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[PMID]:28826686
[Au] Autor:Peverelli E; Catalano R; Giardino E; Treppiedi D; Morelli V; Ronchi CL; Vaczlavik A; Fusco N; Ferrero S; Bertherat J; Beuschlein F; Chiodini I; Arosio M; Spada A; Mantovani G
[Ad] Endereço:Endocrine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: erika.peverelli@guest.unimi.it.
[Ti] Título:Cofilin is a cAMP effector in mediating actin cytoskeleton reorganization and steroidogenesis in mouse and human adrenocortical tumor cells.
[So] Source:Cancer Lett;406:54-63, 2017 Oct 10.
[Is] ISSN:1872-7980
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:cAMP pathway plays a major role in the pathogenesis of cortisol-producing adrenocortical adenomas (CPA). cAMP-induced steroidogenesis is preceded by actin cytoskeleton reorganization, a process regulated by cofilin activity. In this study we investigated cofilin role in mediating cAMP effects on cell morphology and steroidogenesis in adrenocortical tumor cells. We demonstrated that forskolin induced cell rounding and strongly reduced phosphorylated (P)-cofilin/total cofilin ratio in Y1 (-52 ± 16%, p < 0.001) and human CPA cells (-53 ± 18%, p < 0.05). Cofilin silencing significantly reduced both forskolin-induced morphological changes and progesterone production (1.3-fold vs 1.8-fold in controls, p < 0.05), whereas transfection of wild-type or S3A (active), but not S3D (inactive) cofilin, potentiated forskolin effects on cell rounding and increased 3-fold progesterone synthesis with respect to control (p < 0.05). Furthermore, cofilin dephosphorylation by a ROCK inhibitor potentiated forskolin-induced cell rounding and steroidogenesis (2-fold increase vs forskolin alone). Finally, we found a reduced P-cofilin/total cofilin ratio and increased cofilin expression in CPA vs endocrine inactive adenomas by western blot and immunohistochemistry. Overall, these results identified cofilin as a mediator of cAMP effects on both morphological changes and steroidogenesis in mouse and human adrenocortical tumor cells.
[Mh] Termos MeSH primário: Citoesqueleto de Actina/metabolismo
Fatores de Despolimerização de Actina/metabolismo
Neoplasias do Córtex Suprarrenal/metabolismo
Adenoma Adrenocortical/metabolismo
AMP Cíclico/farmacologia
Esteroides/biossíntese
[Mh] Termos MeSH secundário: Fatores de Despolimerização de Actina/antagonistas & inibidores
Fatores de Despolimerização de Actina/genética
Neoplasias do Córtex Suprarrenal/tratamento farmacológico
Neoplasias do Córtex Suprarrenal/patologia
Adenoma Adrenocortical/tratamento farmacológico
Adenoma Adrenocortical/patologia
Animais
Colforsina/farmacologia
Seres Humanos
Hidrocortisona/metabolismo
Camundongos
Fosforilação/efeitos dos fármacos
RNA Interferente Pequeno/genética
Células Tumorais Cultivadas
Vasodilatadores/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Actin Depolymerizing Factors); 0 (RNA, Small Interfering); 0 (Steroids); 0 (Vasodilator Agents); 1F7A44V6OU (Colforsin); E0399OZS9N (Cyclic AMP); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE


  2 / 1009 MEDLINE  
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[PMID]:28578183
[Au] Autor:Ersoy B; Kizilay D; Cayirli H; Temiz P; Gunsar C
[Ad] Endereço:Division of Pediatric Endocrinology, Celal Bayar University, School of Medicine, Manisa, Turkey.
[Ti] Título:Central Precocious Puberty Secondary to Adrenocortical Adenoma in a Female Child: Case Report and Review of the Literature.
[So] Source:J Pediatr Adolesc Gynecol;30(5):591-594, 2017 Oct.
