Metabolic Syndrome Consequent to Endocrine Disorders. Группа авторов

NV, Loughlin T, Yergey AI, Zewadski JK, Booth JD, Winterer JC, Loriaux DL: Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry. J Clin Endocrinol Metab 1991;72:39–45.

89Danilowics K, Bruno OD, Manavela M, Gomez RM, Barkan A: Correction of cortisol over-replacement ameliorates morbidities in patients with hypopituitarism: a pilot study. Pituitary 2008;11:279–285.

90Murry R, Ekman B, Fitts D, Marelli C, Quinkler M, Zelissen P: Effects of adrenal insufficiency on body composition and metabolic indices: data from the European Adrenal Insufficiency Registry (EU-AIR) Endocrine abstracts ECE 2014 volume 35, P55.

91Johansson G, Nilsson AG, Bergthorsdottir R, Burman P, Dalqvist P, Ekman B, Engström BE, Olsson T, Ragnarsson O, Ryberg M, Wahlber J, Biller BM, Monson JP, Stewart PM, Lennernas H, Skrtic S: Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual release formulation. J Clin Endocrinol Metab 2012;97:473–481.

      92Grossman A, Johansson G, Quinkler M, Zelissen P: Perspectives on the management of adrenal insufficiency: clinical insights from across Europe. Eur J Endocrinol 2013;169:R165–175.

93Persani L, Ferretti E, Borgato S, Faglia G, Beck-Pecoz P: Circulating thyrotropin bioactivity in sporadic central hypothyroidism. J Clin Endocrinol Metab 2000;85:3631–3635.

94Beck-Peccoz P, Rodari G, Giavoli G, Lania A: Central hypothyroidism – a neglected thyroid disorder. Nat Rev Endocrinol 2017;10:588–598.

95Losa M, Scavini M, Gatti E, Rossini A, Madaschi S, Formenti I, Caumo A, Stidley CA, Lanzi R: Long-term effects of growth hormone replacement therapy on thyroid function in adults with growth hormone deficiency. Thyroid 2008;18:1249–1254.

96Phelan N, Conway SH, Liahana S, et al: Quantification of the adverse effect of ethynil estradiol containing oral contraceptive pills when used in conjunction with growth hormone replacement in routine practice. Clin Endocrinol 2011;76:729–733.

97Pappachan JM, Raskauskiene D, Kutty VR, Clayton RN: Excess mortality associated with hypopituitarism in adults: a meta-analysis of observational studies. J Clin Endocrinol Metab 2015;100:1405–1411.

98Olsson DS, Nilsson AG, Bryngelsson IL, Trimpou P, Johansson G, Andersson E: Excess mortality in women and young adults with non-functioning pituitary adenoma: a Swedish nationwide study. J Clin Endocrinol Metab 2015,100:2651–2658.

99Olsson DS, Bryngelsson IL, Ragnarsson O: Time trends of mortality in patients with nonfunctioning pituitary adenoma: a Swedish nationwide study. Pituitary 2017;20:218–224.

100Child CJ, Conroy D, Zimmermann AG, Woodmansee WW, Erfurt EM, Robison LL: Incidence of primary cancers and intracranial tumor recurrences in GH-treated and untreated adult hypopituitary patients: analyses from the hypopituitary control and complications study. Eur J Endocrinol 2015;172:779–790.

101Jasim S, Alahdab F, Ahmed AT, Tamhane SU, Sharma A, Donegan D, Nippoldt TB, Murad MH: The effect of growth hormone replacement in patients with hypopituitarism on pituitary tumor recurrence, secondary cancer and stroke. Endocrine 2017;56:33–42.

102De Gregorio C, Andó G, Canavó S, Cotta OR, Trio O, Cusma Piccone M, Trimarchi F, Curtó L: Cardiovascular outcomes and conventional risk factors in non-diabetic adult patients with GH deficiency: a long-term prospective cohort study. Eur J Intern Med 2015;26:813–818.

103Olsson DS, Trimpou P, Hallén T, Bryngelsson IL, Andersson E, Skoglund T, Bengsston BA, Johansson G, Nilsson AG: Life expectancy in patients with pituitary adenoma receiving growth hormone replacement. Eur J Endocrinol 2017;176:67–75.

104de Haas et al: The metabolic syndrome in cancer survivors. Lancet Oncol 2010;11:193–203.

      Prof. Vera Popovic

      Belgrade School of Medicine, University of Belgrade

      Dr Subotica 6

      Belgrade 11 000 (Serbia)

      E-Mail [email protected]

      Popovic V, Korbonits M (eds): Metabolic Syndrome Consequent to Endocrine Disorders.

      Front Horm Res. Basel, Karger, 2018, vol 49, pp 20–28 (DOI: 10.1159/000486001)

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Metabolic Complications of Acromegaly

      Moisés Mercado · Claudia Ramírez-Rentería

      Experimental Endocrinology Unit and Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico

      ______________________

      Abstract

      Diabetes is recognized as one of the most common acromegaly co-morbidities with a prevalence ranging 20–53%, while over one-third of these patients have an altered lipid profile. In fact, as in the non-acromegalic population, carbohydrate and lipid metabolism abnormalities are closely linked. Long term exposure to an excess of growth hormone (GH) and Insulin-like growth factor-1 concentrations results in insulin resistance and an increased hepatic glucose production. The lipolytic effect of GH results in the mobilization of free fatty acids that further contributes to the decreased insulin sensitivity found in these patients. Some studies suggest that the presence of diabetes contributes to the increased mortality of acromegaly, although this remains controversial. Successful treatment of acromegaly usually results in significant, albeit incomplete improvements of the abnormal metabolic profile.

      © 2018 S. Karger AG, Basel

      Introduction

The chronic excess of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) that occurs in acromegaly affects virtually all aspects of metabolism, including protein, lipid, and carbohydrate synthesis and degradation as well as the handling of sodium, calcium, and phosphorus by the kidney. The clinical expression of these metabolic abnormalities varies among patients and is strongly influenced by ethnogentic and environmental factors. The resulting co-morbidities, including diabetes, dyslipidemia, and hypertension, contribute to the increased cardiovascular mortality risk found in these patients. In this brief review, we analyze the pathophysiology, epidemiology, and clinical characteristics of the carbohydrate and lipid metabolism abnormalities that occur in acromegaly. For an in-depth analysis of the effects of chronic GH and IGF-1 excess on the renal handling of sodium, calcium and phosphorus we refer the reader to an excellent review by Kamenicky et al. [1].