Arquivos Brasileiros De Endocrinologia E Metabologia[JOURNAL]
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200 papers
[Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing's syndrome].
Silva JM, Aguiar GB, Conti ML … +3 more , Santos AR, Lima Junior JV, Veiga JC
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372586 · Publisher ↗
OBJECTIVE: To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found. SUBJECTS AND METHODS: Fourteen patients with susp...
OBJECTIVE: To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found. SUBJECTS AND METHODS: Fourteen patients with suspected Cushing's syndrome underwent bilateral inferior petrosal sinuses (IPS) catheterization between 2009 and 2012. The technique for catheterization and for hormone analysis were described. RESULTS: The procedure was well tolerated by all patients, and adequate catheterization was achieved in 92.85% of cases. The diagnosis of Cushing's disease was confirmed in 10 cases. The result of IPS catheterization after CRH infusion was coherent in all cases, without false negatives. CONCLUSION: The catheterization of IPS, despite being an invasive technique, is a safe procedure. The objectives can be done properly in most cases. When well indicated, this procedure remains the gold standard in distinguishing the ectopic form to pituitary source in Cushing's syndrome.
[Impairment of muscle vasodilation during mental stress in women with subclinical hypothyroidism].
Ghetti Fde F, Lacerda RP, Wernek FZ … +5 more , Coelho EF, Vaisman M, Lima JR, Martinez DG, Laterza MC
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372585 · Publisher ↗
OBJECTIVE: To test the hypothesis that women with subclinical hypothyroidism (SH) have forearm vascular conductance (FVC) impaired during mental stress. SUBJECTS AND METHODS: We evaluated 20 women with SH and 21 euthyroi...
OBJECTIVE: To test the hypothesis that women with subclinical hypothyroidism (SH) have forearm vascular conductance (FVC) impaired during mental stress. SUBJECTS AND METHODS: We evaluated 20 women with SH and 21 euthyroid (Control group), matched for age (p = 0.699) and body mass index (p = 0.462). Muscle blood flow (MBF) was assessed by venous occlusion plethysmography and blood pressure by Dixtal2023. Both variables were recorded simultaneously for 3 minutes of baseline followed by 3 minutes of mental stress. The FVC was calculated by dividing MBF by mean arterial pressure. Significant differences were assumed at p < 0.05. RESULTS: The SH group had higher concentrations of thyroid stimulating hormone (7.57 ± 3.17 vs. 2.10 ± 0,88 mU/L, p < 0.001). At baseline, the SH and control groups were similar for MBF (2.50 ± 0.79 vs. 2.55 ± 0,71 mL/ min/100 mL, p = 0.905, respectively) and FVC (2.80 ± 0.90 vs. 2.92 ± 0.88 units, p = 0.952, respectively). Throughout the mental stress test the SH and Control groups increased the MBF (time effect, p < 0.001) and FVC (time effect, p < 0.001) compared to baseline protocol. However, these variables were lower in SH group during the first (MBF: 3.66 ± 0.96 vs. 4.66 ± 1,61 mL/min/100 mL, p = 0.018, FVC: 3.95 ± 1.08 vs. 5.19 ± 1,96 units, p = 0.010) and second (MBF: 3.55 ± 1.01 vs. 4.62 ± 2,27 mL/min/100 ml, p = 0.018; FVC: 3.75 ± 1.07 vs. 4.92 ± 2,37 units, p = 0.020) minutes of mental stress test. CONCLUSION: Women with SH have reduced muscle vasodilatatory response during mental stress.
The effect of weight reduction on antioxidant enzymes and their association with dietary intake of vitamins A, C and E.
Ramezanipour M, Jalali M, Sadrzade-Yeganeh H … +4 more , Keshavarz SA, Eshraghian MR, Bagheri M, Emami SS
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372584 · Publisher ↗
OBJECTIVE: Our goal was to assess the effects of weight loss on antioxidant enzymes of red blood cells and it's relation with vitamins A, E and C intake in 30 obese women. SUBJECTS AND METHODS: General information, anthr...
