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Coskun M, Sendur HN, Babayeva A, Cerit MN, Cerit ET, Yalcin MM, Altinova AE, Akturk M, Karakoc MA, Toruner FB. Quantitative ultrasound techniques and biochemical markers to assess liver steatosis and fibrosis in newly diagnosed acromegaly. J Endocrinol Invest 2024; 47:2823-2833. [PMID: 38709454 PMCID: PMC11473633 DOI: 10.1007/s40618-024-02384-5] [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: 12/30/2023] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE The liver is known to be protected from steatosis under the influence of high GH/IGF-1. Cytokeratin 18 (CK18) and insulin-like growth factor binding protein 7 (IGFBP7) increase in liver steatosis and fibrosis. The aim of this study was to use quantitative ultrasound techniques and biochemical markers to assess liver steatosis and liver fibrosis in newly diagnosed acromegaly. METHODS This single-center, cross-sectional study included 23 patients with newly diagnosed acromegaly and 46 age, sex, body mass index (BMI) and waist circumference (WC)-matched controls. Liver steatosis was assessed using tissue attenuation imaging (TAI), and stiffness, indicative of fibrosis, was assessed by shear wave elastography (SWE). Serum IGFBP7 and CK18 were studied by ELISA. RESULTS The acromegaly group had significantly lower liver steatosis (p = 0.006) and higher liver stiffness (p = 0.004), serum IGFBP7 (p = 0.048) and CK18 (p = 0.005) levels than the control group. The presence of fibrosis (p = 0.012) was significantly higher in the acromegaly group than in the control group. Moreover, CK18 was positively correlated with liver stiffness, WC, HOMA-IR, HbA1c, and triglyceride. In the acromegaly group, liver steatosis was negatively correlated with GH level. Stepwise multiple linear regression analysis revealed that BMI (p = 0.008) and CK18 (p = 0.015) were independent risk factors for increased liver stiffness. CONCLUSION This study showed that there was an increased presence of liver fibrosis independent of liver steatosis in newly diagnosed acromegaly. Serum CK18 appears to be a potential marker of increased liver fibrosis in acromegaly.
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Affiliation(s)
- M Coskun
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - H N Sendur
- Department of Radiology, Faculty of Medicine, Gazi University, 06100, Ankara, Turkey
| | - A Babayeva
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - M N Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, 06100, Ankara, Turkey
| | - E T Cerit
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - M M Yalcin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - A E Altinova
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - M Akturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - M A Karakoc
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - F B Toruner
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
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Arici FN, Gulumsek E, Ozturk HA, Avci BS, Sumbul HE. The relationship between morning blood pressure surge and serum IGF-1 level in acromegaly patients with hypertension. Ir J Med Sci 2024; 193:233-240. [PMID: 37498476 DOI: 10.1007/s11845-023-03478-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 07/24/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE High levels of insulin-like growth factor 1 (IGF-1) in patients with acromegaly cause structural and functional changes specific to the disease. These changes lead to mortality if the disease is not treated. Circadian blood pressure (BP) rhythm as measured by 24-h ambulatory blood pressure monitoring (ABPM) can change with a decrease in BP during sleep and a sudden increase in wakefulness. AIM We aim to evaluate the relationship between changes in BP and IGF-1 levels in patients with acromegaly. METHODS Patients who were diagnosed with acromegaly and the patient group with hypertension were included. Serum biochemistry parameters, serum IGF-1 level and ABPM follow-ups were compared in these patients. RESULTS In our study, 30 patients with acromegaly and 30 patients with hypertension without acromegaly were included. Thirty of the patients were male and 30 were female. There was a statistically significant difference between the groups in terms of IGF-1(p = < 0.001) and GH(p = 0.004). There was no significant difference between patients' office systolic/diastolic BP measurements, day/night, systolic/diastolic BP measurements and all systolic/diastolic BP measurements in ambulatory blood pressure follow-ups. There was a significant difference in morning blood pressure surge(p = < 0.001). A statistically significant difference was found between the acromegaly patient groups with MBPS below and above 25 mmHg in terms of IGF-1 (p = 0.025) and platelet levels (p = 0.004). CONCLUSION As a result, cardiovascular disease risks can be predicted in patients with high serum IGF-1 levels by planning ambulatory blood pressure in the early period.
