Cattoni A, Molinari S, Calì L
… +13 more, Riva B, Nicolosi ML, Fossati C, Gazzarri A, Lattuada M, Medici F, Carzaniga V, Carnevale R, Pangallo E, Primi M, Bonfanti C, Balduzzi A, Capitoli G
PURPOSE: The growth charts for individuals with Down syndrome (DS) available to-date were developed from a cohort of patients from the USA. As diet and environmental factors play a key role on auxological attainment, the...PURPOSE: The growth charts for individuals with Down syndrome (DS) available to-date were developed from a cohort of patients from the USA. As diet and environmental factors play a key role on auxological attainment, the growth of patients from the Mediterranean area should be assessed by means of dedicated centiles. Accordingly, we aimed to develop growth charts from a wide Italian population and to provide a metabolic validation for the BMI distribution outlined. METHODS: Retrospective, bicentric study. We gathered auxological and biochemical data from two cohorts of Italian children and adolescents with DS assessed every 6- to 12-months between 1992 and 2024. RESULTS: 526 patients were enrolled. We longitudinally retrieved the auxological data recorded in the setting of 2796 clinical evaluations. By assessing height, weight and BMI with reference to age, we outlined the age-dependent distribution of each parameter and developed syndrome-specific growth charts. When comparing our charts with the USA ones, the latter showed a statistically greater upward trendline in weight and BMI. Eventually, we assessed the distribution of triglycerides, cholesterol, glycated hemoglobin and uric acid with reference to the BMI. A higher BMI centile was statistically associated with greater triglycerides, cholesterol, and uric acid levels, and we identified the 90th centile of BMI as a risk threshold for dyslipidemia and hyperuricemia. CONCLUSION: We developed DS-specific growth charts from a wide Italian population. The comparison with the USA percentiles outlined statistically significant differences in the distribution of weight and BMI, thus highlighting the need of dedicated charts for individuals from the Mediterranean area.
PURPOSE: The aim of the study is to evaluate the effects of pollution on the prevalence of obesity, diabetic complications, and olfactory disfunction – OD (and their relationships) in two comparable groups of patients wi...PURPOSE: The aim of the study is to evaluate the effects of pollution on the prevalence of obesity, diabetic complications, and olfactory disfunction – OD (and their relationships) in two comparable groups of patients with type 2 diabetes (T2DM) living in different areas with different exposure to pollutants. METHODS: Two comparable groups of patients with T2DM coming from the 2 areas in the Lombardy region with the higher (Milan) and the lower (Sondrio) level of pollution in the past 10 years were analyzed. Each patient underwent a diabetologic, ophthalmologic, cardiologic and otorhinolaryngologic examination which also included the assessment of olfactory abilities and olfactory-related quality of life (QoL). Statistical analysis used non-parametric tests and logistic regression. RESULTS: The prevalence of diabetic complications and OD was significantly higher in patients from Milan than from Sondrio (p = 0.007 and p = 0.039 at Fisher test, respectively), while no significant difference was found for obesity (p = 0.716 at Fisher test). The group with a greater prevalence of OD also reported worse olfactory-related QoL (p = 0.001 and p = 0.016 at Fishertest respectively for Biref-IT-QOD-P and Biref-IT-QOD-NS, respectively). Regression analysis showed a significant association between OD and the presence of diabetic complications (p = 0.011 at multivariable analysis), and between complications and diabetes duration (p = 0.001 at multivariable analysis). Pollution exposure was a weak independent predictor for both OD and complications in patients with T2DM. CONCLUSION: Our study showed that patients with T2DM subject to a higher exposure to pollution were more frequently affected by diabetic complications and OD and reported a poorer olfactory-related QoL compared to patients with a lower exposure. We were also able to highlight a strong association between OD and T2DM complications.
