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Terray A, Baussart B, Zins M, Goldberg M, Kab S, Cazabat L, Brière M, Brue T, Barraud S, Reznik Y, Christin-Maitre S, Illouz F, Raverot G, Young J, Raffin-Sanson ML, Hage M. Gonadotropic status in adult women with pituitary stalk interruption syndrome. Eur J Endocrinol 2024; 190:501-508. [PMID: 38857190 DOI: 10.1093/ejendo/lvae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/06/2024] [Accepted: 06/08/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Pituitary stalk interruption syndrome (PSIS) is a rare cause of congenital hypopituitarism. Limited data exist on the gonadotropic status and fertility of adult women with PSIS. Our study aims to describe pubertal development and the evolution of gonadotropic function and fertility in adult women with PSIS. DESIGN A retrospective multicentric French study. METHODS We described gonadotropic function in 56 adult women with PSIS from puberty onward. We compared live birth rates per woman with PSIS with age-matched controls from the large French epidemiological cohort (CONSTANCES). Additionally, we assessed height, body mass index (BMI), blood pressure, other metabolic parameters, and socioeconomic status. RESULTS AND CONCLUSIONS Among 56 women with PSIS, 36 did not experience spontaneous puberty. Of these, 13 underwent ovarian stimulation, resulting in 7 women having a total of 11 children. In the subgroup with spontaneous puberty (n = 20), 4 had a total of 8 pregnancies, while 6 developed secondary gonadotropic deficiency. Women with PSIS had fewer children than controls (0.33 vs 0.63, P = .04). Median height was also lower (160.5 vs 165.0 cm, P < .0001). Although mean blood pressure was lower in women with PSIS compared with controls (111.3/65.9 ± 11.2/8.1 vs 118.7/72.1 ± 10.1/7.7 mmHg, P < .001), there were no significant differences in other metabolic parameters, notably BMI and lipid profile. Employment/academic status was not different in the 2 groups, but fewer women with PSIS were in relationships (42% vs 57.6% in controls, P = .02). The fertility prognosis in patients with PSIS needs optimization. Patients should be informed about the likelihood of declining gonadotropic function over time.
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Affiliation(s)
- Aglaé Terray
- Department of Endocrinology, Diabetology and Nutrition, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, F-92100 Boulogne Billancourt, France
- EA4340, Université de Versailles Saint-Quentin-en-Yvelines, UFR des Sciences de la Santé Simone Veil, F-78423 Montigny-le-Bretonneux, France
| | - Bertrand Baussart
- Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, La Pitié-Salpêtrière University Hospital, F-75013 Paris, France
- Université Paris Cité, CNRS, INSERM, Institut Cochin, F-75014 Paris, France
| | - Marie Zins
- UMS 011, Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, F-94800 Villejuif, France
| | - Marcel Goldberg
- UMS 011, Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, F-94800 Villejuif, France
| | - Sofiane Kab
- UMS 011, Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, F-94800 Villejuif, France
| | - Laure Cazabat
- UMR 1198 BREED, équipe RHuMA, UFR Simone Veil Santé, Université Versailles Saint Quentin en Yvelines, F-78423 Montigny-le-Bretonneux, France
- Service de Neurochirurgie, Hôpital Foch, F-92150 Suresnes, France
| | - Mathilde Brière
- Department of Endocrinology, Diabetology and Nutrition, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, F-92100 Boulogne Billancourt, France
| | - Thierry Brue
- Aix Marseille Université, APHM, INSERM, MMG, MarMaRa, F-13305 Marseille, France
