Category Archives: J Clin Endocrinol Metab

Approach to the Patient: Perioperative Management of the Patient with Pheochromocytoma or Sympathetic Paraganglioma.

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Approach to the Patient: Perioperative Management of the Patient with Pheochromocytoma or Sympathetic Paraganglioma.
J Clin Endocrinol Metab. 2020 Sep 01;105(9):
Authors: Berends AMA, Kerstens MN, … Continue reading

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Letter to the Editor: “Use of biomarkers to identify new drug targets and to predict risk of cardiometabolic outcomes” by Holmegard HN, et al.

Letter to the Editor: “Use of biomarkers to identify new drug targets and to predict risk of cardiometabolic outcomes” by Holmegard HN, et al.
J Clin Endocrinol Metab. 2016 Feb;101(2):L20-L21
Authors: Abbasi A
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Increased Risk of Atrial Fibrillation After Treatment for Differentiated Thyroid Carcinoma.

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Increased Risk of Atrial Fibrillation After Treatment for Differentiated Thyroid Carcinoma.
J Clin Endocrinol Metab. 2015 Oct 19;:jc20152782
Authors: Klein Hesselink EN, Lefrandt JD, Schuurmans EP, Bu… Continue reading

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Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.

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Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.

J Clin Endocrinol Metab. 2015 Jun;100(6):2181-91

Authors: Chaker L, Baumgartner C, den Elzen WP, Ikram MA, Blum MR, Collet TH, Bakker SJ, Dehghan A, Drechsler C, Luben RN, Hofman A, Portegies ML, Medici M, Iervasi G, Stott DJ, Ford I, Bremner A, Wanner C, Ferrucci L, Newman AB, Dullaart RP, Sgarbi JA, Ceresini G, Maciel RM, Westendorp RG, Jukema JW, Imaizumi M, Franklyn JA, Bauer DC, Walsh JP, Razvi S, Khaw KT, Cappola AR, Völzke H, Franco OH, Gussekloo J, Rodondi N, Peeters RP, Thyroid Studies Collaboration

Abstract
OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism.
DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels.
DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations.
CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.

PMID: 25856213 [PubMed – indexed for MEDLINE]

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Bone marrow function after (131)I therapy in patients with differentiated thyroid carcinoma.

Bone marrow function after (131)I therapy in patients with differentiated thyroid carcinoma.

J Clin Endocrinol Metab. 2015 Aug 11;:jc20152124

Authors: Prinsen HT, Klein Hesselink EN, Brouwers AH, Plukker JT, Sluiter WJ, van der Horst-Schrivers AN, van Imhoff GW, Links TP

Abstract
PURPOSE: Primary aim was to evaluate the short- and long-term toxic effects of radioiodine ((131)I) therapy on bone marrow function in differentiated thyroid carcinoma (DTC) patients. Secondary aim was to define characteristics of patients at risk for impaired bone marrow function after (131)I treatment.
PATIENTS AND METHODS: DTC patients treated with (131)I between 1989 and 2013 were included. We excluded patients with morbidities or treatments that could have influenced blood count parameters. Baseline platelets, leukocytes and haemoglobin were compared with blood counts at three and six months, and at one and five years post-treatment. Logistic multivariate regression analyses were performed to determine patient characteristics associated with thrombocytopenia.
RESULTS: We included 331 patients. Mean±SD age was 47.5±17.2 years, 74.0% were female. Post-treatment platelets were significantly decreased at six months and one year, as compared with baseline. Leukocyte counts were also decreased, at three and six months, and at one year post-treatment. No decreases in haemoglobin were found. Five years post-treatment, platelet and leukocyte counts were comparable to baseline. Fourteen patients (4.2%) developed transient post-treatment thrombocytopenia. Risk factors for thrombocytopenia were older age, T4 tumour stage, male gender and cumulative dose (131)I. After multivariate regression analysis, cumulative dose (131)I remained independently associated with thrombocytopenia.
CONCLUSION: Post-treatment platelets and leukocytes were transiently decreased compared to pre-treatment values in a general DTC population. Cumulative (131)I dose was independently associated with thrombocytopenia. Platelets and leukocytes normalized to baseline levels five years post-treatment, implying that in most patients clinical effects of bone marrow toxicity are limited.

