Anoressia nervosa: amenorrea ipotalamica e metabolismo dell’osso

Anoressia nervosa: amenorrea ipotalamica e metabolismo dell’osso

Daniela Laudisio1,2 Orcid, Chiara Graziadio1,2 Orcid, Renata Simona AuriemmaOrcid, Emanuela FiliceOrcid, Silvia Savastano1,2 Orcid, Annamaria Colao1,2,3 Orcid

1 – Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università “Federico II” di Napoli, Napoli, Italia

2 – Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università “Federico II” di Napoli, Napoli, Italia

3 – Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”,Università “Federico II” di Napoli, Napoli, Italia

Autore di riferimento: Daniela Laudisio

daniela.laudisio@libero.it


DOI: 10.53146/lriog1202154

Abstract

Anorexia nervosa is a psychiatric disorder, predominantly affecting adolescent women, and is characterized by a low body weight following a state of self-induced starvation. This disorder is associated with hormonal adaptations that consume energy expenditure to a minimum in a context of low nutrient intake. These adaptations include: functional hypothalamic amenorrhea, resistance to growth hormone, low concentrations of insulin- like growth factor, low concentrations of leptin and hypercortisolemia. Although, these adaptations may be useful for the short-term survival, often, they contribute to morbidity associated with this disorder, and in particular bone loss, which affects 85% of women with anorexia nervosa. In fact, this category of patients, often demonstrates low bone mineral density and high fractures risk, with low body weight and low gonads being the strongest predictors of observed bone mineral deficiency and fractures risk. Weight restoration and the resumption of menstrual function have the strongest impact on increasing bone mineral density. Other treatment options include bisphosphonates and teriparatide, supported by small clinical trials.

Keywords: nervous anorexia; functional hypothalamic amenorrhea; osteoporosis; bone mineral density; risk of fractures.


Presente in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283


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Patologie paratiroidee, salute ossea e sindrome metabolica

Patologie paratiroidee, salute ossea e sindrome metabolica

Roberta ModicaOrcid, Giuseppe Cannavale1 Orcid, Alessia Liccardi1 Orcid, Renata Simona Auriemma1 Orcid, Annamaria Colao1,2,4Orcid

1 – Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi Federico II Napoli

2 – Cattedra Unesco Educazione alla salute e allo Sviluppo Sostenibile, Università degli Studi Federico II Napoli

Autore di riferimento: Roberta Modica

robertamodica@libero.it


DOI: 10.53146/lriog1202153

Abstract

BACKGROUND: Parathyroid diseases are related to parathyroid hormone (PTH) dysregulation by parathyroid cells or alteration of PTH function. They include hypoparathyroidism (PTH deficiency), pseudohypoparathyroidism (PTH resistance) and hyperparathyroidism (PTH excess). They are known to al- ter calcium metabolism and consequently bone health. Little is known about correlation between parathyroid diseases and metabolic syndrome. METHODS: Aim of this paper is to analyse the literature to identify the role of parathyroid diseases in bone health and metabolic syndrome.
RESULTS: Hypoparathyroidism and pseudohypoparathyroidism reduce bone remodelling, destroying mineral density with increase of fracture risk. Con- versely, hyperparathyroidism induces increase of bone reabsorption with increased fracture risk. Metabolic syndrome may negatively influence pa- rathyroid diseases and worsen bone health.
CONCLUSIONS: Available data confirm the role of parathyroid diseases in worsening bone health and highlight an important relationship between pa- rathyroid diseases, especially hyperparathyroidism, and metabolic syndrome, which is increasingly widespread.

Keywords: parathyroid hormone; hyperparathyroidism; hypoparathyroidism; bone; calcium; metabolic syndrome.


Presente in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283


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Patologie tiroidee ed infertilità femminile

Patologie tiroidee ed infertilità femminile

Chiara Graziadio1,2 Orcid, Emanuele Filice1 Orcid, Rosa Pirchio1 Orcid, Renata Simona Auriemma1 Orcid, Alessandra GraziottinOrcid,

Annamaria Colao1,2,4Orcid

1 – Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi Federico II Napoli

2 – Centro Italiano per la cura ed il benessere del paziente obeso (C.I.B.O.), Università degli Studi Federico II Napoli

3 – Centro di Ginecologia H. San Raffaele Resnati, Milano

4 – Cattedra Unesco “Educazione alla salute e allo Sviluppo Sostenibile”, Università degli Studi Federico II Napoli

