bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUN-633 Increased Risk of Gestational Diabetes Mellitus in Egyptian Females Undergoing In Vitro Fertilization in Alexandria
Authors: Amin Noha Gaber , Ghanem Yehia Moustafa , El Kassar Yasser Saad , Shalaby Mai 
Published: May 2020

Abstract
BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most frequent maternal complications during pregnancy. It has been estimated that most of the cases of hyperglycemia during pregnancy are attributed to GDM (75–90%). Pregnancy complicated with GDM is associated with adverse acute and long term consequences for both mother and infant. Risk factors for GDM include; a previous history of GDM, a family history of type 2 DM, advanced maternal age, overweight, and polycystic ovary syndrome (PCOS). This was an observational prospective study, using data of pregnant women conceived following in vitro fertilization (IVF) and spontaneously, aimed to determine the risk of GDM among Egyptian females following IVF compared to spontaneous pregnancy. The present study included two age and BMI- matched groups. Group I (GpI): 55 pregnant females conceived by IVF, and Group II (GpII): 55 pregnant females conceived spontaneously. We excluded females with a history of pre-pregnancy diabetes, glucose intolerance, corticosteroid therapy, twin pregnancy, and age above 39 years. In addition to detailed history taking, clinical examination and routine laboratory investigations, one- step oral glucose tolerance test (OGTT) was performed at gestational week 20 and 28 in all subjects. Fetal biometric measurements were performed in the third trimester using ultrasonography assessment.
Results: On using the one-step strategy (75 gm OGTT test) to screen for GDM at 28 weeks of gestation; GDM was statistically significantly higher in Gp I (who had undergone IVF) compared to Gp II (spontaneous pregnancy) (20% and 5.5% respectively), p= 0.022. Moreover, it was also noticed that GDM occurred earlier on screening at 20 weeks of gestation in Gp I (16.4%) compared to (3.6%) in Gp II, p= 0.026. Among subjects who had undergone IVF (Gp I), 18.2% had a history of PCOS. There was no statistically significant difference in the incidence of GDM among subjects with PCOS compared to those without a history of PCOS at gestational week 20 and at week 28 in Gp I (p=0.661, and p=0.099 respectively). Data of fetal biometry done at the third trimester showed no significant statistical difference in head circumference, biparietal diameter, abdominal circumference or femur length between both groups. However, fetal body weight was significantly higher in the IVF group (Gp I) compared to (Gp II), p=0.003.Conclusion: These findings show that IVF may increase the risk for GDM, moreover, GDM occurs earlier, recommending selective early screening for GDM in this population. References: Guariguata L, Linnenkamp U, Beagley J, Whiting DR, Cho NH. Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 2014; 103, (2) 176–85.
SAT-602 Hypothalamic P75 Neurotrophin Receptor Regulates Homeostatic Feeding and Food Anticipation
Authors: Podyma Brandon , Johnson Dove , Sipe Laura , Battin Katherine , Remcho Parks , Deppmann Christopher D , Güler Ali D 
Published: May 2020

Abstract
Proper circadian alignment of feeding behavior is necessary to prevent metabolic disease, and thus it is imperative to identify the neural circuits and molecular players that coordinate energy homeostasis. Neurotrophin signaling has been implicated in both metabolic and circadian processes, thereby representing a good candidate for regulating neural circuits driving time-of-day dependent feeding and foraging behavior. Here, we demonstrate that mice lacking the p75 neurotrophin receptor, p75NTR, have a behavioral defect in their ability to adequately respond to energy deficit. In response to fasting, p75KO mice (1) decrease their refeeding food intake compared to controls. Furthermore, following several days of restricted feeding, they (2) are unable to develop food anticipatory behavior (FAA), a phenomenon believed to be the output of a food-entrained circadian oscillator that has yet to be anatomically defined. Strikingly, these two phenotypes are observed only during the daytime, and not at night. These defects lead to increased weight loss, but do not appear to be mediated by changes in peripheral hormones. Notably, these effects are also independent of a role of p75NTR in development, as a global, adult-inducible p75NTR knockout recapitulates the feeding behavior of germline knockout mice. Rather, we demonstrate that p75NTR is discretely expressed in two hypothalamic regions known to be important for feeding behavior, the arcuate (ARC) and dorsomedial (DMH) hypothalamus. We find that p75KO mice have reduced fasting-induced activation of ARC, but not DMH, neurons. In addition, we show that ARC AgRP neuron p75NTR is necessary for fasting-induced refeeding and daytime FAA. We further suggest that AgRP-p75NTR is necessary to mediate AgRP neuron phospho-CREB signaling in response to energy deficit. Finally, given previous reports of involvement of the DMH in food anticipation, we asked whether DMH-p75NTR is necessary for feeding behavior and food anticipation. Strikingly, we find that p75NTR in the DMH is also necessary for FAA, but not for the control of homeostatic feeding. These data establish p75NTR as a novel regulator of energy homeostasis that acts to gate behavioral responses to food scarcity. It further posits that p75NTR may functionally link two independent hypothalamic regions to a time-of-day dependence of circadian food anticipation.
