Jeonghoon Ha, Jung Hwan Park, Kyoung Jin Kim, Jung Hee Kim, Kyong Yeun Jung, Jeongmin Lee, Jong Han Choi, Seung Hun Lee, Namki Hong, Jung Soo Lim, Byung Kwan Park, Jung-Han Kim, Kyeong Cheon Jung, Jooyoung Cho, Mi-kyung Kim, Choon Hee Chung, The Committee of Clinical Practice Guideline of Korean Endocrine Society, The Korean Adrenal Study Group of Korean Endocrine Society
Endocrinol Metab. 2023;38(6):597-618. Published online October 13, 2023
Primary aldosteronism (PA) is a common, yet underdiagnosed cause of secondary hypertension. It is characterized by an overproduction of aldosterone, leading to hypertension and/or hypokalemia. Despite affecting between 5.9% and 34% of patients with hypertension, PA is frequently missed due to a lack of clinical awareness and systematic screening, which can result in significant cardiovascular complications. To address this, medical societies have developed clinical practice guidelines to improve the management of hypertension and PA. The Korean Endocrine Society, drawing on a wealth of research, has formulated new guidelines for PA. A task force has been established to prepare PA guidelines, which encompass epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, and follow-up care. The Korean clinical guidelines for PA aim to deliver an evidence-based protocol for PA diagnosis, treatment, and patient monitoring. These guidelines are anticipated to ease the burden of this potentially curable condition.
Citations
Citations to this article as recorded by
Differences in target organ damage between captopril challenge test-defined definitive-positive and borderline-range groups among patients with primary aldosteronism Naoki Fujiwara, Tatsuya Haze, Hiromichi Wakui, Kouichi Tamura, Mika Tsuiki, Kohei Kamemura, Daisuke Taura, Takamasa Ichijo, Yutaka Takahashi, Minemori Watanabe, Hiroki Kobayashi, Toshifumi Nakamura, Shoichiro Izawa, Norio Wada, Tetsuya Yamada, Kenichi Yok Hypertension Research.2025; 48(2): 540. CrossRef
Major Adverse Cardiovascular Events in Primary Aldosteronism After Adrenalectomy or Mineralocorticoid Receptor Antagonist Treatment: A Systematic Review and Meta‐Analysis Chien‐Wei Huang, Tse‐Ying Huang, Ya‐Fei Yang, Li‐Yang Chang, Yu‐Kang Tu, Vin‐Cent Wu, Jui‐Yi Chen Journal of the American Heart Association.2025;[Epub] CrossRef
Correlation of Histopathologic Subtypes of Primary Aldosteronism with Clinical Phenotypes and Postsurgical Outcomes Chang Ho Ahn, You-Bin Lee, Jae Hyeon Kim, Young Lyun Oh, Jung Hee Kim, Kyeong Cheon Jung The Journal of Clinical Endocrinology & Metabolism.2024; 109(8): e1582. CrossRef
Temporal trends in clinical features of patients with primary aldosteronism over 20 years Seung Shin Park, Chang Ho Ahn, Sang Wan Kim, Jung-Min Koh, Seung Hun Lee, Jung Hee Kim Hypertension Research.2024; 47(8): 2019. CrossRef
Primary aldosteronism: An underdiagnosed clinical entity Peeyush Jain, Atul Kaushik, Nilashish Dey, Ashwani Mehta, Shaloo Kapoor, Chhavi Agrawal Journal of Current Cardiology.2024; 2(2): 65. CrossRef
Historical changes in the clinical features of primary aldosteronism Takamasa Ichijo Hypertension Research.2024; 47(10): 2926. CrossRef
Comparing ARR Versus Suppressed PRA as Screening Tests for Primary Aldosteronism Marco Marcelli, Caixia Bi, John W. Funder, Michael J. McPhaul Hypertension.2024; 81(10): 2072. CrossRef
Screening and treatment of endocrine hypertension focusing on adrenal gland disorders: a narrative review Seung Min Chung Journal of Yeungnam Medical Science.2024; 41(4): 269. CrossRef
Diagnostic efficacy of aldosterone-to-renin ratio to screen primary aldosteronism in hypertension: a systemic review and meta-analysis Ting-Wei Kao, Jui-Yi Chen, Jung-Hua Liu, Wen-Hsin Tseng, Chih-Chia Hsieh, Vin-Cent Wu, Yen-Hung Lin, Zheng-Wei Chen Therapeutic Advances in Endocrinology and Metabolism.2024;[Epub] CrossRef
Comparative Analysis of Liquid Chromatography-Tandem Mass Spectrometry and Radioimmunoassay in Determining Plasma Aldosterone Concentration and Plasma Renin Activity for Primary Aldosteronism Screening So Yoon Kwon, Kyeong-Jin Kim, Soo-Youn Lee, Jae Hyeon Kim Endocrinology and Metabolism.2024; 39(6): 965. CrossRef