PMID: 26262436 [PubMed – as supplied by publisher]

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mvMetabolic Health in short children born SGA treated with GH and GnRHa: Results of a randomized, dose-response trial.

mvMetabolic Health in short children born SGA treated with GH and GnRHa: Results of a randomized, dose-response trial.

J Clin Endocrinol Metab. 2015 Aug 10;:jc20152619

Authors: van der Steen M, Lem AJ, van der Kaay DC, Bakker-van Waarde WM, van der Hulst FJ, Neijens FS, Noordam C, Odink RJ, Oostdijk W, Schroor EJ, Westerlaken C, Hokken-Koelega AC

Abstract
CONTEXT: Previously we showed that pubertal children born small for gestational age (SGA) with a poor adult height (AH) expectation can benefit from treatment with growth hormone (GH) 1mg/m(2)/day (∼0.033mg/kg/day) in combination with 2 years of GnRH analogue (GnRHa) and even more so with a double GH dose. GnRHa treatment is thought to have negative effects on body composition and blood pressure. Long-term effects and GH-dose effects on metabolic health in children treated with combined GH/GnRHa are unknown.
OBJECTIVE: To investigate body composition, blood pressure and lipid profile during GH treatment, either with or without 2 years of additional GnRHa. To assess whether GH 2mg/m(2)/day (∼0.067mg/kg/day) results in a similar or even more favorable metabolic health at AH than GH 1mg/m(2)/day.
METHODS: Longitudinal, randomized, dose-response GH trial involving 107 short SGA children (58 girls) treated with GH until AH (GH randomized 1 or 2mg/m(2)/day during puberty). Sixty-four children received additional GnRHa. At AH, metabolic parameters were compared between children treated with combined GH/GnRHa and those with only GH. The GH-dose effect on metabolic health was evaluated in a subgroup of 47 children who started GH treatment in early puberty (randomized 1 or 2mg/m(2)/day) with 2 years of GnRHa.
RESULTS: At AH, fat mass percentage (FM%) SDS, lean body mass (LBM) SDS, blood pressure SDS and lipid profile were similar between children treated with combined GH/GnRHa and those with only GH. In the pubertal subgroup, FM% SDS was lower during treatment with GH 2mg/m(2)/day. There was no GH dose-dependent effect on LBM SDS, blood pressure and lipid profile.
CONCLUSIONS: Combined GH/GnRHa treatment has no long-term negative effects on metabolic health compared to only GH. Started in early puberty, a GH dose of 2mg/m(2)/day results in a similar metabolic health at AH and a more favorable FM% than GH 1mg/m(2)/day.

PMID: 26259134 [PubMed – as supplied by publisher]

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Bone mineral density in children and adolescents with Prader-Willi syndrome: a longitudinal study during puberty and 9 years of growth hormone treatment.

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Bone mineral density in children and adolescents with Prader-Willi syndrome: a longitudinal study during puberty and 9 years of growth hormone treatment.

J Clin Endocrinol Metab. 2015 Apr;100(4):1609-18

Authors: Bakker NE, Kuppens RJ, Siemensma EP, Tummers-de Lind van Wijngaarden RF, Festen DA, Bindels-de Heus GC, Bocca G, Haring DA, Hoorweg-Nijman JJ, Houdijk EC, Jira PE, Lunshof L, Odink RJ, Oostdijk W, Rotteveel J, Van Alfen AA, Van Leeuwen M, Van Wieringen H, Wegdam-den Boer ME, Zwaveling-Soonawala N, Hokken-Koelega AC