BACKGROUND: Lipid accumulation occurs in kidneys and leads to cellular damage. We aimed to investigate whether renal fat fraction (FF) is an independent predictor for the renal function progression in patients with type...BACKGROUND: Lipid accumulation occurs in kidneys and leads to cellular damage. We aimed to investigate whether renal fat fraction (FF) is an independent predictor for the renal function progression in patients with type 2 diabetes mellitus (T2DM). METHODS: Renal fat fraction (FF) was measured by MRI-Dixon imaging technique. 174 patients with T2DM were included in cross-sectional analysis, and 111 patients were enrolled in longitudinal analysis. After followed up for a median of 18.0 months, 21 of the 111 participants developed renal composite endpoint events. The outcomes were 30% decrease in eGFR from baseline, progression to chronic kidney disease (CKD) (eGFR < 60 ml/min/1.73m2) or end-stage renal disease (ESRD) (eGFR < 15 ml/min/1.73m2). RESULTS: In cross-sectional analysis, multiple linear regression analysis showed that the renal FF was negatively correlated with baseline eGFR, with β coefficients (95% CI) of -16.03 (95% CI: -19.58 to -12.48) after confounders adjustment. In the prospective analysis, cox regression model revealed that each SD increment in baseline renal FF was associated with a higher incidence of renal composite endpoint events (HR = 3.78, 95% CI: 1.22–11.71). When renal FF values were categorized into tertiles, individuals in the highest tertile had an increased risk of renal composite endpoint events compared to those in the lowest tertile (HR = 18.27, 95% CI: 1.03-322.83). Furthermore, the combination of renal FF and uACR improved the predictive effect of renal composite endpoint events, with AUC of 0.78 (95% CI: 0.66–0.89). CONCLUSION: Renal FF was closely associated with the renal function and may serve as a predictor of the renal function progression in patients with T2DM.
OBJECTIVE: The natural history of Graves’ orbitopathy (GO) is believed to be characterized by a late phase of inactivation, possibly related to fibrosis involving orbital tissues. However, to our knowledge, this notion i...OBJECTIVE: The natural history of Graves’ orbitopathy (GO) is believed to be characterized by a late phase of inactivation, possibly related to fibrosis involving orbital tissues. However, to our knowledge, this notion is anecdotal. Thus, the present study aimed to investigate fibrosis in orbital tissues and relate it with the features of GO. METHODS: This retrospective cohort study included 56 consecutive patients with GO who underwent orbital decompression surgery. Fibronectin, CD3- and CD20-positive cells were detected by immunohistochemistry in orbital tissue samples. Collagen was detected by Masson’s trichrome staining. The primary endpoint was the relationship between staining for fibronectin and duration of GO. RESULTS: Staining for fibronectin was observed in 47 patients (83.9%) and correlated inversely with GO duration (P = 0.0014), which was shorter in patients with a positive staining (30 months, IQR 15–47.5) than in those with a negative staining (55 months, IQR 33–70). In spite of the relationship between fibronectin and GO duration, the clinical activity score (CAS), which correlated inversely with GO duration (R = -0.528; P < 0.0001), was similar in patients with a negative [3.6 (1.4) points] or a positive staining for fibronectin [3.2 (1.6) points; mean difference 0.4; 95%CI from -0.7 to 1.5; P = 0.48]. Unlike fibronectin, collagen did not correlate with GO duration. However, there was a direct correlation between collagen and CAS (R = 0.336; P = 0.041). Staining for collagen was similar in patients with a negative staining for fibronectin [15.6% (8.7–28.4)] and those with a positive staining [14.8% (9.8–24.4); P = 0.79]. By multivariate linear regression analysis, both fibronectin and collagen correlated with CD3-positive (fibronectin: R = 0.565; P = 0.00081; collagen: R = 0.567; P = 0.00049) but not with CD20-positive cells. CONCLUSIONS: Fibrosis does not seem to be a late event in the natural history of GO and it may be part of the inflammatory process that occurs relatively early in orbital tissues, possibly as an attempt to repair tissue damage. The notion that fibrosis occurs exclusively in a late stage of GO should be revised. Our findings may have implications in GO treatment with anti-fibrotic drugs.
This piece reflects on Frida Kahlo-the iconic Mexican painter whose art and life remain profoundly intertwined-through the lens of endocrinology. In works such as Self-Portrait with Monkey and Parrot, Kahlo presents hers...This piece reflects on Frida Kahlo-the iconic Mexican painter whose art and life remain profoundly intertwined-through the lens of endocrinology. In works such as Self-Portrait with Monkey and Parrot, Kahlo presents herself with features suggestive of mild hirsutism, including her distinctive monobrow and faint upper-lip hair. The essay explores how her distinctive features, often interpreted as signs of androgen excess, may instead represent an assertion of cultural identity and aesthetic autonomy.