OBJECTIVE: Our goal was to assess the effects of weight loss on antioxidant enzymes of red blood cells and it's relation with vitamins A, E and C intake in 30 obese women. SUBJECTS AND METHODS: General information, anthropometric measurements, 3-day food recall, and fasting blood samples were collected from 30 obese women at the beginning of the study and after 3 months intervention. Weight loss was set at about 10% of their weight before the intervention. RESULTS: Glutathione reductase and catalase activities showed a significant increase (P < 0.01) after weight reduction, but no significant changes were seen in the superoxide dismutase and glutathione peroxidase activities. There was a positive linear correlation between daily vitamin C intake with superoxide dismutase enzyme after intervention (P = 0.004, r = 0.507). There was a negative linear correlation between vitamin E intake and glutathione peroxidase activity before intervention (P = 0.005, r = -0.5). A negative correlation was found between daily vitamin A intake and glutathione reductase enzyme before and after intervention (r = -0.385, r = -0.397, P < 0.05) respectively. No significant correlation was observed between vitamins A, C, E amounts and catalase activity. CONCLUSIONS: Ten percent weight reduction can have a significant role in increasing antioxidant enzymes activities, especially glutathione reductase, and catalase enzymes in obese women. However, it is important to take into consideration a balanced amount of certain nutrients while administering a diet with limited energy.
Zinc transporter 8 autoantibodies in patients with type 1 diabetes from a multiethnic population and their first degree relatives.
Araujo DB, Skärstrand H, Barone B … +7 more , Dantas JR, Kupfer R, Zajdenverg L, Milech A, Vaziri-Sani F, Oliveira JE, Rodacki M
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372583 · Publisher ↗
OBJECTIVE: Zinc transporter 8 autoantibodies (ZnT8A) have been poorly studied in non-Caucasian individuals. We aimed to investigate the prevalence of ZnT8 autoantibodies in patients with T1D and their first degree relati...
OBJECTIVE: Zinc transporter 8 autoantibodies (ZnT8A) have been poorly studied in non-Caucasian individuals. We aimed to investigate the prevalence of ZnT8 autoantibodies in patients with T1D and their first degree relatives (FDR) from a multiethnic population, as well as its relation with the insulin (INS) or the protein tyrosine phosphatase non-receptor 22 (PTPN22) gene polymorphisms. SUBJECTS AND METHODS: ZnT8A were analyzed in sera from T1D patients (n = 72, mean age of 30.3 ± 11.4 years) of variable duration (15.7 ± 11.8 years) and their FDR (n = 78, mean age of 18.3 ± 9.1 years) by a triple mix Radioligand Binding Assay (RBA) for the ZnT8 autoantibody (ZnT8-RWQ) variants. SNP (single nucleotide polymorphism) for INS and PTPN22 were genotyped. RESULTS: The prevalence of ZnT8A was higher in T1D patients than FDR, for ZnT8TripleA (24% vs. 4%,p = 0.001), ZnT8RA (24% vs. 4%, p < 0.001) and ZnT8QA (15% vs. 3%, p = 0.004). All FDR with ZnT8A (n = 3) had at least another positive antibody. Heterozygosis for PTPN22 was associated with a higher frequency of ZnT8TripleA (p = 0.039) and ZnT8RA (p = 0.038). CONCLUSIONS: ZnT8A is observed in non-Caucasian patients with T1D, even years after the disease onset, as well as in their FDR. In those, there was an overlap between ZnT8A and other T1D antibodies. ZnT8A was associated with PTPN22 polymorphisms. Further longitudinal studies are necessary to elucidate the importance of these findings in the natural history of T1D patients with multiethnic background.
Is it necessary to increase the dose of levothyroxine in patients with hypothyroidism who use omeprazole?
Abi-Abib Rde C, Vaisman M
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372582 · Publisher ↗
OBJECTIVE: It is believed that gastric pH interferes in levothyroxine absorption. Omeprazole, which acts by blocking the secretion of gastric acid, might interfere in hypothyroidism control in patients using levothyroxin...