MON-165 Utility of Salivary Cortisol After 1 Mg Oral Dexamethasone in the Evaluation of Incidental Adrenal Tumors
Authors: Arregger Alejandro L , Contreras Liliana N , Cardoso Estela M L , Céspedes María E 
Published: May 2020

Abstract
The subclinical Cushing′s syndrome (SCS) is found in 20% of incidental adrenal tumors (AI). The overnight 1 mg oral dexamethasone suppression test (DST) with the measurement of circulating cortisol (F) is a sensitive method to rule out SCS. The assessment of salivary cortisol (SAF) as a surrogate of F became a non-invasive methodological advance. There are few data on the functional evaluation of AI through SAF in DST (SAFdex). The aim of this retrospective study was to investigate the utility of SAFdex for the detection of SCS in patients with AI. Subjects and Methods: 20 subjects with AI (7 male and 13 women; 65.0 ± 11.0 y/o; BMI: 26.5 ± 1.4) were studied. Sixteen had unilateral and 4 bilateral tumors (size: 10.0 - 90.0 mm; density (UH) was &lt;10.0 in 17 cases and ≥ 10.0 in 3). They were not on drugs that may affect the HPA axis. Eight patients (1 male and 7 women; 20.0–60.0 y/o; BMI: 27.0 ± 3.0) with overt non ACTH dependent Cushing Syndrome (CS) were included as the reference group of active hypercortisolism. CS had unilateral adrenal tumors in 6 cases and bilateral in 2 (size: 11.0 -200.0 mm; density (UH) &lt;10.0: n= 7 and &gt;10.0: n=1).All subjects collected 24-hour urine for urinary free cortisol (UFC). After the urine collection, they obtained whole saliva samples at 23 h for cortisol (SAF23). Subsequently, they received 1 mg oral dexamethasone. The following day at 8 h, simultaneous blood (Fdex) and saliva (SAFdex) samples were obtained. F, SAF and UFC were determined by RIA and ACTH by IRMA. Reference values ​​from our laboratory (n= 100): UFC ≤90.0 µg / 24hs; ACTH: 10.0–50.0 pg / ml, SAF23: 0.5–3.8 nM / l; SAFdex: 0.5–2.0 nM; Fdex: 13.8–50.0 nM. Statistics were performed by Mann-Whitney and Spearman tests, p &lt;0.05 was considered significant. In AI: ACTH 22.0 ± 11.0 pg /ml; UF:C 47.0 ± 20.0 µg / 24hs; SAF23: 1.5 ± 0.9 nM); SAFdex: 1.0 ± 0.5 nM and Fdex: 35.6 ± 10.0 nM were normal and significantly different from CS: 5.6±1.8 pg /ml; 391.0 ± 406.0 µg / 24hs; 20.0 ± 32.0 nM; 27.0 ± 24.0 nM and 674.0 ± 339.0 nM, respectively; p &lt;0.05 in all cases. A positive and significant correlation was demonstrated between SAFdex and Fdex in AI (r = 0.830) and CS (r = 0.905); p &lt;0.05 in both. Interestingly, a woman with overt CS and moderate signs of hypercortisolism, had normal SAF23 (1.5 nM) and UFC (76.0 µg / 24hs), while SAFdex (3.0 nM) and Fdex (69.0 nM) showed absence of suppression. Surgical resection of the adrenal tumor (an adrenocortical adenoma) and postoperative hypocorticism confirmed the diagnosis of CS.
