An overview of the controversies of adult growth hormone deficiency diagnosis.

Introduction: Growth hormone (GH) not only drives growth but also has significant metabolic, structural, and quality-of-life impacts. While GH deficiency (GHD) in childhood impairs growth, in adulthood, it leads to metabolic syndrome and multisystem functional abnormalities, collectively termed adult GHD syndrome. Despite being recognized for decades, adult GHD syndrome continues to pose diagnostic and therapeutic challenge.

Association between the use of proton pump inhibitors and serum PSA levels in the general U.S. population.

Background: Proton pump inhibitors (PPIs) are widely prescribed drugs that have been associated with increased prostate cancer (PCa) cell proliferation in vitro and worse oncological outcomes in vivo. However, data on their influence on PSA levels in the general population are lacking.

Methods: We extracted individual participant data from the 2001-2010 cycles of the National Health and Nutrition Examination Survey (NHANES), in which PSA levels were measured in all male participants aged 40 years or older.

Evaluation of fluid status in patients with acromegaly through bioelectrical impedance vector analysis: a cross-sectional study.

Purpose: The acromegalic state is associated with an increase in total body water and sodium. The aim of our study was to assess the hydration status of patients with acromegaly using bioimpedance vector analysis (BIVA), differentiating patients according to their disease status (active, medically controlled or cured) and to compare the confidence and tolerance ellipses of BIVA in those patients in relation to a reference healthy population.

Methods: We analyzed data from 73 consecutive patients aged 18 years or older, diagnosed with acromegaly and undergoing regular follow-up at our Division for whom a BIVA analysis was available.

Diagnostic delay, older age, and hormonal levels at diagnosis affect disease burden and mortality in acromegaly.

Purpose: Acromegaly, a rare disease with peak incidence in early adulthood, is marked by significant diagnostic delay and increased mortality due to complications. While older patients often show milder disease activity, they experience longer diagnostic delay. Higher hormonal levels, advanced age, and prolonged delay are associated with more systemic complications.

Growth Hormone-Secreting Pituitary Adenoma: Dura Mater Invasion Is Not a Predictor of Acromegaly Persistence After Trans-Sphenoidal Surgery.

: In pituitary adenomas, examinations of surgical specimens have shown that dural invasion occurs in 42-85% of cases. No studies about dura mater invasion have been conducted specifically in acromegaly patients. The aim of the present study was to evaluate the relationship between histologically dural invasion and the main features of GH-secreting adenomas.

Treatment with Long-Acting Somatostatin Analogues in Patients with Acromegaly: When and How.

Somatostatin and its analogs have been for years a mainstay treatment for a variety of hypersecretory conditions and neoplasms of the endocrine system. This chapter summarizes their pharmacological properties, their indication in the context of acromegaly, and the best way to handle this class of drugs for the treatment of the patient with acromegaly.

A 2024 Update on Growth Hormone Deficiency Syndrome in Adults: From Guidelines to Real Life.

Adult growth hormone deficiency (GHD) has been recognized since the late 1980s. The clinical manifestations of adult GHD are often nonspecific, and diagnosis relies on GH stimulation tests, which are intricate, costly, time-consuming, and may carry the risk of adverse effects. Diagnosis is further complicated by factors like age, sex, and BMI, which affect GH response during testing.

Desmopressin dose requirements in patients with permanent arginine vasopressin deficiency: a tertiary center experience.

Purpose: The desmopressin daily dose requirement is highly variable among patients with arginine vasopressin (AVP) deficiency (i.e. central diabetes insipidus) and few studies to date have evaluated this topic, with often inconclusive results.

Skeletal fragility in pituitary disease: how can we predict fracture risk?

Pituitary hormones play a crucial role in regulating skeletal physiology, and skeletal fragility is a frequent complication of pituitary diseases. The ability to predict the risk of fracture events is crucial for guiding therapeutic decisions; however, in patients with pituitary diseases, fracture risk estimation is particularly challenging. Compared to primary osteoporosis, the evaluation of bone mineral density by dual X-ray absorptiometry is much less informative about fracture risk.

Prolactin-secreting tumors, dopamine agonists and pregnancy: a longitudinal experience of a tertiary neuroendocrine center.

Purpose: Prolactin (PRL)-secreting tumours are associated with infertility and can be reverted by dopamine agonist (DA) therapy. The suspension of DA is recommended once pregnancy is established, as all DAs cross the placenta. The aim of the study was to evaluate the rate of maternal-foetal complications in women treated with cabergoline (CAB) or bromocriptine (BRM) for prolactinoma during gestation and the effect of pregnancy on prolactinoma progression.

Radiomic Analysis in Pituitary Tumors: Current Knowledge and Future Perspectives.

Radiomic analysis has emerged as a valuable tool for extracting quantitative features from medical imaging data, providing in-depth insights into various contexts and diseases. By employing methods derived from advanced computational techniques, radiomics quantifies textural information through the evaluation of the spatial distribution of signal intensities and inter-voxel relationships. In recent years, these techniques have gained considerable attention also in the field of pituitary tumors, with promising results.

LEAP-2/ghrelin interplay in adult growth hormone deficiency: Cause or consequence? A pilot study.

Ghrelin and its endogenous antagonist liver-expressed antimicrobial peptide-2 (LEAP-2) are involved in GH secretion and glucose/lipids metabolism. LEAP-2 expression in conditions of metabolic impairment may be upregulated, usually pairing with a concomitant reduction in ghrelin secretion. Adult growth hormone deficiency (aGHD) is characterized by insulin resistance, weight gain, and increased fat mass.