OBJECTIVE: It is believed that gastric pH interferes in levothyroxine absorption. Omeprazole, which acts by blocking the secretion of gastric acid, might interfere in hypothyroidism control in patients using levothyroxine and this effect could be dose dependent. The present study aimed to investigate this possibility. SUBJECTS AND METHODS: Twenty-one patients with primary hypothyroidism who had been using a stabilized levothyroxine dosage for at least one year were selected and randomly assigned to take omeprazole at the dosage of 40 mg or 20 mg per day. The mean levels of thyroid-stimulating hormone (TSH) before and 3 months after omeprazole usage were compared in the entire sample and in each group. RESULTS: Ten patients concluded the entire treatment protocol in the 20 mg group and nine patients in the 40 mg group. There was no significant difference in TSH levels before and 3 months after omeprazole treatment in the entire patient sample (median levels: 2.28 vs. 2.30 mU/L, respectively: p = 0.56). Analysis of each subgroup (20 and 40 mg) showed no significant variation in TSH levels before and 3 months after omeprazole treatment (median levels: 2.24 vs. 2.42 mU/L, p = 0.62, and 2.28 vs. 2.30 mU/L, p = 0.82, respectively). No significant difference in the absolute (p = 0.93) or relative (p = 0.87) delta were observed between the two subgroups. CONCLUSION: Omeprazole in the dosage of 20 or 40 mg/day does not interfere in a clinically relevant manner in the treatment of patients with hypothyroidism that was previously under control.
[Evaluation of fructosamine as a parameter of blood glucose control in diabetic pregnant women].
Feitosa AC, Andrade FS
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372581 · Publisher ↗
OBJECTIVE: To evaluate the alternative parameters to monitor glycemia in pregnant women with diabetes studying the relationship between fructosamine testing and self monitoring of blood glucose in pregnant women with dia...
OBJECTIVE: To evaluate the alternative parameters to monitor glycemia in pregnant women with diabetes studying the relationship between fructosamine testing and self monitoring of blood glucose in pregnant women with diabetes. MATERIALS AND METHODS: Serum fructosamine levels and the self monitoring of blood glucose over 14 days before the collection of fructosamine were evaluated in 47 diabetic pregnant women. RESULTS: Seventy-one fructosamine levels and 2,238 glucose measurements (CGs) were analysed. Levels of fructosamine correlated with high blood glucose index (HBGI) and the standard deviation of glycemias (r = 0.28; p = 0.021 and r = 0.26; p = 0.03, respectively). The comparison between the mothers of the newborns with appropriated or large birthweight and those who gave birth to small newborns for their gestational age (SGA) showed that the latter had a lower glycemic mean (105 vs. 114 and 119 mg/dL), a higher low blood glucose index (5.8 vs. 1.3 and 0.7) and a higher percentage of hyperglycemias (11 vs. 0 and 0%) even when the fructosamine falls within the reference values (242 vs. 218 and 213 μmol/l). CONCLUSION: The levels of fructosamine can be used as further parameter to aid self monitoring of blood glucose to evaluate hyperglycemias and glycemic variability, however, this can underestimate hypoglycemias in pregnant women carrying small-for-gestational age fetuses.
The prevalence of glucose metabolism disturbances in Chinese Muslims and possible risk factors: a study from northwest China.
Liu W, Hua L, Liu WF … +3 more , Song HL, Dai XW, Yang JK
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372580 · Publisher ↗
OBJECTIVE: To survey the prevalence of diabetes mellitus (DM) and pre-diabetes mellitus (PDM) in the Muslim population in northwest China, and discuss the risk factor. MATERIALS AND METHODS: According to the income and t...
OBJECTIVE: To survey the prevalence of diabetes mellitus (DM) and pre-diabetes mellitus (PDM) in the Muslim population in northwest China, and discuss the risk factor. MATERIALS AND METHODS: According to the income and the population, we randomly selected 3 villages with stratified and cluster sampling. The subjects were residents ≥ 20 years of age, and were from families which have been local for > 3 generations. The questionnaire and oral glucose tolerance test (OGTT) were completed and analyzed for 660 subjects. RESULTS: The prevalence of DM and PDM between the Han and Muslim populations were different (P = 0.041). And the prevalence were also different with respect to age in the Han (P < 0.001) and Muslim population (P < 0.001) respectively. Except for the 20-year-old age group the prevalence of DM and PDM within the Muslim population was higher than the Han (P = 0.013), we did not find any significant difference for other age groups (P > 0.05). The intake of salt (P < 0.001) and edible oil (P < 0.001) in the Muslim population was higher than the Han, while cigarette smoking (P < 0.001) and alcohol consumption (P < 0.001) was lower. BMI (P < 0.001), age (P = 0.025), and smoking cigarettes (P = 0.011) were risk factors for DM and PDM, but alcohol consumption (P < 0.001) was a protective factor. CONCLUSIONS: In northwest China, the prevalence of DM was higher in the Muslim population, and it was special higher on the 20-year-old age compared to the Han. This might be explained by the potential genetic differences and poor dietary habits.