Conclusion: SCS was excluded in all AI. The dexamethasone suppression test using saliva as a diagnostic fluid was a sensitive and practical method to rule out hypercortisolism in these patients.
SAT-067 Maternal Transmission of Pituitary Stalk Interruption Syndrome(PSIS)
Authors: Likki Snigdha Reddy , Allen Holley F , Gordner Chelsea 
Published: May 2020

Abstract
BACKGROUND: Pituitary stalk interruption syndrome (PSIS) is a rare entity characterized by thin or absent pituitary stalk, hypoplastic/aplastic anterior pituitary and ectopic posterior pituitary (EPP) on magnetic resonance imaging (MRI). PSIS can be associated with variable degrees of pituitary insufficiency 1. Most cases of combined pituitary hormone deficiency are sporadic, however in familial cases, there can be AD or AR inheritance with more than 30 genes identified in association with combined pituitary hormone deficiency (CPHD). We describe how diagnosis of 2 children with PSIS led to the discovery of the condition in their mother.
Clinical Case: Child 1 presented at age 3yrs with growth failure in 2003 with ht z score -4.24 SD. Subsequent work up revealed low IGF-1 (&lt; 25 ng /mL) and MRI showed EPP, small anterior pituitary gland and absent pituitary stalk. No GH stim test was performed. He was started on GH supplementation and later was diagnosed with central hypothyroidism, central adrenal insufficiency and hypogonadotropic hypogonadism and is doing well on multiple hormone replacement at age 19 yrs.
Child 2, a half-brother to child 1 (same mother), presented at age 1yr with growth failure in 2017 with ht z score -2.06. GH stimulation test with glucagon was abnormal and resulted in a very low GH response (peak GH 0.52 ng/mL). MRI showed EPP with small anterior pituitary gland and interruption of the stalk. Later he was found to have central hypothyroidism and mild central adrenal insufficiency. He is receiving standard hormone replacement at 3 yrs of age.
Mother of above 2 patients presented 6 mos postpartum in 2017 after her 7th and last pregnancy with fatigue and amenorrhea. Laboratory evaluation revealed central hypothyroidism (FT4 0.76 ng/dL) and she was prescribed levothyroxine followed by resumption of her menses. She was unable to breastfeed her children due to lack of supply. There were no concerns for DI, amenorrhea or infertility. She was referred to Endocrinology in 2019 for persistent fatigue with a question of GH deficiency. IGF-1 level was normal 114 ng/mL(z score -0.39) and GH stimulation test (clonidine + glucagon) was abnormal with peak GH 1.85 ng/ml. MRI showed EPP with hypoplastic pituitary stalk. Genetic testing was done for CPHD Sequencing Panel at Prevention Genetics which includes GL12, HESX1, LHX3, LHX4, OTX2, POU1F1, PROP1F1, PROP1, SOX2, SOX3 genes and results were negative. She has 4 other children (21, 12, 11, 10yrs) who are currently being investigated for hormone deficiencies. One child died at 3 months of age due to SIDS.
Conclusion: We present 3 family members with PSIS. This family highlights the variable clinical phenotype of PSIS and importance of careful family history when evaluating children with congenital pituitary abnormalities and supports the need for more extensive gene panels for evaluation of CPHD.