- Department of Endocrinology, Reference Center for Rare Pituitary Diseases HYPO, La Conception University Hospital, AP-HM, F-13305 Marseille, France
| | - Sara Barraud
- Department of Endocrinology Diabetes Nutrition, University of Reims Champagne-Ardenne, Reims University Hospital, CRESTIC, F-51092 Reims, France
| | - Yves Reznik
- Department of Endocrinology, Côte de Nacre University Hospital, F 14033 Caen, France
| | - Sophie Christin-Maitre
- Department of Endocrinology, Saint-Antoine Hospital, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance Publique-Hôpitaux de Paris, ER9 University Pierre et Marie Curie, F-75005 Paris, France
| | - Frédéric Illouz
- Department of Endocrinology, Reference Center for Rare Pituitary Diseases HYPO, Angers University Hospital, F-49000 Angers, France
| | - Gérald Raverot
- Department of Endocrinology, "Groupement Hospitalier Est" Hospices Civils de Lyon, Reference Center for Rare Pituitary Diseases HYPO, F-69500 Bron, France
| | - Jacques Young
- Department of Endocrinology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Pituitary Diseases HYPO, F-94270 Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, F-94270 Le Kremlin-Bicêtre, France
| | - Marie-Laure Raffin-Sanson
- Department of Endocrinology, Diabetology and Nutrition, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, F-92100 Boulogne Billancourt, France
- EA4340, Université de Versailles Saint-Quentin-en-Yvelines, UFR des Sciences de la Santé Simone Veil, F-78423 Montigny-le-Bretonneux, France
| | - Mirella Hage
- Department of Endocrinology, Diabetology and Nutrition, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, F-92100 Boulogne Billancourt, France
- EA4340, Université de Versailles Saint-Quentin-en-Yvelines, UFR des Sciences de la Santé Simone Veil, F-78423 Montigny-le-Bretonneux, France
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Gangitano E, Barbaro G, Susi M, Rossetti R, Spoltore ME, Masi D, Tozzi R, Mariani S, Gnessi L, Lubrano C. Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study. Cells 2022; 11:cells11152420. [PMID: 35954264 PMCID: PMC9367721 DOI: 10.3390/cells11152420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 12/10/2022] Open
Abstract
Obesity is associated with increased cardiovascular morbidity. Adult patients with growth hormone deficiency (GHD) show morpho-functional cardiological alterations. A total of 353 overweight/obese patients are enrolled in the period between 2009 and 2019 to assess the relationships between GH secretory capacity and the metabolic phenotype, cardiovascular risk factors, body composition and cardiac echocardiographic parameters. All patients underwent GHRH + arginine test to evaluate GH secretory capacity, DEXA for body composition assessment and transthoracic echocardiography. Blood samples are also collected for the evaluation of metabolic parameters. In total, 144 patients had GH deficiency and 209 patients had normal GH secretion. In comparing the two groups, we found significant differences in body fat distribution with predominantly visceral adipose tissue accumulation in GHD patients. Metabolic syndrome is more prevalent in the GHD group. In particular, fasting glycemia, triglycerides and systolic and diastolic blood pressure are found to be linearly correlated with GH secretory capacity. Epicardial fat thickness, E/A ratio and indexed ventricular mass are worse in the GHD group. In the population studied, metabolic phenotype, body composition, cardiovascular risk factors and cardiac morphology are found to be related to the GH secretory capacity. GH secretion in the obese patient seems to be an important determinant of metabolic health.