Serum levels of retinol binding protein 4 in women with different levels of adiposity and glucose tolerance.
Comucci EB, Vasques AC, Geloneze B … +3 more , Calixto AR, Pareja JC, Tambascia MA
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372579 · Publisher ↗
OBJECTIVE: Retinol-binding protein 4 (RBP4) is an adipokine responsible for vitamin A (retinol) transportation. Studies associated RBP4 increased levels with severity of type 2 diabetes mellitus (T2DM) and insulin resist...
OBJECTIVE: Retinol-binding protein 4 (RBP4) is an adipokine responsible for vitamin A (retinol) transportation. Studies associated RBP4 increased levels with severity of type 2 diabetes mellitus (T2DM) and insulin resistance (IR). The study aimed to quantify RBP4 serum standards in women with a wide range of body mass index (BMI) and glucose tolerance level. SUBJECTS AND METHODS: Cross-sectional study was performed with 139 women divided into three groups: Group 1 (lean-control, n = 45) and Group 2 (obese, n = 53) with normal glucose tolerance and group 3 (obese with T2DM, n = 41), called G1, G2 and G3. Were assessed clinical, biochemical, anthropometric and body composition parameters. RESULTS: According to data analysis, we obtained in G1 higher RBP4 levels (104.8 ± 76.8 ng/mL) when compared to G2 (87.9 ± 38 ng/mL) and G3 (72.2 ± 15.6 ng/mL) levels. Also, were found: in G1 positive correlations of RBP4 with BMI (r = 0.253), glycated hemoglobin (r = 0.378) and fasting insulin (r = 0.336); in G2 with glycated hemoglobin (r = 0.489); in G3 with glycated hemoglobin (r = 0.330), fasting glucose (r = 0.463), HOMA-IR (r = 0.481). CONCLUSIONS: Although RBP4 have shown lower levels in diabetic and obese, a strong correlation with HOMA-IR index highlights that, in our study, there is growing IR when there is an increasing in RBP4 levels.
The role of imaging in congenital adrenal hyperplasia.
Teixeira SR, Elias PC, Andrade MT … +2 more , Melo AF, Elias Junior J
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372578 · Publisher ↗
Congenital adrenal hyperplasia (CAH) is an autossomic recessive disorder caused by impaired steroidogenesis. Patients with CAH may present adrenal insufficiency with or without salt-wasting, as well as various degrees of...
Congenital adrenal hyperplasia (CAH) is an autossomic recessive disorder caused by impaired steroidogenesis. Patients with CAH may present adrenal insufficiency with or without salt-wasting, as well as various degrees of virilization and fertility impairment, carrying a high incidence of testicular adrenal rest tumors and increased incidence of adrenal tumors. The diagnosis of CAH is made based on the adrenocortical profile hormonal evaluation and genotyping, in selected cases. Follow-up is mainly based on hormonal and clinical evaluation. Utility of imaging in this clinical setting may be helpful for the diagnosis, management, and follow-up of the patients, although recommendations according to most guidelines are weak when present. Thus, the authors aimed to conduct a narrative synthesis of how imaging can help in the management of patients with CAH, especially focused on genitography, ultrasonography, computed tomography, and magnetic resonance imaging.
Diagnosis, treatment, and follow-up of medullary thyroid carcinoma: recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism.
Maia AL, Siqueira DR, Kulcsar MA … +3 more , Tincani AJ, Mazeto GM, Maciel LM
Arq Bras Endocrinol Metabol · 2014 Oct · PMID 25372577 · Publisher ↗
INTRODUCTION: Medullary thyroid carcinoma (MTC) originates in the thyroid parafollicular cells and represents 3-4% of the malignant neoplasms that affect this gland. Approximately 25% of these cases are hereditary due to...
