Body Composition, Sarcopenia, and Serum Myokines in Acromegaly: A Narrative Review.

Patients with active acromegaly have a higher percentage of lean body mass, a lower percentage of fat body mass, and an increase in their extracellular water compartment compared to healthy individuals. However, muscle function appears to be compromised in patients with acromegaly, with some experiencing worsened physical performance and sarcopenia. Myokine alterations, insulin resistance, dysregulation of protein metabolism, muscle oxidative stress, neuromuscular junction impairment, and increased ectopic intramuscular fat deposits may play roles in muscle dysfunction in patients with acromegaly.

"Micromegaly": Acromegaly with apparently normal GH, an entity on its own?

A small proportion of the patients with acromegaly present with apparently normal basal GH levels and suppressible GH levels despite increased IGF-1 levels, a pattern called micromegaly by some authors. Whether this pattern represents a distinct entity or is just an expression of acromegaly in its early stages is still a matter of debate. Nevertheless, these patients have some peculiar characteristics such as being more likely older and male, mostly harbour microadenomas or small macroadenomas, and have lower IGF-1 and postglucose GH levels.

Hypopituitarism due to a Large Osteoclastoma Arising from the Sphenoid Bone Invading the Pituitary Fossa in a Patient with Parathyroid Carcinoma.

Background: Parathyroid carcinoma accounts for <1% of cases of primary hyperparathyroidism (PHPT). This rare condition may present with severe hypercalcemia and bone complications such as osteoclastomas and pathologic fractures. Here, we present a rare condition of panhypopituitarism resulting from an osteoclastoma in the sphenoid bone that invaded the pituitary fossa due to parathyroid carcinoma.

The Role of Bisphosphonates Prior to Denosumab Treatment on Rebound Fractures: A Mini Review.

Denosumab is a potent anti-resorptive medication used to treat patients at high risk for osteoporosis; however, its beneficial effects on the skeletal system are quickly reversed after discontinuation. In contrast, bisphosphonates (BPs) are anti-resorptive agents with residual effects on the bone matrix; thus, these are capable of preserving bone mass for a long time. Therefore, subsequent anti-resorptive treatment with BPs is mandatory to prevent rebound fractures.

Body Composition, Sarcopenia and Physical Performance After Bariatric Surgery: Differences Between Sleeve Gastrectomy and Roux-En-Y Gastric Bypass.

Purpose: Evaluate the differences between surgical techniques in the modifications of body composition and the interference in skeletal muscle health, risk of sarcopenia, and reduced physical performance.

Materials And Methods: This is a cross-sectional prospective study. A total of 71 patients, who underwent sleeve gastrectomy (SG) or underwent Roux-en-Y gastric bypass (RYGB).

Management of Primary Hyperparathyroidism.

Since the last international guidelines were published in 2014 on the evaluation and management of primary hyperparathyroidism (PHPT), new information has become available with regard to evaluation, diagnosis, epidemiology, genetics, classical and nonclassical manifestations, surgical and nonsurgical approaches, and natural history. To provide the most current summary of these developments, an international group, consisting of over 50 experts in these various aspects of PHPT, was convened. This paper provides the results of the task force that was assigned to review the information on the management of PHPT.

Third Ventricle Craniopharyngioma Intraventricular Tumor: A Case Report and a Brief Literature Review.

Craniopharyngioma is a rare embryonic malformation, usually benign, of the sellar or parasellar regions. In this study, an uncommon case of third ventricle craniopharyngioma and a succinct review of its prevalence are presented. Even with low mortality rates, these injuries involve a high degree of endocrinological, visual, and neuropsychological morbidities, which have a huge impact on the patient's quality of life.

Occult Renal Calcifications in Patients with Normocalcemic Primary Hyperparathyroidism and Their Association with the Parathyroid Hormone-Vitamin D Axis.

Normocalcemic primary hyperparathyroidism (NPHPT) is characterized by elevated serum levels of parathyroid hormone (PTH) with persistently normal serum calcium concentrations after excluding secondary causes of hyperparathyroidism. Urolithiasis and/or nephrocalcinosis may occur in hypercalcemic PHPT, but little is known about these complications in NPHPT. .

