Abstract：
:Management of patients with ACTH producing pituitary adenoma remains to be challenging. Removal of the pituitary adenoma through transsphenoidal surgery is the main stay of treatment. Complete resection of the adenoma is followed by the development of ACTH deficiency since the normal corticotrophs are suppressed by the pre-existing hypercortisolemia. The concern for ACTH deficiency has led many centers to advocate the use glucocorticoids before, during and after surgery. We provide evidence that such coverage with glucocorticoids is unnecessary until clinical or biochemical documentation of need is established. Given that patients are closely monitored, they are immediately treated with glucocorticoids once they exhibit any clinical and/or biochemical evidence of adrenal insufficiency. Defining remission in the immediate postoperative period has been rather difficult despite using different biochemical markers. Serum cortisol continues to be the best determinant of disease activity after surgical adenomectomy. However it needs to be interpreted with caution as a biochemical marker of remission in patients given glucocorticoids during and after surgery. Other biochemical markers are also used in the peri-operative period to determine the possibility of remission. These include the dexamethasone suppression test, CRH stimulation without dexamethasone, urinary free cortisol measurements, desmopressin stimulation test, the determination of salivary cortisol and / or plasma ACTH concentrations. Each test has its own advantages and limitations. The simplest and most informative approach is to measure serum cortisol levels repeatedly after surgery without the administration of exogenous glucocorticoids. Low serum cortisol levels (less than 2 μg/dL) in the peri-operative period are highly indicative of surgical success and a high likelihood for clinical remission. Higher serum cortisol levels require careful interpretation and further planning and discussions between the patient and the management team.
journal_name
Rev Endocr Metab Disordjournal_title
Reviews in endocrine & metabolic disordersauthors
AbdelMannan D,Selman WR,Arafah BMdoi
10.1007/s11154-010-9140-6subject
Has Abstractpub_date
2010-06-01 00:00:00pages
127-34issue
2eissn
1389-9155issn
1573-2606journal_volume
11pub_type
杂志文章,评审abstract：:An increasingly pervasive environment of reduced activity and easy access to high caloric food is leading to an epidemic of poor cardiovascular fitness, obesity, insulin resistance and type 2 diabetes (T2DM) in children. Studies have shown that insulin resistance (IR) to be an independent predictor for morbidity as we...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-009-9109-5
更新日期：2009-09-01 00:00:00
abstract：:This paper provides evidence that primary aldosteronism is likely much less common than is believed by the other authors of this collection. The basis for this contrarian view is simple: there is no way to know the true prevalence of PA because of the uncertain validity of all of the diagnostic procedures used to find...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-011-9160-x
更新日期：2011-03-01 00:00:00
abstract：:Neuroendocrine neoplasms (NENs) comprise a heterogeneous group of tumors, mainly localized in the gastrointestinal system. What characterizes NENs is the expression of hormone receptors on the tumor cell surface, making them accessible for diagnostic and therapeutic approaches (theranostics) using radiolabelled peptid...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-020-09552-x
更新日期：2020-06-03 00:00:00
abstract：:Glucokinase is a key enzyme involved in regulating insulin secretion from the pancreatic ß-cell. The unique role of glucokinase in human glucose physiology is illustrated by the fact that genetic mutations in glucokinase can either cause hyperglycaemia or hypoglycaemia. Heterozygous inactivating mutations in glucokina...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-010-9147-z
更新日期：2010-09-01 00:00:00
abstract：:Myo-inositol (Myo-Ins) plays an important role in thyroid function and autoimmunity. Myo-Ins is the precursor for the synthesis of phosphoinositides, which takes part in the phosphatidylinositol (PtdIns) signal transduction pathway, and plays a decisive role in several cellular processes. In the thyroid cells, PtdIns ...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-018-9477-9
更新日期：2018-12-01 00:00:00
abstract：:The incidence of neuroendocrine tumors (NET) increases with age. Lately, the diagnosis of NET was mainly caused by early detection of small NET (<1 cm) in the rectum and stomach, which are depicted by chance during routine and prophylactic endoscopy. Also in patients with large and metastatic pancreatic and intestinal...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-018-9469-9
更新日期：2018-06-01 00:00:00
abstract：:Diabetes is a group of metabolic disorders characterized by persistent hyperglycemia and has become a major public health concern. Autoimmune type 1 diabetes (T1D) and insulin resistant type 2 diabetes (T2D) are the two main types. A combination of genetic and environmental factors contributes to the development of th...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-015-9309-0
