The Experts below are selected from a list of 459 Experts worldwide ranked by ideXlab platform
S Scaltriti - One of the best experts on this subject based on the ideXlab platform.
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Relative Hyperestrogenism in Klinefelter Syndrome: results from a meta-analysis
Endocrine, 2019Co-Authors: Daniele Santi, S Scaltriti, Sara De Vincentis, Vincenzo RochiraAbstract:Objective Klinefelter Syndrome (KS) is classically described as characterized by Hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. Design Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. Methods Meta-analysis was conducted according to the PRISMA statement using RevMan. Results Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: −2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. Conclusions Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative Hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.
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relative Hyperestrogenism in klinefelter syndrome results from a meta analysis
Endocrine, 2019Co-Authors: Daniele Santi, De Vincentis S, S ScaltritiAbstract:Klinefelter Syndrome (KS) is classically described as characterized by Hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. Meta-analysis was conducted according to the PRISMA statement using RevMan. Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: −2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative Hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.
Daniele Santi - One of the best experts on this subject based on the ideXlab platform.
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Relative Hyperestrogenism in Klinefelter Syndrome: results from a meta-analysis
Endocrine, 2019Co-Authors: Daniele Santi, S Scaltriti, Sara De Vincentis, Vincenzo RochiraAbstract:Objective Klinefelter Syndrome (KS) is classically described as characterized by Hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. Design Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. Methods Meta-analysis was conducted according to the PRISMA statement using RevMan. Results Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: −2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. Conclusions Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative Hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.
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relative Hyperestrogenism in klinefelter syndrome results from a meta analysis
Endocrine, 2019Co-Authors: Daniele Santi, De Vincentis S, S ScaltritiAbstract:Klinefelter Syndrome (KS) is classically described as characterized by Hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. Meta-analysis was conducted according to the PRISMA statement using RevMan. Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: −2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative Hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.
Vincenzo Rochira - One of the best experts on this subject based on the ideXlab platform.
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Relative Hyperestrogenism in Klinefelter Syndrome: results from a meta-analysis
Endocrine, 2019Co-Authors: Daniele Santi, S Scaltriti, Sara De Vincentis, Vincenzo RochiraAbstract:Objective Klinefelter Syndrome (KS) is classically described as characterized by Hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. Design Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. Methods Meta-analysis was conducted according to the PRISMA statement using RevMan. Results Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: −2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. Conclusions Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative Hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.
Roberto Vita - One of the best experts on this subject based on the ideXlab platform.
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support for the upregulation of serum thyrotropin by estrogens coming from the increased requirement of levothyroxine in one gynecomastic patient with excess of thyroxine binding globulin secondary to exposure to exogenous estrogens
Journal of clinical & translational endocrinology, 2018Co-Authors: Salvatore Benvenga, Giovanni Capodicasa, Sarah Perelli, Roberto VitaAbstract:Abstract Thyroxine-binding globulin (TBG) is the liver-synthesized and estrogen-upregulated major plasma carrier of thyroid hormones with an affinity binding greater for T4 than T3. It is known that pregnancy, a physiologic state of estrogen-driven elevation of serum TBG, raises the requirement of L-T4 dose in hypothyroid women, especially those with no residual thyroid function. Similar increased requirement was reported for postmenopausal women during estrogen therapy. One known cause of relative hyperestrogenemia, gynecomastia and acquired TBG excess is liver disease, but very rarely chronic liver disease is mentioned as a cause of increased L-T4 requirement. One hypothyroid man with cirrhosis-associated gynecomastia and increased serum levels of both estradiol and TBG was reported recently. His requirement of L-T4 was no longer increased after liver transplantation. We now report the case of a man with primary hypothyroidism under stable replacement therapy with L-T4 until exposure to an exogenous cause of hyperestrogenemia caused increased L-T4 requirement associated to TBG excess. In addition to increased TBG, the high levels of estrogens had caused the appearance of gynecomastia. We fully corrected primary hypothyroidism upon eliminating his exposure to the source of estrogens. Hyperestrogenism can be a cause of increased L-T4 requirement through the rise of circulating levels of TBG also in man with no residual thyroid function.
