Clinical Endocrinology (Clin Endocrinol )

Publisher: Blackwell Publishing

Description

Clinical Endocrinology publishes papers and reviews which focus on the practical aspects of clinical endocrinology, such as protocols for investigation of endocrine disorders, imaging in endocrinology and the clinical application of molecular endocrinology. It also features reviews, current therapy papers and cases of the month. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.

  • Impact factor
    3.40
  • 5-year impact
    3.26
  • Cited half-life
    7.40
  • Immediacy index
    0.87
  • Eigenfactor
    0.02
  • Article influence
    0.99
  • Website
    Clinical Endocrinology website
  • Other titles
    Clinical endocrinology (Oxford, England: Online)
  • ISSN
    1365-2265
  • OCLC
    46569692
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
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    • Some journals impose embargoes typically of 6 or 12 months, occasionally of 24 months
    • no listing of affected journals available as yet
  • Conditions
    • See Wiley-Blackwell entry for articles after February 2007
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    • On author or institutional or subject-based server
    • Server must be non-commercial
    • Publisher copyright and source must be acknowledged with set statement ("The definitive version is available at www.blackwell-synergy.com ")
    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley-Blackwell'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Adrenarche is a component of normal pubertal development. Recent decades have witnessed changes in the timing and tempo of puberty in different populations. We aimed to obtain normative data on dehydroepiandrosterone-sulfate (DHEA-S) secretion in healthy children and to evaluate the age of adrenarche, pubarche, and the DHEA-S levels at which pubarche starts in both sexes.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: The distinction between constitutional delay of growth and puberty (CDGP) and isolated hypogonadotropic hypogonadism (IHH) in males with delayed puberty is difficult but important for timely treatment. We assessed the accuracy of the GnRH agonist test (triptorelin 0.1 mg) in comparison with inhibin B alone or in combination with basal LH for the diagnosis of IHH.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Glucocorticoid replacement therapy in patients with adrenal insufficiency (AI), whether primary (Addison's disease) or secondary (due to hypopituitarism), has been established for some 50 years. The current standard treatment regimen involves twice- or thrice-daily dosing with a glucocorticoid, most commonly oral hydrocortisone. Based on previous small-scale studies and clinical perception, life expectancy with conventional glucocorticoid replacement therapy has been considered normal, with a low incidence of adverse events. Data from the past 10–15 years, however, have shown that morbidity remains high and life expectancy is reduced. The increased morbidity and decreased life expectancy appear to be due to both increased exposure to cortisol and insufficient cortisol coverage during infections and other stress-related events. This is thought to reflect a failure of treatment to replicate the natural circadian rhythm of cortisol release, together with a failure to identify and deliver individualized cortisol exposure and to manage patients adequately when increased doses are required. The resulting over- or under-treatment may result in Cushing-like symptoms or adrenal crisis, respectively. This review summarizes the morbidity and mortality seen in patients receiving the current standard of care for AI and suggests areas for improvement in glucocorticoid replacement therapy.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: We have noted the letter by Chortis et al.1 published in response to our report about supine versus seated blood sampling for diagnosis of phaeochromocytoma.2 There are several issues that the authors have missed and which they might wish to consider further in relation to their cost analysis and the methods employed at their centre. First Chortis et al. describe reference intervals for normetanephrine (120-1180 pmol/l) and metanephrine (80-510 pmol/l) identical to those established by Peaston et al.3This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Objective Osteocalcin has been proposed to be a novel link between bone and energy metabolism. Previous studies showed its relations to exercise, body fat, and glucose metabolism, but their interrelationship remains inconslusive. We evaluated the changes in osteocalcin level following 8-week exercise program and assessed how they are related to concomitant changes in body fat composition, insulin resistance, and various adipocytokines in a single center, randomized, prospective