INTRODUCTION: Medullary thyroid carcinoma (MTC) originates in the thyroid parafollicular cells and represents 3-4% of the malignant neoplasms that affect this gland. Approximately 25% of these cases are hereditary due to activating mutations in the REarranged during Transfection (RET) proto-oncogene. The course of MTC is indolent, and survival rates depend on the tumor stage at diagnosis. The present article describes clinical evidence-based guidelines for the diagnosis, treatment, and follow-up of MTC. OBJECTIVE: The aim of the consensus described herein, which was elaborated by Brazilian experts and sponsored by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism, was to discuss the diagnosis, treatment, and follow-up of individuals with MTC in accordance with the latest evidence reported in the literature. MATERIALS AND METHODS: After clinical questions were elaborated, the available literature was initially surveyed for evidence in the MedLine-PubMed database, followed by the Embase and Scientific Electronic Library Online/Latin American and Caribbean Health Science Literature (SciELO/Lilacs) databases. The strength of evidence was assessed according to the Oxford classification of evidence levels, which is based on study design, and the best evidence available for each question was selected. RESULTS: Eleven questions corresponded to MTC diagnosis, 8 corresponded to its surgical treatment, and 13 corresponded to follow-up, for a total of 32 recommendations. The present article discusses the clinical and molecular diagnosis, initial surgical treatment, and postoperative management of MTC, as well as the therapeutic options for metastatic disease. CONCLUSIONS: MTC should be suspected in individuals who present with thyroid nodules and family histories of MTC, associations with pheochromocytoma and hyperparathyroidism, and/or typical phenotypic characteristics such as ganglioneuromatosis and Marfanoid habitus. Fine-needle nodule aspiration, serum calcitonin measurements, and anatomical-pathological examinations are useful for diagnostic confirmation. Surgery represents the only curative therapeutic strategy. The therapeutic options for metastatic disease remain limited and are restricted to disease control. Judicious postoperative assessments that focus on the identification of residual or recurrent disease are of paramount importance when defining the follow-up and later therapeutic management strategies.
Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions.
Machado MC, Kodaira S, Musolino NR
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211451
Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pitu...
Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas.
Aggressive pituitary lesion with a remarkably high Ki-67.
Marques P, Mafra M, Calado C … +3 more , Martins A, Monteiro J, Leite V
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211450 · Publisher ↗
The uncommon aggressive pituitary tumors are named carcinomas when metastases are detected, either in the central nervous system and/or systemically. Some cases are associated with hormonal overproduction, but most are d...
The uncommon aggressive pituitary tumors are named carcinomas when metastases are detected, either in the central nervous system and/or systemically. Some cases are associated with hormonal overproduction, but most are diagnosed because of local symptoms. These neoplasias are generally refractory to current treatments. A 51 year-old woman presented sudden onset of headache, left arm paresis and left facial hypoesthesia. Computed tomography scan and magnetic resonance imaging revealed a pituitary tumor invading the left sphenoidal and cavernous sinuses. Laboratory data excluded hormonal hypersecretion. The patient underwent transsphenoidal surgery and histological findings showed a neoplasia with Ki-67 estimated at 75%. Medical imaging excluded both a primary occult tumor and central nervous system or systemic dissemination. Three weeks postoperatively, neurological condition worsened, with new onset of ataxia, bilateral ptosis, ophthalmoplegia and an increase in the size of the lesion, leading to surgical intervention by craniotomy, followed by only a few sessions of radiotherapy, because of severe disease progression. Patient died nearly 2 months after the initial manifestations. This case illustrates the aggressiveness of some pituitary lesions, the limited efficacy of current treatment modalities such as surgery or radiotherapy and the pitfalls of the current pituitary tumors classification. To our knowledge, this case corresponds to one of the most aggressive pituitary neoplasms reported so far, with a very high Ki-67 index (75%) and short survival (2 months). Ki-67 index could be of prognostic value in pituitary tumors. Pituitary tumors World Health Organization (WHO) classification could be revisited.