PURPOSE: Malignancy evaluation of thyroid nodules is an important and challenging issue in clinical practice. In this study, we intended to explore novel biomarkers for the differential diagnosis of malignant and benign...PURPOSE: Malignancy evaluation of thyroid nodules is an important and challenging issue in clinical practice. In this study, we intended to explore novel biomarkers for the differential diagnosis of malignant and benign thyroid nodules. METHODS: We performed whole-genome DNA methylation profiling by MethylationEPIC BeadChip and expression profiling by RNA-Sequencing, to identify differentially methylated and expressed genes in fresh-frozen tissues from early-stage papillary thyroid cancer (PTC) and benign thyroid nodule (BTN) patients. The results were validated first in two GEO datasets, and then in two new independent studies (Validation Ⅰ and II) with a total of 757 formalin-fixed paraffin-embedded samples using mass spectrometry. BRAFV600E mutation was examined by Sanger Sequencing. Binary logistic regression analysis was performed to calculate odds ratios (ORs) for per 10% decrease in methylation level. RESULTS: The PARP4 gene was identified in the discovery round and verified in the GEO datasets. Compared to BTNs, PTC cases presented a significant hypomethylation of PARP4 in both Validation Ⅰ (odds ratios ORs > 1.72 per 10% decrease in methylation level, all p≤1.733 × 10− 13) and Validation Ⅱ (ORs > 1.60 per 10% decrease in methylation level, all p≤1.488 × 10− 13). The predictive model was constructed with great performance in Validation Ⅰ (AUC: 0.825) and Validation Ⅱ (AUC: 0.815). Besides, we observed significant correlations between PARP4 methylation and clinical characteristics of early-stage PTC. Totally, the AUCs for PARP4 methylation alone and in combination with BRAFV600E mutation were 0.819 and 0.873, respectively. CONCLUSIONS: We disclosed significant PARP4 hypomethylation in early-stage PTCs compared to BTNs, and constructed a predictive model as a promising tool for differentiating early-stage PTCs from BTNs.
Durhan ST, Yanovski JA, Ozcubukcu S
… +1 more, Yanik T
J Endocrinol Invest
· 2026 Apr · PMID 41410731
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PURPOSE: The melanocortin 3 receptor (MC3R) is a G-protein coupled receptor that has been identified as a regulator of energy balance mechanisms. In addition to its role in weight gain and appetite regulation mechanisms,...PURPOSE: The melanocortin 3 receptor (MC3R) is a G-protein coupled receptor that has been identified as a regulator of energy balance mechanisms. In addition to its role in weight gain and appetite regulation mechanisms, recent studies have shown that MC3R is important for growth, puberty, circadian rhythms, and liver autophagy. In human populations, loss-of-function mutations of MC3R, particularly the Thr6Lys/Val81Ile MC3R variant are linked to early-onset obesity. This variant is characterized by decreased activity and reduced cAMP signaling capacity. Also, research has indicated that wild type (WT) MC3R and growth hormone secretagogue receptor 1A (GHSR-1A) receptors dimerize and increase MC3R-induced cAMP signaling. Moreover, MC3R can interact with ring finger protein 11 (RNF11), an E3 ligase. METHODS: In this study RNF11 was used to examine heterodimerization efficiency and functional properties of both WT and Thr6Lys/Val81Ile MC3R+GHSR-1A by using Förster Resonance Energy Transfer (FRET) technique and H187 EPAC cAMP detection biosensor. RESULTS: It was found that overexpression of RNF11 increased the WT MC3R’s heterodimerization efficiency and heterodimer specific MC3R cAMP production function, whereas no such effect was observed for Thr6Lys/Val81Ile MC3R. CONCLUSION: Altered heterodimer function may help explain the signaling insufficiency of the Thr6Lys/Val81Ile MC3R haplotype.
