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| 2. |
- Hammarstedt, Lilian, et al.
(author)
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Adrenal lesions in patients with extra-adrenal malignancy - benign or malignant?
- 2012
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In: Acta oncologica. - 1651-226X. ; 51:2, s. 215-221
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Journal article (peer-reviewed)abstract
- Abstract Background. Adrenal lesions in patients with extra-adrenal malignancy can be part of disseminated tumour disease, but may also be incidental, benign finding. Strict characterisation is therefore crucial, and may have profound effects on patient management. Purpose. To prospectively characterise and follow-up adrenal lesions in patients with extra-adrenal malignancy, stratified into those with past or concurrent malignancy, with or without metastases. Material and methods. All incidentally detected adrenal lesions identified at cross-sectional imaging during 18 months in a defined geographical region were prospectively reported. All adult oncologic patients with adrenal lesions were subjected to biochemical work-up and dedicated adrenal imaging for lesion characterisation, including a two year follow-up. Results. Benign adrenal lesions were found in 74% (29/39) of patients who had a history of extra-adrenal malignancy, in 53% (57/108) of those with concurrent extra-adrenal malignancy without metastatic disease and in 25% (27/109) in those with signs of metastatic disease. Conclusion. An adrenal lesion occurring in a patient with past malignancy has a high likelihood of representing a benign lesion, and even in patients with present signs of malignant disease at least one fourth to one half of such lesions are benign. Dedicated adrenal imaging including computed tomography attenuation measurements with wash-out characteristics, in addition to biochemical testing for adrenal dysfunction, is highly recommended in these cases, especially in patients without any other signs of metastatic spread.
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| 3. |
- Muth, Andreas, 1974, et al.
(author)
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Cohort study of patients with adrenal lesions discovered incidentally.
- 2011
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In: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 98:10, s. 1383-91
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Journal article (peer-reviewed)abstract
- This prospective cohort study investigated the incidence, clinical features and natural history of incidentally discovered adrenal mass lesions (adrenal incidentaloma, AI) in an unselected population undergoing radiological examination.
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| 4. |
- Sigurjónsdóttir, Helga A, 1964, et al.
(author)
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GH effect on enzyme activity of 11betaHSD in abdominal obesity is dependent on treatment duration.
- 2006
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In: European journal of endocrinology / European Federation of Endocrine Societies. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 154:1, s. 69-74
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Journal article (peer-reviewed)abstract
- OBJECTIVE: In the past years the interaction of GH and 11beta hydroxysteroid dehydrogenase (11betaHSD) in the pathogenesis of central obesity has been suggested. DESIGN: We studied the effects of 9 months of GH treatment on 11betaHSD activity and its relationship with body composition and insulin sensitivity in 30 men with abdominal obesity, aged 48-66 years, in a randomised, double-blind, placebo-controlled trial. METHODS: Urinary steroid profile was used to estimate 11betaHSD type 1 and 2 (11betaHSD1 and 11betaHSD2) activities. Abdominal s.c. and visceral adipose tissues were measured using computed tomography. Glucose disposal rate (GDR) obtained during a euglycaemic-hyperinsulinaemic glucose clamp was used to assess insulin sensitivity. RESULTS: In the GH-treated group the 11betaHSD1 activity decreased transiently after 6 weeks (P < 0.01) whereas 11betaHSD2 increased after 9 months of treatment (P < 0.05). Between 6 weeks and 9 months, GDR increased and visceral fat mass decreased. Changes in 11betaHSD1 correlated with changes in visceral fat mass between baseline and 6 weeks. There were no significant correlations between 11betaHSD1 and 11betaHSD 2 and changes in GDR. DISCUSSION: The study demonstrates that short- and long-term GH treatment has different effects on 11betaHSD1 and 11betaHSD2 activity. Moreover, the data do not support that long-term metabolic effects of GH are mediated through its action on 11betaHSD.
