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Endocrines, Volume 2, Issue 4 (December 2021) – 14 articles

Cover Story (view full-size image): Telemedicine has been widely used by patients with type 1 diabetes (T1D) during the pandemic. Survey respondents from across the U.S. report that their adoption of telemedicine was driven by providers limiting in-person care, health concerns, public policies discouraging in-person contact, and changes in insurance and provider policies, which made telehealth newly accessible. The majority of patients utilizing telemedicine for T1D feel that it is effective, and hope to continue using it in the future. However, certain demographic groups report fewer perceived benefits from telemedicine, suggesting that it may be a less patient-centered care modality for some individuals with T1D. View this paper.
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17 pages, 363 KiB  
Review
Optimal Type 2 Diabetes Mellitus Management and Active Ageing
by Alessia Maria Calabrese, Valeria Calsolaro, Sara Rogani, Chukwuma Okoye, Nadia Caraccio and Fabio Monzani
Endocrines 2021, 2(4), 523-539; https://doi.org/10.3390/endocrines2040047 - 13 Dec 2021
Cited by 1 | Viewed by 3380
Abstract
Type two diabetes mellitus (T2DM) represents a chronic condition with increasing prevalence worldwide among the older population. The T2DM condition increases the risk of micro and macrovascular complications as well as the risk of geriatric syndromes such as falls, fractures and cognitive impairment. [...] Read more.
Type two diabetes mellitus (T2DM) represents a chronic condition with increasing prevalence worldwide among the older population. The T2DM condition increases the risk of micro and macrovascular complications as well as the risk of geriatric syndromes such as falls, fractures and cognitive impairment. The management of T2DM in the older population represents a challenge for the clinician, and a Comprehensive Geriatric Assessment should always be prioritized, in order to tailor the glycated hemoglobin target according to functional and cognitive status comorbidities, life expectancy and type of therapy. According to the most recent guidelines, older adults with T2DM should be categorized into three groups: healthy patients with good functional status, patients with complications and reduced functionality and patients at the end of life; for each group the target for glycemic control is different, also according to the type of treatment drug. The therapeutic approach should always begin with lifestyle changes; after that, several lines of therapy are available, with different mechanisms of action and potential effects other than glucose level reduction. Particular interest is growing in sodium-glucose cotransporter-2 inhibitors, due to their effect on the cardiovascular system. In this review, we evaluate the therapeutic options available for the treatment of older diabetic patients, to ensure a correct treatment approach. Full article
8 pages, 270 KiB  
Communication
PCOS and Assisted Reproduction Technique: Role and Relevance of Inositols
by Paolo Giovanni Artini, Elisa Malacarne and Vito Cela
Endocrines 2021, 2(4), 515-522; https://doi.org/10.3390/endocrines2040046 - 10 Dec 2021
Viewed by 2384
Abstract
Polycystic ovary syndrome is an endocrine disorder often characterized by insulin resistance and hyperinsulinemia, especially in overweight/obese women. Among insulin sensitizers, the positive role of inositols has been increasingly established in recent years. The action of inositols not only concerns the metabolic parameters [...] Read more.
Polycystic ovary syndrome is an endocrine disorder often characterized by insulin resistance and hyperinsulinemia, especially in overweight/obese women. Among insulin sensitizers, the positive role of inositols has been increasingly established in recent years. The action of inositols not only concerns the metabolic parameters of these patients, but also the hormonal profile, resulting in beneficial effects on ovarian function. For this reason, many studies have tried to recognize their role in PCOS infertile women who underwent in vitro fertilization (IVF) procedures. Full article
1 pages, 163 KiB  
Addendum
Addendum: Hackney, A.C.; Willett, H.N. Testosterone Responses to Intensive, Prolonged Endurance Exercise in Women. Endocrines 2020, 1, 119–124
by Anthony C. Hackney and Hannah N. Willett
Endocrines 2021, 2(4), 514; https://doi.org/10.3390/endocrines2040045 - 8 Dec 2021
Viewed by 1560
Abstract
It has been brought to our attention that the Ethics Committee and approval code were missing in the Materials and Methods Section of our published paper [...] Full article
(This article belongs to the Special Issue Exercise Endocrinology)
12 pages, 310 KiB  
Review
Stress Axis in the Cancer Patient: Clinical Aspects and Management
by Felicetti Francesco, Nervo Alice, Gatti Filippo, Rosso Daniela, Brignardello Enrico and Arvat Emanuela
Endocrines 2021, 2(4), 502-513; https://doi.org/10.3390/endocrines2040044 - 6 Dec 2021
Cited by 5 | Viewed by 3399
Abstract
Hypothalamus–pituitary–adrenal (HPA) axis alterations are common in cancer patients, mainly due to the different antitumoral therapies, which lead to several acute and late endocrine side effects. This review summarizes the most recent evidence regarding HPA derangement, both in patients with active neoplasms and [...] Read more.