This review intends to provide the reader with a practical overview of several (patho)physiological conditions in which knowledge of the interplay between growth hormone (GH), insulin-like growth factor-1 (IGF-1), and insulin is important. This might help treating physicians in making the right decisions on how to intervene and improve metabolism for the benefit of patients, and to understand why and how metabolism responds in their specific cases. We will specifically address the interplay between GH, IGF-1, and insulin in type 1 and 2 diabetes mellitus, liver cirrhosis, and acromegaly as examples in which this knowledge is truly necessary.
Citations
Citations to this article as recorded by
Insulin-Like Growth Factor Signaling in Alzheimer’s Disease: Pathophysiology and Therapeutic Strategies Jie Miao, Yanli Zhang, Chen Su, Qiandan Zheng, Junhong Guo Molecular Neurobiology.2025; 62(3): 3195. CrossRef
Signaling pathways and targeted therapies in Ewing sarcoma Ke Jia, Li Cao, Yihan Yu, Doudou Jing, Wei Wu, Brian Andrew Van Tine, Zengwu Shao Pharmacology & Therapeutics.2025; 266: 108765. CrossRef
IGF-1 and IGF-2 as Molecules Linked to Causes and Consequences of Obesity from Fetal Life to Adulthood: A Systematic Review Justyna Szydlowska-Gladysz, Adrianna Edyta Gorecka, Julia Stepien, Izabela Rysz, Iwona Ben-Skowronek International Journal of Molecular Sciences.2024; 25(7): 3966. CrossRef
Insulin resistance reduction, intermittent fasting, and human growth hormone: secondary analysis of a randomized trial Benjamin D. Horne, Jeffrey L. Anderson, Heidi T. May, Tami L. Bair, Viet T. Le, Leslie Iverson, Kirk U. Knowlton, Joseph B. Muhlestein npj Metabolic Health and Disease.2024;[Epub] CrossRef
GHRH in diabetes and metabolism Charlotte Steenblock, Stefan R. Bornstein Reviews in Endocrine and Metabolic Disorders.2024;[Epub] CrossRef
Growth hormone/insulin-like growth factor I axis in health and disease states: an update on the role of intra-portal insulin Kevin C. J. Yuen, Rikke Hjortebjerg, Ashok Ainkaran Ganeshalingam, David R. Clemmons, Jan Frystyk Frontiers in Endocrinology.2024;[Epub] CrossRef
Expanding the Clinical and Mutational Spectrum of Biallelic POC1A Variants: Characterization of Four Patients and a Comprehensive Review of POC1A‐Related Phenotypes Umut Altunoglu, Gozde Tutku Turgut, Esin Karakılıç Özturan, Tuğba Kalaycı, Mert Kaya, Güven Toksoy, Firdevs Baş, Hülya Kayserili, Feyza Darendeliler Clinical Genetics.2024;[Epub] CrossRef
Adrenal incidentalomas represent an increasingly common clinical conundrum with significant implications for patients. The revised 2023 European Society of Endocrinology (ESE) guideline incorporates cutting-edge evidence for managing adrenal incidentalomas. This paper provides a concise review of the updated contents of the revised guideline. In the 2023 guideline, in patients without signs and symptoms of overt Cushing’s syndrome, a post-dexamethasone cortisol level above 50 nmol/L (>1.8 μg/dL) should be considered as mild autonomous cortisol secretion. Regarding the criteria of benign adrenal adenomas, a homogeneous adrenal mass with ≤10 Hounsfield units on non-contrast computed tomography requires no further follow-up, irrespective of its size. The updated guideline also discusses steroid metabolomics using tandem mass spectrometry to discriminate malignancy. It underscores the importance of high-volume surgeons performing adrenalectomy and emphasizes the pivotal role of a multidisciplinary team approach in deciding the treatment plan for indeterminate adrenal masses. The guideline advocates for more proactive surgical treatment for indeterminate adrenal masses in young patients (<40 years) and pregnant women. This review of the 2023 ESE guideline underscores the ongoing evolution of the adrenal incidentaloma management landscape, emphasizing the need for further research and adaptation of diagnostic and therapeutic strategies.