Reference:. Acta Endocrinologica, 2017. 13(1):96–105
SUN-189 A Case of Delayed Hypoaldosteronism Following Unilateral Adrenalectomy for Primary Aldosteronism
Authors: Schommer Julie , Shibli-Rahhal Amal A 
Published: May 2020

Abstract
BACKGROUND: Hypoaldosteronism occurs in 6–30% of patients following unilateral adrenalectomy for primary aldosteronism. The Endocrine Society guidelines recommend discontinuing potassium supplementation and spironolactone postoperatively with repeat renin and aldosterone after surgery to monitor for cure. Clinical Case: A 69-year-old male with a 15-year history of hypertension on amlodipine 10 mg daily, atenolol 100 mg daily, terazosin 5 mg daily, valsartan 160 mg daily, spironolactone 50 mg three times daily, with longstanding hypokalemia on potassium chloride 20 mEq four times daily presented with an ischemic stroke and persistent hypertension (BP 182/79). Following discontinuation of spironolactone, evaluation revealed aldosterone concentration of 214 ng/dL (normal 4.0 - 31) and plasma renin activity of 0.1 ng/mL/hr (normal 0.5 - 4.0), giving an aldosterone-to-renin ratio of 2,140. CT of the abdomen showed a 3 cm right adrenal mass. He underwent uncomplicated right adrenalectomy for primary aldosteronism. Postoperative potassium was 3.4 mEq/L (normal 3.5–5.0) and hypertension persisted, so he was discharged on potassium chloride 10 mEq, losartan 100 mg daily, amlodipine 10 mg daily, and labetalol 200 mg twice daily. Two weeks later potassium level was 5.1 mEq/L and potassium chloride supplement was discontinued. Six months postoperatively, potassium was 5.7 mEq/L with well-controlled blood pressure, so losartan was discontinued. Labs over the subsequent several weeks showed persistent hyperkalemia up to 6.2 mEq/L and new hyponatremia to 128 mEq/L (normal 134 - 150). Repeat plasma renin activity was 0.51 ng/mL/hr and aldosterone concentration &lt;1.0 ng/dL. Morning cortisol concentration was 18.3 ug/dL (normal 6.7 - 22.6) and ACTH 38 pg/mL (normal 6.0 - 50 pg/mL). He was diagnosed with postsurgical hypoaldosteronism. Potassium stabilized at 5.1 mEq/L and sodium stabilized at 134 mEq/L, so he was monitored without treatment for hypoaldosteronism. One year postoperatively his labs showed: potassium 5.1 mEq/L, sodium 135 mEq/L, renin 1.0 ng/mL/hr, and aldosterone 5.7 ng/dL. Conclusion: This patient had primary aldosteronism leading to suppression of aldosterone secretion from the contralateral healthy adrenal gland. This resulted in postoperative hypoaldosteronism once the affected adrenal gland was resected. This case demonstrates the need for continued monitoring of potassium, sodium, renin, and aldosterone following unilateral adrenalectomy for primary aldosteronism, especially in the setting of postoperative angiotensin receptor blocker use or other medications which can affect the renin-angiotensin-aldosterone system.
SAT-021 Effects of E2/P4 Oral Capsules on Bone Turnover in Women with Vasomotor Symptoms
Authors: Constantine Ginger , McClung Michael R , Kagan Risa , Graham Shelli , Bernick Brian , Mirkin Sebastian 
Published: May 2020

Abstract
Menopausal hormone therapy slows bone turnover and reduces the risk of osteoporotic fractures. The objective of this post hoc analysis was to evaluate bone turnover markers (BTM) in the phase 3 REPLENISH trial, which evaluated vasomotor symptoms (VMS) with an oral estradiol/progesterone (E2/P4) in postmenopausal women with a uterus.
