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Objective: The novel coronavirus caused a disease that mainly affected the respiratory system. The effect of severe acute respiratory syndrome coronavirus 2 on the hypot halam ic–pi tuita ry–ad renal axis is unknown. This study assesses the prognostic accuracy of serum cortisol levels and prediction tools in predicting mortality rates in patients with coronavirus disease 2019 (COVID-19). Methods: We prospectively analyzed 106 inpatients (53 COVID-19 positive, 53 non-COVID-19; mean 59.9 ± 17.3 years; 38 males and 68 females) with serum cortisol and adrenocorticotropic hormone levels compared with prognostic scores. Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores determined the disease’s severity. The predictive value of serum cortisol, APACHE, and SOFA on mortality was assessed using receiver operating characteristic curve analysis and the area under the curve (AUC). Results: No significant age or sex differences were found between groups. Serum cortisol levels were similar. The APACHE-II scores in the COVID-19 group were higher than in the other group, while SOFA scores showed no significant difference. The AUC for the APACHE-II score in predicting mortality was 0.765 (95% CI 0.672-0.842), with an optimal cutoff (>9) demonstrating 62.5% sensitivity and 86.7% specificity for overall participants. No correlation was found between serum cortisol levels and prediction tools such as APACHE-II and SOFA. Conclusion: The measurement of serum cortisol did not provide additional prognostic information beyond that established by the APACH-II score. This study highlights the significance of assessing novel prognostic tools for predicting outcomes in hospitalized patients with COVID-19. [ABSTRACT FROM AUTHOR]

The increasing incidence of obesity and type 2 diabetes mellitus (T2DM) is a global problem. Although the obesity epidemic is mostly associated with a lack of physical activity and diet, several chemicals have been demonstrated to have a potential role in its pathophysiological mechanisms. An accumulating volume of evidence indicates that a subclass of endocrine-disrupting chemicals (EDCs) can impair hormonally regulated metabolic processes, particularly in the case of exposure early in life when the defense mechanisms of the human body are yet to be fully developed. These chemicals are called "obesogenic EDCs" and might cause some people to gain weight despite their attempts to increase physical activity and limit calorie intake. Similarly, background exposure to some environmental EDCs has been associated with diabetes and impaired glucose metabolism. Certain widespread EDCs, including pesticides, dioxins, and bisphenol A, in animal models may change β function and insulin resistance. These EDCs, which may accumulate in adipose tissue and cause a pro-inflammatory response, can also be found at measurable levels in human blood and can either imitate or block some hormonal reactions. In this review, we evaluate EDCs in relation to obesity and T2DM in light of the current literature. [ABSTRACT FROM AUTHOR]

Objectives: Central venous sampling (CVS) with corticotropin-releasing hormone (CRH) stimulation is a crucial technique in evaluating adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS). We evaluated central venous sampling (CVS) and magnetic resonance imaging (MRI) findings in predicting the localization and lateralization of pituitary microadenomas. Methods: We analyzed 29 patients with CS who underwent CVS with CRH stimulation and examined with MRI retrospectively. Catheterization to central sinuses was successfully performed in 26 patients. Three patients with variant anatomy or inability to cannulate were diagnosed with CD after examination of pathology. Results: After CVS, among 26 patients, 23 patients were determined to have CD (88.4%) and 2 (7.7%) patients were diagnosed with ectopic ACTH syndrome. One patient was diagnosed with CD postoperatively. While the sensitivity of the CVS was 95.6%, sensitivity of the preoperative pituitary MRI was lower (69.5%). Also, the negative predictive value ratio was higher in CVS than in MRI (66% versus 22%). Diagnostic accuracy in the lateralization of the tumor was high as in CVS as in MRI (76.4% versus 73.9%). Conclusion: Central venous sampling with higher sensitivity in the localization of pituitary microadenoma, also has approximately similar diagnostic accuracy in lateralizing the tumor with MRI. [ABSTRACT FROM AUTHOR]

We examined the patients with hyperinsulinemic hypoglycemia who were performed noninvasive imaging techniques with doubtful or failed results. We compared the performances of the Selective Arterial Calcium Stimulation Test (SACST) and non-invasive imaging techniques. Eight patients with hyperinsulinemic hypoglycemia, performed SACST after evaluating with imaging modalities were examined retrospectively. Three patients were diagnosed with Non-Insulinoma Pancreatogenous Hypoglycemia Syndrome (NIPHS), 4 with insulinoma, and 1 with autoimmune hypoglycemia after SACST. While the concordance between the SACST and surgery-proven pathology for insulinoma was 50% (2/4), the accuracy in the localization of insulinoma was 25%. Although SACST does not have high concordance with surgery-proven pathology and accuracy in the localization of insulinoma, it may be preferred in the differential diagnosis of hyperinsulinemic hypoglycemia in medical centers where other imaging techniques are not available, or in cases where other imaging methods obtain suspicious/inadequate diagnosis. [ABSTRACT FROM AUTHOR]

Objective: This report aimed to examine changes in constituents of body composition that correlate to cardiovascular morbidity and mortality in patients with acromegaly using bioelectrical impedance analysis (BIA). Materials and Methods: This prospective study included 62 patients who were followed up after their acromegaly diagnosis and 40 healthy volunteers. All patients' body compositions were evaluated using a body composition analyzer (TANITA MC-780-Black) with the BIA method. The laboratory and anthropometric measurements and body composition parameters were compared between the patients with acromegaly and the controls. Moreover, these parameters were examined according to the disease activity. Results: This study showed that patients with acromegaly have higher plasma glucose levels than the control group (p=0.001). The homeostasis model assessment-insulin resistance index of patients with acromegaly was significantly higher than that of the controls (p=0.02). The compartments of intracellular water (ICW) and extracellular water (ECW) in the patients with acromegaly were larger than that in the controls (respectively; p=0.02 and p=0.001). The lean mass of the patients with acromegaly in the trunk and extremities was significantly higher than the controls (respectively; p=0.002 and p=0.001). The compartment of muscle was significantly larger than that in the controls (p=0.001). The basal metabolism in patients with acromegaly was significantly higher than that in the controls (p=0.002). Conclusion: Determining the body composition using the BIA method can provide important information about the cardiovascular risks in patients with acromegaly. With the BIA method, cardiovascular risk can be estimated and reduced with effective strategies. [ABSTRACT FROM AUTHOR]

Aim: Different comments are stated in the studies about the association between Graves' disease and thyroid neoplasms. The aim of this research was to evaluate the prevalance of thyroid neoplasm in patients with Graves' disease who underwent thyroidectomy. Materials and Methods: A retrospective examination was made of 200 patients, who were followed up with the diagnosis of Graves' disease between 2008 and 2020. A total of 46 patients who underwent thyroidectomy were evaluated in the study. Euthyroidism was achieved in all patients before the operation. Results: Thyroidectomy for Graves' disease was performed in 46 cases. Thyroid neoplasm was identified in the surgically-resected specimens of 12 patients (26.1%). The prevalence of thyroid neoplasm was higher in patients with nodules than in those without (p= 0.08). The level of white blood cells was higher in patients with neoplasm than in those without. The levels of thyroglobuline antibody and thyroid peroxidase, which are increased in autommune thyroiditis, were higher in patients without neoplasms than in those with neoplasm. Conclusion: In addition to careful physical examination, thyroid ultrasonography should be performed in patients with Graves' disease. Surgery should be recommended for patients with suspicious or malignant findings on thyroid ultrasonography and fine needle aspiration biopsy. Also, increased white blood cell count and low thyroid autoantibody levels should raise suspicion of the presence of neoplasm. [ABSTRACT FROM AUTHOR]