Exploring sex-specific hematological changes and their impact on quality of life in patients with prolactinoma

Pituitary, Год журнала: 2025, Номер 28(1)

Опубликована: Фев. 1, 2025

Abstract Context Despite prolactin´s (PRL) role in stimulating hematopoiesis, anemia is commonly observed men with macroprolactinomas. However, hematological changes microprolactinomas and women prolactinomas remain unexplored, the impact of erythropoietic alterations on quality life (QoL) still unclear. Objective To explore sex-related red blood cell (RBC) parameters their potential QoL at initial diagnosis prolactinoma after normalization PRL under dopamine agonists. Design Retrospective, monocentric study involving 205 patients (127 women, 62%). The SF-36 questionnaire was administered to 57 34 men. Results In no significant RBC were or normalization, regardless adenoma size. Conversely, microprolactinoma showed a increase hematocrit (HCT) hemoglobin (Hb) levels (median HCT 42.3 vs.44.0%; Hb 14.5 vs. 15.1 g/dL; both p < 0.005). Men macroprolactinoma exhibited similar improvements (HCT 40.2 43.9%; 14.0 0.0001). men, hypogonadism 73% baseline, 11% normalization. male where energy improvement 50 60, 0.05). While not significantly impacting persistence negatively impacted all scores Conclusion Patients show sex-dependent parameters. Unlike exhibit decreased irrespective Of note, failure recover from affected

Язык: Английский

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Cardiometabolic complications after Cushing’s disease remission

Journal of Endocrinological Investigation, Год журнала: 2025, Номер unknown

Опубликована: Март 26, 2025

Язык: Английский

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The impact of hypercortisolism beyond metabolic syndrome on left ventricular performance: a myocardial work analysis

Cardiovascular Diabetology, Год журнала: 2025, Номер 24(1)

Опубликована: Март 21, 2025

Abstract Background and aims Endogenous Cushing's syndrome (CS) is characterized by an unfavorable cardiovascular (CV) metabolic risk profile, but the potential adverse effects of hypercortisolism on myocardial function are not well known. Myocardial Work analysis a new echocardiographic method that utilizes left ventricular pressure-strain loops to quantify cardiac performance independent afterload. Methods results In cross-sectional analysis, we compared four groups: patients with overt endogenous CS (n = 31, mean age 47 ± 12 years, 71% women), in long-term remission after medical cure (CS-LTR; n 49, 53 78% healthy subjects 439; 49 11 57% individuals 305, 59 10 37% women). Both patient groups exhibited CV pattern profile worse than better syndrome. Analyses adjusted for sex revealed higher Wasted both (median; quartiles: 105 mmHg%; 74, 147) CS-LTR (97 69, 158), respectively, when (75 54, 109, p < 0.01) or (95 mmHg%, 65, 136, 0.05), resulting compromised Efficiency ( 0.05). Conclusion Left beyond alterations found sharing equal factors remains so despite biochemical during LTR period. suited detect subtle yet clinically relevant differences between different phenotypes involvement.

Язык: Английский

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Impact of etiology, sex, diabetes mellitus and remission status on erythrocytic profile in patients with cushing’s syndrome: a large population database study

Pituitary, Год журнала: 2024, Номер 27(4), С. 389 - 402

Опубликована: Май 20, 2024

Язык: Английский

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Impact of etiology, sex, diabetes mellitus and remission status on erythrocytic profile in patients with Cushing’s syndrome: a large population database study

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Фев. 15, 2024

Purpose The study aimed to characterize the erythrocytic profile in patients with Cushing’s syndrome (CS) versus controls from normal population according etiology, sex, presence of diabetes mellitus (DM) and hypercortisolemia remission status. Methods This retrospective cohort analysis compared parameters between CS pituitary (CD) adrenal (aCS) etiology age, body mass index (BMI) socioeconomic status-matched a 1:5 ratio. Laboratory values at baseline were calculated as mean during year preceding diagnosis, over one thereafter. Results included 397 (68.26% female; age 51.11 ± 16.85 years) 1970 controls. Patients had significantly higher median levels hemoglobin (Hgb) (13.70 g/dL vs. 13.12 [p < 0.0001]) hematocrit (Hct) (41.64% 39.80% These differences observed for both CD aCS sexes. who attained Hgb Hct comparable (13.20 40.08% 13.20 39.98% controls). Meanwhile, those persistent/recurrent disease maintained elevated levels. comorbid DM similar but (p = 0.0419), while without showed 0.0001). Conclusion Our data illustrates that are directly influenced by glucocorticoid excess CS, normalize after remission. We have identified influence on first time.