Citations
Citations to this article as recorded by
Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach Mara Carsote, Mihai-Lucian Ciobica, Oana-Claudia Sima, Adrian Ciuche, Ovidiu Popa-Velea, Mihaela Stanciu, Florina Ligia Popa, Claudiu Nistor Cancers.2024; 16(10): 1868. CrossRef
Temporal trends in clinical features of patients with primary aldosteronism over 20 years Seung Shin Park, Chang Ho Ahn, Sang Wan Kim, Jung-Min Koh, Seung Hun Lee, Jung Hee Kim Hypertension Research.2024; 47(8): 2019. CrossRef
Steroid Profiling in the Differential Diagnosis of Cushing's Syndrome and Diagnosis of MACS A. Nankova, T. Kamenova, V. Vasilev, At. Elenkova, D. Svinarov, G. Kirilov, S. Zaharieva Acta Medica Bulgarica.2024; 51(2): 1. CrossRef
Adrenal incidentalomas Ivana Ságová Vnitřní lékařství.2024; 70(5): E9. CrossRef
Ectopic Mediastinal Thyroid: A Crossroad Between a Multi-Layered Endocrine Perspective and a Contemporary Approach in Thoracic Surgery Claudiu Nistor, Mihai-Lucian Ciobica, Oana-Claudia Sima, Anca-Pati Cucu, Florina Vasilescu, Lucian-George Eftimie, Dana Terzea, Mihai Costachescu, Adrian Ciuche, Mara Carsote Life.2024; 14(11): 1374. CrossRef
Mature Adrenal Ganglioneuroma With Lipomatous Content: A Radiological and Histopathological Diagnostic Challenge Mohammed Lameir Hussein, Shams O Alkhateeb, Jouhar J Kolleri, Ala' Saleem Abu-Dayeh, Khaled Murshed, Nabil Sherif Mahmood Cureus.2024;[Epub] CrossRef
Comparative Analysis of Liquid Chromatography-Tandem Mass Spectrometry and Radioimmunoassay in Determining Plasma Aldosterone Concentration and Plasma Renin Activity for Primary Aldosteronism Screening So Yoon Kwon, Kyeong-Jin Kim, Soo-Youn Lee, Jae Hyeon Kim Endocrinology and Metabolism.2024; 39(6): 965. CrossRef
Adrenal insufficiency (AI) can be classified into three distinct categories based on its underlying causes: primary adrenal disorders, secondary deficiencies in adrenocorticotropin, or hypothalamic suppression from external factors, most commonly glucocorticoid medications used for anti-inflammatory therapy. The hallmark clinical features of AI include fatigue, appetite loss, unintentional weight loss, low blood pressure, and hyponatremia. Individuals with primary AI additionally manifest skin hyperpigmentation, hyperkalemia, and salt craving. The diagnosis of AI is frequently delayed due to the non-specific symptoms and signs early in the disease course, which poses a significant challenge to its early detection prior to an adrenal crisis. Despite the widespread availability of lifesaving glucocorticoid medications for decades, notable challenges persist, particularly in the domains of timely diagnosis while simultaneously avoiding misdiagnosis, patient education for averting adrenal crises, and the determination of optimal replacement therapies. This article reviews recent advancements in the contemporary diagnostic strategy and approaches to optimal treatment for AI.
