Abstract：
:Establishing the cause of Cushing's syndrome (CS) is one of the most challenging processes in clinical endocrinology. Biochemical testing, including measurement of plasma adrenocorticotropin (ACTH), high-dose dexamethasone suppression, and corticotropin-releasing hormone stimulation testing, is integral to the differential diagnosis. No existing test has sufficient diagnostic accuracy when used alone, however. The adjunctive use of focused imaging, including CT, MRI, and nuclear imaging modalities, often can provide a diagnosis. In patients with ACTH-dependent CS, bilateral inferior petrosal sinus sampling can facilitate a diagnosis in those with discrepant clinical features, biochemistry, or imaging. This article focuses on current biochemical and radiologic strategies for the differential diagnosis of CS.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Lindsay JR,Nieman LKdoi
10.1016/j.ecl.2005.01.009subject
Has Abstractpub_date
2005-06-01 00:00:00pages
403-21, xissue
2eissn
0889-8529issn
1558-4410pii
S0889-8529(05)00010-1journal_volume
34pub_type
杂志文章,评审abstract：:Hypergonadotropic forms of amenorrhea in young women are many and varied, and the disorder is not nearly as uncommon as previously believed. It is likely that all physicians seeing women with amenorrhea will encounter this disorder. Careful evaluation is warranted to eliminate any associated autoimmune disorders. Beca...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-03-01 00:00:00
abstract：:This article discusses several unusual forms of primary thyroid neoplasms. The TCV of PTC and insular thyroid carcinoma appears to have a more aggressive clinical behavior than DTC in most patient groups and may respond to thyroid hormone suppression and radioiodine. Anaplastic thyroid carcinoma, which may develop fro...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70312-1
更新日期：1996-03-01 00:00:00
abstract：:This article links the understanding of developmental physiology of the adrenal cortex to adrenocortical tumor formation. Many molecular mechanisms that lead to formation of adrenocortical tumors have been discovered via next-generation sequencing approaches. The most frequently mutated genes in adrenocortical tumors ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.01.007
更新日期：2017-06-01 00:00:00
abstract：:A number of morphologic and physiologic changes accompany pregnancy such as an increase in lactotrophs and prolactin production, and a decrease in gonadotropins and GH. The hormonal milieu can affect patients with prolactinomas, especially macroadenomas, to cause an increase in size in a minority of patients. Complica...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Trabecular bone score (TBS) is a novel method that assesses skeletal texture from spine dual-energy X-ray absorptiometry (DXA) images. TBS improves fracture-risk prediction beyond that provided by DXA bone mineral density (BMD) and clinical risk factors, and can be incorporated to the Word Health Organization Fracture...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2016.09.005
更新日期：2017-03-01 00:00:00
abstract：:Unlike other pituitary hormones, PRL is under tonic inhibition by the hypothalamus by way of the PRL inhibitory factor, dopamine. GAP and GABA may also be inhibitory. PRL-releasing factors include TRH and VIP and possibly others. Circulating PRL is predominantly monomeric, although some patients with hyperprolactinemi...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-12-01 00:00:00
abstract：:Diuretics and beta-blockers have a strong tendency to affect serum lipids adversely, whereas the peripherally acting alpha-blocking agents consistently result in beneficial effects. Most of the other antihypertensive agents (calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists, and drugs that ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70033-5
更新日期：1998-09-01 00:00:00
abstract：:Approximately one half of young women who have 46,XX spontaneous premature ovarian failure have ovarian follicles remaining in the ovary. These follicles function intermittently and unpredictably, and pregnancies can occur in these women without intervention, even many years after the diagnosis. Clearly, the term "pre...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(03)00043-4
更新日期：2003-09-01 00:00:00
abstract：:Rates of obesity counseling are low among physicians because of the lack of time and training in this area. In recognition of this challenge, recent national guidelines encourage physicians to refer patients with obesity to intensive, comprehensive lifestyle programs to lose weight. Some commercial weight-loss program...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2020.02.006
更新日期：2020-06-01 00:00:00
abstract：:Surgical intervention is a necessary part of a multimodal approach to pituitary lesions. This article summarizes the surgical approach to different neoplastic processes affecting the sellar region. ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2007.10.006
更新日期：2008-03-01 00:00:00
abstract：:The liver is key to glucose homeostasis. Any disruption of its metabolism, structural integrity, or intracellular dynamics may alter the liver's ability to maintain normal glucose homeostasis. When such disruption affects hepatic glucose output, hypoglycemia may eventuate. Multiple drugs including alcohol may alter th...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-03-01 00:00:00
abstract：:Hypertension is an important and modifiable risk factor for the macrovascular and microvascular complications of diabetes. Prior literature outlines the significance of lowering blood pressure and subsequent cardiovascular and microvascular benefits. Blood pressure targets of less than 140/90 mm Hg are recommended in ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.10.008
更新日期：2018-03-01 00:00:00
abstract：:Transgender persons receiving gender-affirming hormone therapy and procedures may face specific skin conditions. Skin diseases in transgender patients often are underdiagnosed and underrecognized despite their important impact on quality of life and mental health. This article discusses pathophysiology, diagnosis, and...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2019.01.005
更新日期：2019-06-01 00:00:00
abstract：:Serum prolactin is reliably elevated by the antipsychotic drugs. Prolactin levels have been followed in psychotic patients during the use of these drugs as an indicator of underlying pathophysiology or as a reflection of drug activity. Considerable research is underway to elucidate further the potential clinical and r...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-03-01 00:00:00