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Affiliation(s)
- Elena Gangitano
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Giuseppe Barbaro
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Martina Susi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Rebecca Rossetti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Maria Elena Spoltore
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Davide Masi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Rossella Tozzi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Stefania Mariani
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Carla Lubrano
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
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Aali Y, Ebrahimi S, Shiraseb F, Mirzaei K. The association between dietary polyphenol intake and cardiometabolic factors in overweight and obese women: a cross-sectional study. BMC Endocr Disord 2022; 22:120. [PMID: 35538570 PMCID: PMC9088119 DOI: 10.1186/s12902-022-01025-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 04/19/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The previous evidence shows that there is an association between total dietary polyphenols intake (DPI) and its subclasses and lower risk of metabolic Syndrome (MetS). This cross-sectional study aims to evaluate associations between DPI and cardiometabolic factors in Iranian women. METHODS A total of 404 Iranian women were included in this study. Dietary intakes and polyphenols intakes were measured using a validated semi-quantitative food frequency questionnaire (FFQ) and the Phenol-Explorer database, respectively. Biochemical variables and blood pressure were evaluated using Pars Azmoon kits and mercury sphygmomanometer. RESULTS The mean intake of total polyphenol was 2533.96 ± 1223.67 g. While there were significant negative associations between stilbenes and lignans intake and body mass index (BMI) (P-value = 0.04; P-value = 0.02, respectively), beverages containing phenolic acids and hip circumference (HC) (P-value = 0.02), total polyphenols intake and weight to hip ratio (WHR) (P-value = 0.04). Also there was significant negative associations between stilbenes intake and cholesterol (CHOL) level (P-value = 0.03), other polyphenols intake and triglyceride (TG) ((P-value = 0.01), lignan intake and homeostasis model assessment insulin resistance (HOMA-IR) (P-value = 0.03). CONCLUSION These findings demonstrated that dietary polyphenols were associated with cardiometabolic factors in Iranian women. Prospective and interventional studies in both genders, different populations and ethnicities need to be conducted to further the knowledge about examine associations between consumption of polyphenols and metabolic component.
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Affiliation(s)
- Yasaman Aali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Sara Ebrahimi
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
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Rissetti G, Zeni D, Ongaratti BR, Pereira-Lima JFS, Rech CGSL, da Costa Oliveira M. Lipid profile and response to statin therapy in patients with hypopituitarism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 64:673-678. [PMID: 33049128 PMCID: PMC10528624 DOI: 10.20945/2359-3997000000292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Dyslipidemia is prevalent among patients with hypopituitarism, especially in those with growth hormone (GH) deficiency. This study aimed to evaluate the response to statin therapy among adult patients with dyslipidemia and hypopituitarism. METHODS A total of 113 patients with hypopituitarism following up at a neuroendocrinology unit were evaluated for serum lipid levels. Dyslipidemia was diagnosed in 72 (63.7%) of these patients. A control group included 57 patients with dyslipidemia and normal pituitary function. The distribution of gender, age, weight, and dyslipidemia type was well balanced across both groups, and all participants were treated with simvastatin at doses adjusted to obtain normal lipid levels. RESULTS Patients with hypopituitarism and dyslipidemia presented deficiency of TSH (69%), gonadotropins (69%), ACTH (64%), and GH (55%) and had a similar number of deficient pituitary axes compared with patients with hypopituitarism but without dyslipidemia. All patients with dyslipidemia (with and without hypopituitarism) had lipid levels well controlled with doses of simvastatin ranging from 20-40 mg/day. The mean daily dose of simvastatin was not significantly different between patients with and without hypopituitarism (26.7 versus 23.5 mg, p = 0.10). Similarly, no significant variation in simvastatin dose was observed between patients with different causes of hypopituitarism, presence or absence of GH deficiency, number of deficient pituitary axes, prior pituitary radiation therapy or not, and presence or absence of obesity. CONCLUSION Patients with GH deficiency without GH replacement showed good response to simvastatin at a mean dose equivalent to that used in individuals with dyslipidemia and normal pituitary function.