Citations
Citations to this article as recorded by
Adrenal insufficiency in severely wounded men with combat gunshot injury N.Yu. Seliukova, K.V. Misiura, E.M. Khoroshun, V.V. Makarov, V.V. Nehoduiko, O.I. Zalyubovska, E. Szucsik INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2025; 20(8): 573. CrossRef
Post-Traumatic Hypopituitarism Nissa Blocher Current Physical Medicine and Rehabilitation Reports.2024; 12(4): 405. CrossRef
Severe Fatigue in Uncontrolled Asthma: Contributing Factors and Impact of Rehabilitation Karin B. Fieten, Lianne ten Have, Linde N. Nijhof, Lucia Rijssenbeek-Nouwens, Anneke ten Brinke The Journal of Allergy and Clinical Immunology: In Practice.2024; 12(12): 3292. CrossRef
Adrenal Insufficiency in Patients with Beta Thalassemia: A Meta-Analysis Christos Savvidis, Dimitra Ragia, Sophia Delicou, Aikaterini Xydaki, Manfredi Rizzo, Ioannis Ilias Medicina.2024; 60(10): 1571. CrossRef
長期間の呼吸管理および遷延する低血圧から診断に至ったACTH単独欠損症の1例(A case of isolated ACTH deficiency diagnosed after long–term respiratory management and persistent hypotension) 古谷 慎太郎, 神山 治郎, 多喜 亘, 山本 大輔, 五木田 昌士, 田口 茂正, 清田 和也 Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine.2024; 35(12): 965. CrossRef
Pituitary neuroendocrine tumors (PitNETs) are the third most frequently diagnosed intracranial tumors, with nonfunctioning PitNETs (nfPitNETs) accounting for 30% of all pituitary tumors and representing the most common type of macroPitNETs. NfPitNETs are usually benign tumors with no evidence of hormone oversecretion except for hyperprolactinemia secondary to pituitary stalk compression. Due to this, they do not typically present with clinical syndromes like acromegaly, Cushing’s disease or hyperthyroidism and instead are identified incidentally on imaging or from symptoms of mass effects (headache, vision changes, apoplexy). With the lack of effective medical interventions, first-line treatment is transsphenoidal surgical resection, however, nfPitNETs often have supra- or parasellar extension, and total resection of the tumor is often not possible, resulting in residual tumor regrowth or reoccurrence. While functional PitNETs can be easily followed for recurrence using hormonal biomarkers, there is no similar parameter to predict recurrence in nfPitNETs, hence delaying early recognition and timely management. Therefore, there is a need to identify prognostic biomarkers that can be used for patient surveillance and as therapeutic targets. This review focuses on summarizing the current evidence on nfPitNETs, with a special focus on potential new biomarkers and therapeutics.
Citations
Citations to this article as recorded by
Phenotype Transformation of PitNETs Zhenwei Li, Yinzi Wu, Guannan He, Renzhi Wang, Xinjie Bao Cancers.2024; 16(9): 1731. CrossRef
Donor–Acceptor–Donor Strategy Rouses the Photodynamic Therapy Anticancer Activity of a Bis-terpyridyl Ru(II) Complex Zhongyu Wang, Li Wei, Junfeng Lin, Can Huang, Huitong Chen, Dong Fan, Weiyu Hu, Jing Liu, Huaiyi Huang, Zongming Wang, Xin Wang Journal of Medicinal Chemistry.2024; 67(15): 13435. CrossRef
A Study in Pituitary Neuroendocrine Tumors (PitNETs): Real-Life Data Amid Baseline and Serial CT Scans Mihai Costachescu, Oana-Claudia Sima, Mihaela Stanciu, Ana Valea, Mara Carsote, Claudiu Nistor, Mihai-Lucian Ciobica Cancers.2024; 16(20): 3477. CrossRef
Editorial: Prognostic factors in pituitary tumors: clinical, biochemical, imaging, and pathological aspects Toru Tateno, Roxana-Ioana Dumitriu Stan, Stephanie Du Four Frontiers in Endocrinology.2024;[Epub] CrossRef
Adaptive evaluation of gross total resection rates for endoscopic endonasal approach based on preoperative MRI morphological features of pituitary adenomas Ao Shen, Yue Min, Dongjie Zhou, Lirui Dai, Liang Lyu, Wenyi Zhan, Shu Jiang, Peizhi Zhou Frontiers in Oncology.2024;[Epub] CrossRef
Original Article
Adrenal gland Big Data Articles (National Health Insurance Service Database)
Background The severity of coronavirus disease 2019 (COVID-19) among patients with long-term glucocorticoid treatment (LTGT) has not been established. We aimed to evaluate the association between LTGT and COVID-19 prognosis.