3β-hydroxysteroid dehydrogenase type II deficiency on newborn screening test.
Araújo VG, Oliveira RS, Gameleira KP … +2 more , Cruz CB, Lofrano-Porto A
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211449 · Publisher ↗
3β-hydroxysteroid dehydrogenase II (3β-HSD) deficiency represents a rare CAH variant. Newborns affected with its classic form have salt wasting in early infancy and genital ambiguity in both sexes. High levels of 17-hydr...
3β-hydroxysteroid dehydrogenase II (3β-HSD) deficiency represents a rare CAH variant. Newborns affected with its classic form have salt wasting in early infancy and genital ambiguity in both sexes. High levels of 17-hydroxypregnenolone (Δ517OHP) are characteristic, but extra-adrenal conversion to 17-hydroxyprogesterone (17OHP) may lead to positive results on newborn screening tests. Filter paper 17OHP on newborn screening test was performed by immunofluorometric assay, and serum determinations of 17OHP and Δ517OHP, by radioimmunoassay. A 46,XY infant with genital ambiguity and adrenal crisis at three months of age presented a positive result on newborn screening for CAH. Serum determinations of 17OHP and Δ517OHP were elevated, and a high Δ517OHP/cortisol relation was compatible with the diagnosis of 3β-HSD deficiency. Molecular analysis of the HSD3B2 gene from the affected case revealed the presence of the homozygous p.P222Q mutation, whereas his parents were heterozygous for it. We present the first report of 3β-HSD type II deficiency genotype-proven detected at the Newborn Screening Program in Brazil. The case described herein corroborates the strong genotype-phenotype correlation associated with the HSD3B2 p.P222Q mutation, which leads to a classic salt-wasting 3β-HSD deficiency. Further evaluation of 17OHP assays used in newborn screening tests would aid in determining their reproducibility, as well as the potential significance of moderately elevated 17OHP levels as an early indicator to the diagnosis of other forms of classic CAH, beyond 21-hydroxylase deficiency.
Rare association between penile squamous cell carcinoma and parathyroid related peptide (PTH-rP) secretion.
Trejo-Rosales R, Nevarez-Barragan MJ, Rosas-Jurado MG … +2 more , Perez-Diaz I, Bezaury AP
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211448 · Publisher ↗
We report on a rare case of an adult with severe hypercalcemia secondary to the ectopic secretion of parathyroid-related peptide (PTH-rP) from a penile squamous cell cancer (PC). A patient of 47 years old was admitted wi...
We report on a rare case of an adult with severe hypercalcemia secondary to the ectopic secretion of parathyroid-related peptide (PTH-rP) from a penile squamous cell cancer (PC). A patient of 47 years old was admitted with warty lesions and areas of ulceration covered by purulent material in a large area of the groin, scrotum and penis. Laboratory tests revealed severe hypercalcemia and elevation of PTH-rP; the biopsy reported PC. Hypercalcemia was successfully treated with zoledronic acid, however, the tumor displayed aggressive behavior, which resulted in a poor prognosis for the patient.
Lack of association between polymorphisms in the UBASH3A gene and autoimmune thyroid disease: a case control study.
Cai T, Wang X, Muhali FS … +6 more , Song R, Shi X, Jiang W, Xiao L, Li D, Zhang J
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211447 · Publisher ↗
OBJECTIVE: The aim of this study was to investigate UBASH3A gene variation association with autoimmune thyroid disease and clinical features in a Chinese Han population. SUBJECTS AND METHODS: A total of 667 AITD patients...
OBJECTIVE: The aim of this study was to investigate UBASH3A gene variation association with autoimmune thyroid disease and clinical features in a Chinese Han population. SUBJECTS AND METHODS: A total of 667 AITD patients (417 GD and 250 HT) and 301 healthy controls were genotyped for two single nucleotide polymorphisms (SNPs) rs11203203, rs3788013 of UBASH3A gene, utilizing the Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometer (MALDI-TOF-MS) Platform. RESULTS: Between the control group and AITD, GD and HT group, no statistically significant difference was observed in the genotypic and allelic frequencies of the two SNPs. There was no significant difference in allelic frequencies of the two SNPs between GD with and without ophthalmopathy. There was no significant difference in haplotype distributions between the control group and AITD, GD or HT group. CONCLUSION: Rs11203203 and rs3788013 in UBASH3A gene may not be associated with AITD patients in Chinese Han population.