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Affiliation(s)
- Graziela Rissetti
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
- Centro de Neuroendocrinologia, Complexo Hospitalar Santa Casa, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Débora Zeni
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
- Centro de Neuroendocrinologia, Complexo Hospitalar Santa Casa, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Bárbara Roberta Ongaratti
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Júlia Fernanda Semmelmann Pereira-Lima
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
- Centro de Neuroendocrinologia, Complexo Hospitalar Santa Casa, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Carolina Garcia Soares Leães Rech
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
- Centro de Neuroendocrinologia, Complexo Hospitalar Santa Casa, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Miriam da Costa Oliveira
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
- Centro de Neuroendocrinologia, Complexo Hospitalar Santa Casa, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil,
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5
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Ebrahimi F, Kutz A, Wagner U, Illigens B, Siepmann T, Schuetz P, Christ-Crain M, Mueller B, Christ ER. Excess Mortality Among Hospitalized Patients With Hypopituitarism-A Population-Based, Matched-Cohort Study. J Clin Endocrinol Metab 2020; 105:5891746. [PMID: 32785679 DOI: 10.1210/clinem/dgaa517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/09/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Patients with hypopituitarism face excess mortality in the long-term outpatient setting. However, associations of pituitary dysfunction with outcomes in acutely hospitalized patients are lacking. OBJECTIVE The objective of this work is to assess clinical outcomes of hospitalized patients with hypopituitarism with or without diabetes insipidus (DI). DESIGN, SETTING, AND PATIENTS In this population-based, matched-cohort study from 2012 to 2017, hospitalized adult patients with a history of hypopituitarism were 1:1 propensity score-matched with a general medical inpatient cohort. MAIN OUTCOME MEASURES The primary outcome was in-hospital mortality. Secondary outcomes included all-cause readmission rates within 30 days and 1 year, intensive care unit (ICU) admission rates, and length of hospital stay. RESULTS After matching, 6764 cases were included in the study. In total, 3382 patients had hypopituitarism and of those 807 (24%) suffered from DI. All-cause in-hospital mortality occurred in 198 (5.9%) of patients with hypopituitarism and in 164 (4.9%) of matched controls (odds ratio [OR] 1.32, [95% CI, 1.06-1.65], P = .013). Increased mortality was primarily observed in patients with DI (OR 3.69 [95% CI, 2.44-5.58], P < .001). Patients with hypopituitarism had higher ICU admissions (OR 1.50 [95% CI, 1.30-1.74], P < .001), and faced a 2.4-day prolonged length of hospitalization (95% CI, 1.94-2.95, P < .001) compared to matched controls. Risk of 30-day (OR 1.31 [95% CI, 1.13-1.51], P < .001) and 1-year readmission (OR 1.29 [95% CI, 1.17-1.42], P < .001) was higher among patients with hypopituitarism as compared with medical controls. CONCLUSIONS Patients with hypopituitarism are highly vulnerable once hospitalized for acute medical conditions with increased risk of mortality and adverse clinical outcomes. This was most pronounced among those with DI.
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Affiliation(s)
- Fahim Ebrahimi
- Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel, Basel, Switzerland
- University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland
| | - Alexander Kutz
- Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel, Basel, Switzerland
- Division of Endocrinology, Diabetes, and Metabolism, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Ulrich Wagner
- Foundation National Institute for Cancer Epidemiology and Registration (NICER) University of Zurich, Zurich, Switzerland
| | - Ben Illigens
- Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Dresden International University, Dresden, Germany
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Timo Siepmann
- Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Dresden International University, Dresden, Germany
- Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Philipp Schuetz
- Division of Endocrinology, Diabetes, and Metabolism, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Mirjam Christ-Crain
- Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Beat Mueller
- Division of Endocrinology, Diabetes, and Metabolism, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Emanuel R Christ
- Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
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Abe SY, Dos Santos KS, Barbosa BFB, Biondo CMP, Takito D, Hayashi SK, Amarilla VGV, Ulbrich AZ, Boguszewski CL. Metabolic syndrome and its components in adult hypopituitary patients. Pituitary 2020; 23:409-416. [PMID: 32418172 DOI: 10.1007/s11102-020-01048-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the prevalence of metabolic syndrome (MetS) and its components in adult hypopituitary patients. PATIENTS AND METHODS Retrospective, cross-sectional analysis of a cohort of hypopituitary adult patients followed in a single reference center for pituitary diseases. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Patients with 18 years or older, presenting two or more anterior pituitary deficiencies associated or not with diabetes insipidus (DI), were included, while patients with hypopituitarism due to Acromegaly or Cushing's disease were excluded. RESULTS We studied 99 hypopituitary patients (52 males, mean age 50.1 ± 16.3 years, mean age at diagnosis 33.7 ± 17.6 years) who have been followed for a mean time of 15.9 ± 10.1 years. Hypothalamic-pituitary tumors and non-tumoral etiologies were observed in 53.4% and 46.6% of the cases, respectively. FSH/LH, GH, TSH, ACTH deficiency and DI was present in 99%, 98.6%, 96%, 81.8%, and 23.2%, respectively. The prevalence of MetS was 39.4% and was significantly higher in patients older than 50 years (p = 0.02), overweight/obese (p < 0.001), with hypopituitarism diagnosed in adult life (p = 0.02), who did not replace GH (p = 0.004) and in smokers (p = 0.007). In the logistic regression model, body mass index (BMI) and GH replacement were significantly associated with the presence of MetS. Reduced HDL cholesterol was the most prevalent component of MetS in hypopituitary patients. CONCLUSIONS MetS is a common finding in adult hypopituitary patients, which is mainly influenced by increased BMI and untreated GH deficiency. Trial Registration number (Plataforma Brasil): CAAE 51008815.2.0000.0096 (May 31, 2017) .