更新日期：2015-03-01 00:00:00
abstract：:The skeletal muscle is one of the major target organs of insulin and plays an essential role in insulin-induced glucose uptake. Some evidence indicates that insulin delivery to skeletal muscle interstitium through the endothelial cells is the rate-limiting step in insulin-stimulated glucose uptake. Researchers have al...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-013-9242-z
更新日期：2013-06-01 00:00:00
abstract：UNLABELLED:We aimed to review and summarize the evidence from accomplished trials analyzing factors influencing mortality in patients with T2DM and to provide some recommendations for targets and treatment in the European region. The following databases were searched for relevant trials: PubMed and the Cochrane Library...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-016-9349-0
更新日期：2016-03-01 00:00:00
abstract：:Ectopic Cushing's syndrome usually relates to the ectopic ACTH syndrome (EAS) and represents ∼20% of ACTH-dependent and ∼10% of all types of Cushing's syndrome (CS). Nearly any neuroendocrine or non-endocrine tumours may be associated with EAS, but the more prevalent tumours are bronchial carcinoids, small cell lung c...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-010-9139-z
更新日期：2010-06-01 00:00:00
abstract：:From the age of 2 years, an American child is more likely to consume a sugar-sweetened product than a fruit or vegetable on any given day-a troubling statistic, given that food preferences are established early in childhood, as well as the strong association between this dietary pattern and increased risk of developin...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-016-9360-5
更新日期：2016-06-01 00:00:00
abstract：:The 13th Acromegaly Consensus Conference was held in November 2019 in Fort Lauderdale, Florida, and comprised acromegaly experts including endocrinologists and neurosurgeons who considered optimal approaches for multidisciplinary acromegaly management. Focused discussions reviewed techniques, results, and side effects...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-020-09588-z
更新日期：2020-12-01 00:00:00
abstract：:Lifestyle changes such as dietary habits, sedentary life and consumption of energy-dense foods that have occurred over the years has led to an epidemic of abdominal obesity, which in turn resulted in dramatic increase in the prevalence of metabolic syndrome (MetS). Different expert panels have provided various definit...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-013-9268-2
更新日期：2013-09-01 00:00:00
abstract：:An emerging branch of research is examining the linkage between Vitamin D and nonskeletal disorders, including endocrine diseases. In this regard, a still little studied aspect concerns the involvement of vitamin D in adrenal gland disorders. Adrenal gland disorders, which might be theoretically affected by vitamin D ...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-016-9391-y
更新日期：2017-09-01 00:00:00
abstract：:The peak in incidence for schizophrenia is during late adolescence for both sexes, but within this time frame the peak is both earlier and steeper for males. Additionally, women have a second peak in incidence following menopause. Two meta-analyses have reported that men have an overall ∼40% greater chance of developi...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-011-9184-2
更新日期：2012-09-01 00:00:00
abstract：:Incretin hormones are intestinally derived peptides that are known to augment glucose-stimulated insulin secretion and suppress glucagon levels. Incretin mimetics are attractive adjunctive therapy for type 2 diabetes due to its efficacy on reducing hyperglycemia with a minimal risk of hypoglycemia. In contrast to most...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-011-9170-8
更新日期：2011-09-01 00:00:00
abstract：:The hypothalamic pituitary adrenal (HPA) axis is the most common of the endocrine lines/axis' to be affected by HIV infection. There are multiple factors that contribute to this HPA axis dysregulation. Direct invasion of the various organs in the axis can be either by opportunistic infections or infiltrative diseases....
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-013-9244-x
更新日期：2013-06-01 00:00:00
abstract：:Deleterious mutations in two breast and ovarian cancer susceptibility genes, BRCA1 and BRCA2 have been identified in breast and ovarian cancer families. Women with a BRCA1 or BRCA2 mutation are candidates for additional risk reduction measures such as intensive screening, prophylactic surgery or chemoprevention. Addit...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-007-9038-0
更新日期：2007-09-01 00:00:00
abstract：:Pituitary tumors are among the most common neoplasms in man; they account for approximately 15% of all primary intracranial lesions (Jagannathan et al., Neurosurg Focus, 19:E4, 2005). Although almost never malignant and rarely clinically expressed, pituitary tumors may cause significant morbidity in affected patients....