Secondary Hyperparathyroidism, Bone Density, and Bone Turnover After Bariatric Surgery: Differences Between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy.

Purpose: Bariatric surgery may lead to metabolic bone disease.

Materials And Methods: In this cross-sectional study, we compared the prevalence of secondary hyperparathyroidism (SHPT), impact on bone mass and turnover markers, and serum leptin after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in 117 patients (91% female, 51% RYGB, age 41.8 ± 6.

Fracture Risk After Bariatric Surgery: A Systematic Literature Review and Meta-Analysis.

Objective: Bariatric surgery has undeniable benefits for cardiovascular and metabolic health, but it can result in negative effects on mineral and bone metabolism. This study aimed to review the current data on fractures after the main types of bariatric surgery.

Methods: Therefore, a systematic review was performed using the electronic literature available in the databases LILACS, CENTRAL, Web of Science, Embase, and PubMed/MEDLINE, with results until January 2021.

Vitamin D deficiency and visceral adipose tissue in early pregnant women.

Background: We aimed to assess the correlation between vitamin D serum level and visceral fat tissue during early pregnancy.

Methods: This cross-sectional study was performed in Pernambuco, Brazil. 190 low risk pregnant women (8-16 gestational weeks) were eligible.

Agreement Between American and European Thyroid Imaging, Reporting, and Data System (TIRADS) in the Diagnosis of 473 Thyroid Nodules From a Single Center in Brazil.

Objective: To compare 2 ultrasound-based risk stratification systems in malignancy risk assessment of thyroid nodules and the clinical applicability of these guidelines in Brazil.

Methods: We retrospectively reviewed the ultrasound findings of 314 patients (473 thyroid nodules) who underwent fine-needle aspiration (FNA) biopsy and/or surgery between February 2018 and March 2019. All nodules were classified using 2 systems: the Thyroid Imaging, Reporting, and Data System (TIRADS) of the American College of Radiology (ACR-TIRADS) and the TIRADS of the European Thyroid Association (EU-TIRADS).

Machine Learning-based Prediction Model for Treatment of Acromegaly With First-generation Somatostatin Receptor Ligands.

Context: Artificial intelligence (AI), in particular machine learning (ML), may be used to deeply analyze biomarkers of response to first-generation somatostatin receptor ligands (fg-SRLs) in the treatment of acromegaly.

Objective: To develop a prediction model of therapeutic response of acromegaly to fg-SRL.

Methods: Patients with acromegaly not cured by primary surgical treatment and who had adjuvant therapy with fg-SRL for at least 6 months after surgery were included.

Impaired physical function and evaluation of quality of life in normocalcemic and hypercalcemic primary hyperparathyroidism.

Introduction: Severe primary hyperparathyroidism may be associated with muscle weakness and fatigue, but little is known about this effect in milder forms of the disease. This study aimed to evaluate physical function and quality of life in patients with normocalcemic (NPHPT) and hypercalcemic (HPHPT) primary hyperparathyroidism.

Methods: This was a case-control study on 40 postmenopausal women.

Nesidioblastosis Associated with Pancreatic Heterotopia as a Differential Diagnosis of Hypoglycemia: A Literature Review and Case Report.

BACKGROUND Nesidioblastosis is a rare disease that is part of the differential diagnosis of pancreatogenic hyperinsulinemic hypoglycemia (PHH) in patients whose imaging studies do not localize insulinoma. Pancreatic heterotopia is a rare congenital abnormality characterized by pancreatic tissue anatomically separated from the main gland and found in 0.5% of abdominal surgeries.

Body Composition, Serum Sclerostin and Physical Function After Bariatric Surgery: Performance of Dual-Energy X-ray Absorptiometry and Multifrequency Bioelectrical Impedance Analysis.

Introduction: The aim of this study was to determine the effects of bariatric surgery and weight loss on body composition, serum sclerostin and physical performance.