design.Study design and MethodsA total of 39 young obese, otherwise healthy males were randomly assigned to control(n=10) and exercise(n=29) groups. Subjects in Exercise group were on 8-week supervised exercise training program of four sessions per week. Body fat compositions were analyzed using whole body bone mineral density, and various metabolic parameters, osteocalcin, and adipocytokines were assessed from fasting blood samples before and after 8-week exercise program.ResultsBody fat reduction following exercise significantly increased serum total (1.51±0.36 vs. 1.69±0.39 mmol/L, P=0.01, baseline vs. post-exercise) and undercarboxylated osteocalcin level (0.44±0.14 vs. 0.64±0.26 mmol/L, P<0.01), and the increase in osteocalcin was in negative correlations with changes in body weight, BMI, and body fat percent as well as HOMA-IR and leptin (all P<0.05). The changes in osteocalcin and leptin were not independent predictors of changes in insulin resistance and osteocalcin, respectively.Conclusions In a physiologic axis of bone-fat-energy metabolism, exercise-induced body fat reduction and improved insulin sensitivity were accompanied by an increase in serum osteocalcin and leptin levels, but other factors also seem to be involved in this interrelationship.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Biosynthetic human Growth Hormone (r-hGH) has an extremely good efficacy and safety profile. The use of r-hGH has expanded from classic GH deficiency to wider indications such as Turner Syndrome and Chronic Renal Failure. This wider use has been predicated in part by the safety profile of r-hGH. Long-term outcomes of treating children with r-hGH are lacking although concern has been raised by preliminary data linking r-hGH use with premature death (1). These observations have been extended in a paper by Poidvin et al (2) from the Safety and Appropriateness of Growth Hormone Treatments in Europe (SAGhE) French cohort.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: In a case-control study(1) , Hung et al. found that statin use was associated with thyroid cancer in female patients. We suggest that the immunomodulatory action of statin drugs may represent a mechanism underlying this detrimental association. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Objective To study the interaction between copeptin and hypothalamic-pituitary-adrenal (HPA) activation in men and women during hypoglycaemic stress.Design and patientsA prospective study in 118 patients (mean age 47.7±13.6 yrs., n=52 women) undergoing insulin tolerance testing for suspected pituitary dysfunction.MeasurementsSerum copeptin was measured in serially collected blood samples and assessed in relation to ACTH, cortisol and other endocrine parameters.ResultsSymptomatic hypoglycaemia (mean glucose nadir, 1.6±0.5 mmol/l) resulted in a rapid significant increase of serum copeptin. Individuals with impaired pituitary function had lower stress-induced copeptin levels (median, 6.26 pmol/l) than patients with intact pituitary (8.46 pmol/l, P < 0.001). A weak overall correlation between stress-induced copeptin and cortisol levels was observed (rs = 0.31, P < 0.001). In female individuals, there was a positive correlation between stress-induced copeptin and ACTH (rs = 0.47, P < 0.001) or cortisol levels (rs = 0.42, P = 0.002), while in males no correlation to ACTH (rs = 0.03, P = 0.75) and poor correlation to cortisol levels (rs = 0.24, P = 0.045). was observed. Patients with central diabetes insipidus showed lowest baseline (2.20 pmol/l) and stimulated copeptin levels (3.68 pmol/l).Conclusions The data from this study indicate that stress-induced release of AVP in women, but not in men, is linked to the co-activation of the hypothalamic-pituitary-adrenal system.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Objective Post partum thyroiditis (PPT) is a common phenomenon in the general population. To date there have been few studies examining the incidence of PPT in women with hypothyroidism antedating pregnancy. This study aimed to assess the incidence and potential predictors of PPT in women with treated hypothyroidism antedating pregnancy.DesignRetrospective cohort studyPatients and Methods We compiled a cohort of 97 women with previous hypothyroidism antedating pregnancy seen in the Endocrinology in Pregnancy clinic from 1999-2011, collecting data on thyroid function, antibodies, and levothyroxine doses post-partum. The incidence of PPT and its predictors were analyzed.ResultsA total of 66 (68%) women had fluctuations in thyroid function consistent with postpartum thyroiditis (PPT). Of these, 22 (33%) had a hyperthyroid phase alone, 22 (33%) had a hypothyroid phase alone and 22 (33%) had both a hyper and hypo phase. The majority of women had their dose of thryoid medication adjusted during the PPT episode. Women who were on a full dose of thyroxine post partum were significantly less likely to have a hypothyroid phase. In multivariable analysis the only predictor of PPT was the presence of thyroid antibodies, with 83% of antibody postiive women having PPT compared to 44% of antibody negative women (p = 0.0001).Conclusions In our cohort, 2/3 of women had fluctuations in thyroid function consistent with PPT and most required adjustment of their thyroid dose. Women with hypothyroidism antedating pregnancy are at high risk for PPT and should be closely monitored during the first year postpartum.