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Support for the upregulation of serum thyrotropin by estrogens coming from the increased requirement of levothyroxine in one gynecomastic patient with excess of thyroxine-binding globulin secondary to exposure to exogenous estrogens
Elsevier, 2018Co-Authors: Salvatore Benvenga, Giovanni Capodicasa, Sarah Perelli, Roberto VitaAbstract:Thyroxine-binding globulin (TBG) is the liver-synthesized and estrogen-upregulated major plasma carrier of thyroid hormones with an affinity binding greater for T4 than T3. It is known that pregnancy, a physiologic state of estrogen-driven elevation of serum TBG, raises the requirement of L-T4 dose in hypothyroid women, especially those with no residual thyroid function. Similar increased requirement was reported for postmenopausal women during estrogen therapy. One known cause of relative hyperestrogenemia, gynecomastia and acquired TBG excess is liver disease, but very rarely chronic liver disease is mentioned as a cause of increased L-T4 requirement. One hypothyroid man with cirrhosis-associated gynecomastia and increased serum levels of both estradiol and TBG was reported recently. His requirement of L-T4 was no longer increased after liver transplantation. We now report the case of a man with primary hypothyroidism under stable replacement therapy with L-T4 until exposure to an exogenous cause of hyperestrogenemia caused increased L-T4 requirement associated to TBG excess. In addition to increased TBG, the high levels of estrogens had caused the appearance of gynecomastia. We fully corrected primary hypothyroidism upon eliminating his exposure to the source of estrogens. Hyperestrogenism can be a cause of increased L-T4 requirement through the rise of circulating levels of TBG also in man with no residual thyroid function. Keywords: Thyroxine-binding globulin, Estrogens, Thyrotropin, Levothyroxine therapy, Refractory hypothyroidis
Gary L Keeney - One of the best experts on this subject based on the ideXlab platform.
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Hyperestrogenism a relevant risk factor for the development of cancer from endometriosis
Gynecologic Oncology, 2000Co-Authors: Gerardo Zanetta, Maurice J Webb, Gary L KeeneyAbstract:Abstract Objective. Endometriosis is extremely common in developed countries. Obesity is a major health concern and may cause Hyperestrogenism. Hormonal replacement, particularly unopposed estrogens after hysterectomy, is becoming popular. Because endometriosis is ectopic endometrium, Hyperestrogenism (either endogenous or exogenous) may cause hyperplasia or transformation into cancer. This study was conducted to describe the main clinical and pathologic features of malignancies in endometriosis and define the treatment and outcome and to compare patients who had cancer arising in endometriosis with patients who had endometriosis but no cancer. Methods. Patients who had tumors from endometriosis diagnosed from 1986 to 1997 were analyzed retrospectively. Each patient was matched with two control patients (endometriosis without cancer) treated during the same study interval. Clinical and epidemiologic variables were compared to identify risk factors for the development of cancer. Result. We identified 31 patients with cancer developing from endometriosis. Fifteen women were obese, 9 had a history of endometriosis, and 9 were taking unopposed estrogen. Endometrioid adenocarcinoma was the most common histologic type (16 patients). When the patients with cancer were compared with controls, no significantly higher risk for the development of cancer was found with prolonged use of unopposed estrogens or with higher body mass index, but a trend was observed. When obesity and use of unopposed estrogens were considered together, the difference was statistically significant ( P = 0.05). Conclusion. Hyperestrogenism, either endogenous or exogenous, is a significant risk factor for the development of cancer from endometriosis. The prevalences of endometriosis, obesity, and use of hormonal replacement therapy in women in developed countries are increasing, and this trend justifies the assumption that cancer developing in endometriosis might become more common in the future.