Valutazione dell’insulino-sensibilità tramite clamp euglicemico iperinsulinemico in bambini in terapia sostitutiva con GH.

Background I dati sugli effetti della terapia sostitutiva con ormone somatotropo (GH) sull’insulino-sensibilità sono variabili e talora discordanti tra loro e per gran parte ricavati dall’utilizzo di indici surrogati basali, come Homa-IR, o derivati dall’OGTT, come ISI Matsuda. Scopo Valutare la variazione dell’insulino-sensibilità in un gruppo di pazienti affetti da deficit di GH (GHD) pediatrico confrontando i suddetti indici con il clamp euglicemico iperinsuliemico. Materiali e Metodi In 20 bambini affetti da GHD idiopatico isolato alla diagnosi e dopo 12 mesi di terapia con GH e in 10 controlli con bassa statura costituzionale, oltre ai classici parametri clinico-auxologici (statura, BM…

Comparison of clinical and metabolic effects of pasireotide and pituitary surgery in Cushing disease

Pituitary surgery represents the first-line treatment for most patients with Cushing’s disease (CD). In the case of surgery failure, additional treatment options are required. Pasireotide has shown favourable results in the first-line treatment of patients with CD, who are not candidates for surgery or in the second-line when surgery has failed. The aim of the current study is to compare the effects of surgery and pasireotide treatment in a cohort of patients with CD, and to evaluate the differences in response rate in terms of hormonal and clinical control, and improvement of metabolic complications.

Efficacy and safety of long-term ezetimibe/simvastatin treatment in patients with familial hypercholesterolemia

Aim. Patients with heterozygous familial hypercholesterolemia (FH) have an increased risk of premature myocardial infarction, stroke, and surgical revascularization, and an increased rate of progression of carotid intima-media thickness (IMT). The most commonly used drugs for cholesterol lowering, statins, have a limited action in these patients. Ezetimibe, a novel compound, selectively inhibits cholesterol uptake and when associated with statins has an additional low-density lipoprotein cholesterol (LDL-C) reducing effect. The aim of this study is to evaluate the effects of long-term combined Ezetimibe/Simvastatin (EZE/SIMVA) therapy (30 months) on the lipidic pattern, inflammatory markers…

Epidemiology of pancreatic neuroendocrine neoplasms. a gender perspective

Purpose: Pancreatic neuroendocrine neoplasms (PNENs) are a group of clinically rare and heterogeneous tumors of the pancreas. Currently there are no studies investigating the gender difference in PNEN susceptibility. Thus, the purpose of this study was aimed at examining how gender shapes risk factors, clinicopathological features, and comorbidities in PNENs. Methods: The study design consisted of an Italian multicenter, retrospective study. The study included all consecutive patients with PNENs followed at the participating centers. Two hundred and twenty-nine patients (105 males,124 females, age 54 ± 0.98 years) with PNENs were enrolled at the participating centers. The clinicopathologica…

Clinical and metabolic impact of three-times-weekly versus daily growth hormone (GH) treatment in naïve GH-deficient children

OBJECTIVE: Growth hormone treatment (GHT) is commonly administered daily, although pulsatile GH secretion is unlikely to be achieved. The auxological effect of a three-injections-per-week (TIW) regimen is controversial, while the metabolic effects have been never evaluated in children. The objective was to evaluate whether two different regimens of weekly injections could lead to similar auxological and metabolic effects in children with GH deficiency (GHD). DESIGN: 32 GHD children (25 males, mean age 10.5 ± 2.2 yr) were randomly assigned to receive daily (group A, No 16) or TIW (group B, No 16) GHT for 12 months. METHODS: Auxological parameters, insulin-like growth factor-I (IGF-I), glucos…

Modificazioni di insulino-secrezione, insulino-sensibilità e funzione adiposa durante terapia con pasireotide in un gruppo di pazienti con malattia di Cushing

Background: La terapia con pasireotide (PAS) è efficace nel miglioramento del quadro clinico e biochimico dei soggetti con Malattia di Cushing (MC) da adenoma ipofisario ACTH-secernente, ma una della principali cause di interruzione della stessa è l’insorgenza di eventi avversi, tra i quali l’iperglicemia è il più frequente. Obiettivi: Valutare l’effetto della terapia con PAS su metabolismo glucidico, insulino-secrezione e sensibilità. Metodi: Abbiamo valutato in 8 pazienti con MC recidivata post-chirurgia durante un follow-up terapeutico di 12 mesi, oltre ai parametri clinici ed ormonali, l’insulino-secrezione tramite HOMAβ e area sotto la curva del C-peptide (AUC2hc-peptide) durante MMTT,…