J Endocrinol Invest
· 2026 Apr · PMID 41385135
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INTRODUCTION: In women with gestational diabetes (GDM), 1,5-Anhydroglucitol (1,5-AG) levels are lower compared to controls. However, data on 1,5-AG changes in the postpartum and its associations with indices of insulin s...INTRODUCTION: In women with gestational diabetes (GDM), 1,5-Anhydroglucitol (1,5-AG) levels are lower compared to controls. However, data on 1,5-AG changes in the postpartum and its associations with indices of insulin secretion or resistance in the perinatal period are lacking. This prospective study assessed the trajectory of 1,5-AG, 1,5-AG/HOMA-IR and 1,5-AG/BMI during pregnancy up to 1-year postpartum, their association with indices of insulin secretion/resistance and whether these indices can predict glucose intolerance (prediabetes and diabetes) at 1-year postpartum in women with GDM. METHODS: We included 211 women with GDM and assessed 1,5-AG levels at 28–32 weeks of gestational age, at 6–8 weeks and at 1-year postpartum. In the context of changing body mass and insulin resistance, we also investigated 1,5-AG/BMI and 1,5-AG/HOMA-IR to adjust for prevailing BMI and HOMA-IR. RESULTS: Circulating 1,5-AG levels and 1,5-AG/BMI were stable between pregnancy and 6–8 weeks postpartum but increased at 1-year postpartum (p < 0.001). 1,5-AG/HOMA-IR increased between pregnancy and the early postpartum and stabilized at 1-year postpartum (p < 0.001). In the perinatal period, 1,5-AG/HOMA-IR was related to a higher insulin-resistance adjusted insulin secretion index (ISSI-2), lower BMI and higher MATSUDA (all p ≤ 0.001). 1,5-AG/pre-pregnancy BMI during pregnancy and 1,5-AG/HOMA-IR at 6–8 weeks postpartum (both p ≤ 0.024) predicted a lower risk of glucose intolerance at 1-year postpartum, the latter remained significant after adjusting for HbA1c. CONCLUSIONS: These results suggest that 1,5-AG/HOMA-IR and 1,5-AG/pre-pregnancy BMI change in the perinatal period. They could provide useful information and may serve as markers of future glucose intolerance, and for early risk stratification in women after GDM.
BACKGROUND AND AIMS: The prevalence and impact on physical function of osteosarcopenia in the Chinese population remain unclear. The purpose of this study was to assess the prevalence of osteosarcopenia and its associati...BACKGROUND AND AIMS: The prevalence and impact on physical function of osteosarcopenia in the Chinese population remain unclear. The purpose of this study was to assess the prevalence of osteosarcopenia and its association with physical function in the elderly population of China. METHODS AND RESULTS: A total of 519 participants (327 males, 192 females; mean age: 67.2 years) elderly people were recruited. Physical performance was evaluated using the Timed Up and Go test and the Short Physical Performance Battery (SPPB). Osteoporosis was diagnosed based on the 1994 WHO criteria, while sarcopenia was defined according to the AWGS guidelines. Osteosarcopenia was diagnosed when both sarcopenia and osteoporosis were present. Among the participants, osteosarcopenia was identified in 27 (5.20%), sarcopenia-alone in 6 (1.16%), and osteoporosis-alone in 257 (49.52%). Logistic regression analysis revealed that age (OR = 1.188, 95% CI: 1.085-1.300) and insufficient exercise (< 30 min/day) (OR = 5.606, 95% CI: 1.591-19.762) were significant associated factors for osteosarcopenia. Conversely, body mass index (OR = 0.569, 95% CI: 0.440-0.736), basal metabolic rate (OR = 0.992, 95% CI: 0.989-0.996), and weekly egg consumption (OR = 0.713, 95% CI: 0.564-0.900) were negatively associated with osteosarcopenia. Regarding physical function, individuals with osteosarcopenia exhibited significantly poorer physical performance, including longer times in the five-repetition sit-to-stand test, slower TUG times, reduced handgrip strength, lower SPPB scores, and slower gait speeds (P < 0.01-P < 0.001). CONCLUSION: This study highlights the prevalence of osteosarcopenia and its impact on physical function in the elderly Chinese population. It identifies key associated factors that could guide the early recognition, diagnosis, and management of osteosarcopenia in China.