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Affiliation(s)
- Fatih Necip Arici
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Dr. Mithat Özsan Bulvarı Kısla Neighbourhood 4522 Street No: 1 Yuregir, Adana, Turkey
| | - Erdinc Gulumsek
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Dr. Mithat Özsan Bulvarı Kısla Neighbourhood 4522 Street No: 1 Yuregir, Adana, Turkey
| | - Huseyin Ali Ozturk
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Dr. Mithat Özsan Bulvarı Kısla Neighbourhood 4522 Street No: 1 Yuregir, Adana, Turkey
| | - Begum Seyda Avci
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Dr. Mithat Özsan Bulvarı Kısla Neighbourhood 4522 Street No: 1 Yuregir, Adana, Turkey
| | - Hilmi Erdem Sumbul
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Dr. Mithat Özsan Bulvarı Kısla Neighbourhood 4522 Street No: 1 Yuregir, Adana, Turkey.
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Coskun M, Sendur HN, Cerit MN, Babayeva A, Cerit ET, Yalcin MM, Altinova AE, Akturk M, Karakoc MA, Toruner FB. Assessment of forearm muscles with ultrasound shear wave elastography in patients with acromegaly. Pituitary 2023; 26:716-724. [PMID: 37899388 DOI: 10.1007/s11102-023-01352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE The effects of acromegaly on soft tissues, bones and joints are well-documented, but information on its effects on muscle mass and quality remains limited. The primary goal of this study is to assess the sonoelastographic features of forearm muscles in patients with acromegaly. METHOD Forty-five patients with acromegaly and 45 healthy controls similar in terms of gender, age, and body mass index (BMI) were included in a single-center, multidisciplinary, cross-sectional study. The body composition was analyzed using bioelectrical impedance analysis (BIA), and height-adjusted appendicular skeletal muscle index (hSMI) was calculated. The dominant hand's grip strength was also measured. Two radiologists specialized in the musculoskeletal system employed ultrasound shear wave elastography (SWE) to assess the thickness and stiffness of brachioradialis and biceps brachii muscles. RESULTS The acromegaly group had significantly higher thickness of both the biceps brachii (p = 0.034) and brachioradialis muscle (p = 0.046) than the control group. However, the stiffness of the biceps brachii (p = 0.001) and brachioradialis muscle (p = 0.001) was lower in the acromegaly group than in the control group. Disease activity has not caused a significant difference in muscle thickness and stiffness in the acromegaly group (p > 0.05). The acromegaly group had a higher hSMI (p = 0.004) than the control group. The hand grip strength was similar between the acromegaly and control group (p = 0.594). CONCLUSION The patients with acromegaly have an increased muscle thickness but decreased muscle stiffness in the forearm muscles responsible for elbow flexion. Acromegaly can lead to a permanent deterioration of the muscular structure regardless of the disease activity.
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Affiliation(s)
- Meric Coskun
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey.
| | - Halit Nahit Sendur
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey
| | - Afruz Babayeva
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Ethem Turgay Cerit
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mehmet Muhittin Yalcin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Alev Eroglu Altinova
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mujde Akturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mehmet Ayhan Karakoc
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Fusun Balos Toruner
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
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Koca SB, Seber T. Factors Affecting Thyroid Elastography in Healthy Children and Patients with Hashimoto’s Thyroiditis. J Clin Res Pediatr Endocrinol 2023; 15:7-15. [PMID: 35984228 PMCID: PMC9976168 DOI: 10.4274/jcrpe.galenos.2022.2022-4-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Hashimoto’s thyroiditis (HT) is the most common form of thyroiditis in childhood. In addition to thyroid ultrasonography, shear-wave elastography (SWE) can evaluate thyroid parenchyma tissue stiffness, and more detailed findings can be obtained with this method. We aimed to evaluate the relationship between SWE values and clinical, biochemical and hormonal parameters of patients with HT and in healthy individuals. METHODS We compared 46 newly diagnosed HT cases with 46 healthy controls. We examined the effect of all metabolic parameters and thyroid-related markers on SWE values. RESULTS The mean SWE values in those patients with euthyroid HT were 12.5±5.1 kilopascal (kPa), whereas it was 8.2±2.82 kPa in healthy controls (p<0.001). Although the clinical [age, gender and body mass index (BMI)] and laboratory parameters (such as thyroid function tests, homeostasis model assessment of insulin resistance, insulin-like growth factor-1 values, which we think may affect SWE scores) of those children with HT and the healthy controls were statistically similar (p>0.05), except for their thyroid autoantibodies and thyroglobulin, SWE values and thyroid volume were significantly higher in those individuals with HT (p<0.001). Multiple linear regression analysis was performed to evaluate the direction and degree of the effect of the variables on thyroid elasticity scores. It was observed that age (p=0.002), BMI standard deviation score (SDS) (p=0.04) and anti-thyroid peroxidase (p=0.008) levels were effective on the thyroid elasticity score in the regression model. We detected a SWE cut-off value of 9.68 kPa with 68% sensitivity and 72% specificity, a 70% positive predictive value, and a 69% negative predictive value in thyroid elastography when differentiating between cases with HT and healthy controls. CONCLUSION Our results show that no metabolic factor other than BMI SDS has any effect on SWE scores, especially in healthy children. There was a positive correlation between BMI SDS and SWE in healthy children (r=0.353; p=0.02), but not in those patients with HT (r=0.196; p=0.19). Likewise, age is another factor affecting SWE only in healthy children. We do not recommend routine evaluation of any laboratory parameters other than thyroid functions before thyroid elastography.