[Is] ISSN:1873-4332
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pediatric adrenocortical tumors are rare but significant causes of virilization and peripheral precocious puberty (PPP). CASE: A 4-year-old girl presented with development of breast, pubic hair, and facial acne. Her bone age was advanced, and her gonadotropin level did not elevate in a gonadotropin-releasing hormone (GnRH) test. High levels of dehydroepiandrosterone sulfate, estradiol, and testosterone, and detection of a tumor in the left adrenal gland of the abdomen using computed tomography led to a diagnosis of PPP due to adrenal tumor. Adrenal adenoma was diagnosed with pathology after the tumor was removed. Ultrasonography detected multicystic ovaries before surgery. Although the androgen levels decreased, high estrogen levels persisted after complete tumor resection. Approximately 1 year after the surgery, the patient's breast development persisted, bone age progressed rapidly, and gonadotropin levels increased in a GnRH test. Central precocious puberty was diagnosed, and treatment with GnRH analogues was started. SUMMARY AND CONCLUSION: Adrenal adenoma might present with isosexual PPP as well as virilization in girls. The ovaries should be carefully assessed in these patients. Prolonged exposure to androgen and estrogen might cause ovarian multicysts leading to persistence of high estrogen levels and initiation of central precocious puberty.
[Mh] Termos MeSH primário: Neoplasias do Córtex Suprarrenal/complicações
Glândulas Suprarrenais/patologia
Adenoma Adrenocortical/complicações
Puberdade Precoce/etiologia
[Mh] Termos MeSH secundário: Neoplasias do Córtex Suprarrenal/cirurgia
Glândulas Suprarrenais/cirurgia
Adenoma Adrenocortical/cirurgia
Pré-Escolar
Feminino
Hormônio Liberador de Gonadotropina
Seres Humanos
Ovário/patologia
Puberdade Precoce/diagnóstico
Testosterona
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
33515-09-2 (Gonadotropin-Releasing Hormone); 3XMK78S47O (Testosterone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE


  3 / 1009 MEDLINE  
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[PMID]:28545287
[Au] Autor:Zhang P; Kong LQ; Huang DJ
[Ti] Título:[Liddle syndrome complicating with nonfunctional adrenal cortical adenoma: a case report].
[So] Source:Zhonghua Xin Xue Guan Bing Za Zhi;45(4):331-332, 2017 Apr 24.
[Is] ISSN:0253-3758
[Cp] País de publicação:China
[La] Idioma:chi
[Mh] Termos MeSH primário: Neoplasias das Glândulas Suprarrenais/complicações
Adenoma Adrenocortical/complicações
Síndrome de Liddle/complicações
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170527
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3758.2017.04.015


  4 / 1009 MEDLINE  
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[PMID]:28494487
[Au] Autor:Carroll R; Gould A; Feltham J; Harper S
[Ad] Endereço:Endocrine, Diabetes and Research Centre, Wellington Regional Hospital, Wellington.
[Ti] Título:A case of confirmed primary hyperaldosteronism diagnosed despite normal screening investigations.
[So] Source:N Z Med J;130(1455):129-132, 2017 May 12.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Primary hyperaldosteronism is a common cause of hypertension in the adult population. We report a case of histologically and biochemically confirmed hyperaldosteronism related to an adrenal adenoma, where initial screening and biochemical tests were potentially misleading. The case highlights the importance of clinical suspicion in the current diagnostic approach to primary hyperaldosteronism.
[Mh] Termos MeSH primário: Neoplasias do Córtex Suprarrenal/diagnóstico por imagem
Adenoma Adrenocortical/diagnóstico por imagem
Hiperaldosteronismo/complicações
Hipertensão/etiologia
[Mh] Termos MeSH secundário: Neoplasias do Córtex Suprarrenal/patologia
Neoplasias do Córtex Suprarrenal/cirurgia
Adenoma Adrenocortical/patologia
Adenoma Adrenocortical/cirurgia
Aldosterona/sangue
Seres Humanos
Masculino
Meia-Idade
Potássio/sangue
Renina/sangue
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
4964P6T9RB (Aldosterone); EC 3.4.23.15 (Renin); RWP5GA015D (Potassium)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170518
[Lr] Data última revisão:
170518
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE


  5 / 1009 MEDLINE  
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[PMID]:28402131
[Au] Autor:Mosconi C; Vicennati V; Papadopoulos D; Dalmazi GD; Morselli-Labate AM; Golfieri R; Pasquali R
[Ad] Endereço:1 Radiology Unit, Department of Diagnostic and Preventive Medicine, S. Orsola-Malpighi Hospital, Via Albertoni 15, 40138 Bologna, Italy.
[Ti] Título:Can Imaging Predict Subclinical Cortisol Secretion in Patients With Adrenal Adenomas? A CT Predictive Score.