PURPOSE: The hypothalamus serves as a crucial regulator of energy homeostasis, and accumulating research shows that defects in the hypothalamus are implicated in the link between type 2 diabetes mellitus (T2DM) and obesi...PURPOSE: The hypothalamus serves as a crucial regulator of energy homeostasis, and accumulating research shows that defects in the hypothalamus are implicated in the link between type 2 diabetes mellitus (T2DM) and obesity. This study was designed to explore the patterns of hypothalamic damage under conditions of metabolic disorders through transcriptome sequencing. METHODS: Five wild-type pigs (WT) and five transgenic pigs (PIGinH11) of comparable ages and body weights were selected for this study. Both groups were fed a high-fat, high-sucrose diet (HFHSD) for 12 weeks. Subsequently, serological parameters were evaluated, and RNA sequencing was carried out on hypothalamic tissues. The transcriptome sequencing results were verified by RT‒PCR and immunofluorescence experiments. RESULTS: A total of 561 differentially expressed genes were identified in the PIGinH11 pigs, with 176 genes being upregulated and 381 genes being downregulated. Protein‒protein interaction (PPI) analysis revealed that the top differentially expressed genes could be grouped into three clusters, namely, vasoconstriction and dilation, inflammation, and metabolism. The genes CD8A, HDG, and NOS1 might be the core genes of each cluster. The KEGG pathway enriched by Gene Set Enrichment Analysis (GSEA) results revealed that pathways related to protein synthesis-related inflammation were upregulated in PIGinH11 pigs, whereas those associated with calcium homeostasis were downregulated. CONCLUSION: The results of the present study demonstrated that in PIGinH11 pigs, which are sensitive to energy alterations, the hypothalamus exhibited inflammation, calcium dysregulation, and activated protein synthesis at the transcriptomic level under metabolic disorders. The NO-sGC-cGMP pathway may play a critical role in hypothalamic inflammation, warranting further in-depth investigation.
PURPOSE: To investigate Anti-Müllerian Hormone (AMH) levels in women with anorexia nervosa (AN) compared to individuals with constitutional thinness (CT) and healthy controls, and to evaluate the association between AMH,...PURPOSE: To investigate Anti-Müllerian Hormone (AMH) levels in women with anorexia nervosa (AN) compared to individuals with constitutional thinness (CT) and healthy controls, and to evaluate the association between AMH, body mass index (BMI), and weight recovery. METHODS: This monocentric cross-sectional study included 191 women with AN, 41 with CT, and 55 controls. A subgroup of 42 patients with AN was reassessed after weight recovery. Hormonal, metabolic, and psychological parameters were analyzed. AMH was measured using a validated electrochemiluminescence immunoassay. Comparisons and correlations were performed using nonparametric tests and Pearson coefficients. RESULTS: Mean AMH plasma level was higher in patients with AN (30.5 ± 1.6 pmol/l) than in controls (23.3 ± 2.5 pmol/l, p = 0.0252) and CT (21.4 ± 2.7 pmol/l, p = 0.0088). AMH was positively correlated with BMI, leptin, FSH, and LH in the AN group, and inversely associated with disease duration. AMH was the lowest in extreme undernutrition state (BMI ≤ 13 kg/m²: AMH: 19.5 ± 4.4pmol/l) and the highest in moderate undernutrition state (BMI 16.5-18.5 kg/m²: AMH:35.8 ± 3.1pmol/l; p = 0.0343 vs. previous). During weight recovery, AMH remained stable overall but tended to decrease in patients who regained menstrual cycles. CONCLUSIONS: Mean AMH is globally elevated in AN, but modulated by nutritional status, being very low in extreme undernutrition and higher during partial recovery, remaining elevated with weight normalization in patients with persistent amenorrhea. AMH might reflect the severity of undernutrition in AN, with low AMH marking the most severe forms, and relatively higher AMH indicating some preserved or recoverable reproductive function, helping the clinician in assessing reproductive prognosis in AN.