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| 5. |
- Sigurjónsdóttir, Helga A, 1964
(author)
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Inhibition of 11 ß-HSD. Hemodynamic and hormonal response induced by liquorice
- 2002
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Doctoral thesis (other academic/artistic)abstract
- Introduction: The enzyme 11 ß-hydroxysteroid-dehydrogenas (11 ß-HSD) type 2 that converts the active hormone cortisol to the inactive cortisone is inhibited by glycyrrhetinic acid (GA), the active substance in liquorice. This leads to hypertension, hypokalaemia and sodium- and fluid retention, the syndrome of pseudo-hyperaldosteronism. The aim of this thesis was to further explore the hemodynamic and hormonal response to the inhibition of 11 ß-HSD by GA.Methods The hormonal effects of liquorice consumption were investigated by use of 5 different doses of GA (75, 135, 150, 270 and 540 mg). For comparison of the genders, women started the study on day 1-4 in the menstruation cycle in the last two studies. In study 4, 36 individuals consumed 150 mg GA (15 women and 21 men) of which 11 had essential hypertension. Blood pressure, blood tests and 24-hour urine samples were taken at baseline, after 2 and 4 weeks of liquorice consumption and at the end of the wash-out period.Results Daily consumption of 75 mg GA (50 gr liquorice) induced significant hemodynamic changes, the lowest dose by our knowledge reported with this effect. The hemodynamic changes due to GA showed a linear dose-response relationship. The maximal rise in blood pressure was registered after 2 weeks, not increasing with prolonged consumption, and the individual response in the group followed the normal distribution curve. Patients with hypertension increased more prominently in blood pressure than normotensive individuals independent of age, salt-sensitivity and weight. The difference in hemodynamic response between the genders was not significant although more women than men quitted the consumption due to adverse effects. The hormonal response was primarily on cortisol, aldosterone and DHEA-s. The decrease in aldosterone lead to more increased blood pressure in men than women and in hypertensive compared with normotensive individuals. Androgen changes were minor. The inconsistent change in testosterone concentration is controversial with earlier reports. Prolactin was minimally affected.Conclusion: A moderate daily dose of GA, 75 mg, is sufficient to cause hemodynamic response that has a dose-response relationship. This response follows the normal distribution curve. Subjects with essential hypertension are more sensitive to the inhibition of 11 ß-HSD by GA than normotensive subjects. This inhibition primarily affects the adrenal hormones and minimally the sex steroid hormones.
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| 6. |
- Sigurjónsdóttir, Helga A, 1964, et al.
(author)
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Lack of regulation of 11beta-hydroxysteroid dehydrogenase type 1 during short-term manipulation of GH in patients with hypopituitarism.
- 2009
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In: European journal of endocrinology / European Federation of Endocrine Societies. - 1479-683X. ; 161:3, s. 375-80
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Evidence from long-term clinical studies measuring urinary steroid ratios, and from in vitro studies, suggests that GH administered for longer than 2 months down-regulates 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1), thereby reducing cortisol regeneration in liver and adipose tissue. We aimed to measure acute effects of GH on 11beta-HSD1 in liver and adipose tissue in vivo, including using a stable isotope tracer. DESIGN: Observational studies of GH withdrawal and reintroduction in patients with hypopituitarism. METHODS: Twelve men with benign pituitary disease causing GH and ACTH deficiency on stable replacement therapy for >6 months were studied after GH withdrawal for 3 weeks, and after either placebo or GH injections were reintroduced for another 3 weeks. We measured cortisol kinetics during 9,11,12,12-(2)H(4)-cortisol (d4-cortisol) infusion, urinary cortisol/cortisone metabolite ratios, liver 11beta-HSD1 by appearance of plasma cortisol after oral cortisone, and 11beta-HSD1 mRNA levels in subcutaneous adipose biopsies. RESULTS: GH withdrawal and reintroduction had no effect on 9,12,12-[(2)H](3)-cortisol (d3-cortisol) appearance, urinary cortisol/cortisone metabolite ratios, initial appearance of cortisol after oral cortisone, or adipose 11beta-HSD1 mRNA. GH withdrawal increased plasma cortisol 30-180 min after oral cortisone, increased d4-cortisol clearance, and decreased relative excretion of 5alpha-reduced cortisol metabolites. CONCLUSIONS: In this setting, GH did not regulate 11beta-HSD1 rapidly in vivo in humans. Altered cortisol metabolism with longer term changes in GH may reflect indirect effects on 11beta-HSD1. These data do not suggest that glucocorticoid replacement doses need to be increased immediately after introducing GH therapy to compensate for reduced 11beta-HSD1 activity, although dose adjustment may be required in the longer term.