Hypothalamus–pituitary–adrenal (HPA) axis alterations are common in cancer patients, mainly due to the different antitumoral therapies, which lead to several acute and late endocrine side effects. This review summarizes the most recent evidence regarding HPA derangement, both in patients with active neoplasms and in cancer survivors, with particular attention to the impact of the different antitumoral treatments, focusing on the major clinical aspects. While acute hormone failure usually results from injury caused directly by tumor burden or surgical interventions, short- and long-term effects are generally due to chemotherapy, radiotherapy and, as more recently shown, to different types of targeted- and immuno-therapy. Adrenal insufficiency (AI) is mostly caused by pituitary or hypothalamic injury rather than a direct damage of the adrenal gland. Moreover, other treatments commonly employed as supportive therapy or in the context of palliative care (i.e., glucocorticoids, opioids) can lead to HPA dysfunction. Epidemiology and pathophysiology of stress axis alterations in cancer patients still require clarification. Since AI may represent a life-threatening condition, monitoring adrenal function in cancer patients is mandatory, especially in subjects who experience fatigue or during stress conditions, in order to promptly start replacement treatment when needed. Full article
(This article belongs to the Special Issue Neuroregulation of the Hypothalamus-Pituitary-Adrenal)
17 pages, 750 KiB  
Review
Maturity-Onset Diabetes of the Young (MODY): Genetic Causes, Clinical Characteristics, Considerations for Testing, and Treatment Options
by Zoltan Antal
Endocrines 2021, 2(4), 485-501; https://doi.org/10.3390/endocrines2040043 - 3 Dec 2021
Cited by 7 | Viewed by 9253
Abstract
Maturity Onset Diabetes of the Young (MODY) encompasses a group of rare monogenic forms of diabetes distinct in etiology and clinical presentation from the more common forms of Type 1 (autoimmune) and Type 2 diabetes. Since its initial description as a clinical entity [...] Read more.
Maturity Onset Diabetes of the Young (MODY) encompasses a group of rare monogenic forms of diabetes distinct in etiology and clinical presentation from the more common forms of Type 1 (autoimmune) and Type 2 diabetes. Since its initial description as a clinical entity nearly 50 years ago, the underlying genetic basis for the various forms of MODY has been increasingly better elucidated. Clinically, the diagnosis may be made in childhood or young adulthood and can present as overt hyperglycemia requiring insulin therapy or as a subtle form of slowly progressive glucose impairment. Due to the heterogeneity of clinical symptoms, patients with MODY may be misdiagnosed as possessing another form of diabetes, resulting in potentially inappropriate treatment and delays in screening of affected family members and associated comorbidities. In this review, we highlight the various known genetic mutations associated with MODY, clinical presentation, indications for testing, and the treatment options available. Full article
(This article belongs to the Special Issue Genetics in Pediatric Endocrinology)
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13 pages, 486 KiB  
Review
Dance and Music for Improving Health among Patients with Breast Cancer and Parkinson’s Disease: A Narrative Review
by Francesca Greco, Elisa Grazioli, Attilio Parisi, Emanuela A. Greco and Gian Pietro Emerenziani
Endocrines 2021, 2(4), 472-484; https://doi.org/10.3390/endocrines2040042 - 24 Nov 2021
Cited by 1 | Viewed by 3209
Abstract
Although a longer life may bring new opportunities for older people and society, advancing age is a leading risk factor for developing several chronic diseases, consequently limiting the health span. During the ageing process, changes in the activity of several endocrine glands may [...] Read more.
Although a longer life may bring new opportunities for older people and society, advancing age is a leading risk factor for developing several chronic diseases, consequently limiting the health span. During the ageing process, changes in the activity of several endocrine glands may occur, leading to different clinical conditions. Being physically active becomes fundamental for healthy ageing. Despite regular physical activity being shown to have many health benefits, patients with cancer and neurodegenerative diseases remain physically inactive. Over the past two decades, there has been a major increase in arts engagement (e.g., dance and music) on health and well-being in both clinical and non-clinical contexts. Dance and music have been shown to induce positive effects on hormonal glands, patients’ sociality, and self-confidence. Therefore, this review aims to highlight evidence regarding the effects of music and dance on hormonal responses and as preventive and compliance tools for heathy ageing in breast cancer and Parkinson’s disease patients. Full article
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15 pages, 1034 KiB  
Review
Benefits of the Phytoestrogen Resveratrol for Perimenopausal Women
by Osamu Wada-Hiraike
Endocrines 2021, 2(4), 457-471; https://doi.org/10.3390/endocrines2040041 - 2 Nov 2021
Cited by 2 | Viewed by 4068
Abstract
Endometriosis, characterized by macroscopic lesions in the ovaries, is a serious problem for women who desire conception. Damage to the ovarian cortex is inevitable when lesions are removed via surgery, which finally decreases the ovarian reserve, thereby accelerating the transition to the menopausal [...] Read more.