Eligible women for this analysis had ≥50 moderate to severe VMS/week, &lt;5 years since last menstrual period, and BTM measurements at baseline, and months 6 and 12. Percent changes for 3 BTM (bone specific alkaline phosphatase [BSAP], C-terminal telopeptide of type I collagen [CTX-1], and N-terminal propeptide of type I procollagen [PINP]) assessed by immunoassay methods were evaluated from baseline to months 6 and 12 for the 1/100, 0.5/100 and placebo groups.
A total of 157 women (40–61 years, 69% White) were analyzed (56 for each 1/100 and 0.5/100; 45 for placebo). Mean baseline values ranged from 14.0–14.3 U/L for BSAP, 0.34–0.39 ng/mL for CTX-1, and 76.9–79.3 ng/mL for PINP. Mean differences in percent change from baseline versus placebo significantly decreased with both E2/P4 doses for all 3 BTM at months 6 and 12. Mean differences from placebo for E2/P4 at months 6/12 ranged from -8.1% to -17.8% for BSAP (all, P≤0.02), -30% to -41% for CTX-1 (all, P≤0.001), and -14% to -29% for PINP (all, P≤0.007).
REPLENISH data provide support for a potential skeletal benefit of E2/P4 when used for the treatment of moderate to severe VMS.
MON-041 Diagnostic Performance of Ovarian Morphology for Anovulatory Conditions in Lean and Overweight Women
Authors: Brink Heidi Vanden , Jarrett Brittany Y , Pereira Nigel , Spandorfer Steven D , Hoeger Kathleen M , Lujan Marla Elaine 
Published: May 2020

Abstract
Introduction: Sonographic evidence of polycystic ovarian morphology (PCOM) is a cardinal feature of polycystic ovary syndrome (PCOS), a condition which reflects a spectrum of phenotypes. The criteria to define PCOM are based on an upper threshold for follicle number and ovarian size in lean, regularly cycling women. Whether ovarian features can be used to distinguish between distinct anovulatory conditions is unclear, as is any impact of body mass index (BMI) on the diagnostic performance of ovarian morphology for anovulatory conditions.
Objectives: To determine whether ovarian morphology can discriminate between women with regular cycles, normoandrogenic anovulation (NA-Anov), and hyperandrogenic (HA-Anov) anovulation. Any impact of BMI-specific thresholds to improve the diagnostic performance of ovarian morphology for anovulatory conditions was determined.
Methods: Women with HA-Anov (biochemical and/or clinical hyperandrogenism and irregular cycles; N=53), NA-Anov (irregular cycles in the absence of hyperandrogenism; N=42), and normoandrogenic women with regular cycles (Controls, N=41) underwent a reproductive health history, physical exam, transvaginal ultrasound scan of their ovaries and fasting blood tests for reproductive hormones. Follicle number per ovary (FNPO, 2-9mm) and ovarian volume (OV) were determined. The diagnostic performance of sonographic markers for anovulatory conditions was tested using receiver operating characteristic curves.
Results: FNPO and OV discriminated between HA-Anov and Controls when all women were considered (area under the curve [AUC]=0.82, sensitivity [Se] 72%, specificity [Sp] 90% and AUC=0.84, Se 77%, Se 81%, respectively). The diagnostic accuracy (AUC = 0.87) and sensitivity (83%) of FNPO improved in lean women (BMI &lt; 25kg/m2), whereas specificity (93%) improved for women with overweight/obesity (BMI &gt; 25kg/m2). By contrast, the diagnostic performance of OV declined when BMI was considered. FNPO discriminated between HA-Anov and NA-Anov in lean women (AUC=0.77) whereas OV discriminated between anovulatory conditions in women with overweight or obesity (AUC=0.76). FNPO, but not OV, differentiated between NA-Anov and controls – albeit thresholds were lower for women in lean (&gt;22 follicles) versus overweight categories (&gt;38 follicles).