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| 7. |
- Sigurjónsdóttir, Helga A, 1964, et al.
(author)
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Lakrits - så mycket mer än godis
- 2015
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In: Lakartidningen. - 0023-7205 .- 1652-7518. ; 112
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Journal article (other academic/artistic)
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| 8. |
- Sigurjónsdóttir, Helga A, 1964, et al.
(author)
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Liquorice in moderate doses does not affect sex steroid hormones of biological importance although the effect differs between the genders.
- 2006
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In: Hormone research. - : S. Karger AG. - 0301-0163. ; 65:2, s. 106-10
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIM: Liquorice is commonly consumed, at least in the western world, and we have earlier shown that even moderate doses of liquorice have significant effects on the cortisol metabolism by inhibiting 11beta-hydroxysteroid dehydrogenase type 2. The suggestion that liquorice decreases the testosterone levels in men makes it vital to study the effect of moderate doses of liquorice on sex steroid hormones. METHODS: Fifteen women and 21 men (healthy volunteers and subjects with essential hypertension) consumed 100 g of liquorice (150 mg glycyrrhetinic acid) daily in a 9-week, open-treatment trial. Blood and 24-hour urine samples were collected for hormone analysis before and after 4 weeks of liquorice consumption and 4 weeks after cessation of liquorice intake. RESULTS: The liquorice induced a moderate decrease in the serum concentrations of dehydroepiandrostenedione sulphate in men (p = 0.002). The relative change in serum levels of dehydroepiandrosterone sulphate differed between the genders (p = 0.03). No significant changes were observed in the serum testosterone levels after 4 weeks of liquorice consumption, and the urine excretion of androgens (etiocholanolone and androstenedione) did not change. CONCLUSIONS: Liquorice in moderate doses primarily affects the cortisol metabolism and only marginally the androgen hormones. Gender may influence the action of liquorice.
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| 9. |
- Sigurjónsdóttir, Helga A, 1964, et al.
(author)
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The liquorice effect on the RAAS differs between the genders.
- 2006
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In: Blood pressure. - : Informa UK Limited. - 0803-7051 .- 1651-1999. ; 15:3, s. 169-72
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Liquorice-induced increase in blood pressure (BP) is more profound in subjects with essential hypertension (HT) than in healthy individuals. Liquorice induces pseudohyperaldosteronism by inhibiting the 11beta-hydroxysteroid dehydrogenase type 2 and is also known to inhibit the renin-angiotensin-aldosterone system (RAAS). We explored the difference in response in BP, considering the RAAS and the genders. DESIGN: Patients with HT (eight men and three women, mean age 40.7 years) and healthy controls (13 men and 12 women, mean age 31.2 years) consumed 100 g of liquorice (150 mg glycyrrhetinic acid) daily for 4 weeks. METHODS: Blood, urine samples and BP were evaluated before and after 4 weeks of liquorice consumption and 4 weeks after cessation of liquorice consumption. RESULTS: The relative change in serum aldosterone levels differed between the genders (p < 0.02), men being more responsive than women, but not between patients with HT and healthy subjects. CONCLUSION: The liquorice-induced inhibition of aldosterone secretion differs between the genders and is not influenced by the BP levels. This difference between the genders has not been exposed before.
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