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-007-9066-9
更新日期：2008-03-01 00:00:00
abstract：:Celiac disease is a chronic enteropathy caused by permanent intolerance to gluten and similar proteins found in wheat, barley and rye. The intestinal mucosa of susceptible individuals is crossed by undigested gluten, which leads to a marked inflammatory response. The clinical features may vary from overt intestinal sy...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-007-9069-6
更新日期：2008-06-01 00:00:00
abstract：:The carcinoid as originally described is part of the relatively large family of neuroendocrine neoplasia found in almost every organ. Historical reasons back their current definitions. Neuroendocrine cancer is most frequently observed in the lung and the digestive tract. In the lung is defined as carcinoid (typical an...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-017-9428-x
更新日期：2017-12-01 00:00:00
abstract：:Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders characterized by androgen excess, oligo-ovulation and polycystic ovaries. Although ovaries are the main source of increased androgens in the syndrome, between 20 and 30% of patients with PCOS have adrenal androgen (AA) excess, detectable pr...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-007-9054-0
更新日期：2007-12-01 00:00:00
abstract：:The last decade has been characterized by an intense research on the composition of the gut microbiome and the links with human health. While previous work was focused on the effects of prebiotics and probiotics, nowadays several laboratories are describing the gut microbiome and its metabolic functions. Gut microbiom...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-019-09533-9
更新日期：2019-12-01 00:00:00
abstract：:Obstructive sleep apnea (OSA) is a common disorder associated with cardiovascular disease (CVD). One theory to explain this relationship proposes that OSA can induce systemic inflammation, thereby inducing CVD. This theory is based on the premise that obesity is a pro-inflammatory state, and that physiological derange...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-014-9304-x
更新日期：2015-03-01 00:00:00
abstract：:The term "HCV syndrome" encompasses several organ- and systemic pathophysiological states, which often recognize autoimmunity or neoplastic evolution in their pathophysiology, as well as chronic HCV infection as trigger. The clinical features of HCV patients are heterogenous, and may include endocrine or metabolic dis...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-018-9475-y
更新日期：2018-12-01 00:00:00
abstract：:Vitamin D is a key hormone involved in the regulation of calcium/phosphorous balance and recently it has been implicated in the pathogenesis of sub-inflammation, insulin resistance and obesity. The two main forms of vitamin D are cholecalciferol (Vitamin D3) and ergocalciferol (Vitamin D2): the active form (1,25-dihyd...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-017-9423-2
更新日期：2017-06-01 00:00:00
abstract：:Prediabetes is a heterogeneous term that encompasses different origins of insulin resistance and insulin secretion that contribute to distinct patterns of hyperglycemia. In fact, prediabetes is an umbrella term that characterizes individuals at high risk for developing type 2 diabetes (T2D) and/or cardiovascular disea...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-016-9352-5
更新日期：2016-03-01 00:00:00
abstract：:Methionine and folate are the key components of one carbon metabolism, providing the methyl groups for numerous methyl transferase reactions via the ubiquitous methyl donor, s-adenosyl methionine. Methionine metabolism is responsive to nutrient intake, is regulated by several hormones and requires a number of vitamins...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-012-9215-7
更新日期：2012-06-01 00:00:00
abstract：:Vitamin D deficiency is highly prevalent among children and adolescents worldwide. The high rates of vitamin D deficiency during childhood are of major public health relevance, given the growing evidence that vitamin D deficiency may play a key role in the pathophysiology of many chronic diseases beyond rickets, inclu...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-007-9072-y
更新日期：2008-06-01 00:00:00
abstract：:In the last 10 years, several studies have shown that the pancreas of patients with type 1 diabetes (T1D), and even of subjects at risk for T1D, was smaller than the pancreas from healthy subjects. This arose the question of the relationships between the endocrine and exocrine parts of the pancreas in T1D pathogenesis...
journal_title：Reviews in endocrine & metabolic disorders
pub_type： 杂志文章,评审
doi：10.1007/s11154-019-09501-3
更新日期：2019-06-01 00:00:00
