyros, Dimitris P. Mikhailidis

The IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) reported a significant reduction in first primary endpoint (PEP) post-acute coronary syndrome (ACS) in patients (n=18,144) on ezetimibe + simvastatin compared with placebo + simvastatin.1 The low-density lipoprotein cholesterol (LDL-C) levels in the combination group were significantly lower than in the monotherapy group (53.7 vs 69.5 mg/dl; 1.4 vs 1.8 mmol/l) …

Expert consensus on the rational clinical use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors

Posted on by

Apostolos Achimastos, Theodoros Alexandrides, Dimitrios Alexopoulos, Vasilios Athyros, Alexandra Bargiota, Eleni Bilianou, Christina Chrysochoou, Evridiki Drogari, Moses Elisaf, Emanouel Ganotakis, Ioannis Goudevenos, Ioannis Ioannidis, Genovefa Kolovou, Vasilios Kotsis, Ioannis Lekakis, Evangelos Liberopoulos, Andreas Melidonis, Vasilios Nikolaou, George Ntaios, Nikolaos Papanas, Stavros Pappas, Christos Pitsavos, Loukianos Rallidis, Dimitrios Richter, Ioannis Skoumas, Nicolaos Tentolouris, Dimitrios Tousoulis, Alexandros Tselepis, KonstantinosTsioufis, Dimitrios Tziakas, Konstantinos Tziomalos, Panagiotis Vardas, Charalabos Vlachopoulos, Dimitrios Vlahakos

Two proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, evolocumab and alirocumab, have recently been approved by both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of hypercholesterolemia. These fully human monoclonal antibodies selectively block PCSK9, thus permitting the low-density lipoprotein (LDL) receptor to effectively recycle to the surface of liver cells. The administration of these antibodies leads to robust LDL …

Neoadjuvant therapy for advanced pancreatic neuroendocrine tumors: an emerging treatment modality?

Posted on by

Iraklis Perysinakis, Chrysanthi Aggeli, Gregory Kaltsas, George N. Zografos

OBJECTIVE: Complete surgical resection is the only potentially curative treatment of localized pancreatic neuroendocrine tumors. Unfortunately, a significant proportion of these patients present with unresectable locally advanced tumors or massive metastatic disease. Recently, a new therapeutic approach for this subset of patients has emerged consisting of neoadjuvant therapy followed by surgical exploration in responders …

Recent advances in the molecular mechanisms causing primary generalized glucocorticoid resistance

Posted on by

Nicolas C. Nicolaides, Agaristi Lamprokostopoulou, Amalia Sertedaki, Evangelia Charmandari

Primary Generalized Glucocorticoid Resistance is a rare condition characterized by generalized, partial, target tissue insensitivity to glucocorticoids owing to inactivating mutations, insertions or deletions in the human glucocorticoid receptor (hGR) gene (NR3C1). Recent advances in molecular and structural biology have enabled us to elucidate the molecular mechanisms of action of the mutant receptors and to understand how certain conformational alterations …

Lipid accumulation product is associated with metabolic syndrome in women with polycystic ovary syndrome

Posted on by

Djuro Macut, Ivana Božić Antić, Jelica Bjekić-Macut, Dimitrios Panidis, Konstantinos Tziomalos, Danijela Vojnović Milutinović, Olivera Stanojlović, Biljana Kastratović-Kotlica, Milan Petakov, Nataša Milić

OBJECTIVE: There is a need for a simple and accurate method for the assessment of cardiovascular risk in polycystic ovary syndrome (PCOS). Lipid accumulation product (LAP) is based on the assessment of waist circumference and serum triglycerides that yield an estimation of lipid overaccumulation. We aimed to determine whether LAP is associated with metabolic syndrome (MetS) in Caucasian women with PCOS …

Long-term follow-up results of growth hormone therapy for patients with adult growth hormone deficiency

Posted on by

Hidetoshi Ikeda, Masataka Kudo

Objective: We evaluated the long-term effects of growth hormone (GH) on markers of quality of life, glucose metabolism, and lipid metabolism to validate the adequacy of long-term GH replacement therapy for adult GH deficiency (AGHD). Design: Eighty-three of 100 sequentially followed patients who received GH therapy …

Corticotropin-releasing factor (CRF) system localization in human fetal heart

Posted on by

Efterpi Chouridou, Maria Lambropoulou, Maria Koureta, Christina Zarouchlioti, Ioanna Balgouranidou, Evangelia Nena, Nikolaos Papadopoulos, Ekaterini Chatzaki

OBJECTIVE: The corticotropin-releasing factor (CRF) family consists of the neuropeptides CRF, Ucn I, II and III and the binding sites CRFR1, CRFR2 and CRF-BP. It regulates stress response and the homeostasis of an organism. In this study, we examined the presence of the CRF system in the human hearts of normal and pathological fetuses. DESIGN: Heart tissues from 40 archival human fetuses were divided …