Abstract
CONTEXT: Longitudinal data on bone mineral density (BMD) in children and adolescents with Prader-Willi Syndrome (PWS) during long-term GH treatment are not available.
OBJECTIVE: This study aimed to determine effects of long-term GH treatment and puberty on BMD of total body (BMDTB), lumbar spine (BMDLS), and bone mineral apparent density of the lumbar spine (BMADLS) in children with PWS.
DESIGN AND SETTING: This was a prospective longitudinal study of a Dutch PWS cohort.
PARTICIPANTS: Seventy-seven children with PWS who remained prepubertal during GH treatment for 4 years and 64 children with PWS who received GH treatment for 9 years participated in the study.
INTERVENTION: The children received GH treatment, 1 mg/m(2)/day (≅ 0.035 mg/kg/d).
MAIN OUTCOME MEASURES: BMDTB, BMDLS, and BMADLS was measured by using the same dual-energy x-ray absorptiometry machine for all annual measurements.
RESULTS: In the prepubertal group, BMDTB standard deviation score (SDS) and BMDLSSDS significantly increased during 4 years of GH treatment whereas BMADLSSDS remained stable. During adolescence, BMDTBSDS and BMADLSSDS decreased significantly, in girls from the age of 11 years and in boys from the ages of 14 and 16 years, respectively, but all BMD parameters remained within the normal range. Higher Tanner stages tended to be associated with lower BMDTBSDS (P = .083) and a significantly lower BMADLSSDS (P = .016). After 9 years of GH treatment, lean body mass SDS was the most powerful predictor of BMDTBSDS and BMDLSSDS in adolescents with PWS.
CONCLUSIONS: This long-term GH study demonstrates that BMDTB, BMDLS, and BMADLS remain stable in prepubertal children with PWS but decreases during adolescence, parallel to incomplete pubertal development. Based on our findings, clinicians should start sex hormone therapy from the age of 11 years in girls and 14 years in boys unless there is a normal progression of puberty.

PMID: 25668198 [PubMed – indexed for MEDLINE]

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No Association of Blood Type O with Neuroendocrine Tumors in Multiple Endocrine Neoplasia Type 1.

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No Association of Blood Type O with Neuroendocrine Tumors in Multiple Endocrine Neoplasia Type 1.
J Clin Endocrinol Metab. 2015 Aug 6;:jc20152615
Authors: Nell S, van Leeuwaarde RS, Pieterman CR, de L… Continue reading

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Long-term natural course of pituitary tumors in patients with MEN1: results from the Dutch MEN1 study group (DMSG).

Long-term natural course of pituitary tumors in patients with MEN1: results from the Dutch MEN1 study group (DMSG).
J Clin Endocrinol Metab. 2015 Jun 30;:JC20152015
Authors: de Laat JM, Dekkers OM, Pieterman CR, Klui… Continue reading

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Diencephalic syndrome in childhood craniopharyngioma–results of German multicenter studies on 485 long-term survivors of childhood craniopharyngioma.

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Diencephalic syndrome in childhood craniopharyngioma–results of German multicenter studies on 485 long-term survivors of childhood craniopharyngioma.

J Clin Endocrinol Metab. 2014 Nov;99(11):3972-7

Authors: Hoffmann A, Gebhardt U, Sterkenburg AS, Warmuth-Metz M, Müller HL

Abstract
CONTEXT: Childhood craniopharyngiomas (CPs) are known to be associated with an increased risk of excessive weight gain and hypothalamic obesity. Atypical clinical manifestations include the development of a diencephalic syndrome (DS) with a failure to thrive or maintain weight at appropriate body mass index.
CASES AND METHODS: In a retrospective study, we analyzed 21 of 485 childhood CP patients (4.3%) who presented with a low weight (< -2 body mass index SD) at the time of diagnosis. Eleven of the 21 patients were identified with a DS due to proven hypothalamic involvement. We show the clinical manifestations of DS and weight development before and after diagnosis in these 11 patients. The first significant differences between patients with low weight at diagnosis and normal-weight patients at diagnosis are observed at 5 years of age. Within the first 2 years after diagnosis, the weight of DS patients and normal-weight patients converge to a similar level. Tumor size does not play a role with respect to DS development. Finally, tumor characteristics of DS patients were compared with magnetic resonance imaging scans of obese CP patients at the time of diagnosis.
CONCLUSIONS: DS is a rare clinical manifestation in childhood CP and should be considered as a discrete diagnosis in failure to thrive. DS at the time of diagnosis does not preclude weight gain after diagnosis of a CP with hypothalamic involvement.