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Affiliation(s)
- Simone Yae Abe
- Center for Health Science, Medical School, Federal University of Parana, Curitiba, Brazil
| | | | | | | | - Débora Takito
- Center for Health Science, Medical School, Federal University of Parana, Curitiba, Brazil
| | - Sayuri Kuhnen Hayashi
- Center for Health Science, Medical School, Federal University of Parana, Curitiba, Brazil
| | | | - Anderson Zampier Ulbrich
- Research Group of Exercise Medicine, Department of Integrative Medicine, Federal University of Parana, Curitiba, Brazil
| | - Cesar Luiz Boguszewski
- SEMPR (Endocrine Division), Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil.
- Serviço de Endocrinologia e Metabologia do Hospital de Clínicas da Universidade Federal do Paraná, Agostinho Leão Junior 285, Curitiba, PR, 80030-110, Brazil.
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7
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Kim JH, Chae HW, Chin SO, Ku CR, Park KH, Lim DJ, Kim KJ, Lim JS, Kim G, Choi YM, Ahn SH, Jeon MJ, Hwangbo Y, Lee JH, Kim BK, Choi YJ, Lee KA, Moon SS, Ahn HY, Choi HS, Hong SM, Shin DY, Seo JA, Kim SH, Oh S, Yu SH, Kim BJ, Shin CH, Kim SW, Kim CH, Lee EJ. Diagnosis and Treatment of Growth Hormone Deficiency: A Position Statement from Korean Endocrine Society and Korean Society of Pediatric Endocrinology. Endocrinol Metab (Seoul) 2020; 35:272-287. [PMID: 32615711 PMCID: PMC7386113 DOI: 10.3803/enm.2020.35.2.272] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/23/2020] [Indexed: 12/29/2022] Open
Abstract
Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.
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Affiliation(s)
- Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul,
Korea
| | - Sang Ouk Chin
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul,
Korea
| | - Cheol Ryong Ku
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
Korea
| | - Kyeong Hye Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - Dong Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kwang Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
Korea
| | - Jung Soo Lim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju,
Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Yun Mi Choi
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong,
Korea
| | - Seong Hee Ahn
- Department of Endocrinology, Inha University School of Medicine, Incheon,
Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Yul Hwangbo
- Department of Internal Medicine, National Cancer Center, Goyang,
Korea
| | - Ju Hee Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Bu Kyung Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan,
Korea
| | - Yong Jun Choi
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon,
Korea
| | - Kyung Ae Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju,
Korea
| | - Seong-Su Moon
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju,
Korea
| | - Hwa Young Ahn
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Hoon Sung Choi
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon,
Korea
| | - Sang Mo Hong
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong,
Korea
| | - Dong Yeob Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
Korea
| | - Ji A Seo
- Division of Endocrinology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan,
Korea
| | - Se Hwa Kim
- Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon,
Korea
| | - Seungjoon Oh
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul,
Korea
| | - Sung Hoon Yu
- Department of Endocrinology and Metabolism, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri,
Korea
| | - Byung Joon Kim
- Division of Endocrinology, Department of Internal Medicine, Gachon University College of Medicine, Incheon,
Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul,
Korea
| | - Sung-Woon Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul,
Korea
| | - Chong Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon,
Korea
| | - Eun Jig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
Korea
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8
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Association between Use of Nutritional Labeling and the Metabolic Syndrome and Its Components. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224486. [PMID: 31739478 PMCID: PMC6888637 DOI: 10.3390/ijerph16224486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/09/2019] [Accepted: 11/10/2019] [Indexed: 12/18/2022]
Abstract