[So] Source:AJR Am J Roentgenol;209(1):122-129, 2017 Jul.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study is to determine whether any correlation between CT findings and functional parameters exists to predict subclinical glucocorticoid secretion. MATERIALS AND METHODS: This is a retrospective database study of 55 patients with incidentally discovered adenomas, investigated through CT with an adrenal protocol, assessing diameters and attenuation values on the unenhanced and contrast-enhanced phases. Patients underwent blood cortisol and corticotropin evaluation and overnight dexamethasone suppression test (DST), in accordance with clinical recommendations. Cortisol levels higher than 50 nmol/L after DST identified subclinical cortisol secretion. We identified 28 subjects with lipid-rich nonsecreting adenomas, nine with lipid-rich secreting adenomas, 11 with lipid-poor nonsecreting adenomas, and seven with lipid-poor secreting adenoma. RESULTS: Cortisol levels after DST were significantly and positively related to mass diameters. At univariate analysis, maximum and minimum diameters and attenuation in the delayed phase were significantly related to the presence of secreting or nonsecreting adenoma; at multivariate analysis, only the minimum diameter and the attenuation in the venous phase entered the stepwise logistic regression. Similarly, minimum diameter and attenuation in the venous phase emerged also at the multivariate stepwise regression between radiologic parameters and cortisol levels after DST. The formula of the radiologic score computed by using the coefficients of the multivariate regression was as follows: (0.1914 × minimum diameter) + (0.0308 × enhanced attenuation). The diagnostic accuracy of this discriminatory score in differentiating secreting from nonsecreting adenomas was 84.9%, the sensitivity was 81.3%, and the specificity was 87.2%. Adenomas with scores greater than 7.59 were considered as secreting adenomas, and adenomas with scores less than 7.36 were considered as nonsecreting adenomas. CONCLUSION: This study shows that imaging parameters can predict subclinical cortisol hypersecretion in patients with adrenal adenomas.
[Mh] Termos MeSH primário: Adenoma Adrenocortical/diagnóstico por imagem
Adenoma Adrenocortical/patologia
Hidrocortisona/secreção
[Mh] Termos MeSH secundário: Hormônio Adrenocorticotrópico/secreção
Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores/sangue
Meios de Contraste
Feminino
Seres Humanos
Achados Incidentais
Iopamidol/análogos & derivados
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Contrast Media); 17E17JBP8L (iomeprol); 9002-60-2 (Adrenocorticotropic Hormone); JR13W81H44 (Iopamidol); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.16.16965


  6 / 1009 MEDLINE  
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[PMID]:28385310
[Au] Autor:Monticone S; Burrello J; Tizzani D; Bertello C; Viola A; Buffolo F; Gabetti L; Mengozzi G; Williams TA; Rabbia F; Veglio F; Mulatero P
[Ad] Endereço:Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy.
[Ti] Título:Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practice.
[So] Source:J Am Coll Cardiol;69(14):1811-1820, 2017 Apr 11.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite being widely recognized as the most common form of secondary hypertension, among the general hypertensive population the true prevalence of primary aldosteronism (PA) and its main subtypes, aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH), remains a matter of debate. OBJECTIVES: This study sought to determine the prevalence and clinical phenotype of PA in a large cohort of unselected patients with hypertension, consecutively referred to our hypertension unit, by 19 general practitioners from Torino, Italy. METHODS: Following withdrawal from all interfering medications, patients were screened for PA using the ratio of serum aldosterone to plasma renin activity. PA was diagnosed according to Endocrine Society guidelines. The diagnosis was confirmed or excluded by an intravenous saline infusion test or captopril challenge test and subtype differentiation was performed by adrenal computed tomography scanning and adrenal vein sampling, using strict criteria to define successful cannulation and lateralization of aldosterone production. RESULTS: A total of 1,672 primary care patients with hypertension (569 newly diagnosed and 1,103 patients already diagnosed with arterial hypertension) were included in the study. A total of 99 patients (5.9%) were diagnosed with PA and conclusive subtype differentiation by adrenal vein sampling was made in 91 patients (27 patients with an APA and 64 patients with BAH). The overall prevalence of PA increased with the severity of hypertension, from 3.9% in stage 1 hypertension to 11.8% in stage 3 hypertension. Patients with PA more frequently displayed target organ damage and cardiovascular events compared with those without PA, independent of confounding variables. CONCLUSIONS: Our results demonstrated that PA is a frequent cause of secondary hypertension, even in the general population of patients with hypertension, and indicates that most of these patients should be screened for PA.