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Affiliation(s)
- Serkan Bilge Koca
- University of Health Sciences Turkey, Kayseri City Hospital, Clinic of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey,* Address for Correspondence: University of Health Sciences Turkey, Kayseri City Hospital, Clinic of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey Phone: +90 537 320 56 41 E-mail:
| | - Turgut Seber
- University of Health Sciences Turkey, Kayseri City Hospital, Clinic of Radiology, Division of Pediatric Radiology, Kayseri, Turkey
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Düğer H, Kızılgül M, Akhanlı P, Çalapkulu M, Bostan H, Hepşen S, Gül Ü, Sencar ME, Çakal E, Uçan B. The role of elastography in the assessment of thyroid nodules in acromegaly. Turk J Med Sci 2023; 53:303-309. [PMID: 36945936 PMCID: PMC10388051 DOI: 10.55730/1300-0144.5585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 12/21/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Nodular thyroid disease is a frequent finding seen in patients with acromegaly. Ultrasound-elastography (US-E) appears to be a helpful tool for the diagnosis of thyroid cancer. The aims of this study were to evaluate thyroid nodules in acromegaly and to assess the diagnostic accuracy of US-E in detecting thyroid cancer in this population. METHODS US-E was applied to 166 nodules detected in 102 acromegalic patients and to 105 nodules found in 95 nonacromegalic subjects. The lesions were classified according to the elasticity scores (ES) as soft (ES 1-2) or hard (ES 3-4). RESULTS : Mean age was 55.1 ± 12.47 years [59 (58%) women]. The prevalence of hard nodules (ES 3 and 4) was significantly higher in the group of acromegalic patients than in control subjects (48% to 20%, p < 0.001). Mean ES was higher in patients with acromegaly (2.45 to 2.22, p: 0.001), however, the mean strain index (SI) was similar between groups (1.53 to 1.65, p: 0.204). DISCUSSION Thyroid nodules in acromegaly patients have a higher elasto score and the prevalence of hard nodules is higher in active disease. However, increased stiffness of nodules by US-E in patients with acromegaly does not seem to estimate the malignancy of the nodules.
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Affiliation(s)
- Hakan Düğer
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Muhammed Kızılgül
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Pınar Akhanlı
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Murat Çalapkulu
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Hayrı Bostan
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Sema Hepşen
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ümran Gül
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Muhammed Erkam Sencar
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Çakal
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Bekir Uçan
- Health Sciences University, Dışkapı Yıldırım Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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Sumbul HE, Gulumsek E, Avci BS, Ay N, Okyay RA, Sahin AR, Gold J, Avci A, Koc M. Serum Elabela level is significantly increased in patients with acromegaly. Ir J Med Sci 2022; 192:665-670. [PMID: 35665895 DOI: 10.1007/s11845-022-03042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the bioactive peptides associated with the apelinergic system are known to be associated with heart failure and ischemic heart disease, there are no data on their association with acromegaly. AIM We aimed to investigate the change in serum Elabela levels, a novel peptide of the apelinergic system, in patients with acromegaly. METHODS Our study included 30 treatment naive patients who were recently diagnosed with acromegaly, and 50 age-and-sex-matched healthy controls. In addition to routine history, physical examination and laboratory examinations, serum Elabela level was measured. Participants were divided into two groups as individuals with and without acromegaly and compared to each other. RESULTS Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were found to be higher in patients with acromegaly. Serum glucose, Hs-CRP, NT-proBNP, insulin-like growth factor-1, growth hormone and serum Elabela levels were higher in patients with acromegaly (p < 0.05 for each). Left ventricular ejection fraction (LV-EF) was found to be lower in patients with acromegaly than the patients in healthy control group (p < 0.05). In multivariate analysis; age, systolic blood pressure, NT-proBNP, Insulin-like growth factor 1 and growth hormone levels were found to be very closely and positively related to serum Elabela level (p < 0.05 for each). CONCLUSIONS Serum Elabela level can be used as an early and objective indicator of early cardiovascular involvement in patients with acromegaly. Further research is needed to clarify the role of serum Elabela levels on cardiovascular system in acromegaly patients.