In this study, we looked into the association between the diagnosis of metabolic syndrome (MetS) and nutritional label awareness. This study used data from the Korea National Health and Nutritional Examination Survey (KNHANES) for the years 2007 to 2015. The study population consisted of a total of 41,667 Koreans of which 11,401 (27.4%) were diagnosed with metabolic syndrome and 30,266 (72.6%) were not. Groups not using nutritional labeling had a 24% increase in odds risk (OR: 1.24, 95% CI 1.14-1.35) of MetS compared to groups using nutritional labeling. Use of nutritional labeling was associated with all components of MetS. Central obesity showed the highest increase in odds risk (OR: 1.23, 95% CI 1.13-1.35) and high blood pressure showed the lowest increase in odds risk (OR: 1.11, 95% CI 1.02-1.20). Subgroup analysis revealed that statistically significant factors were smoking status, drinking status and stress status. Groups that smoke, groups that do not drink and groups with high stress were more vulnerable to MetS when not using nutritional labeling. People not using food labels tends to develop metabolic syndromes more than people using foods labels. In the subgroup analysis, drinking status, smoking status and stress status were significant factors.
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9
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Dietary Total Antioxidant Capacity and Dietary Polyphenol Intake and Prevalence of Metabolic Syndrome in Polish Adults: A Nationwide Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:7487816. [PMID: 29770169 PMCID: PMC5892227 DOI: 10.1155/2018/7487816] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/28/2018] [Accepted: 02/18/2018] [Indexed: 01/08/2023]
Abstract
Specific classes and subclasses of polyphenols have been studied for their potential effects on noncommunicable diseases, but studies on association between dietary polyphenol intake (DPI) and dietary total antioxidant capacity (DTAC) and MetS (metabolic syndrome) are scarce. Therefore, the aim of this study was to determine associations between DTAC and DPI and the prevalence of MetS and its components in the Polish adult population. Subjects (5690) were participants of the Polish National Multicentre Health Examination Survey (WOBASZ II study) performed in 2013-2014. MetS was defined according to the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria. Daily food consumption was assessed by 24-hour dietary recall. DTAC and DPI were evaluated using the data of food consumption and antioxidant potential of foods, measured by FRAP (ferric reducing antioxidant potential) method, and total polyphenol content in foods, measured by Folin-Ciocalteu assay. Logistic regression models were used to assess the relationship between DTAC and DPI and MetS and its components. Crude, age-adjusted, and multivariable-adjusted models were performed. This study demonstrated that in Polish women, high DPI and high DTAC were significantly associated with a reduced odds ratio for the prevalence of MetS components, such as elevated blood pressure and diabetes. In contrast, in men, high DPI and high DTAC did not have the potential to alleviate MetS components.
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10
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Increased Cardiovascular Risk in Patients with Adrenal Insufficiency: A Short Review. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3691913. [PMID: 29376070 PMCID: PMC5742446 DOI: 10.1155/2017/3691913] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/06/2017] [Accepted: 11/15/2017] [Indexed: 11/18/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of death in the world. Recent studies have shown an association between adrenal insufficiency (AI) and increased cardiovascular risk (CVR). Patients with AI receive glucocorticoid (GC) replacement therapy which can lead to varying levels of blood cortisol. It was shown that these imbalances in blood cortisol may lead to a higher prevalence of coronary heart disease, major adverse coronary events, and increased mortality. GC substitution is essential in the treatment of AI without which the disease has been shown to be fatal. The most frequently used GC formula for replacement therapy is hydrocortisone (HC). There is no uniform opinion on hydrocortisone replacement therapy. Alternative GC such as prednisolone is also in use. Overreplacement of GC may lead to adverse effects including obesity, high blood pressure, and hyperglycaemia. Outcome may vary between primary and secondary AI mainly due to differences in the renin-angiotensin-aldosterone system (RAAS). Furthermore, decreased blood levels of cortisol may lead to a compensatory secretion of inflammatory mediators such as Interleukin-1 (IL-1), Interleukin-6 (IL-6), and/or tumor-necrosis factor (TNF). Physicians and patients should be properly educated about the increased risk of CVD in patients with AI.