Conclusion: Ovarian morphology has diagnostic potential for anovulatory conditions – but its performance is impacted by BMI status. OV differentiated between HA and NA status, whereas follicle counts discriminated anovulatory conditions from controls suggesting differential roles for FNPO and OV in reproductive dysfunction. Consideration of BMI improved diagnostic performance in some cases, however the overlap in morphological features between NA- and HA-Anov is too extensive to propose condition-specific thresholds at this time.
SAT-305 Veldoreotide (COR005) Mechanisms of Action Studies: Comparison to Octreotide and Pasireotide
Authors: Dasgupta Pooja , Schulz Stefan 
Published: May 2020

Abstract
Stable somatostatin analogs (SSAs) are the first choice for medical treatment of pituitary adenomas and other neuroendocrine tumors. The somatostatin analogs octreotide, pasireotide, and veldoreotide primarily have been characterized according to their binding profiles. However, their ability to activate individual somatostatin receptor subtypes (SSTs) has not been directly assessed so far. In this study, we assessed G-protein signaling in human embryonic kidney (HEK293) cells stably expressing G protein-coupled inwardly rectifying potassium (GIRK) channels and SSTs using a novel fluorescence-based membrane potential assay. Dose-response curves obtained for veldoreotide revealed high potency and efficacy in cells expressing SST2, SST4, and SST5. Veldoreotide also inhibited proliferation and chromogranin A secretion in SST4-transfected BON-1 cells. In addition, we assessed G-protein signaling in primary pituitary cultures from SST2 and SST5 knockout mice. Our results show that octreotide mediates its effects selectively via the SST2 receptor. Conversely, pasireotide mediates its effects selectively via the SST5 receptor. In contrast, veldoreotide can activate both SST2 and SST5 receptors under otherwise identical conditions. Thus, veldoreotide is a unique SSA with full agonistic activity at the SST2, SST4, and SST5 receptors.
MON-583 Identifying Active Duty Military Meal Planning Preferences to Maximize Nutrition Therapy for Obesity
Authors: Clerc Philip , Wardian Jana 
Published: May 2020

Abstract
INTRODUCTION: Obesity rates exceed 30% for active duty service members with vitals in the military health system electronic medical records. Although nutrition therapy is a cornerstone of treatment for all individuals with obesity, it is even more important in active duty service members, who have restrictions for obesity medications and are not eligible to receive bariatric surgery. Among nutrition therapy services, online nutritional cooking classes are the most desired intervention by patients at our institution. We currently do not have this resource available. The aim of this survey was to identify meal planning preferences among active duty service members to guide the development of online nutritional cooking classes.
METHODS: Surveys were distributed to active duty service members and/or their spouses at San Antonio Military Medical Center and Wilford Hall Medical Center in the summer of 2019. Data included preferences for time spent cooking each meal, weekly grocery budget, meal size, batch cooking preference, available kitchen equipment, most common meals eaten, and desired features in an online nutritional cooking class.
RESULTS: 141 surveys were collected, 77% of whom were active duty service members and 23% of whom were spouses of active duty service members. Most respondents stated they could spend 15 minutes or less on cooking breakfast (65%) and lunch (69%) on a daily basis. The majority of respondents (84%) were willing to batch cook. Half of respondents (50%) were willing to spend $100-$150 on food per week. Over 90% of respondents had to cook for a household of 4 people or less. Of respondents with children, 78% fed children the same meal that they cooked for themselves. About half of respondents had a food processor (55%) and an electronic pressure cooker (52%). Few respondents (14%) shopped for food at specialty grocery stores or farmer’s markets. Half of respondents (50%) preferred a 5–10 minute duration for each online nutritional cooking class. Of the many highly desired features for the classes, the option to watch on a smart phone was the most desired feature (97%).
CONCLUSION: This sample of active duty service members and their spouses demonstrated a high degree of congruity for meal planning preferences and requested features for online nutritional cooking classes. Development of online nutritional cooking classes targeted to these preferences may lead to a higher success rate of nutrition therapy than current interventions.
DISCLAIMER: The views expressed are those of the authors and do not reflect the official views or policy of the Department of Defense or its Components.