[Mh] Termos MeSH primário: Hiperaldosteronismo/epidemiologia
Atenção Primária à Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Hiperplasia Suprarrenal Congênita/complicações
Adenoma Adrenocortical/complicações
Adulto
Feminino
Seres Humanos
Hiperaldosteronismo/diagnóstico
Hiperaldosteronismo/etiologia
Itália/epidemiologia
Masculino
Meia-Idade
Fenótipo
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE


  7 / 1009 MEDLINE  
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[PMID]:28368480
[Au] Autor:Omata K; Yamazaki Y; Nakamura Y; Anand SK; Barletta JA; Sasano H; Rainey WE; Tomlins SA; Vaidya A
[Ad] Endereço:Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109.
[Ti] Título:Genetic and Histopathologic Intertumor Heterogeneity in Primary Aldosteronism.
[So] Source:J Clin Endocrinol Metab;102(6):1792-1796, 2017 Jun 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: Whether primary aldosteronism (PA) is the consequence of a monoclonal or multiclonal process is unclear. Case Description: A 48-year-old man with severe bilateral PA refractory to medical therapy underwent unilateral adrenalectomy of the dominant adrenal. Although computed tomography showed three left-sided cortical nodules, postsurgical histopathology and genetic analysis revealed five different adrenocortical adenomas. Two zona fasciculata (ZF)-like aldosterone-producing adenomas (APAs) each harbored distinct known somatic KCNJ5 mutations (L168R and T158A). A zona glomerulosa-like APA harbored a known CACNA1D G403R somatic mutation, whereas a zona reticularis-like adenoma, which was grossly black in pigmentation with histologic characteristics more associated with cortisol-producing adenomas, expressed CYP11B2, CYP17, and DHEA-ST by immunohistochemistry (IHC) and harbored no known somatic mutations. The fifth adenoma was ZF-type, negative for CYP11B2 and CYP17 IHC, and harbored no known somatic mutations. Conclusions: This case highlights complex intertumor heterogeneity in histology, steroidogenesis, and somatic mutations in multiple adrenocortical adenomas arising in a single patient with PA. These findings suggest that the syndrome of PA can involve heterogeneous and multiclonal functional adrenal adenomas.
[Mh] Termos MeSH primário: Neoplasias do Córtex Suprarrenal/genética
Adenoma Adrenocortical/genética
Hiperaldosteronismo/genética
Neoplasias Primárias Múltiplas/genética
[Mh] Termos MeSH secundário: Neoplasias do Córtex Suprarrenal/metabolismo
Neoplasias do Córtex Suprarrenal/patologia
Neoplasias do Córtex Suprarrenal/cirurgia
Adenoma Adrenocortical/metabolismo
Adenoma Adrenocortical/patologia
Adenoma Adrenocortical/cirurgia
Canais de Cálcio Tipo L/genética
Citocromo P-450 CYP11B2/metabolismo
Canais de Potássio Corretores do Fluxo de Internalização Acoplados a Proteínas G/genética
Seres Humanos
Hiperaldosteronismo/metabolismo
Hiperaldosteronismo/patologia
Hiperaldosteronismo/cirurgia
Imuno-Histoquímica
Masculino
Meia-Idade
Neoplasias Primárias Múltiplas/metabolismo
Neoplasias Primárias Múltiplas/patologia
Neoplasias Primárias Múltiplas/cirurgia
Esteroide 17-alfa-Hidroxilase/metabolismo
Sulfotransferases/metabolismo
Zona Fasciculada/patologia
Zona Glomerulosa/patologia
Zona Reticular/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CACNA1D protein, human); 0 (Calcium Channels, L-Type); 0 (G Protein-Coupled Inwardly-Rectifying Potassium Channels); 0 (KCNJ5 protein, human); EC 1.14.14.19 (Steroid 17-alpha-Hydroxylase); EC 1.14.15.4 (Cytochrome P-450 CYP11B2); EC 2.8.2.- (Sulfotransferases); EC 2.8.2.- (dehydroepiandrosterone sulfotransferase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2016-4007


  8 / 1009 MEDLINE  
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[PMID]:28222025
[Au] Autor:Farrugia FA; Martikos G; Surgeon C; Tzanetis P; Misiakos E; Zavras N; Charalampopoulos A
[Ti] Título:Radiology of the adrenal incidentalomas. Review of the literature.
[So] Source:Endocr Regul;51(1):35-51, 2017 Jan 01.