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11
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Martínez-Torres J, Correa-Bautista JE, González-Ruíz K, Vivas A, Triana-Reina HR, Prieto-Benavidez DH, Carrillo HA, Ramos-Sepúlveda JA, Villa-González E, García-Hermoso A, Ramírez-Vélez R. A Cross-Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E233. [PMID: 28264459 PMCID: PMC5369069 DOI: 10.3390/ijerph14030233] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/16/2017] [Accepted: 02/21/2017] [Indexed: 02/06/2023]
Abstract
Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.
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Affiliation(s)
- Javier Martínez-Torres
- Grupo GICAEDS, Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá DC 110311, Colombia.
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC 110231, Colombia.
| | - Andrés Vivas
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC 110231, Colombia.
| | - Héctor Reynaldo Triana-Reina
- Grupo GRINDER, Programa de Educación Física y Deportes, Universidad del Valle, Santiago de Cali DC 760010, Colombia.
| | - Daniel Humberto Prieto-Benavidez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - Hugo Alejandro Carrillo
- Grupo GRINDER, Programa de Educación Física y Deportes, Universidad del Valle, Santiago de Cali DC 760010, Colombia.
| | - Jeison Alexander Ramos-Sepúlveda
- Facultad de Educación a Distancia y Virtual, Institución Universitaria Antonio José Camacho, Santiago de Cali DC 760010, Colombia.
| | - Emilio Villa-González
- Department of Education Sciences, University of Almería, Almería DC 04120, Spain.
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada DC 18010, Spain.
| | - Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago DC 9160030, Chile.
| | - Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
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12
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Yang SA. Association study between growth hormone receptor ( GHR ) gene polymorphisms and obesity in Korean population. J Exerc Rehabil 2016. [PMID: 28119888 PMCID: PMC5227328 DOI: 10.12965//jer.1632844.422] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A main target of growth hormone (GH) is adipose tissue in human body. The GH secretion in obesity patients is impaired. It is needless to say that growth hormone receptor (GHR) is necessary in GH hormone signaling. The purpose of the present study is to examine the association between single nucleotide polymorphisms (SNPs) and the development of obesity. A total of 211 overweight/obese subjects with a body mass index (BMI) ≥23 kg/m2 and 157 nonoverweight/obese controls with a BMI of 18.5–23.0 kg/m2 were involved in this study. Seven SNPs including the rs6451620 (intron), rs4130114 (intron), rs4410646 (intron), rs6898743 (intron), rs4394131 (intron), rs6182 (Cys440Phe), and rs6184 (Pro579Thr) and rs2229765 SNPs of GHR gene were genotyped. Genotyping was performed using custom DNA chip. SNPStats was used to calculate the odds ratio, 95% confidence interval, and P-value. The link-age disequilibrium block and haplotypes among seven SNPs were determined using Haploview version 4.2. Dominant, recessive, and log-additive genetic models were conducted for genetic analyzing. Among tested SNPs in GHR gene, rs4410646 and rs6898743 showed significant association with obesity (rs4410646, P=0.02 in dominant model and P=0.036 in log-additive model; rs6898743, P=0.039 in dominant model and P=0.044 in log-additive model). In summary, these results suggest that GHR gene polymorphisms might play a role in the development of obesity in the Korean population.
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Affiliation(s)
- Seung-Ae Yang
- College of Nursing, Sungshin Women's University, Seoul, Korea
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