Methods A Korean nationwide cohort database of COVID-19 patients between January 2019 and September 2021 was used. LTGT was defined as exposure to at least 150 mg of prednisolone (≥5 mg/day and ≥30 days) or equivalent glucocorticoids 180 days before COVID-19 infection. The outcome measurements were mortality, hospitalization, intensive care unit (ICU) admission, length of stay, and mechanical ventilation.
Results Among confirmed patients with COVID-19, the LTGT group (n=12,794) was older and had a higher proportion of comorbidities than the control (n=359,013). The LTGT group showed higher in-hospital, 30-day, and 90-day mortality rates than the control (14.0% vs. 2.3%, 5.9% vs. 1.1%, and 9.9% vs. 1.8%, respectively; all P<0.001). Except for the hospitalization rate, the length of stay, ICU admission, and mechanical ventilation proportions were significantly higher in the LTGT group than in the control (all P<0.001). Overall mortality was higher in the LTGT group than in the control group, and the significance remained in the fully adjusted model (odds ratio [OR], 5.75; 95% confidence interval [CI], 5.31 to 6.23) (adjusted OR, 1.82; 95% CI, 1.67 to 2.00). The LTGT group showed a higher mortality rate than the control within the same comorbidity score category.
Conclusion Long-term exposure to glucocorticoids increased the mortality and severity of COVID-19. Prevention and early proactive measures are inevitable in the high-risk LTGT group with many comorbidities.
Citations
Citations to this article as recorded by
Hormonal Implications of SARS‐CoV‐2: A Review of Endocrine Disruptions Aliya Yskak, Yevgeniy Sokharev, Kuanysh Zhumalynov, Elizaveta Koneva, Natalia Afanasyeva, Dmitri Borodulin, Dmitrii Babaskin, Almabek Nugmanov, Murat Nurushev, Vadim Chashkov, Gianmarco Ferrara Scientifica.2025;[Epub] CrossRef
Outpatient glucocorticoid use and COVID-19 outcomes: a population-based study Almudena Rodríguez-Fernández, Irene Visos-Varela, Maruxa Zapata-Cachafeiro, Samuel Pintos-Rodríguez, Rosa M. García-Álvarez, Teresa M. Herdeiro, María Piñeiro-Lamas, Adolfo Figueiras, Ángel Salgado-Barreira, Rosendo Bugarín-González, Eduardo Carracedo-Mar Inflammopharmacology.2024; 32(4): 2305. CrossRef
Glucocorticoids as a Double-Edged Sword in the Treatment of COVID-19: Mortality and Severity of COVID-19 in Patients Receiving Long-Term Glucocorticoid Therapy Eun-Hee Cho Endocrinology and Metabolism.2023; 38(2): 223. CrossRef
Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo Journal of Clinical Medicine.2023; 12(14): 4799. CrossRef
The clinical characteristics and prognoses of acromegaly vary among patients. Assessment of current and novel predictors can lead to multilevel categorization of patients, allowing integration into new clinical guidelines and a reduction in the increased morbidity and mortality associated with acromegaly. Despite advances in the diagnosis and treatment of acromegaly, its pathophysiology remains unclear. Recent advancements in multiomics technologies, including genomics, transcriptomics, proteomics, metabolomics, and radiomics, have offered new opportunities to unravel the complex pathophysiology of acromegaly. This review comprehensively explores the emerging role of multiomics approaches in elucidating the molecular landscape of acromegaly. We discuss the potential implications of multiomics data integration in the development of novel diagnostic tools, identification of therapeutic targets, and the prospects of precision medicine in acromegaly management. By integrating diverse omics datasets, these approaches can provide valuable insights into disease mechanisms, facilitate the identification of diagnostic biomarkers, and identify potential therapeutic targets for precision medicine in the management of acromegaly.
