Scurvy and rickets are largely considered historical diseases in developed countries. However, deficiencies in vitamins C and D are re-emerging due to increased consumption of processed foods and reduced fresh foods in the Western diet, as well as to an indoor sedentary lifestyle away from sun exposure. These dietary and lifestyle factors also predispose one to diabetes and metabolic syndrome. Our understanding of the potential roles of vitamin C (an antioxidant) and vitamin D (a biologically active hormone) in disease is increasing. In this review, we present observational, interventional, and mechanistic studies that examine the potential links between vitamins C and D in reversing defects in glucose homeostasis and the prevention of type 2 diabetes. Studies suggest an association between vitamin C deficiency and diabetes. An association between vitamin D and insulin resistance has been well described; however, the role of vitamin C and D supplementation in diabetes and its prevention requires further controlled trials.
This report describes a case of pituitary adenoma with interspersed adrenal cortical cells. The pituitary cells were confirmed to be corticotrophs with Tpit and adrenocorticotropic hormone immunohistochemistry, whereas the adrenal cortical cells were verified to be such with steroidogenic factor-1 (SF-1), inhibin, calretinin, and Melan A staining. The presence of normal adrenal cortical cells in the heterotopic location of the sella fulfills the definition of choristoma. The origin of adrenal cortical cells within a pituitary adenoma remains unexplained. The important role of SF-1 in both pituitary and adrenal cortex may explain a relationship that supports the possibility of an abnormal proliferation and differentiation of uncommitted mesenchymal stem cells within the sella. However, it remains possible that misplaced adrenal cortical cells derived during embryogenesis give rise to this rare but distinct morphological entity that can pose a difficult diagnostic dilemma. The approach to differential diagnosis is discussed.
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