[Is] ISSN:1210-0668
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The term "adrenal incidentaloma" is a radiological term. Adrenal incidentalomas are adrenal tumors discovered in an imaging study that has been obtained for indications exclusive to adrenal conditions (Udelsman 2001; Linos 2003; Bulow et al. 2006; Anagnostis et al. 2009). This definition excludes patients undergoing imaging testing as part of staging and work-up for cancer (Grumbach et al. 2003; Anagnostis et al. 2009). Papierska et al. (2013) have added the prerequisite that the size of a tumor must be "greater than 1cm in diameter", in order to be called incidentaloma. Although in the most cases these masses are non-hypersecreting and benign, they still represent an important clinical concern because of the risk of malignancy or hormone hyperfunction (Barzon et al. 2003). Th e adrenal tumors belong to the commonest incidental findings having been discovered (Kanagarajah et al. 2012).
[Mh] Termos MeSH primário: Neoplasias do Córtex Suprarrenal/diagnóstico por imagem
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem
Adenoma Adrenocortical/diagnóstico por imagem
Carcinoma Adrenocortical/diagnóstico por imagem
Feocromocitoma/diagnóstico por imagem
[Mh] Termos MeSH secundário: 3-Iodobenzilguanidina
Doença de Addison/diagnóstico por imagem
Doenças das Glândulas Suprarrenais/diagnóstico por imagem
Síndrome de Cushing/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética
Fluordesoxiglucose F18
Hemorragia/diagnóstico por imagem
Seres Humanos
Hiperaldosteronismo/diagnóstico por imagem
Índio
Radioisótopos de Índio
Linfoma/diagnóstico por imagem
Imagem por Ressonância Magnética
Mielolipoma/diagnóstico por imagem
Octreotida
Tomografia por Emissão de Pósitrons
Cintilografia
Compostos Radiofarmacêuticos
Tomografia Computadorizada por Raios X
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Indium Radioisotopes); 0 (Radiopharmaceuticals); 045A6V3VFX (Indium); 0Z5B2CJX4D (Fluorodeoxyglucose F18); 35MRW7B4AD (3-Iodobenzylguanidine); RWM8CCW8GP (Octreotide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE


  9 / 1009 MEDLINE  
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[PMID]:28132968
[Au] Autor:Kishino M; Yoshimoto T; Nakadate M; Katada Y; Kanda E; Nakaminato S; Saida Y; Ogawa Y; Tateishi U
[Ad] Endereço:Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
[Ti] Título:Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion.
[So] Source:Endocr J;64(3):347-355, 2017 Mar 31.
[Is] ISSN:1348-4540
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:We evaluated the influence of catheter sampling position and size on left adrenal venous sampling (AVS) in patients with primary aldosteronism (PA) and analyzed their relationship to cortisol secretion. This retrospective study included 111 patients with a diagnosis of primary aldosteronism who underwent tetracosactide-stimulated AVS. Left AVS was obtained from two catheter positions - the central adrenal vein (CAV) and the common trunk. For common trunk sampling, 5-French catheters were used in 51 patients, and microcatheters were used in 60 patients. Autonomous cortisol secretion was evaluated with a low-dose dexamethasone suppression test in 87 patients. The adrenal/inferior vena cava cortisol concentration ratio [selectivity index (SI)] was significantly lower in samples from the left common trunk than those of the left CAV and right adrenal veins, but this difference was reduced when a microcatheter was used for common trunk sampling. Sample dilution in the common trunk of the left adrenal vein can be decreased by limiting sampling speed with the use of a microcatheter. Meanwhile, there was no significant difference in SI between the left CAV and right adrenal veins. Laterality, determined according to aldosterone/cortisol ratio (A/C ratio) based criteria, showed good reproducibility regardless of sampling position, unlike the absolute aldosterone value based criteria. However, in 11 cases with autonomous cortisol co-secretion, the cortisol hypersecreting side tended to be underestimated when using A/C ratio based criteria. Left CAV sampling enables symmetrical sampling, and may be essential when using absolute aldosterone value based criteria in cases where symmetrical cortisol secretion is uncertain.