Endometriosis, characterized by macroscopic lesions in the ovaries, is a serious problem for women who desire conception. Damage to the ovarian cortex is inevitable when lesions are removed via surgery, which finally decreases the ovarian reserve, thereby accelerating the transition to the menopausal state. Soon after cessation of ovarian function, in addition to climacteric symptoms, dyslipidemia and osteopenia are known to occur in women aged >50 years. Epidemiologically, there are sex-related differences in the frequencies of dyslipidemia, hypertension, and osteoporosis. Females are more susceptible to these diseases, prevention of which is important for healthy life expectancy. Dyslipidemia and hypertension are associated with the progression of arteriosclerosis, and arteriosclerotic changes in the large and middle blood vessels are one of the main causes of myocardial and cerebral infarctions. Osteoporosis is associated with aberrant fractures in the spine and hip, which may confine the patients to the bed for long durations. Bone resorption is accelerated by activated osteoclasts, and rapid bone remodeling reduces bone mineral density. Resveratrol, a plant-derived molecule that promotes the function and expression of the sirtuin, SIRT1, has been attracting attention, and many reports have shown that resveratrol might exert cardiovascular protective effects. Preclinical reports also indicate that it can prevent bone loss and endometriosis. In this review, I have described the possible protective effects of resveratrol against arteriosclerosis, osteoporosis, and endometriosis because of its wide-ranging functions, including anti-inflammatory and antioxidative stress functions. As ovarian function inevitably declines after 40 years, intake of resveratrol can be beneficial for women with endometriosis aged <40 years. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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8 pages, 344 KiB  
Article
Patient Perspectives on Use of Video Telemedicine for Type 1 Diabetes Care in the United States during the COVID-19 Pandemic
by Stephanie S. Crossen, Crystal C. Romero, Lindsey A. Loomba and Nicole S. Glaser
Endocrines 2021, 2(4), 449-456; https://doi.org/10.3390/endocrines2040040 - 1 Nov 2021
Cited by 14 | Viewed by 3184
Abstract
The COVID-19 pandemic has resulted in widespread adoption of telemedicine for management of chronic conditions such as type 1 diabetes (T1D), but few data have been collected about the patient experience and perceived quality of care during this time. We surveyed members of [...] Read more.
The COVID-19 pandemic has resulted in widespread adoption of telemedicine for management of chronic conditions such as type 1 diabetes (T1D), but few data have been collected about the patient experience and perceived quality of care during this time. We surveyed members of the T1D Exchange patient registry and online community regarding their experiences with and opinions about telemedicine care during the pandemic. Among 2235 survey respondents, 65% had utilized telemedicine. The most common reasons for adopting telemedicine were providers not offering in-person care (66%), concerns about the health risks of in-person care (59%), providers offering (52%) or insurance covering (19%) telemedicine for the first time, and local or state orders to stay home (33%). Among telemedicine users, 62% felt video care was as effective as or more effective than in-person care, and 82% hoped to use telemedicine in the future. The most-cited reason for non-use of telemedicine was that providers were not offering it (49%). Our findings highlight the role of telemedicine in maintaining access to T1D care during the COVID-19 pandemic. Respondents’ satisfaction with telemedicine and interest in its continued use signifies the need for ongoing access to this care modality and for the development of telemedicine best practices within T1D care. Full article
(This article belongs to the Special Issue Type 1 Diabetes)
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10 pages, 1216 KiB  
Review
Endocrinological and Nutritional Implications of Anorexia of Aging
by Alessio Molfino, Giovanni Imbimbo and Maurizio Muscaritoli
Endocrines 2021, 2(4), 439-448; https://doi.org/10.3390/endocrines2040039 - 26 Oct 2021
Cited by 3 | Viewed by 2845
Abstract
Poor appetite—known as anorexia—is a common condition in aging and is associated with poor outcomes, including reduced survival and impaired quality of life. The anorexia of aging is mainly the result of several complex endocrinological, metabolic, and nutritional changes occurring with later age. [...] Read more.