Язык: Английский

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Medical Therapy of Endogenous Cushing’s Syndrome with Steroidogenesis Inhibitors: Treatment Rationale, Available Drugs, and Therapeutic Effects

Experimental and Clinical Endocrinology & Diabetes, Год журнала: 2024, Номер unknown

Опубликована: Апрель 30, 2024

Abstract Endogenous Cushing’s syndrome (CS) is a rare disease characterized by glucocorticoid excess. If inadequately treated, hypercortisolism can lead to increased morbidity and mortality. Surgical removal of the underlying tumor first-line treatment but sometimes not feasible or even contraindicated. Additionally, in cases with severe CS, rapid control may be required. In these scenarios, steroidogenesis inhibitors represent therapeutic alternative surgery. Over last years, knowledge broad effects per se number available drugs have increased. However, large comparative studies are still lacking. Accordingly, decision on which drug used certain patient clinical setting difficult. This review aims summarize main characteristics inhibitors.

Язык: Английский

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Comparison of clinical, hormonal, pathological and treatment outcomes of ectopic Cushing’s syndrome by sex: results of a multicenter study

Endocrine, Год журнала: 2024, Номер 86(3), С. 1148 - 1155

Опубликована: Сен. 17, 2024

Язык: Английский

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Amenorrhea as a presentation of Cushing’s syndrome

Endocrinology Diabetes and Metabolism Case Reports, Год журнала: 2024, Номер 2024(3)

Опубликована: Июль 1, 2024

Summary Menstrual cycle abnormalities are common in premenopausal females with Cushing’s syndrome, although the underlying mechanism is poorly understood. Signs and symptoms found syndrome overlap polycystic ovarian (PCOS). The patient a 33-year-old female previously diagnosed by gynecologist PCOS treated oral contraceptive pills (OCPs) for 2 years. She then discontinued her OCPs without consulting clinician, resulting amenorrhea 6 months, which she presented. also had of depression anxiety but no other signs except plethoric face. Initial lab work showed evidence central hypogonadism (low luteinizing hormone, follicle-stimulating estrogen), so complete anterior pituitary hormone workup was done. Her thyroid-stimulating low free T4 level. Prolactin level normal, surprisingly, AM cortisol high. revealed non-suppressed after 1 mg dexamethasone suppression test positive 24-h urine suppressed adrenocorticotrophic hormone. A CT scan adrenal glands left adenoma. underwent adrenalectomy, menstrual cycles became regular again, function has recovered. Learning points In Cushing's patients can have due to high levels, affect gonadotrophin levels. We encourage clinicians include differential diagnosis hypogonadism.

Язык: Английский

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An Overview of Cardiovascular Risk in Pituitary Disorders

Medicina, Год журнала: 2024, Номер 60(8), С. 1241 - 1241

Опубликована: Июль 30, 2024

Cardiovascular comorbidities owing to hormonal excess or deficiency are the main cause of mortality in patients with pituitary disorders. In Cushing's Disease, there is an increased prevalence cardiovascular diseases and/or risk factors including visceral obesity, insulin resistance, atherosclerosis, arterial hypertension, dyslipidaemia, hypercoagulability as well structural and functional changes heart, like cardiac hypertrophy left ventricle (LV) dysfunction. Notably, these demonstrate limited reversibility even after remission. Furthermore, acromegaly may manifest resistance but also heart changes, known "acromegalic cardiomyopathy". Patients prolactinomas aggravation metabolic parameters, dysregulation glucose lipid metabolism endothelial Hypopituitarism conventional replacement therapy contribute unhealthy status, which promotes atherosclerosis lead premature mortality. This review discusses literature on disorders increase physician awareness regarding this aspect management

Язык: Английский

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Prevalence and outcome of secondary hypogonadism in male patients with Cushing's syndrome and mild autonomous cortisol secretion

European Journal of Endocrinology, Год журнала: 2024, Номер 191(2), С. 232 - 240

Опубликована: Июль 29, 2024

Abstract Background Secondary hypogonadism (SH) is common in men with Cushing's syndrome (CS), but its impact on comorbidities largely unknown and longitudinal data are scarce. If SH also affects mild autonomous cortisol secretion (MACS) unknown. Methods We included 30 treatment-naïve adult CS 17 MACS diagnosed since 2012. Hypogonadism was based total testosterone (TT) concentrations &lt; 10.4 nmol/L age-specific cut-offs. Outcomes were compared to age- BMI-matched controls. In 20 remission of CS, a analysis conducted at 6, 12, 24 months. Results Men had significantly lower TT, bioavailable T, free T controls (P .0001) lowest ectopic CS. Likewise, TT At baseline, 93% 59% SH. Testosterone correlated negatively late night salivary serum pre- post-1 mg dexamethasone suppression test. Following successful surgery, increased = .001), normalising within 6 Despite normalisation, several RBC parameters remained even 2 years after surgery. Conclusions usually reversible The persisting changes observed need be further investigated larger cohorts longer follow-up durations.

Язык: Английский

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