Citations
Citations to this article as recorded by
“Micromegaly”: Acromegaly with apparently normal GH, an entity on its own? Lucio Vilar, Luciana Ansaneli Naves, Manoel Ricardo Alves Martins, Antônio Ribeiro-Oliveira Jr Best Practice & Research Clinical Endocrinology & Metabolism.2024; 38(3): 101878. CrossRef
Jung Heo, Yeon-Lim Suh, Se Hoon Kim, Doo-Sik Kong, Do-Hyun Nam, Won-Jae Lee, Sung Tae Kim, Sang Duk Hong, Sujin Ryu, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Jae Hyeon Kim, Kyu Yeon Hur
Endocrinol Metab. 2024;39(2):387-396. Published online February 5, 2024
Background Thyroid-stimulating hormone (TSH)-secreting pituitary neuroendocrine tumor (TSH PitNET) is a rare subtype of PitNET. We investigated the comprehensive characteristics and outcomes of TSH PitNET cases from a single medical center. Also, we compared diagnostic methods to determine which showed superior sensitivity.
Methods A total of 17 patients diagnosed with TSH PitNET after surgery between 2002 and 2022 in Samsung Medical Center was retrospectively reviewed. Data on comprehensive characteristics and treatment outcomes were collected. The sensitivities of diagnostic methods were compared.
Results Seven were male (41%), and the median age at diagnosis was 42 years (range, 21 to 65); the median follow-up duration was 37.4 months. The most common (59%) initial presentation was hyperthyroidism-related symptoms. Hormonal co-secretion was present in four (23%) patients. Elevated serum alpha-subunit (α-SU) showed the greatest diagnostic sensitivity (91%), followed by blunted response at thyrotropin-releasing hormone (TRH) stimulation (80%) and elevated sex hormone binding globulin (63%). Fourteen (82%) patients had macroadenoma, and a specimen of one patient with heavy calcification was negative for TSH. Among 15 patients who were followed up for more than 6 months, 10 (67%) achieved hormonal and structural remission within 6 months postoperatively. A case of growth hormone (GH)/TSH/prolactin (PRL) co-secreting mixed gangliocytoma-pituitary adenoma (MGPA) was discovered.
Conclusion The majority of the TSH PitNET cases was macroadenoma, and 23% showed hormone co-secretion. A rare case of GH/TSH/PRL co-secreting MGPA was discovered. Serum α-SU and TRH stimulation tests showed great diagnostic sensitivity. Careful consideration is needed in diagnosing TSH PitNET. Achieving remission requires complete tumor resection. In case of nonremission, radiotherapy or medical therapy can improve the long-term remission rate.
Citations
Citations to this article as recorded by
TSH-secreting pituitary adenomas and bone Marco Losa, Alberto Vassallo, Stefano Frara, Pietro Mortini, Andrea Giustina Pituitary.2024; 27(6): 752. CrossRef
Background Delayed postoperative hyponatremia (DPH) is the most common cause of readmission after pituitary surgery. In this study, we aimed to evaluate the cutoff values of serum copeptin and determine the optimal timing for copeptin measurement for the prediction of the occurrence of DPH in patients who undergo endoscopic transsphenoidal approach (eTSA) surgery and tumor resection.
Methods This was a prospective observational study of 73 patients who underwent eTSA surgery for pituitary or stalk lesions. Copeptin levels were measured before surgery, 1 hour after extubation, and on postoperative days 1, 2, 7, and 90.