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Affiliation(s)
- Hilmi Erdem Sumbul
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
| | - Erdinc Gulumsek
- Department of Gastroenterology, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
| | - Begum Seyda Avci
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
| | - Nurettin Ay
- Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
| | - Ramazan Azim Okyay
- Health Science University, Adana City Research and Training Hospital, Adana, Turkey
| | - Ahmet Riza Sahin
- Department of Infectious Diseases and Clinical Microbiology, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
| | | | - Akkan Avci
- Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Dr. Mithat Özsan Bulvarı Kışla Mah. 4522 Sok. No: 1 Yüreğir, 01060, Adana, Turkey.
| | - Mevlut Koc
- Department of Cardiology, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
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Burakgazi G, Ilhan G, Ozcan O, Dirican E. Ultrasonographic shear wave elastography of the thyroid in patients with sickle cell anemia. ASIAN BIOMED 2022; 16:137-143. [PMID: 37551381 PMCID: PMC10321170 DOI: 10.2478/abm-2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Although thyroid radiology has been conducted in patients with sickle cell anemia (SCA), to our knowledge, there is no report of thyroid gland assessment using ultrasonographic shear wave elastography (US-SWE). Objectives To determine values for ultrasonographic US-SWE of the thyroid in patients with SCA and correlations between thyroid elasticity and biochemical variables used to evaluate thyroid function. Methods Prospective case-control observational study of 36 patients with SCA and 33 healthy volunteer controls. US-SWE measurements of thyroid gland parenchyma and biochemical parameters of the participants were obtained and compared, and the diagnostic accuracy of elasticity was determined. Results The thyroid volume was smaller in patients with SCA than that in controls (P = 0.001). Compared with the controls, the patients with SCA had significantly lower serum levels of free triiodothyronine (fT3) (P = 0.004) and thyroglobulin (Tg) (P = 0.001) and significantly higher levels of thyroid-stimulating hormone (P = 0.028). Thyroid stiffness was significantly higher in the left lobe (LL) of the patients with SCA than in the controls (P = 0.003). In the patients with SCA, we found a significant correlation between right lobe (RL) and LL stiffness and serum levels of Tg (RL [r = -0.439] and LL [r = -0.484]; P = 0.021) and fT3 (RL [r = -0.463] and LL [r = -0.386]; P = 0.012). Receiver operating characteristic (ROC) curve analysis of thyroid elasticity that represented a diagnosis of SCA found a cutoff of >7.31 kPa, a sensitivity of 52.0%, and a specificity of 72.0% for the RL (P = 0.316, area under the curve [AUC] 0.570), and a cutoff of >8.06 kPa, a sensitivity of 58.0%, and a specificity of 84.0% for the LL (P = 0.011, AUC 0.680). Conclusions US-SWE can be used to follow up thyroid changes in patients with SCA.