[Mh] Termos MeSH primário: Glândulas Suprarrenais/irrigação sanguínea
Aldosterona/sangue
Cateterismo/instrumentação
Hidrocortisona/sangue
Hiperaldosteronismo/sangue
Flebotomia/instrumentação
[Mh] Termos MeSH secundário: Neoplasias do Córtex Suprarrenal/diagnóstico
Neoplasias do Córtex Suprarrenal/fisiopatologia
Neoplasias do Córtex Suprarrenal/secreção
Glândulas Suprarrenais/efeitos dos fármacos
Glândulas Suprarrenais/secreção
Adenoma Adrenocortical/diagnóstico
Adenoma Adrenocortical/fisiopatologia
Adenoma Adrenocortical/secreção
Aldosterona/agonistas
Aldosterona/secreção
Doenças Assintomáticas
Cosintropina/farmacologia
Síndrome de Cushing/diagnóstico
Síndrome de Cushing/fisiopatologia
Dexametasona/farmacologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Hidrocortisona/antagonistas & inibidores
Hidrocortisona/secreção
Hiperaldosteronismo/etiologia
Hiperaldosteronismo/metabolismo
Hiperaldosteronismo/fisiopatologia
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Estudos Retrospectivos
Índice de Gravidade de Doença
Veias
Veia Cava Inferior
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
16960-16-0 (Cosyntropin); 4964P6T9RB (Aldosterone); 7S5I7G3JQL (Dexamethasone); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170131
[St] Status:MEDLINE
[do] DOI:10.1507/endocrj.EJ16-0433


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[PMID]:28111382
[Au] Autor:Tsurutani Y; Sugisawa C; Ishida A; Inoue K; Saito J; Omura M; Nagasaka S; Nishikawa T
[Ad] Endereço:Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan.
[Ti] Título:Aldosterone excess may inhibit insulin secretion: A comparative study on glucose metabolism pre- and post-adrenalectomy in patients with primary aldosteronism.
[So] Source:Endocr J;64(3):339-346, 2017 Mar 31.
[Is] ISSN:1348-4540
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Conflicting data have been published on the effects of aldosterone excess on glucose metabolism. Specifically, there are limited data on whether adrenalectomy in patients with aldosterone-producing adenomas (APA) can improve glucose metabolism. In this study we evaluated changes in glucose metabolism, before and after surgery for APA. The subjects were 61 patients treated with unilateral adrenalectomy, localized by adrenal venous sampling. A 75g-oral glucose tolerance test (OGTT) was performed before and 1 year after adrenalectomy. Patients with diabetes mellitus or a serum cortisol level >3 µg/dL after a 1 mg dexamethasone suppression test, were excluded. Using the 75g-OGTT data, insulin secretion and insulin resistance (or sensitivity) indices were calculated. The results showed that immunoreactive insulin levels during the OGTT increased significantly after adrenalectomy, whereas plasma glucose levels, before and after surgery, were comparable. The insulinogenic index significantly increased after surgery (0.5 [0.4-0.8] to 0.8 [0.4-1.1], p < 0.001). The disposition index remained largely unchanged (806.2 [489.4-1,138.9] to 686.6 [479.4-922.1], p = 0.25). The homeostatic model assessment of insulin resistance increased significantly (1.0 [0.6-1.5] to 1.5 [1.0-2.2], p < 0.001) and the ISI decreased significantly (6.9 [4.5-10.4] to 5.2 [3.4-7.9], p < 0.001). Changes in these indices were not correlated with changes in potassium and aldosterone levels before and after surgery. In conclusion, insulin secretion increased after adrenalectomy for APA, indicating that aldosterone excess inhibits insulin secretion. However, because of a parallel increase in insulin resistance, plasma glucose levels remained unchanged.
[Mh] Termos MeSH primário: Aldosterona/metabolismo
Hiperaldosteronismo/metabolismo
Resistência à Insulina
Células Secretoras de Insulina/secreção
Insulina/secreção
[Mh] Termos MeSH secundário: Neoplasias do Córtex Suprarrenal/fisiopatologia
Neoplasias do Córtex Suprarrenal/secreção
Neoplasias do Córtex Suprarrenal/cirurgia
Adrenalectomia
Adenoma Adrenocortical/fisiopatologia
Adenoma Adrenocortical/secreção
Adenoma Adrenocortical/cirurgia
Adulto
Aldosterona/sangue
Aldosterona/secreção
Glicemia/análise
Feminino
Teste de Tolerância a Glucose
Seres Humanos
Hiperaldosteronismo/sangue
Hiperaldosteronismo/etiologia
Hiperaldosteronismo/prevenção & controle
Insulina/sangue
Japão
Masculino
Meia-Idade
Período Pós-Operatório
Potássio/sangue
Período Pré-Operatório
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Insulin); 4964P6T9RB (Aldosterone); RWP5GA015D (Potassium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1507/endocrj.EJ16-0500



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