Results Among 73 patients, 23 patients (31.5%) developed DPH. The baseline ratio of copeptin to serum sodium level showed the highest predictive performance (area under the curve [AUROC], 0.699), and its optimal cutoff to maximize Youden’s index was 2.5×10–11, with a sensitivity of 91.3% and negative predictive value of 92.0%. No significant predictors were identified for patients with transient arginine vasopressin (AVP) deficiency. However, for patients without transient AVP deficiency, the copeptin-to-urine osmolarity ratio at baseline demonstrated the highest predictive performance (AUROC, 0.725). An optimal cutoff of 6.5×10–12 maximized Youden’s index, with a sensitivity of 92.9% and a negative predictive value of 94.1%.
Conclusion The occurrence of DPH can be predicted using baseline copeptin and its ratio with serum sodium or urine osmolarity only in patients without transient AVP deficiency after pituitary surgery.
Citations
Citations to this article as recorded by
Impact Factors of Blood Copeptin Levels in Health and Disease States Yutong Wang, Shirui Wang, Siyu Liang, Xinke Zhou, Xiaoyuan Guo, Bochuan Huang, Hui Pan, Huijuan Zhu, Shi Chen Endocrine Practice.2024; 30(12): 1197. CrossRef
Background To identify a screening tool for obstructive sleep apnea (OSA) and evaluate the effects of endoscopic transsphenoidal surgery on improving OSA in patients with acromegaly.
Methods We prospectively enrolled adults with acromegaly scheduled for endoscopic transsphenoidal surgery. All measurements were conducted when participants were admitted for a baseline work-up for acromegaly before surgery and surveillance approximately 3 to 6 months after surgery. Respiratory event index (REI) was used as a surrogate for apnea-hypopnea index (Trial Registration: NCT03526016).
Results Of the 35 patients with acromegaly (median age, 47 years; 40% men; median body mass index, 24.4 kg/m2), 24 (68.6%) had OSA (REI ≥5/hour), 15 (42.9%) had moderate-to-severe OSA (REI ≥15/hour). At baseline, serum insulin-like growth factor 1 (IGF-1) levels were positively correlated with the REI (ρ=0.53, P=0.001). The sensitivity and negative predictive value of a Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, age, Neck circumference, and Gender (STOP-Bang) score ≥ 3 were 93.3% and 87.5%, respectively, detecting moderate-to-severe OSA. Biochemical acromegaly remission was achieved in 32 (91.4%) patients. The median difference in the REI was –9.5/hour (95% confidence interval, –13.3 to –5.3). Half of the 24 patients diagnosed with OSA preoperatively had REI <5/hour postoperatively. In a linear mixed-effects model, changes in the REI across surgery were related to changes in IGF-1 levels.
Conclusion The STOP-Bang questionnaire is a reliable tool for OSA among patients with acromegaly. Improvement in OSA severity after surgery is related to decreased IGF-1 levels.
Citations
Citations to this article as recorded by
How Different Treatments for Acromegaly Modulate Sleep Quality: A Psychometric Study Gaspare Alfì, Danilo Menicucci, Dalì Antonia Ciampa, Vito Di Giura, Giulia Marconcini, Claudio Urbani, Fausto Bogazzi, Angelo Gemignani Endocrines.2024; 5(3): 408. CrossRef
Prolactinomas are the most prevalent type of pituitary neuroendocrine adenomas, primarily affecting women of reproductive age. Unlike other pituitary tumors, the first-line management has traditionally been pharmacological rather than surgical. This preference is due to the effectiveness of dopamine agonists (DAs), which typically reduce tumor size and normalize prolactin levels in most patients. However, this does not imply that there is no room for improvement; the duration of treatment and medication side effects often lead to compliance issues among patients. Recent advances in surgical techniques and molecular biology have paved the way for the development of precision medicine, allowing for more flexible and personalized treatment strategies for prolactinomas. This review aims to enhance clinical decision-making and patient care for endocrinologists by focusing on several key factors: predictive markers of DA sensitivity, clinical characteristics and suitability for transsphenoidal adenomectomy as a potential first-line treatment, factors determining the successful withdrawal of DAs after prolonged use, safety concerns during pre/post-pregnancy and breastfeeding, and determinants of tumor aggressiveness. Through tailored therapy—a patient-focused, multidisciplinary approach— we aim to improve the management of prolactinoma patients.