INTRODUCTION: This Position Statement presents the recommendations of the Italian Society of Endocrinology (SIE) to identify patients with Cushing's syndrome in specific clinical settings. We set two overarching research...INTRODUCTION: This Position Statement presents the recommendations of the Italian Society of Endocrinology (SIE) to identify patients with Cushing's syndrome in specific clinical settings. We set two overarching research questions: 1. Which subjects should be screened ("who" should be screened)? 2. Which is the most appropriate first-line test ("how" to screen) for screening? All suggestions/recommendations are evidence-based and directed at endocrinologists and other physicians who deal with patients who have presumptive Cushing's syndrome. METHODS: The recommendations, developed by a SIE committee, were formulated based on eight short-reviews commissioned to experts of the SIE Pituitary and Adrenal Clubs. These short reviews, published in a special issue of the Journal of Endocrinological Investigation, reported a comprehensive review of the literature, and each of them answered the two research questions (who and how to screen for hypercortisolism) in a specific population: (1) patients with type 2 diabetes mellitus or obesity; (2) patients with arterial hypertension; (3) children and adolescents; (4) women with hyperandrogenism and/or menstrual irregularities; (5) patients with osteoporosis and/or fractures; (6) patients with mood disorders; (7) patients with adrenal and pituitary incidentaloma; (8) patients with unusual infections or thrombotic events. Finally, 24 recommendations were formulated, based on the quality of available evidence. CONCLUSIONS: The evidence-based Position Statement provides clear and pragmatic advice regarding "who" and "how" to screen for Cushing's syndrome. The suggestions/recommendations are developed for all health care providers, not only endocrinologists, to raise awareness on the diagnosis of Cushing's syndrome.
Cetani F, Bertoldo F, Bononi M
… +6 more, Tarallo M, Camozzi V, Cipriani C, Palermo A, Pasquali D, Zavatta G
J Endocrinol Invest
· 2026 Apr · PMID 41335198
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BACKGROUND: Hypoparathyroidism (HypoPT) is a rare endocrine disorder characterized by insufficient or absent secretion of parathyroid hormone (PTH), which results in hypocalcemia, hyperphosphatemia, and disruption of cal...BACKGROUND: Hypoparathyroidism (HypoPT) is a rare endocrine disorder characterized by insufficient or absent secretion of parathyroid hormone (PTH), which results in hypocalcemia, hyperphosphatemia, and disruption of calcium phosphate homeostasis. Despite advances in understanding its pathophysiology and management, HypoPT remains a complex and impactful condition associated with significant morbidity, impaired quality of life, and long-term complications affecting the skeletal, renal, and neurological systems. METHODS: A literature search was performed on PubMed. Articles were selected based on their relevance to the main topic of the review, with particular attention to recent studies. RESULTS: This review provides a comprehensive synthesis of the current knowledge on HypoPT, addressing its epidemiology, underlying pathophysiological mechanisms, genetic and acquired etiologies, clinical manifestations, diagnostic strategies, and chronic disease-related complications. Emphasis is placed on the genetic spectrum of the disease, challenges of postsurgical management, and burden of conventional therapy, which often fails to fully restore mineral homeostasis and patient well-being. The evolving therapeutic landscape is detailed, highlighting advances from traditional calcium and active vitamin D supplementation to innovative PTH replacement strategies. Among these, palopegteriparatide and eneboparatide (phase 3 clinical trial ongoing) are reshaping treatment paradigms by enabling more physiological restoration of calcium-phosphate balance, reducing complications, and improving patient-centered outcomes, including renal function and quality of life. CONCLUSIONS: By integrating clinical expertise with the latest research developments, this review offers an updated and holistic perspective on HypoPT management, aiming to support clinicians in delivering effective and individualized care to patients across the spectrum of disease severity.