abstract：:Women who cannot or choose not to take estrogens do have alternatives; however, the options are few and unproven in longterm clinical trials with respect to safety and efficacy. Many available alternative treatments may alleviate the symptoms of the menopause, but do not convey long-term protection against osteoporosi...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70253-x
更新日期：1997-06-01 00:00:00
abstract：:Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are s...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2010.08.009
更新日期：2010-12-01 00:00:00
abstract：:The most recent elucidation of an inherited disorder of the pancreas concerns the Johanson-Blizzard syndrome (JBS). Positional cloning identified loss-of-function mutations in the UBRI gene on the long arm of chromosome 15 to be the cause of JBS in more than a dozen patients. In patients with JBS the absence of UBRI r...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.02.013
更新日期：2006-06-01 00:00:00
abstract：:Elevated plasma concentrations of lipoprotein(a) (Lp[a]) are an emerging risk factor for the development of coronary heart disease (CHD). Recent genetic and epidemiologic data have provided strong evidence for a causal role of Lp(a) in CHD. Despite these developments, which have attracted increasing interest from clin...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2014.08.002
更新日期：2014-12-01 00:00:00
abstract：:Only two drugs are currently approved for long-term use in the treatment of obesity and four others for short-term use. Evaluating the risk-benefit profile is an essential first step. For individuals who have a low body mass index for whom the risk is small, the risk profile must make the drug acceptable for almost ev...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2008.08.004
更新日期：2008-12-01 00:00:00
abstract：:Obesity is associated with a spectrum of metabolic and cardiovascular disorders, including hypertension. Both the degree and the distribution of excess adipose tissue impact on the risk of hypertension and associated cardiovascular diseases. The mechanisms that may lead to hypertension in obese individuals include inc...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-06-01 00:00:00
abstract：:Neuroendocrine tumors (NETs) are rare neoplasms found in diverse locations within the body. These tumors are commonly classified by the primary tumor's location, further subclassified by their differentiation, and finally segregated by their ability to hypersecrete peptides or amines. A number of groups have summarize...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2010.08.004
更新日期：2011-03-01 00:00:00
abstract：:Hyperglycemia is common during pregnancy, involving multisystem adaptations. Pregnancy-induced metabolic changes increase insulin resistance. Pregnancy-induced insulin resistance adds to preexisting insulin resistance. Preexisting pancreatic β-cell defect compromises the ability to enhance insulin secretion, leading t...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2019.05.009
更新日期：2019-09-01 00:00:00
abstract：:In this article, the literature is reviewed regarding the role of blood pressure variability and nocturnal nondipping of blood pressure as well as the presence of diabetic kidney disease (DKD), in the absence of albuminuria, as risk predictors for progressive DKD. The importance of glycemic and blood pressure control ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2013.06.002
更新日期：2013-12-01 00:00:00
abstract：:This review has highlighted some of the experimental studies in animals and humans that have shown an important link between dietary change and atherosclerosis. This relationship was further supported by population studies showing a key role for saturated fat intake in the determination of serum cholesterol level and ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-06-01 00:00:00
abstract：:Lifestyle modification is the cornerstone treatment of type 2 diabetes in the obese patient, and is highly effective at promoting glucose regulation. However, many individuals struggle over time to maintain optimal glycemic control and/or body weight with lifestyle modification. Therefore, additional therapeutic appro...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2016.04.007
更新日期：2016-09-01 00:00:00
abstract：:Various clinical syndromes illustrate the essential role of insulin in modulating somatic growth both in utero and after birth. The effect of insulin on growth is a consequence of direct effects transduced via its homologous receptor and post-receptor signaling pathways and indirect effects on other modulators of grow...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70344-3
更新日期：1996-09-01 00:00:00
abstract：:Acromegaly is an unusual insidious but potentially serious chronic pituitary disorder. The delay in diagnosis results not only in unique somatic disfigurement but is also associated with significant mental and emotional dysfunction. This article reviews and describes some of these nonclassic and often overlooked featu...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:Osteoporosis is prevalent in transplant recipients and is related to pre- and post-transplantation factors. Low bone density and fractures may antedate transplantation, related to traditional risk factors for osteoporosis, effects of chronic illness, and end-stage organ failure and its therapy, on the skeleton. Bone l...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2007.07.008
更新日期：2007-12-01 00:00:00
abstract：:More than 80% of women experience psychologic or physical symptoms in the late reproductive years, with varying degrees of severity and disruption in their lives. Patients and clinicians have misconceptions about what changes are considered "normal" or"abnormal" during this period. Of importance to clinicians, large-s...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2004.07.003
更新日期：2004-12-01 00:00:00
abstract：:Ambiguity of the external genitalia may be based on disordered steroid biosynthesis or may arise from fundamental genetic and chromosomal abnormalities that produce failure of gonadogenesis. This article first discusses congenital adrenal hyperplasia and then considers the diverse abnormalities that cause disordered g...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
