0000000000955270
AUTHOR
C Pivonello
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…
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…
EFFECTS OF CABERGOLINE TREATMENT ON METABOLIC SYNDROME AND VISCERAL ADIPOSITY INDEX IN PATIENTS WITH HYPERPROLACTINEMIA.
Introduction: Hyperprolactinemia is reportedly associated with an impaired metabolic profile, particularly in patients with concomitant hypogonadism. The current study aimed at investigating the effects of short (12 months) and long (60 months) treatment with cabergoline (CAB) on metabolic complications, metabolic syndrome (MS) prevalence and visceral adiposity index (VAI) in hyperprolactinemic patients (pts). Patients and Methods: Seventy-one pts (51 F, 20 M, aged 35.4±11.7 yrs), including 36 with microprolactinomas, 32 with macroprolactinomas and 3 with non-tumoral hyperprolactinemia, entered the study. In all pts, PRL and metabolic parameters (BMI, waist circumference, lipid and glucose …