Methods: Seventy-three consecutive patients (36 non-surgical controls and 37 who underwent bariatric surgery) were evaluated by means of laboratory tests, multifrequency bioelectrical impedance analysis (BIA), total-body dual-energy X-ray absorptiometry (DXA), gait speed and handgrip strength.

Results: The differences between non-surgical and surgical patients were as follows: body mass index (BMI) 42.

Serum Sclerostin, Body Composition, and Sarcopenia in Hemodialysis Patients with Diabetes.

Sclerostin (Scl) is an osteoblast-inhibiting glycoprotein that is secreted mainly by osteocytes and is regulated by hormonal changes and skeletal loading. Decreased physical function and high serum Scl concentrations have been reported in chronic renal failure patients but little is known to date about the differences between diabetic and non-diabetic patients on hemodialysis who are susceptible to both sarcopenia and bone fragility. .

High Rate of Occult Urolithiasis in Normocalcemic Primary Hyperparathyroidism.

Introduction: Normocalcemic primary hyperparathyroidism (NPHPT) is characterized by elevations in serum parathyroid hormone levels in the presence of normal serum calcium concentrations after exclusion of secondary hyperparathyroidism. We have previously demonstrated no differences in the prevalence of clinically active urolithiasis between NPHPT and hypercalcemic asymptomatic PHPT, and that it is significantly higher in postmenopausal osteoporotic women with NPHPT in comparison to women with normal serum PTH and calcium concentrations. Few studies have addressed the occurrence of silent or occult kidney stones in asymptomatic hypercalcemic PHPT, but no data are available for NPHPT.

Vitamin D Deficiency, Skin Phototype, Sun Index, and Metabolic Risk Among Patients with High Rates of Sun Exposure Living in the Tropics.

We sought to evaluate serum 25-hydroxycholecalciferol (vitamin D [25-OHD]) levels, skin phototype, and sun index in a sample of patients to determine the association between these factors and metabolic risk. This was a cross-sectional study involving 729 adults (50.2% male).

Better performance of four-dimension computed tomography as a localization procedure in normocalcemic primary hyperparathyroidism.

Introduction: The multi-phase or four-dimensional computed tomography (4D CT) has emerged as a promising technique for preoperative localization of parathyroid lesions in patients with primary hyperparathyroidism (PHPT), but little is known about its accuracy in patients with normocalcemic primary hyperparathyroidism (NPHPT).

Methods: A total of 18 patients diagnosed with PHPT underwent three methods of preoperative localization (4D CT, TC-99-Sestamibi scintigraphy and ultrasonography). After surgery, the results of imaging were compared with operative findings, pathological and biochemical data to evaluate the sensitivity and of each localization procedure.

Normal bone density and trabecular bone score, but high serum sclerostin in congenital generalized lipodystrophy.

Context: Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty in storing lipids in adipocytes, low body fat mass, hypoleptinemia, and hyperinsulinemia. Sclerostin is a product of SOST gene that blocks the Wnt/β-catenin pathway, decreasing bone formation and enhancing adipogenesis. There are no data about sclerostin in people with BSCL.

Bone Density in Patients With Berardinelli-Seip Congenital Lipodystrophy Is Higher in Trabecular Sites and in Type 2 Patients.

Berardinelli-Seip congenital lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty storing lipid in adipocytes, low body fat, hypoleptinemia, and hyperinsulinemia. We report here laboratory, bone mineral density (BMD), and bone mineral content findings of 21 patients (24.1 ± 8.

Vitamin D Deficiency Is Associated with Severity of Acute Coronary Syndrome in Patients with Type 2 Diabetes and High Rates of Sun Exposure.

Background: Vitamin D deficiency has been associated with cardiovascular risk factors, including type 2 diabetes mellitus (T2DM). Evidence shows that patients with low serum 25-hydroxyvitamin D (25OHD) concentrations have a higher risk of developing coronary artery disease.

Objective: The objective of this study was to assess vitamin D as a predictor of the severity in diabetics with acute coronary syndrome (ACS).