Searchable abstracts of presentations at key conferences in endocrinology

ea0094p180 | Adrenal and Cardiovascular | SFEBES2023

The golden ratio for cortisol replacement

Evans Rosemary , Gallagher Meurig , Smith David

Current cortisol dosing regimes for patients with adrenal insufficiency are unable to accurately replicate the physiological profile of healthy patients. This work is part of an interdisciplinary study with the aim of using mathematical approaches to understand the treatment strategies for patients with adrenal insufficiency. We also aim to then tailor treatments specific to an individual or situation. We present a simplified model of hydrocortisone delivery via intravenous bo...

ea0104p46 | Bone & Calcium | SFEIES24

Two cases of pseudohypoparathyroidism type 1B presenting to a tertiary dublin hospital

McDonnell David , Smith Diarmuid , Agha Amar

Pseudohypoparathyroidism (PHPT) is a very rare disorder characterised by a lack of response to parathyroid hormone at the level of the proximal tubule. In the absence of the classical features of Albright Osteodystrophy, the diagnosis can be missed. We present two cases of type 1B PHPT. The first case was of a 39 year old man presenting with non-specific abdominal symptoms and was found to have a corrected calcium of 1.89 mmol/ (2.21-2.52 mmol/l) with a paired PTH of 734pg/ml ...

ea0050p018 | Adrenal and Steroids | SFEBES2017

Prednisolone should be first line replacement therapy for adrenal insufficiency

Prabhudev Hemanth , Smith David , Choudhury Sirazum , Meeran Karim

Introduction: We offer patients needing glucocorticoid replacement in primary and secondary adrenal insufficiency the choice of either once daily prednisolone or thrice daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers, including glucose, weight, body mass index (BMI), systolic and diastolic blood pressure and waist circumference, although they did suggest an increase in cholesterol and low densit...

ea0050p018 | Adrenal and Steroids | SFEBES2017

Prednisolone should be first line replacement therapy for adrenal insufficiency

Prabhudev Hemanth , Smith David , Choudhury Sirazum , Meeran Karim

Introduction: We offer patients needing glucocorticoid replacement in primary and secondary adrenal insufficiency the choice of either once daily prednisolone or thrice daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers, including glucose, weight, body mass index (BMI), systolic and diastolic blood pressure and waist circumference, although they did suggest an increase in cholesterol and low densit...

ea0025oc1.2 | Young Endocrinologists prize session | SFEBES2011

Does ‘mild' primary hyperparathyroidism progress if left untreated? A natural history study

Yu Ning , Donnan Peter , Smith David , Leese Graham

The prevalence of primary hyperparathyroidism (PHPT) is increasing and the majority (over 85%) are now asymptomatic and remain untreated. In order to know whether or not they can be left safely without surgery, issues on disease progression need to be addressed. We aimed to update the natural history of PHPT, with a focus of serum calcium progression in mild untreated patients, selected from a large pre-defined cohort of PHPT in Tayside, Scotland. Possible predictors of progre...

ea0015p322 | Steroids | SFEBES2008

Serine phosphorylation of IRS-1 as a mechanism of glucocorticoid induced insulin resistance in mouse C2C12 myotubes

Morgan Stuart A , Gathercole Laura L , Bujalska Iwona , Stewart Paul M , Smith David , Tomlinson Jeremy W

Glucocorticoid (GC) excess is characterized by increased adiposity, skeletal myopathy and insulin resistance. Despite the increasing use of GCs as therapeutic agents, the molecular mechanisms that underpin GC mediated changes in insulin signalling are not clear. Within skeletal muscle, the microsomal enzyme, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive GC, 11-dehydrocorticosterone (A) to active corticosterone (B) and thus regulates GC availabi...

ea0013p283 | Steroids | SFEBES2007

Regulation of insulin signalling across differentiation and following glucocorticoid treatment in human skeletal myocytes

Morgan Stuart , Gathercole Laura , Bujalska Iwona , Stewart Paul , Smith David , Tomlinson Jeremy

Glucocorticoid (GC) excess is characterized by increased adiposity, skeletal myopathy and insulin resistance. Despite the increasing use of GCs as therapeutic agents, the molecular mechanisms that underpin the GC mediated changes in insulin signalling are not clear. The majority of previous studies have used rodent models and have shown regulation at the level of the insulin receptor (IR), IRS-1 and PI3 kinase.Primary cultures of human skeletal myocytes ...

ea0050oc2.5 | Clinical Highlights | SFEBES2017

Additional value of 4D-CT in patients with primary hyperparathyroidism and negative conventional imaging; a reason to change primary imaging modality in patients over 60?

Alkemade Gonnie , Sifontes-Dubon Mildred , Bhatt Dhruti , Smith David , Duguid Rebecca , Straiton Jack , Dymot Jane , Graveling Alex , Abraham Prakash

Introduction: Minimally invasive surgical treatment of primary hyperparathyroidism (PHPT) requires optimal preoperative localisation imaging. Parathyroid four-dimensional CT (4D-CT) has been reported to provide greater sensitivity than MIBI-SPECT/CT in localizing parathyroid adenomas. We analysed the additional value of 4D-CT in our cohort of PHPT patients.Materials and methods: Patients who attended our parathyroid clinic between February 2016 and April...

ea0050oc2.5 | Clinical Highlights | SFEBES2017

Additional value of 4D-CT in patients with primary hyperparathyroidism and negative conventional imaging; a reason to change primary imaging modality in patients over 60?

Alkemade Gonnie , Sifontes-Dubon Mildred , Bhatt Dhruti , Smith David , Duguid Rebecca , Straiton Jack , Dymot Jane , Graveling Alex , Abraham Prakash

Introduction: Minimally invasive surgical treatment of primary hyperparathyroidism (PHPT) requires optimal preoperative localisation imaging. Parathyroid four-dimensional CT (4D-CT) has been reported to provide greater sensitivity than MIBI-SPECT/CT in localizing parathyroid adenomas. We analysed the additional value of 4D-CT in our cohort of PHPT patients.Materials and methods: Patients who attended our parathyroid clinic between February 2016 and April...

ea0028oc5.4 | Growth, tumours and pituitary | SFEBES2012

Steroid metabolomics in adrenocortical carcinoma reveals mitotane as an inducer of CYP3A4 and an inhibitor of 5alpha-reductase activity with major implications for drug metabolism and hydrocortisone replacement

Chortis Vasileios , Taylor Angela , Schneider Petra , Tomlinson Jeremy , Hughes Beverly , Smith David , Porfiri Emilio , Shackleton Cedric , Stewart Paul , Arlt Wiebke

Mitotane (o,p’DDD) is the first-line treatment for metastatic adrenocortical carcinoma (ACC) and is also regularly used in the adjuvant setting after presumed complete removal of the primary tumour. Mitotane is considered an adrenolytic substance, but no information is available regarding distinct steroidogenic effects. Here we carried out steroid metabolomics by gas chromatography/mass spectrometry in 24-hour urine samples from 106 patients with ACC and with samples coll...