Presence of the RET Cys634Tyr mutation and Gly691Ser functional polymorphism in Iranian families with multiple endocrine neoplasia type 2A

Posted on by

Maryam Nasiri Aghdam, Mohammad Reza Abbaszadegan, Alireza Tafazoli, Mohammad Aslzare, Zohreh Mosavi

PURPOSE: Multiple Endocrine Neoplasia type 2A (MEN2A) is a complex autosomal dominant inherited syndrome characterized by medullary thyroid carcinoma (MTC), pheochromocytoma and primary parathyroid hyperplasia. In patients with only one or two clinical features, identification of a germ line RET (REarranged in Transfection) mutation is required to make the diagnosis and initiate genetic counseling. METHODS: We analyzed blood DNA from three Iranian families with three generations …

The growth endocrine axis and inflammatory responses after laparoscopic cholecystectomy

Posted on by

Themistoklis Floros, Anastassios Philippou, Dimitrios Bardakostas, Dimitrios Mantas, Michael Koutsilieris

OBJECTIVE: It is well known that conventional surgery leads to detrimental immune and catabolic responses, thus there is growing interest in the effect of minimally invasive techniques on postoperative endocrine and immune function. The aim of this prospective study was to evaluate the growth hormone (GH)/insulin-like growth factor-1 (IGF-1)/IGF binding protein-3 (IGFBP-3) axis and acute phase (interleukin-6, IL-6, and C-reactive protein, CRP) responses in patients who underwent laparoscopic cholecystectomy …

Progesterone pretreatment increases the stress response to social isolation in ewes

Posted on by

Aline Freitas-de-Melo, Juan Pablo Damián, Maria José Hötzel, Georgget Banchero, Rodolfo Ungerfeld

OBJECTIVE: In rodents, progesterone (P4) pretreatment increases anxiety and response to stressors. Social isolation is a stressor that generates physiological and behavioural stress responses in sheep. The aim of the study was to compare the stress response of anoestrous ewes previously treated or not with P4 to the social isolation test. DESIGN: Ten ewes received P4 treatment during 13 d (group P4-W) and another 10 remained untreated as controls (group Con) …

Prevalence and determinants of type 2 diabetes mellitus in a Greek adult population

Posted on by

Sofia Tsirona, Fotis Katsaros, Alexandra Bargiota, Stergios A. Polyzos, George Arapoglou, George N. Koukoulis

The prevalence of diabetes mellitus (DM) is increasing worldwide reaching epidemic proportions. The aim of the present study was to estimate the prevalence of DM in Thessaly, a large region of Central Greece, and to extrapolate our results to the population of the entire country. A random sample of 805 adults (421 females and 384 men) living in Thessaly, aged 18-80 years, was surveyed. After completing a questionnaire about health status and a thorough physical examination …

The relationship between retinol-binding protein 4 and apolipoprotein B-containing lipoproteins is attenuated in patients with very high serum triglycerides: A pilot study

Posted on by

Georgios A. Christou, Constantinos C. Tellis, Moses S. Elisaf, Alexandros D. Tselepis, Dimitrios N. Kiortsis

OBJECTIVE: The investigation of the association between retinol-binding protein 4 (RBP4)and lipoproteins in subjects with hypertriglyceridemia. DESIGN: Forty-six obese or overweight hypertriglyceridemic patients were studied at baseline and 20 of them underwent a hypocaloric low-fat diet for 3 months …

Clinical and biochemical responses after Gamma Knife surgery for a dopamine-secreting paraganglioma: case report

Posted on by

Constantin Tuleasca, Yves Jaquet, Valerie Schweizer, Laura Negretti, Vera Magaddino, Philippe Maeder, Karim-Alexandre Abid, Benoit Lhermitte, Eric Grouzmann, Marc Levivier

INTRODUCTION: The efficacy of Gamma Knife surgery (GKS) in local tumor control of non-secreting paragangliomas (PGLs) has been fully described by previous studies. However, with regard to secreting PGL, only one previous case report exists advocating its efficacy at a biological level. CASE REPORT: The aims of this study were: 1) to evaluate the safety/efficacy of GKS in a dopamine-secreting …

Multiple endocrine neoplasia type 1 associated with a new germline Men1 mutation in a family with atypical tumor phenotype

Posted on by

Nikolaos Perakakis, Felix Flohr, Gian Kayser, Oliver Thomusch, Lydia Parsons, Franck Billmann, Ernst von Dobschuetz, Susanne Rondot, Jochen Seufert, Katharina Laubner

BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal-dominant hereditary disorder associated with the development of endocrine tumors due to reduced expression of the tumor suppressor protein menin. Recent studies indicate a general role of menin in carcinogenesis, affecting the prevalence and clinical course of common non-endocrine tumors such as breast cancer, hepatocellular carcinoma and melanoma. Here we report a new germline missense mutation …

Intractable hypoglycaemia in a patient with advanced carcinoid syndrome successfully treated with hepatic embolization

Posted on by

Angelos Kyriacou, Was Mansoor, Jeremy Lawrance, Peter J. Trainer

A male patient presented at the age of 54 years with metastatic pancreatic neuroendocrine tumour (NET). He was managed with interferon and multiple courses of MIBG therapy which controlled his disease for about seven years. He then developed symptomatic hypoglycaemia which resolved with the introduction of somatostatin analogue treatment and further therapeutic MIBG. However, three years later he was admitted to hospital with severe and intractable hypoglycaemia …

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

Posted on by

Zadalla Mouslech, Maria Somali, Anastasia Konstantina Sakali, Christos Savopoulos, George Mastorakos, Apostolos I. Hatzitolios

A 43-year-old woman, previously misdiagnosed as having primary hyperthyroidism and treated with antithyroid drugs, presented to us with overt hyperthyroidism, high levels of thyroid hormones and elevated thyroid-stimulating hormone (TSH). Μagnetic resonance imaging (MRI) revealed a pituitary microadenoma extending suprasellarly. The patient responded favorably to initial treatment with somatostatin analogs for 2 years but due to the escape phenomenon, TSH levels escalated and hyperthyroidism relapsed …

Identification of a novel mutation of the PRKAR1A gene in a patient with Carney complex with significant osteoporosis and recurrent fractures

Posted on by

Labrini Papanastasiou, Stelios Fountoulakis, Nikos Voulgaris, Theodora Kounadi, Theodosia Choreftaki, Akrivi Kostopoulou, George Zografos, Charalampos Lyssikatos, Constantine A. Stratakis, George Piaditis

OBJECTIVE: Carney complex (CNC) is a rare autosomal dominant multiple neoplasia syndrome characterized by the presence of endocrine and non-endocrine tumors. More than 125 different germline mutations of the protein Kinase A type 1-α regulatory subunit (PRKAR1A) gene have been reported. We present a novel PRKAR1A gene germline mutation in a patient with severe osteoporosis and recurrent vertebral fractures. DESIGN: Clinical case report …

Landmarks in the history of adrenal surgery

Posted on by

Marios Papadakis, Andreas Manios, Georgios Schoretsanitis, Constantinos Trompoukis

The last 100 years have seen a revolution in the understanding of adrenal disease and its surgical treatment. The isolation of its hormones, the detailed study of the adrenal medulla and the cortex together with the enormous expansion of surgical methods served as catalysts to this revolution. The Greek word for adrenal (epinephridio, from the Greek epi, upon, and nephros, kidney) dates back to the age of Homer who mentions the adrenal glands …

Does ambient light at night reduce total melatonin production?

Posted on by

Christopher C.M. Kyba, Thomas Kantermann

It was with great interest that we read the recent study by Hersh et al. on the effects of sleep and light at night on melatonin in adolescents. Of particular interest was their focus on electronic use after “lights out”. The authors highlight the importance of understanding what effects this may have on sleep, citing a survey that showed that 72% of American 13-18 year olds regularly use a cellphone or computer before trying to go to sleep …

Central precocious puberty due to hypothalamic hamartoma in neurofibromatosis type 1

Posted on by

Emanuele Bartolini, Stefano Stagi, Perla Scalini, Andrea Bianchi, Antonio Ciccarone, Mario Mascalchi

In neurofibromatosis type 1 (NF1), Central Precocious Puberty (CPP) occurs almost invariably in association with optic pathway tumors, usually pilocytic astrocytoma. However, at times the aetiology remains. On the other hand, in the general population CPP develops due to an underlying hypothalamic hamartoma in up to 10% of patients. To the best of our knowledge, CPP due to hypothalamic hamartomas in NF1 has been reported only once in the literature …

Diversity in endocrinology practice: the case of Ramadan

Posted on by

Ioannis Ilias, Luai Said Tayeh, Isidoros Pachoundakis

There is today an imperative need to raise health workers’ awareness of contemporary cultural diversity and different beliefs, values and attitudes concerning health and disease in order to provide culturally appropriate and professionally competent care. Muslims currently account for 1%-10% of the population in Western Europe …

Depressive symptoms in obese patients study

Posted on by

Bulent Canbaz

The study by Huang et al sheds valuable light on how obesity may cause depression. However, depressed people are known to be at higher risk for developing obesity in the first place. It is therefore important to know whether any of the participants had a history of prior depression …