0000000000955236
AUTHOR
R Pivonello
The adipose visceral dysfunction plays an important role in diabetes in Cushing disease.
Background: Cushing disease (CD) is associated with increased morbidity and mortality caused by cardiometabolic alterations. Visceral Adiposity Index (VAI) expresses impaired adipose distribution and function which are related to the cardiometabolic risk. Aim: To evaluate in a cohort of CD patients the correlation between VAI and other parameters, such as gender, etiology, age, cortisol values measured in the morning (8 am) and at the midnight, urinary free cortisol (24h sample of urine, average of three samples) and glucose tolerance as normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG+IGT and diabetes mellitus. Materials and methods: We …
Effect of the switch from conventional to “dual release hydrocortisone” in adult patients with primary and secondary adrenal insufficiency: a six-months multicenter study
Treatment of skeletal impairment in patients with endogenous hypercortisolism: when and how?
Guidelines for the management of osteoporosis induced by endogenous hypercortisolism are not available. Both the American College of Rheumatology and the International Osteoporosis Foundation recommend to modulate the treatment of exogenous glucocorticoid-induced osteoporosis (GIO) based on the individual fracture risk profile (calculated by FRAX) and dose of glucocorticoid used, but it is difficult to translate corticosteroid dosages to different degrees of endogenous hypercortisolism, and there are no data on validation of FRAX stratification method in patients with endogenous hypercortisolism. Consequently, it is unclear whether such recommendations may be adapted to patients with endoge…
Maggior rischio cardiometabolico nelle donne affette da Cushing, anche in assenza di una franca Sindrome Metabolica.
The hypertension of Cushing's syndrome: Controversies in the pathophysiology and focus on cardiovascular complications
Cushing's syndrome is associated with increased mortality, mainly due to cardiovascular complications, which are sustained by the common development of systemic arterial hypertension and metabolic syndrome, which partially persist after the disease remission. Cardiovascular diseases and hypertension associated with endogenous hypercortisolism reveal underexplored peculiarities. The use of exogenous corticosteroids also impacts on hypertension and cardiovascular system, especially after prolonged treatment. The mechanisms involved in the development of hypertension differ, whether glucocorticoid excess is acute or chronic, and the source endogenous or exogenous, introducing inconsistencies a…