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Objective Growth hormone insensitivity (GHI) may be caused by failure of GH receptor function. Some patients bearing specific GHR mutations differ from classical GHI individuals by extremely elevated GH binding protein (GHBP) serum concentrations. We investigated clinical, genetic and biochemical characteristics of a severely growth retarded Chinese boy with classical Laron syndrome manifestations.Patients and MeasurementsDNA and mRNA from blood cells of the patient and 11 family members were investigated for GHR mutations. Basal GH, GHBP, IGF-1 and IGFBP-3 concentrations were determined in serum samples. The impact of the aberrant mRNA on GHR protein expression and secretion was analyzed in vitro by transfection studies in HEK293 cells.ResultsThe proband and 7 relatives had excessively elevated GHBP serum concentration. Basal GH in these individuals was significantly greater compared to family members with normal GHBP. The GHBP increase originated from a novel GHR intragenic deletion comprising parts of exon and intron 8 that caused exon 8 skipping from the GHR mRNA transcript. Transfection studies revealed that the predicted loss of plasma membrane anchorage results in direct secretion of the mutant GHR.Conclusions The partial GHR deletion causes excessively elevated GHBP serum concentrations regardless of the state of zygosity of the mutation. The increase in GHBP is associated with significantly elevated basal GH levels. Clinically, only homozygous carriers exhibit classical GHI manifestations. The truncated GHR protein resulting from exon 8 skipping is directly secreted out of the cell.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Objective To evaluate current management time lines in adrenal crisis (AC) and to establish time targets and limits for emergency treatment.Design/patientsPatients from a prospective study who had reported an AC (n=46) were contacted and asked about management of their AC. A survey among 24 European endocrinologists collected expert recommendations concerning time targets and limits for contact - arrival time of emergency health professionals and presentation of emergency card - glucocorticoid (GC) injection time.ResultsMedian time targets and limits regarded by experts as adequate for contact – arrival time were 45 and 90 min, respectively and for card – injection time 15 and 30 min, respectively. 37 of 46 patients could be interviewed. All patients were equipped with an emergency card but only 23 (62%) with an emergency kit. Seven patients (19%) were trained in GC self-injection. The median time interval between contacting a health professional and arrival was 20 min (range 2-2880min); ≤45 min: n=32 (86%), <90 min: n=34 (92%), The median time interval between arrival and administration of GC was 30 min (range 2-2400min); ≤15 min: n=17 (46%), ≤30 min: n=20 (54%).Conclusion While the time between contacting health professionals and their arrival was within the limits set by experts, initiation of GC administration was delayed in 46% of patients. Thus improved management of AC needs to focus on shortening the presentation of card - injection time. Given the current reality in the management of AC, promotion of self-injection of GC (s.c. or i.m.) is warranted.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Objectives Septic patients always develop muscle wasting, which delays the rehabilitation and contributes to the increased complications and mortality. Previous studies have implied the crucial role of central inflammation and neuropeptides in the energy balance and muscle metabolism. Insulin has been confirmed to attenuate muscle degradation and inhibit inflammation. We tested the hypothesis whether insulin ameliorating muscle wasting was associated with modulating hypothalamic inflammation and neuropeptides.Design and subjectsThirty-two adult male Sprague-Dawley rats were in intraperitoneally injected with lipopolysaccharide (LPS) (5mg/kg) or saline, followed by subcutaneous injection of insulin (5 IU/kg) or saline. Twenty-four hours after injection, skeletal muscle and hypothalamus tissues were harvested. Muscle wasting was measured by the mRNA expression of two E3 ubiquitin ligases, muscle ring finger 1 (MuRF-1) and muscle atrophy F-box (MAFbx), as well as 3-methylhistidine (3-MH) and tyrosine release. Hypothalamic inflammatory markers and neuropeptides expression were also measured in four groups.ResultsLPS injection led to significant increase of hypothalamic inflammation as well as muscle wasting. Also, increased hypothalamic neuropeptides, proopiomelanocortin (POMC), cocaine and amphetamine-related transcript (CART) and neuropeptides Y (NPY), and decreased agouti-related protein (AgRP) were observed. Insulin treatment ameliorated endotoxemia-induced muscle wasting and hypothalamic inflammation, and attenuated the alteration of neuropeptides, POMC, CART and NPY.Conclusion Hypothalamic inflammation and neuropeptides are involved in the endotoxemia-induced muscle wasting. Insulin treatment can reduce muscle wasting, which is associated with reduced hypothalamic inflammation and alteration of hypothalamic neuropeptides.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Normal physiological changes of pregnancy warrant the need to employ gestation specific reference ranges for the interpretation of thyroid function tests. Thyroid hormones play crucial roles in fetal growth and neurodevelopment which are dependent on adequate supply of maternal thyroid hormones from early gestation onwards. The prevention of significant adverse obstetric and neurodevelopmental outcomes from hypothyroidism requires a strategy of empirical levothyroxine dose increases and predictive dose adjustments in pregnancy combined with regular thyroid function testing, starting before pregnancy and until the postpartum period.Subclinical hypothyroidism has been associated with an increased risk of pregnancy loss and neurocognitive deficits in children, especially when diagnosed before or during early pregnancy. Whilst trials of levothyroxine replacement for mild hypothyroidism in pregnancy have not indicated definite evidence of improvements in these outcomes, professional guidelines recommend treatment, especially if evidence of underlying thyroid autoimmunity is present. Studies of isolated hypothyroxinaemia in pregnancy have shown conflicting evidence with regards to adverse obstetric and neurodevelopmental outcomes and no causative relationships have been determined. Treatment of this condition in pregnancy may be considered in those with underlying thyroid autoimmunity. Whilst the evidence for a link between the presence of anti-TPO antibodies and increased risks of pregnancy loss and infertility is compelling, the results of ongoing randomised trials of levothyroxine in euthyroid women with underlying autoimmunity are currently awaited.Further studies to define the selection of women who require levothyroxine replacement and to determine the benefits of a predictive dose adjustment strategy are required.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: ObjectiveLIN28 control cells reprogramming and pluripotency mainly through miRNA regulation and has been overexpressed in many advanced cancers. In this study, we evaluated the prognostic role of LIN28 and its regulatory miRNAs in a large cohort of adrenocortical tumors (ACTs).Patients and methodsLIN28 protein expression was assessed in 266 adults ACTs (78 adenomas and 188 carcinomas) from Brazil and Germany. LIN28A and LIN28B gene expression was analyzed in 59 ACTs (31 adenomas and 28 carcinomas) and copy number variation in 39 ACTs. In addition, we determined the expression of let-7 family, mir-9, mir-30 and mir-125 in 28 carcinomas.ResultsLIN28A gene was overexpressed in aggressive ACCs when compared with adenomas and non-aggressive ACCs, but no LIN28A copy number variation was found in ACTs. Unexpectedly, weak LIN28 protein expression was significantly associated with reduced disease-free survival in ACC patients (p= 0.01), but for overall survival only a trend was detectable (p= 0.117). In the multivariate analysis, only Ki67 index ≥ 10% (HR 4.6, p= 0.000) and weak LIN28 protein expression (HR 2.0, p= 0.03) were independent predictors of recurrence in ACC patients. Interestingly, mir-9 expression, a negative LIN28A/B regulator, was significantly higher in aggressive than in non-aggressive ACCs [2076 (from 36 to 9307) vs. 133.4 (from 2.4 to 5193); p= 0.011] and was highly associated with reduced overall (p= 0.01) and disease-free survival (p= 0.01). However, mir-9 prognostic role should be further evaluated in a larger cohort.Conclusion Weak LIN28 protein expression was associated with recurrence in ACCs. Additionally, overexpression of mir-9, a negative LIN28A regulator, was associated with poor outcome.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 09/2014;
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    ABSTRACT: Malignant phaeochromocytomas are rare and highly aggressive tumours. This retrospective study evaluated the outcome of combined chemotherapy with Cyclophosphamide, Vincristine, and Dacarbazine (also known as CVD regimen).
