Endocrine Abstracts

The 250 mg short synacthen test (SST) is the most commonly used tool to assess the integrity of hypothalamic-pituitary-adrenal (HPA) axis. There are many instances when compromise to HPA-axis function is potentially reversible (including the use of suppressive dose of prescribed glucocorticoids), but currently there are no data to guide clinicians as to the frequency of repeat testing or to the likelihood of HPA-axis recovery. We performed an observational, retrospective, anal...

Leptin is an adipocytokine with a role in appetite, energy expenditure and reproductive regulation. In normal, non-obese individuals, leptin levels are higher in females, independent of differences in body fat between the genders. High levels of leptin that were disproportionate to body mass index (BMI) have been reported in craniopharyngioma patients, thus we hypothesised that surgical resection and hypothalamic damage conferred leptin resistance on craniopharyngioma patients...

Obesity is a recognised complication of craniopharyngioma (CP), but its aetiology is not understood. Leptin, which signals energy reserve, and ghrelin, which regulates appetite, are implicated in the development of obesity.Our aim was to assess leptin and ghrelin levels in CP patients and to compare these to normal and BMI-matched controls.CP patients were identified from the local database. All CP patients were on hormone replacem...

Glucocorticoids (GC) are commonly prescribed and their use is associated with adverse metabolic side effects. 5a-reductase (5aR) inhibitors are also frequently prescribed mainly for their ability to inhibit the conversion of testosterone to dihydrotestosterone. However, they also have a role to inactivate and clear GCs. We hypothesised that 5aR inhibitors have the potential to exacerbate the adverse metabolic effects of GCs. We conducted a prospective, randomised, study in 19 ...

Glucocorticoids (GC) are commonly prescribed and their use is associated with adverse metabolic side effects. 5a-reductase (5aR) inhibitors are also frequently prescribed mainly for their ability to inhibit the conversion of testosterone to dihydrotestosterone. However, they also have a role to inactivate and clear GCs. We hypothesised that 5aR inhibitors have the potential to exacerbate the adverse metabolic effects of GCs. We conducted a prospective, randomised, study in 19 ...

Introduction: Glucocorticoids (GC) are prescribed to 2–3% of the population of the UK and USA. Their use is associated with a significant side effect profile that includes the development of central obesity, insulin resistance and type 2 diabetes. 5α-reductase (5αR) inhibitors (Finasteride and Dutasteride) are also commonly prescribed in the context of prostate disease, where they inhibit the conversion of testosterone to dihydrotestosterone. Additionally, they ...

Increased adiposity is associated with insulin resistance, type 2 diabetes and metabolic dysfunction. Altered adipokine secretion, changes in local and systemic glucocorticoid metabolism and increased inflammation have all been postulated as contributory mechanisms. We have previously described changes in subcutaneous adipose tissue (SAT) gene expression that are associated with obesity and glucose intolerance in cross-sectional studies. However, the effects of longitudinal ch...

In the pathogenesis of obesity, dysregulated tissue cortisol metabolism (controlled by 11β-HSD1), is postulated to be involved. Fifteen patients (seven mens, mean BMI 50.8±7 kg/m2) awaiting Roux En Y gastric Bypass (RYGB) surgery underwent assessment of 11β-HSD1 activity using cortisol generation profile. Corticosteroids in serum and subcutaneous adipose tissue microdialysis fluid and urinary corticosteroid metabolites were analysed by liquid and gas ...

Background: The short Synacthen test (SST) is the most widely used dynamic assessment of adrenal reserve. In some situations, the SST may be difficult to perform. Random basal cortisol levels could provide an alternative screening assessment to rationalize which patients need dynamic testing. This is highly clinically relevant, given the large numbers of patients taking prescribed glucocorticoids who are at risk of iatrogenic adrenal suppression.Methods:...

Recent literature suggests anterior pituitary hormone deficiency (APHD) is common in paediatric patients with idiopathic cranial diabetes insipidus (CDI); this has been attributed to autoimmune panhypopituitarism.1 We therefore determined the frequency of coexisting APHD and autoimmune disease in our cohort of patients with idiopathic adult CDI.Eight patients with idiopathic CDI were reviewed (6 females mean age at diagnosis 30 years, range 7&...