Poor appetite—known as anorexia—is a common condition in aging and is associated with poor outcomes, including reduced survival and impaired quality of life. The anorexia of aging is mainly the result of several complex endocrinological, metabolic, and nutritional changes occurring with later age. The modulation of different peptides and hormones has been identified as an important determinant for the development of low appetite; in particular, an altered imbalance of plasma ghrelin, leptin, and cholecystokinin and increased inflammatory markers are implicated in its pathophysiology, and robust evidence of their involvement in anorexia of aging has been produced in the clinical setting. More recently, researchers identified that the gut microbiome composition significantly varies according to the appetite status. Other important clinical factors may worsen the symptoms of the anorexia in the elderly, in particular the potential concomitant presence of chronic catabolic comorbidities. Importantly, data indicate that anorexia is prevalent in frail older adults, negatively impacting body composition and specifically in altering muscle mass and function. For all these reasons, a prompt and early diagnosis of anorexia in the elderly is crucial to implement personalized metabolic and nutrition interventions to improve the outcomes and ameliorate quality of life. Full article
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12 pages, 5685 KiB  
Review
Metabolic Reprogramming in Thyroid Cancer: Role of the Epithelial-Mesenchymal Transition
by Monica Fedele, Sabrina Battista and Laura Cerchia
Endocrines 2021, 2(4), 427-438; https://doi.org/10.3390/endocrines2040038 - 22 Oct 2021
Cited by 2 | Viewed by 2710
Abstract
Thyroid cancer (TC) represents the most common endocrine malignancy, with an increasing incidence all over the world. Papillary TC (PTC), a differentiated TC subtype, is the most common and, even though it has an excellent prognosis following radioiodine (RAI) ablation, it shows an [...] Read more.
Thyroid cancer (TC) represents the most common endocrine malignancy, with an increasing incidence all over the world. Papillary TC (PTC), a differentiated TC subtype, is the most common and, even though it has an excellent prognosis following radioiodine (RAI) ablation, it shows an aggressive behavior in 20–30% of cases, becoming RAI-resistant and/or metastatic. On the other side, anaplastic thyroid carcinoma (ATC), the most undifferentiated TC, is a rare but devastating disease, indicating that progression of differentiated to undifferentiated forms of TC could be responsible for RAI-resistance and increased mortality. The epithelial-to-mesenchymal transition (EMT) plays a pivotal role in both tumor progression and resistance to therapy. Moreover, during tumor progression, cancer cells modify their metabolism to meet changed requirements for cellular proliferation. Through these metabolic changes, cancer cells may adopt cancer stem cell-like properties and express an EMT phenotype. EMT, in turn, can induce metabolic changes to which cancer cells become addicted. Here we review metabolic reprogramming in TC highlighting the role of EMT with the aim to explore a potential field to find out new therapeutic strategies for advanced-stage PTC. Accordingly, we discuss the identification of the metabolic enzymes and metabolites, critical to TC progression, which can be employed either as predicting biomarkers of tumor response to RAI therapy or possible targets in precision medicine. Full article
(This article belongs to the Section Endocrine Oncology)
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10 pages, 291 KiB  
Communication
Role of Vitamin D in Cardiovascular Diseases
by Valentino Condoleo, Corrado Pelaia, Giuseppe Armentaro, Giandomenico Severini, Elvira Clausi, Velia Cassano, Sofia Miceli, Teresa Vanessa Fiorentino, Elena Succurro, Franco Arturi, Francesco Andreozzi, Giorgio Sesti and Angela Sciacqua
Endocrines 2021, 2(4), 417-426; https://doi.org/10.3390/endocrines2040037 - 18 Oct 2021
Cited by 5 | Viewed by 3497
Abstract
Vitamin D represents a group of secosteroids involved in the calcium and phosphate metabolism. The active form of vitamin D, 1,25-dihydroxylcalciferol, exerts its biological mechanisms via the VDR (vitamin D receptor) which acts as a regulator of several target genes. Hypovitaminosis D is [...] Read more.