The treatment of hyperinsulinemic hypoglycaemia in adults: an update

Treatment of hyperinsulinemic hypoglycaemia (HH) is challenging due to the rarity of this condition and the difficulty of differential diagnosis. The aim of this article is to give an overview of the recent literature on the management of adult HH. A search for reviews, original articles, original case reports between 1995 and 2016 in PubMed using the following keywords: hyperinsulinemic hypoglycaemia, insulinoma, nesidioblastosis, gastric bypass, autoimmune hypoglycaemia, hyperinsulinism, treatment was performed. One hundred and forty articles were selected and analysed focusing on the most recent treatments of HH. New approaches to treatment of HH are available including mini-invasive sur…

Gender-specific soluble α-klotho levels as marker of GH deficiency in children: a case-control study.

Abstract Purpose To evaluate circulating soluble α-klotho (sαKL) levels in GHD children before and after 12 months of GH treatment (GHT). Methods Auxological and basal metabolic parameters, oral glucose tolerance test for glucose and insulin levels, insulin sensitivity indices and klotho levels were evaluated before and after 12 months of follow-up in 58 GHD children and 56 healthy controls. Results At baseline, GHD children showed significantly lower growth velocity standard deviation score (SDS) (p < 0.001), bone/chronological age ratio (p < 0.001), GH peak and area under the curve (AUC) after arginine test (ARG) (both p < 0.001) and glucagon stimulation test (GST) (p < 0.001 …

Colorectal cancer in patients with type 2 diabetes mellitus: a single-center experience

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of colorectal cancer (CRC). The aim of the study is to evaluate the prevalence of CRC in a cohort of Caucasian patients with T2DM and the association with other variables previously known to be related with increased risk of CRC. We retrospectively evaluated the data of 741 consecutive Caucasian patients with T2DM who underwent colonoscopic screening in our tertiary referral center. A control cohort of 333 patients with thyroid disease was selected to evaluate the difference in the incidence of CRC. At a median follow-up of 132.5 months (range 33.3-175.7), 67 cases of cancer (prevalence 9%) occurred; among these, 14 cases …

Circulating adipokine levels in diabetic patients with Cushing disease on pasireotide treatment compared with patients with type 2 diabetes mellitus

EFFECTS OF PASIREOTIDE TREATMENT ON CARDIOMETABOLIC RISK IN PATIENTS WITH CUSHING’S DISEASE : AN ITALIAN, MULTICENTER STUDY

Miglioramento clinico e metabolico in pazienti affetti da diabete mellito tipo 1 associato ad altre endocrinopatie (APS) dopo shift della terapia insulinica basale con glargine a degludec

Background L’utilizzo di insulina degludec, rispetto ad altre insuline basali, sembra associato ad una ridotta incidenza di episodi ipoglicemici e di conseguenza ad una maggiore stabilità glicemica con miglioramento del compenso glicometabolico. Materiali e Metodi Abbiamo analizzato i parametri clinico-metabolici e i profili glicemici di 51 consecutivi pazienti affetti da diabete tipo 1 associato ad altre endocrinopatie (APS) in stabile terapia basale con glargine (in baseline) e suddivisi in 2 gruppi: gruppo A (n.21) a cui è stata confermata la terapia con glargine e gruppo B (n.30) a cui è stata sostituita glargine con degludec per un periodo di 6 mesi. A tutti i pazienti è stato chiesto …

Janus kinase (JAK) 2 V617F mutation as the cause of primary thrombocythemia, severe visceromegaly and divergence between growth hormone and insulin-like growth factor-1 concentrations in acromegaly due to a therapeutically resistant pituitary GH-secreting macroadenoma

GENOMIC AND PROTEOMIC EVALUATION OF VISCERAL AND SUBCUTANEOUS ADIPOSE DERIVED STEM CELLS AND FUNCTIONAL ROLES OF PLURIPOTENCY TRANSCRIPTION FACTORS