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Affiliation(s)
- Gulen Burakgazi
- Department of Radiology, Faculty of Medicine, Mustafa Kemal University, Antakya, Hatay31100, Turkey
| | - Gul Ilhan
- Department of Hematology, Faculty of Medicine, Mustafa Kemal University, Antakya, Hatay31100, Turkey
| | - Oguzhan Ozcan
- Department of Biochemistry, Faculty of Medicine, Mustafa Kemal University, Antakya, Hatay31100, Turkey
| | - Emre Dirican
- Department of Biostatistics, Faculty of Medicine, Mustafa Kemal University, Antakya, Hatay31100, Turkey
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Sumbul HE, Avci BS, Bankir M, Pekoz BC, Gulumsek E, Koc AS. Ovarian Stiffness Is Significantly Increased in Polycystic Ovary Syndrome and Related With Anti-Mullerian Hormone: A Point Shear Wave Elastography Study. Ultrasound Q 2022; 38:83-88. [PMID: 35020692 DOI: 10.1097/ruq.0000000000000592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Parenchymal stiffness obtained by point shear-wave elastography (pSWE) in solid organs is used as a sign of damage in these organs. However, its clinical use and whether patients with polycystic ovary syndrome (PCOS) have increased ovarian tissue stiffness are still unclear. The aim of this study is to determine the parameters related to ovarian stiffness and whether there is an increase in ovarian stiffness in patients with PCOS compared with healthy controls. METHODS Forty-five women who were followed up regularly with the diagnosis of PCOS and 30 healthy controls similar to age and sex were included in this study. In addition to the routine follow-up parameters for PCOS, serum homeostatic model assessment of insulin resistance and anti-Mullerian hormone (AMH) levels were examined in all patients, and pSWE examination was performed with pelvic ultrasound (US) and ElastPQ technique. RESULTS Serum dehydroepiandrosterone sulfate, luteinizing hormone/follicle-stimulating hormone, testosterone, homeostatic model assessment of insulin resistance, and AMH were higher in PCOS compared with healthy controls (P < 0.001). Right, left, and mean ovary stiffness and volumes were significantly higher in PCOS group than healthy controls (P < 0.001). Correlation analysis was performed between mean ovary stiffness and dehydroepiandrosterone sulfate, luteinizing hormone/follicle-stimulating hormone, testosterone, homeostatic model assessment, and AMH and ovary volumes (P < 0.01 for each one). In linear regression analysis, only AMH was found to be related to mean ovary stiffness (P < 0.001 and β = 0.734). CONCLUSIONS Ovarian stiffness value obtained by ElastPQ technique and pSWE method increases in PCOS patients compared with healthy controls and is closely related to serum AMH levels. In patients with PCOS, in addition to the conventional US, ovarian stiffness measured by pSWE may be an auxiliary examination in the follow-up of the disease. However, it was concluded that the ovarian stiffness measurement obtained in our current study should be supported by studies involving more patients and the transvaginal US method.
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Affiliation(s)
| | | | | | - Burcak Cakir Pekoz
- Department of Radiology, Adana City Research and Training Hospital, Health Science University, Adana
| | | | - Ayse Selcan Koc
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Parolin M, Dassie F, Vettor R, Maffei P. Acromegaly and ultrasound: how, when and why? J Endocrinol Invest 2020; 43:279-287. [PMID: 31502218 DOI: 10.1007/s40618-019-01111-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acromegaly is a rare disease caused by an excess of growth hormone and insulin-like growth factor 1. It is usually diagnosed because of typical signs such as macroglossia, acral enlargement, jaw prognathism and malocclusion. Systemic complications are a major cause of morbidity and mortality in acromegaly, and many patients remain undiagnosed for several years. Increased ultrasound (US) application in the general population, and including among acromegaly patients, has revealed many suggestive features which, taken together with clinical suspicion, could induce suspicion of this disease. PURPOSE This review describes main US features in acromegaly. Echocardiography shows a typical cardiomyopathy, characterized by left ventricular hypertrophy, diastolic and systolic dysfunction, aortic and mitral regurgitation, and increased aortic root diameters. US preclinical markers of atherosclerosis, such as intima media thickness (IMT), seem also to be impaired. Visceromegaly and increased organ stiffness are other features of acromegaly, including enlarged prostate, kidneys, liver, and thyroid. In addition, other US findings are: renal cysts, micronephrolithiasis, impairment of renal haemodynamic parameters, gallstones and gallbladder polyps, hepatic steatosis, thyroid nodules, multinodular goiter, and polycystic ovaries. Musculoskeletal US findings are increased cartilage thickness, impaired density and elasticity of bones, nerve enlargement, carpal and cubital tunnel syndrome, and trigger finger. CONCLUSIONS Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.
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Affiliation(s)
- M Parolin
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy.
| | - F Dassie
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
| | - R Vettor
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
| | - P Maffei
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
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