Vitamin D represents a group of secosteroids involved in the calcium and phosphate metabolism. The active form of vitamin D, 1,25-dihydroxylcalciferol, exerts its biological mechanisms via the VDR (vitamin D receptor) which acts as a regulator of several target genes. Hypovitaminosis D is associated with many diseases, which are not only limited to the metabolism of the skeleton, but growing evidence links the deficit of vitamin D to cardiovascular, metabolic, immune, and neoplastic diseases. In regard to the cardiovascular system, current evidence shows the presence of VDR in endothelial cells. Moreover, both in vitro and animal experimental models demonstrated that the deficit of vitamin D can promote endothelial dysfunction and atherosclerosis development. Vitamin D can interfere with vascular functions also by affecting the production of vasodilator mediators. VDR is also expressed in left ventricle cardiomyocytes, and hypovitaminosis D can relate to cardiac hypertrophy and heart failure. Randomized clinical trials (RCT) designed to prove the therapeutic role of vitamin D supplementation have been inconclusive to date. The aim of this review is to highlight the main interactions between vitamin D metabolism and cardiovascular diseases; thus, focusing on pathogenic mechanisms and related clinical manifestations. Full article
12 pages, 4487 KiB  
Review
Neuroendocrine Changes during Menopausal Transition
by Andrea Giannini, Marta Caretto, Andrea R. Genazzani and Tommaso Simoncini
Endocrines 2021, 2(4), 405-416; https://doi.org/10.3390/endocrines2040036 - 14 Oct 2021
Cited by 9 | Viewed by 7010
Abstract
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. Quality of life of postmenopausal woman is the result of a series of psychobiological transformations, that see in the reduction of sex hormones and steroids the etiopathogenetic determinant [...] Read more.
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. Quality of life of postmenopausal woman is the result of a series of psychobiological transformations, that see in the reduction of sex hormones and steroids the etiopathogenetic determinant moment. Symptoms of menopause range from somatic side such as metabolic changes, increased cardiovascular disease, irregular vaginal bleeding, urogenital symptoms, vaginal dryness, osteoporosis and risk of bones fractures to changes of central nervous system as vasomotor symptoms, sleep disruption, mood changes, migraine, sexual dysfunctions. It is fundamental to know the mechanisms underlying changes in the central nervous system during menopause, related to hypoestrogenism, to be able to create appropriate target therapy for patients, improving their quality of life. In fact, the central nervous system is now one of the major targets of sex steroids that cannot be achieved disregard when dealing with the problem of choice of a particular type of MHT. Full article
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21 pages, 2213 KiB  
Review
Copeptin and Stress
by Marianna Martino and Giorgio Arnaldi
Endocrines 2021, 2(4), 384-404; https://doi.org/10.3390/endocrines2040035 - 12 Oct 2021
Cited by 5 | Viewed by 5215
Abstract
Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response [...] Read more.
Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response to osmotic and hemodynamic stimuli in clinical practice. Moreover, evidence highlighting the prognostic potential of copeptin in several acute diseases, where the activation of the AVP system is primarily linked to stress, as well as in psychologically stressful conditions, has progressively emerged. Furthermore, organic stressors induce a rise in copeptin levels which, although non-specific, is unrelated to plasma osmolality but proportional to their magnitude: suggesting disease severity, copeptin proved to be a reliable prognostic biomarker in acute conditions, such as sepsis, early post-surgical period, cardiovascular, cerebrovascular or pulmonary diseases, and even in critical settings. Evidence on this topic will be briefly discussed in this article. Full article
(This article belongs to the Special Issue Neuroregulation of the Hypothalamus-Pituitary-Adrenal)
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18 pages, 697 KiB  
Review
Mediterranean Diet and Physical Activity for Successful Aging: An Update for Nutritionists and Endocrinologists
by Evelyn Frias-Toral, Sebastian Chapela, Maria de los Angeles Carignano, Dino Moretti, Andres Martinuzzi, Dolores Rodríguez-Veintimilla, Mery Guerrero, Gabriella Pugliese, Giovanna Muscogiuri and Luigi Barrea
Endocrines 2021, 2(4), 366-383; https://doi.org/10.3390/endocrines2040034 - 29 Sep 2021
Cited by 3 | Viewed by 3770
Abstract
The constant advancement in the medical field has allowed for the diagnosis and treatment of several health conditions. It has also contributed to increasing the average human lifespan, which is considered an outstanding achievement in history. Nevertheless, the impact of this in an [...] Read more.
The constant advancement in the medical field has allowed for the diagnosis and treatment of several health conditions. It has also contributed to increasing the average human lifespan, which is considered an outstanding achievement in history. Nevertheless, the impact of this in an ever-increasing aged population with chronic diseases and, most of the time, with limited and poor quality of life was not considered. Thus, it is imperative to establish strategies to age successfully. In order to do have a better understanding of this crucial issue, this review will analyze the endocrine changes in the elderly. It will present common conditions found in this population, chronic inflammation, and oxidative stress. Additionally, we will explain aging-related metabolic and physical performance decline related to hormone changes and lifestyle modifications. We will propose the Mediterranean diet and some specific guidelines about physical activity as part of the plan to have an active and successful aging process. Full article
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