Hydrochloride pioglitazone protects diabetic rats against podocyte injury through preserving glomerular podocalyxin expression.
Xing Y, Ye S, Chen Y … +2 more , Hu W, Chen Y
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211446 · Publisher ↗
OBJECTIVE: We sought to test the effect of different dosages of pioglitazone (PIO) on the glomerular expression of podocalyxin and urinary sediment podocalyxin excretion and to explore the potential renoprotective mechan...
OBJECTIVE: We sought to test the effect of different dosages of pioglitazone (PIO) on the glomerular expression of podocalyxin and urinary sediment podocalyxin excretion and to explore the potential renoprotective mechanism. MATERIALS AND METHODS: Type 1 diabetes induced with streptozotocin (65 mg/kg) in 36 male Sprague-Dawley rats were randomly allocated to be treated with vehicle or 10, 20, 30 mg/kg/d PIO respectively for 8 weeks. Eight rats were enrolled in the normal control group. RESULTS: At 8th week, rats were sacrificed for the observation of kidney injury through electron microscope. Glomerular podocalyxin production including mRNA and protein were determined by RT-PCR and immunohistochemistry respectively. Levels of urinary albumin excretion and urinary sediment podocalyxin, kidney injury index were all significantly increased, whereas expression of glomerular podocalyxin protein and mRNA were decreased significantly in diabetic rats compared to normal control. Dosages-dependent analysis revealed that protective effect of PIO ameliorated the physiopathological changes and reached a peak at dosage of 20 mg/kg/d. CONCLUSION: PIO could alleviate diabetic kidney injury in a dose-dependent pattern and the role may be associated with restraining urinary sediment podocalyxin excretion and preserving the glomerular podocalyxin expression.
Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil.
Teixeira LM, Nisihara R, Utiyama SR … +4 more , Bem RS, Marcatto C, Bertolazo M, Carvalho GA
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211445 · Publisher ↗
OBJECTIVE: The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern...
OBJECTIVE: The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern Brazil. SUBJECTS AND METHODS: From the years 2007 to 2011, 254 patients with ATD were enrolled consecutively, Grave's disease was diagnosed in 143 (56.3%) and Hashimoto's thyroiditis in 111 (43.7%) of them. All patients answered a questionnaire related to symptoms that could be associated with CD and serum samples to screen for IgA anti-endomysial (EmA-IgA) were collected. EmA-IgA-positive patients were offered upper gastrointestinal endoscopy and biopsy of duodenum. RESULTS: A total of 254 patients were included; 222 (87.4%) female, mean age 45.4 ± 13.43 years (18 to 79 years). EmA-IgA was positive in seven patients (2.7%) and five done endoscopy with biopsy. Of these, three diagnosis of CD was confirmed (1.2%). All the three patients with CD had higher EmA-IgA titration, were female and had Hashimoto's thyroiditis. Like other patients with ATD, CD patients had nonspecific gastrointestinal symptoms, such as heartburn and gastric distention. In our study, one in each 85 patients confirmed the diagnosis of CD. CONCLUSION: We found a prevalence of 1.2% (1:85) of confirmed CD among Brazilian patients with ATD. Although some IgA-EmA positive patients had Graves' disease and one was male, all three patients with confirmed CD were female and had Hashimoto's thyroiditis.
Evaluation of parathyroid function and mineral metabolism in psychiatric patients using lithium salts.
Oliveira TC, Campos Neto IA, Aguiar-Oliveira MH … +1 more , Pereira Fde A
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211444 · Publisher ↗
OBJECTIVE: To evaluate parathyroid function and mineral metabolism in psychiatric patients users of lithium salts. MATERIALS AND METHODS: We measured the serum levels of calcium, ionized calcium, inorganic phosphorus, al...
