Abstract Mild autonomous cortisol secretion is the most prevalent hormonal disorder identified in adrenal incidentalomas. Previous studies suggest a potential correlation between adrenal adenoma size and cortisol secretion. The aim of this study was to evaluate the associations of maximum adenoma diameter and adenoma volume with 24-hour urinary free cortisol levels and post-1-mg dexamethasone suppression test cortisol levels in patients with mild autonomous cortisol secretion. This cross-sectional observational study included 48 patients aged 18–65 years diagnosed with mild autonomous cortisol secretion. Mild autonomous cortisol secretion is defined as a serum cortisol level of ≥ 1.8 µg/dL after the 1-mg dexamethasone suppression test and a low morning adrenocorticotropic hormone. The 24-hour urinary free cortisol level was measured using liquid chromatography-tandem mass spectrometry. A radiologist blinded to hormonal test results assessed the maximum adenoma diameter and adenoma volume. The study population comprised 48 patients (women/men=43/5) with a mean age of 56.79±8.81 years. The mean maximum adenoma diameter and adenoma volume were 31.39±9.43 mm and 10.00±7.71 cm3, respectively. The mean 24-hour urinary free cortisol level was 25.34±18.21 µg/24 h. The 24-hour urinary free cortisol levels were positively correlated with both the maximum adenoma diameter and adenoma volume (ρ=0.518, p<0.001 and ρ=0.520, p<0.001, respectively), whereas no significant correlations were observed between post-1-mg dexamethasone suppression test cortisol levels and either the maximum adenoma diameter or adenoma volume. In patients with mild autonomous cortisol secretion, 24-hour urinary free cortisol levels were positively associated with maximum adenoma diameter and adenoma volume, whereas no significant associations were observed for post-1-mg dexamethasone suppression test cortisol levels. The clinical significance of these cross-sectional associations requires further investigation in large prospective longitudinal studies.
Abstract We evaluated long-term trends in pharmacotherapy costs and cardiovascular risk factor target achievement among people with type 2 diabetes attending tertiary diabetes centres in Greece. This periodic, multicenter, cross-sectional study analysed data from 4,963 people with type 2 diabetes attending three diabetes centres at specific time points: 1998, 2006, 2012, 2018, and 2024. We compared glycated haemoglobin, systolic blood pressure, low-density lipoprotein cholesterol, and body mass index and the achievement of individual cardiovascular risk factor targets (glycated haemoglobin: < 7%, systolic blood pressure: < 140 mm Hg, and low-density lipoprotein cholesterol: < 100 mg/dL) and all three targets simultaneously. Annual pharmacotherapy costs were compared using inflation-adjusted values. Simultaneous achievement of all three cardiovascular risk factor targets increased from 0.6% in 1998 to 29.1% in 2024. Individual target achievements improved: glycated haemoglobin from 29.4 to 58.6%, systolic blood pressure from 45.3 to 62.5%, and low-density lipoprotein cholesterol from 6.3 to 73.4%. Mean low-density lipoprotein cholesterol showed the greatest reduction from 128.4 to 79.0 mg/dL. Median body mass index increased until 2018 and then declined in 2024. Total pharmacotherapy costs per patient rose from €341 in 1998 to €1,609 in 2024, primarily due to glucose-lowering therapies (€167–€1,257). Over 26 years, people with type 2 diabetes attending tertiary diabetes centres in Greece demonstrated improvements in cardiovascular risk factor target achievement, alongside rising pharmacotherapy costs, primarily driven by glucose-lowering therapies.
Abstract:Aims: Since type 2 diabetes is one of the greatest burdens in public health over the past decade, evidence regarding its impact on the Greek population is scarce. To address this situation, the current study aims to reveal epidemiological data on type 2 diabetes in Greece by calculating the annual prevalence between 2016 and 2022 and to investigate trends regarding age and sex factors. Abstract:Methods: Real-world prescription data were used from the official database of the e-Government Center for Social Security Services. The study population comprised individuals who were entitled to type 2 diabetes care, with the relevant International Classification of Diseases, 10th Revision code. Descriptive statistics, chi-square tests and regression analysis were performed by calculating prevalence rates, using 2011 official census of Greek population. Abstract:Results: Prevalence rates of type 2 diabetes follow an increasing trend, increasing from 7.97% in 2016 to 8.65% in 2022. A similar trend was observed among male and female individuals; the male prevalence rate increased from 8% in 2016 to 8.86% in 2022, whereas the female prevalence rate increased from 7.95% in 2016 to 8.46% in 2022. The prevalence rate ratios between 2016 and 2022 underline the increasing trends of type 2 diabetes in population, as the total prevalence rate ratio was equal to 1.09 (95% confidence interval: 1.08-1.09, p < 0.001). Linear regression revealed the association between the prevalence rate and the sex or age factor. Abstract:Conclusions: Type 2 diabetes prevalence in Greece increased between 2016 and 2022, in accordance with the European and International data, with higher rates observed among males and older adults. The marked relative increase among individuals aged 18 to 29 years constitutes an important epidemiological finding and highlights the need for targeted prevention and early intervention strategies.