PMID: 25077898 [PubMed – indexed for MEDLINE]

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Sex hormone binding globulin deficiency due to a homozygous missense mutation.

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Sex hormone binding globulin deficiency due to a homozygous missense mutation.
J Clin Endocrinol Metab. 2014 Sep;99(9):E1798-802
Authors: Vos MJ, Mijnhout GS, Rondeel JM, Baron W, Groeneveld PH
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Natural course and survival of neuroendocrine tumors of thymus and lung in MEN1 patients.

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Natural course and survival of neuroendocrine tumors of thymus and lung in MEN1 patients.

J Clin Endocrinol Metab. 2014 Sep;99(9):3325-33

Authors: de Laat JM, Pieterman CR, van den Broek MF, Twisk JW, Hermus AR, Dekkers OM, de Herder WW, van der Horst-Schrivers AN, Drent ML, Bisschop PH, Havekes B, Vriens MR, Valk GD

Abstract
CONTEXT: The natural course and survival of neuroendocrine tumors (NETs) of thymus (Th) and lung in multiple endocrine neoplasia type 1 (MEN1) patients are still unknown.
OBJECTIVE: Our objective was to assess prevalence, tumor growth, and survival of Th and lung NETs in an unselected MEN1 population with long-term follow-up.
DESIGN: This was an observational study.
PATIENTS AND METHODS: A longitudinal study was performed using the Dutch national MEN1 database, including >90% of the Dutch MEN1 population >16 years of age. Patients under care of the Dutch University Medical Centers (1990-2011) (n = 323) were included.
MAIN OUTCOME MEASURES: The prevalence and survival of Th and lung NETs were assessed. Linear mixed-models analysis was applied to assess tumor growth with age as a possible confounder and gender, genotype and baseline tumor size as possible effect modifiers.
RESULTS: Th NETs occurred in 3.4% of patients, almost exclusively in males with a 10-year survival of 25% (95% confidence interval = 8%-80%). A thoracic computed tomography scan was available in 188 patients (58.2%). A lung NET was identified in 42 patients (13.0%) with a 10-year survival of 71.1% (95% confidence interval = 51%-100%). Tumor volume of lung NETs increased 17% per year (P < .001) (tumor doubling time 4.5 years). Tumor doubling time in males was 2.5 vs 5.5 years in females (P = .05). Lung NET growth was not associated with genotype or with baseline tumor size (<1 vs ≥1 cm).
CONCLUSION: In MEN1 patients, Th NETs almost exclusively occurred in males and had a very low prevalence and a high mortality. Lung NETs occurred more often than previously thought, had an indolent course, and occurred equally in both sexes. Tumor growth in males was double compared with female patients.

PMID: 24915123 [PubMed – indexed for MEDLINE]

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Associations of 25(OH) and 1,25(OH)2 Vitamin D with Long-Term Outcomes in Stable Renal Transplant Recipients.

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Associations of 25(OH) and 1,25(OH)2 Vitamin D with Long-Term Outcomes in Stable Renal Transplant Recipients.