    Clinical Endocrinology 08/2014;
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    ABSTRACT: Prophylactic central lymph node dissection (CLND) in clinically node negative patients remains controversial and predictive factors for central lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC) are not well defined. Herein, we conducted a systematic review to quantify the clinicopathologic factors predictive for CLNM in patients with PTC.
    Clinical Endocrinology 08/2014;
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    ABSTRACT: Objective To investigate the potential prognostic significance of leptin and its receptor (Ob-R) in thyroid carcinoma.Patients and Methods The study cohort consisted of 173 patients including 93 cases with papillary thyroid carcinoma (PTC), 41 cases with follicular thyroid carcinoma (FTC), 25 cases with medullary thyroid carcinoma (MTC), and 14 cases with anaplastic thyroid carcinoma (ATC). We investigated the correlation between clinicopathologic features and leptin or Ob-R. The Kaplan–Meier method was used to analyze the survival rate.ResultsThere was a strong correlation of leptin expression with Ob-R expression in PTC, FTC and ATC. For PTC, Leptin expression was strongly correlated with older age, larger tumor size, nodal metastasis and advanced stage. Ob-R was significantly correlated with larger tumor size, nodal metastasis and advanced stage. The five-year disease free survival (DFS) rate in patients with positive leptin or its receptor expression was lower than that in patients without expression (with statistical difference). For FTC, patients with positive leptin or Ob-R expression developed no recurrence or metastasis during the follow-up. For MTC, Ob-R was significantly correlated with nodal metastasis and advanced stage (p<0.05). For ATC, Patients with positive Ob-R expression had longer median DFS than those with negative expression (436±185 vs 57±71 days), and the difference in the survival rate was statistically significant (p<0.05).Conclusions There was a strong correlation of leptin expression with Ob-R expression in PTC, FTC and ATC. Leptin and Ob-R had negative prognostic significance in PTC, while Ob-R may play a protective role in ATC.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 08/2014;
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    ABSTRACT: We read with interest the paper ‘How good is a morning cortisol in predicting an adequate response to intramuscular Synacthen test’ by Yo et al. in Clinical Endocrinology.1 Based on this retrospective analysis of 505 short Synacthen test (SST) results from their dataset derived from the pathology department, the authors have concluded that a basal morning cortisol of >375 nmol/L can predict an adequate SST response with 95% specificity. A significant proportion of published literature usually addresses the value of SST in assessing cortisol axis in pituitary patients; the clinical value of baseline cortisol analysis outside the remits of pituitary disease has been explored in less detail.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 08/2014;
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    ABSTRACT: Background/objectiveThere is an increasing rate of papillary thyroid carcinomas that may never progress to cause symptoms or death. Predicting outcome and determining tumor aggressiveness could help diminish the number of patients submitted to aggressive treatments. We aimed to evaluate whether markers of the immune system response and of tumor-associated inflammation could predict outcome of differentiated thyroid cancer (DTC) patients.DesignRetrospective cohort study.PatientsWe studied 399 consecutive patients, including 325 papillary and 74 follicular thyroid carcinomas.MeasurementsImmune cell markers were evaluated using immunohistochemistry, including tumor-associated macrophages (CD68) and subsets of tumor-infiltrating lymphocytes (TIL), such as CD3, CD4, CD8, CD16, CD20, CD45RO, GRANZYME B, CD69 and CD25. We also investigated the expression of cyclooxygenase 2 (COX2) in tumor cells and the presence of concurrent lymphocytic infiltration characterizing chronic thyroiditis.ResultsConcurrent lymphocytic infiltration characterizing chronic thyroiditis was observed in 29% of the cases. Among all the immunological parameters evaluated, only the enrichment of CD8+ lymphocytes (p=0.001) and expression of COX2 (p=0.01) were associated with recurrence. A multivariate model analysis identified CD8+ TIL/COX2 as independent risk factor for recurrence. A multivariate analysis using Cox's proportional-hazards model adjusted for the presence of concurrent chronic thyroiditis demonstrated that the presence of concurrent chronic thyroiditis had no effect on prognostic prediction mediated by CD8+ TIL and COX2.Conclusion In conclusion, we suggest the use of a relatively simple pathology tool to help select cases that may benefit of a more aggressive approach sparing the majority of patients from unnecessary procedures.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 08/2014;

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