BACKGROUND: The concept of the heart as both a target and source of hormones has reshaped cardiovascular and endocrine medicine. Classic endocrine axes—including pituitary, thyroid, adrenal, and gonadal hormones, govern...BACKGROUND: The concept of the heart as both a target and source of hormones has reshaped cardiovascular and endocrine medicine. Classic endocrine axes—including pituitary, thyroid, adrenal, and gonadal hormones, govern cardiac growth, contractility, metabolism, and stress adaptation. Endocrine disorders such as thyroid dysfunction, Cushing’s syndrome, acromegaly, diabetes, and obesity frequently present with distinct cardiovascular phenotypes. Conversely, cardiac disease induces systemic endocrine disturbances, from low T3 syndrome to insulin resistance and hypogonadism, underscoring a bidirectional relationship. OBJECTIVE: To highlight the bidirectional regulatory loops that link the heart with endocrine systems, including aldosterone and the renin–angiotensin–aldosterone system (RAAS), cardiac natriuretic peptides, and sympathetic nervous system interactions, and to emphasize the clinical implications of cardiac neurohormones and cardiokines. METHODS: Narrative synthesis of mechanisms describing aldosterone activity, RAAS signaling, natriuretic peptide pathways, sympathetic activation, catecholaminergic regulation, and endocrine–autonomic balance, together with the role of cardiokines in vascular homeostasis, myocardial remodeling, metabolism, inflammation, and biomarker application. RESULTS: Aldosterone, produced by the adrenal cortex, physiologically supports sodium balance and vascular tone, while chronic RAAS activation promotes myocardial fibrosis, hypertrophy, and adverse remodeling. Cardiac natriuretic peptides attenuate aldosterone synthesis and RAAS signaling, illustrating a key bidirectional loop between the heart and adrenal gland. Catecholamines acutely support cardiac output through β-adrenergic stimulation, whereas chronic sympathetic overactivation promotes hypertrophy, arrhythmias, and adverse remodeling. Cardiac neurohormones and cardiokines, including adrenomedullin, apelin/elabela, FGF21, GDF15, IL-33/ST2, C1q/TNF-related protein 9, and CTRP9, modulate vascular homeostasis, metabolism, inflammation, and remodeling. These mediators serve as clinically relevant biomarkers (BNP/NT-proBNP, sST2, GDF15, FGF21) that improve diagnosis, risk stratification, and therapeutic guidance in heart failure. Interpretation requires consideration of confounders such as obesity, diabetes, chronic kidney disease, atrial fibrillation, and ARNI therapy. Advances in translational research include ARNI and cyclic GMP-targeted drugs, while genetic determinants of NPPA/NPPB and omics technologies are expanding future precision medicine approaches. CONCLUSIONS: Appreciating the integrative endocrine–cardiac axis enriches pathophysiological understanding and opens new avenues for biomarker-guided management and hormone-based therapies. Progress requires close collaboration between endocrinologists, internists, and cardiologists.
PURPOSE: Patients with adamantinomatous craniopharyngiomas (aCP) often present hypothalamic involvement (HI) either by the tumor or therapeutic interventions, resulting in hypothalamic obesity (HyOb). This study aims to...PURPOSE: Patients with adamantinomatous craniopharyngiomas (aCP) often present hypothalamic involvement (HI) either by the tumor or therapeutic interventions, resulting in hypothalamic obesity (HyOb). This study aims to investigate how appetite sensations and orexigenic and anorexigenic hormones response may contribute to the HyOb pathogenesis in these subjects. SUBJECTS AND METHODS: Fifteen patients with aCP submitted to surgical resection (31,1 ± 12 years; 9 women) and 15 controls (31 ± 11,7 years) paired by sex, age and BMI were included in this cross-sectional study. Leptin and adiponectin were measured in basal conditions (T0'). Glucose, insulin, ghrelin, GLP-1, and PYY levels were assessed at T0', T30', T60', T120', and T180' minutes after a standard meal test. Sensations of hunger, fullness and prospective food consumption were measured using a visual analogic scale at the same time points. RESULTS: Intergroup differences on appetite sensations and biochemical variables were not significant between patients with aCP and controls. Intragroup analyses revealed distinct post-meal dynamics: compared to matching controls, patients with aCP showed earlier increase in hunger, and decrease in fullness (both P = 0.005) and prospective food consumption (P = 0.06) ratings from T0' to T180'. There was a tendency towards higher fasting leptin concentrations (P = 0.06), while adiponectinemia was significantly lower (P = 0.002). Insulin and HOMA-IR (both P < 0.01) were higher at T180', whereas the anorexigenic hormones GLP-1 (P = 0.03) and PYY (P = 0.02) were higher at T120'. PYY and ghrelin showed earlier postprandial rise and fall, respectively, in patients with aCP. CONCLUSIONS: Although intergroup differences were limited, our intragroup analyses revealed reduced satiety persistence and earlier appetite rebound, particularly in patients with HyOb and severe HI, providing new insights into the complex, multifactorial pathophysiology of HyOb associated with aCP.