J Clin Endocrinol Metab. 2014 Oct 31;:jc20143012

Authors: Keyzer CA, Riphagen IJ, Joosten MM, Navis G, Muller Kobold AC, Kema IP, Bakker SJ, de Borst MH

Abstract
Context: Vitamin D deficiency is common in renal transplant recipients (RTR). The long-term implications of vitamin D deficiency in RTR remain unclear. Objective: We investigated whether 25(OH) or 1,25(OH)2 levels are associated with mortality, renal function decline, and graft failure in stable RTR. Design: Observational study with longitudinal design; follow-up of 7.0 [6.2-7.5] years. Setting: Single-center outpatient clinic. Participants: 435 stable RTR, 51% men, mean age 52±12 years, included at a median of 6 [3-12] years after kidney transplantation. Main Outcome Measures: All-cause mortality, annual change of renal function (eGFR), graft failure. Results: Mean 25(OH)D and 1,25(OH)2D were 21.6±9.1 ng/mL and 45.2±19.0 pg/mL, respectively. During follow-up, 99 patients died (22.8%) and 44 patients developed graft failure (10.1%). In univariate analysis, both 25(OH)D and 1,25(OH)2D were significantly associated with mortality (HR 0.64 [95%CI 0.51-0.81], P<0.001 and 0.69 [0.55-0.87], P=0.002 per SD increase, respectively). The inverse association of 25(OH)D with mortality remained significant after adjustment for potential confounders (HR 0.68 [0.52-0.89], P=0.004 per SD increase). The associations of 1,25(OH)2D with mortality and graft failure lost significance after adjustment for renal function. Severe vitamin D deficiency (25[OH]D <12 ng/mL) was independently associated with stronger annual eGFR decline . Conclusions: Low 25(OH)D is independently associated with an increased risk of all-cause mortality and 25(OH)D <12 ng/mL with a rapid eGFR decline in stable RTR. The association of low 1,25(OH)2D with mortality or graft failure depends on renal function. These results should encourage RCTs evaluating the effect of vitamin D supplementation after kidney transplantation..

PMID: 25361179 [PubMed – as supplied by publisher]

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Hypoglycemia in a patient with a big “big”-IGF-II-producing tumor.

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Hypoglycemia in a patient with a big “big”-IGF-II-producing tumor.

J Clin Endocrinol Metab. 2013 Aug;98(8):3113-4

Authors: Alkemade GM, Bakker M, Rikhof…

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Role of HDL cholesterol and estimates of HDL particle composition in future development of type 2 diabetes in the general population: the PREVEND study.

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Role of HDL cholesterol and estimates of HDL particle composition in future development of type 2 diabetes in the general population: the PREVEND study.

J Clin…

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Eight Years of Growth Hormone Treatment in Children With Prader-Willi Syndrome: Maintaining the Positive Effects.

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Eight Years of Growth Hormone Treatment in Children With Prader-Willi Syndrome: Maintaining the Positive Effects.

J Clin Endocrinol Metab. 2013 Sep 3;

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Unilateral and bilateral adrenalectomy for pheochromocytoma requires adjustment of urinary and plasma metanephrine reference ranges.

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Unilateral and bilateral adrenalectomy for pheochromocytoma requires adjustment of urinary and plasma metanephrine reference ranges.

J Clin Endocrinol Metab. 2013…

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Adrenal hemorrhage causing adrenal insufficiency in a patient with antiphospholipid syndrome: increased adrenal 18F-FDG uptake.

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Adrenal hemorrhage causing adrenal insufficiency in a patient with antiphospholipid syndrome: increased adrenal 18F-FDG uptake.

J Clin Endocrinol Metab. 2012…

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Adult Height in Short Children Born SGA Treated with Growth Hormone and Gonadotropin Releasing Hormone Analog: Results of a Randomized, Dose-Response GH Trial.

Adult Height in Short Children Born SGA Treated with Growth Hormone and Gonadotropin Releasing Hormone Analog: Results of a Randomized, Dose-Response GH Trial.

J Clin Endocrinol Metab. 2012…

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Functional imaging in hyperinsulinemic hypoglycemia after gastric bypass surgery for morbid obesity.

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Functional imaging in hyperinsulinemic hypoglycemia after gastric bypass surgery for morbid obesity.
J Clin Endocrinol Metab. 2012 Jun;97(6):E963-7
Authors: de Heide LJ, Glaudemans AW, Oomen PH, Apers JA, Tott… Continue reading

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