Abstract:INTRODUCTION: The aim of this study was to compare the clinical, biochemical, and disease control characteristics of newly diagnosed Graves' disease (GD) before and during the coronavirus disease 2019 (COVID-19) era. Abstract:METHODS: In this retrospective, single-center observational study, 95 patients with newly diagnosed GD between January 2015 and November 2024 were evaluated for thyroid function, autoantibody levels, antithyroid drug (ATD) doses, and disease control status. Patients diagnosed before January 2019 were classified as the pre-COVID-19 group (n=46), whereas those diagnosed after March 2020 were classified as the COVID-19 era group (n=49); patients diagnosed between January 2019 and March 2020 were excluded due to potential classification ambiguity. Only patients treated with ATD for at least 12 months were included in the analysis. Abstract:RESULTS: Patients diagnosed during the COVID-19 era had higher thyroglobulin antibody (TgAb) titers at diagnosis (p=0.001) and higher free thyroxine levels at 12 months and at the final visit (p=0.001). Although the time to euthyroidism was lower in the COVID-19 era group, the difference was not statistically significant. End-of-treatment thyrotropin receptor antibody (TRAb) levels were similar between groups; however, fewer patients in the COVID-19 era group achieved TRAb normalization. Disease control rates and time to achieve disease control under ATD therapy were comparable between the two groups. Among patients diagnosed during the COVID-19 era, 89.8% received at least one messenger RNA vaccine dose, and 40.8% had a positive polymerase chain reaction test. Abstract:CONCLUSION: The COVID-19 era was not associated with a major change in the overall clinical course of GD . However, patients diagnosed during the COVID-19 era had higher TgAb levels at diagnosis and incomplete TRAb normalization in some cases, suggesting subtle differences in thyroid immuneactivity.
Abstract:BACKGROUND: Polycystic ovary syndrome is a complex endocrine-metabolic disorder associated with various dermatological manifestations. However, the histomorphological alterations underlying these skin findings remain poorly characterized. This study aimed to investigate skin alterations associated with polycystic ovary syndrome in an experimental mouse model using histochemical staining, morphometric evaluation, and immunofluorescence analysis. Abstract:METHODS: An experimental study was performed using 16 Swiss albino female mice. The polycystic ovary syndrome model was induced by dehydroepiandrosterone (6 mg/100 g body weight; subcutaneous). Model validation was performed using ovarian histology, estrous cycle monitoring, body weight, fasting blood glucose, and the intraperitoneal glucose tolerance test. Skin tissues were evaluated using haematoxylin and eosin staining for epidermal and dermal thicknesses, Masson's trichrome staining for collagen content (quantified with ImageJ), and immunofluorescence staining for Ki-67 and vascular endothelial growth factor immunoreactivity. Abstract:RESULTS: The polycystic ovary syndrome model was successfully validated using histological, reproductive, and metabolic parameters. The epidermal thickness was significantly reduced in the polycystic ovary syndrome group compared with the control group, and the dermal collagen content was also decreased. Ki-67 immunoreactivity appeared reduced in the polycystic ovary syndrome group, suggesting decreased cellular proliferative activity. Vascular endothelial growth factor immunoreactivity showed a similar staining pattern in both groups. Abstract:CONCLUSIONS: Dehydroepiandrosterone-induced polycystic ovary syndrome resulted in significant histological alterations in the skin, including epidermal thinning, reduced proliferative activity, and decreased dermal collagen content. These findings suggest that PCOS-associated skin alterations may be linked to impaired epidermal renewal and disrupted extracellular matrix organization, supporting the concept that polycystic ovary syndrome exerts systemic effects beyond the reproductive organs.