Autore di riferimento: Chiara Graziadio

chiaragraziadio@live.it


DOI: 10.53146/lriog1202152

Abstract

BACKGROUND: Thyroid diseases (hypothyroidism, hyperthyroidism and thyroid autoimmunity) have been independently associated with fertility di- sorders and pregnancy failure, both in case of spontaneous conception and/ or after assisted reproduction technology (ART). Several studies have looked at the association between thyroid dysfunctions, thyroid autoimmunity (TAI) and reproduction. The aim of this paper is to identify the impact of thyroid diseases, starting from birth, on female infertility, by means of review of the recent pertinent literature.
METHODS: We reviewed the pertinent literature regarding the association between thyroid diseases and female infertility off the main international database (MEDLINE, PubMed).
RESULTS: Thyroid dysfunctions, associated or not with thyroid autoimmunity, can alter ovulation and the associated immunoendocrine processes with con- sequent menstrual irregularities. These complexes endocrine disruptions can result in mild to severe fertility disorders and increased spontaneous abor- tions. Thyroid autoimmunity is associated with an increased risk of miscar- riage and preterm delivery, both in spontaneous pregnancies as well as in pregnancies after ART.
CONCLUSIONS: Thyroid dysfunctions may lead to menstrual disorders and infertility via direct and indirect interactions with the hypothalamo-pituitary- ovarian axis and the reproductive organs.
In the management of the infertile woman, the complete screening of thyroid hormones and autoimmunity is recommended in order to promptly treat any hormonal dysfunctions that may be a cofactor or the cause of infertility. Fur- ther studies are needed to improve diagnostic and therapeutic fertility issues associated with or due to thyroid disorders.

Keywords: hashimoto’s thyroiditis; Basedow-Graves’disease; hyperthyroidism; hypothyroidism; female infertility; thyroid autoimmunity.


Presente in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283


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Sindrome endocrino-metabolica in menopausa

Sindrome endocrino-metabolica in menopausa

Roberta Scairati1 Orcid, Renata Simona AuriemmaOrcid, Annamaria Colao1,2 Orcid, Alessandra Graziottin3,4 – Orcid

1 – Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Naples, Italy

2 – United Nations Educational, Scientific and Cultural Organization (UNESCO), Chair for Health Education and Sustainable Development, University Federico II, Naples, Italy

3 – Direttore del Centro di Ginecologia e Sessuologia Medica, H. San Raffaele Resnati, Milano

4 – Presidente Fondazione Graziottin per la cura del dolore nella donna – ONLUS

Autore di riferimento: Roberta Scairati

robertascairati@gmail.com


DOI: 10.53146/lriog1202149

Abstract

Background: Menopause is associated with a high risk for cardiometabolic diseases, including metabolic syndrome (MetS), cardiovascular disease (CVD) and type 2 diabetes (DMT2).
Insulin resistance, abdominal obesity, dyslipidemia and hypertension are in- terdependent factors associated with menopause. The increase in the syste- mic inflammation is the common denominator of MetS. The purposes of this review are i) to clarify how the natural cessation of ovarian function, which is characterized by the decline of female sexual hormones and the relative in- crease of androgens, could explain the relationship between MetS, increase of the inflammatory indexes and menopause; ii) to understand how surgical menopause could influence the onset of MetS; iii) to highlight the role of hormone replacement therapy.
Methods: We revised the published literature in english language on PubMed database, from year 1992 to year 2021, by searching the following keywords, including 1) a refined definition of metabolic syndrome 2) relationship betwe- en metabolic syndrome and systemic inflammation 3) relationship between metabolic syndrome and obesity, insulin resistance, hypertension, osteoporo- sis and hypothyroidism, 4) surgical menopause and metabolic syndrome, 5) effects of HRT on the components of the MetS in post-menopausal women. Results: Derived evidences suggest an increased incidence of metabolic syn- drome in menopause, probably due to woman aging and hormonal chan- ges in menopause, worsened by hypothyroidism, inappropriate lifestyles and lack of timely initiated HRT.
Conclusions: Menopause plays a crucial role in the development of MetS and surgical menopause; sudden cessation of ovarian function can lead to a hi- gher incidence of MetS and systemic inflammation than physiological me- nopause. Hormone replacement therapy (HRT) and a healthy lifestyle may positively influence some aspects of Mets. Our observations can help in the clinical management of menopause-related MetS.

Keywords: menopause; surgical menopause; metabolic syndrome; inflammation; hormone replacement therapy.


Presente in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283


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