OBJECTIVE: To evaluate parathyroid function and mineral metabolism in psychiatric patients users of lithium salts. MATERIALS AND METHODS: We measured the serum levels of calcium, ionized calcium, inorganic phosphorus, alkaline phosphatase, albumin, parathyroid hormone (PTH), urea, creatinine, 25-hydroxy-vitamin D and lithium of 35 patients diagnosed with bipolar disorder in use of lithium carbonate (LC) for at least one year (Lithium Group - LG) and 35 healthy subjects (Control Group - CG). RESULTS: The LG and CG were matched by sex and age. There was only statistic difference in relation to the levels of PTH and ionized calcium, with p < 0.004 and p < 0.03, respectively. Secondary form of hyperparathyroidism (HPT) was found in eight (22.8%) LG patients and in none of the CG. There was no correlation between lithemia, usage time and dosage of LC. CONCLUSION: Our data demonstrate that lithium may create an imbalance in the parathyroid axis, characterized by elevated levels of PTH.
[Insulin resistance and components of metabolic syndrome, analysis by gender and stage of adolescence].
Faria ER, Faria FR, Franceschini Sdo C … +6 more , Peluzio Mdo C, Sant Ana LF, Novaes JF, Ribeiro SM, Ribeiro AQ, Priore SE
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211443 · Publisher ↗
OBJECTIVE: To analyze the influence of metabolic syndrome components in insulin resistance, by gender and adolescence phase. SUBJECTS AND METHODS: We evaluated biochemical, clinical, lifestyle and body composition data o...
OBJECTIVE: To analyze the influence of metabolic syndrome components in insulin resistance, by gender and adolescence phase. SUBJECTS AND METHODS: We evaluated biochemical, clinical, lifestyle and body composition data of 800 adolescents from 10 to 19 years old, from both genders, from Viçosa, MG/Brasil, and there was the division by stage: early (10 to 13 years), intermediate (14 to 16 years) and late (17 to 19 years). RESULTS: 10.3 and 3.4% had, respectively, insulin resistance and metabolic syndrome. In the initial phase there was a higher prevalence of dyslipidemia and intermediate hyperuricemia and excess body fat. Females had a higher prevalence of dyslipidemia, excess body fat and insulin resistance and higher male prevalence of low HDL, hyperuricemia and blood pressure changes. Those from the initial phase had higher levels of total cholesterol, LDL, HDL, triglycerides, fasting glucose and waist/hip ratio, stayed less time sitting and had more meals (p < 0.05) in relation to other phases. The final model, adjusted for gender, was different for each phase of adolescence. CONCLUSIONS: Insulin resistance is associated with inadequate body composition, in biochemical levels and lifestyle, being the factors associated different in each phase of adolescence.
Obesity, insulin resistance and comorbidities? Mechanisms of association.
Castro AV, Kolka CM, Kim SP … +1 more , Bergman RN
Arq Bras Endocrinol Metabol · 2014 Aug · PMID 25211442 · Full text
Overall excess of fat, usually defined by the body mass index, is associated with metabolic (e.g. glucose intolerance, type 2 diabetes mellitus (T2DM), dyslipidemia) and non-metabolic disorders (e.g. neoplasias, polycyst...
Overall excess of fat, usually defined by the body mass index, is associated with metabolic (e.g. glucose intolerance, type 2 diabetes mellitus (T2DM), dyslipidemia) and non-metabolic disorders (e.g. neoplasias, polycystic ovary syndrome, non-alcoholic fat liver disease, glomerulopathy, bone fragility etc.). However, more than its total amount, the distribution of adipose tissue throughout the body is a better predictor of the risk to the development of those disorders. Fat accumulation in the abdominal area and in non-adipose tissue (ectopic fat), for example, is associated with increased risk to develop metabolic and non-metabolic derangements. On the other hand, observations suggest that individuals who present peripheral adiposity, characterized by large hip and thigh circumferences, have better glucose tolerance, reduced incidence of T2DM and of metabolic syndrome. Insulin resistance (IR) is one of the main culprits in the association between obesity, particularly visceral, and metabolic as well as non-metabolic diseases. In this review we will highlight the current pathophysiological and molecular mechanisms possibly involved in the link between increased VAT, ectopic fat, IR and comorbidities. We will also provide some insights in the identification of these abnormalities.
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