Endocrine Abstracts

Introduction: Patients with primary adrenal insufficiency (PAI) and patients with congenital adrenal hyperplasia (CAH) receive life-long glucocorticoid (GC) replacement therapy. Today daily GC doses are still higher than the reported adrenal cortisol production rate, and are not able to reproduce the physiological secretion pattern. This might result in long-term morbidities such as osteoporosis. Until now no prospective trial was performed investigating the long-term effect o...

Introduction: Patients with primary adrenal insufficiency (PAI) and patients with congenital adrenal hyperplasia (CAH) receive glucocorticoid replacement therapy, which might cause osteoporosis.Objective: i) Is bone mineral density (BMD) depending on the height of the daily glucocorticoid dose? ii) Is BMD decreasing over a 2-year period of glucocorticoid replacement therapy?Methods: Prospective, longitudinal study including 56 pati...

Introduction: Patients with primary adrenal insufficiency (Addison’s disease) and patients with congenital adrenal hyperplasia (CAH) still tend to receive more glucococorticoids than the normal endogenous production in healthy subjects. CAH patients start glucocorticoid treatment usually with diagnosis in their early childhood, whereas Addison’s patients have a later onset of their disease and start of their treatment.Objective: To compare pati...

Adrenal insufficiency can result in severe hyponatremia due to inappropriate high plasma vasopressin (pAVP). To elucidate the glucocorticoid AVP feedback we monitored thirsting of 12 male volunteers without and after on or five days of prednisolone (30 mg/d). Although prednisolone suppressed pAVP below 0.2 pg/ml the rise in plasma osmolality during thirsting was not influenced by prednisolone. Independent of exogenous glucocorticoid thirsting resulted in higher urine osmolalit...

Introduction: Free fatty acids (FFAs) affect pituitary function. While no effect of FFAs on ACTH and cortisol seems to exist in men, data in women are somewhat controversial. Therefore, we aimed to assess the effect of an acute increase of circulating FFA levels induced by the infusion of a lipid-heparin infusion on ACTH and cortisol secretion in healthy young women.Methods: Following a 10-h overnight fast 13 healthy female volunteers were investigated i...

Objective: Hypokalemic Conn’s syndrome is a rare disease with a prevalence of 0.5% in unselected hypertensive populations. However, recent studies indicate a higher prevalence of a milder variant of Conn’s syndrome, reaching 10% in some studies. Long term outcome and health care costs of hypo- and normokalemic variants are largely unknown. The National Conn’s Registry is an initiative to create a national database of sufficient epidemiological strength to invest...

Objective: Primary aldosteronism (PA) is associated with vascular end organ damage. We evaluated the newly established German Conn’s Register for evidence of renal impairment and compared the data with renal function from hypertensive subjects from an epidemiologic cohort.Methods: The registry was founded in 2006 and has at present 7 participating centres in 5 locations. Data are entered in a central electronic database. Up to July 2007 555 patients...

Context: Primary aldosteronism (PHA) is the most common cause of secondary hypertension. Distinguishing unilateral (UAH) from bilateral (BAH) and other causes of PHA is one of the greatest challenges in the diagnostic process. Adrenal venous sampling (AVS) is widely considered to be the gold standard for subtype differentiation.Methods: Technical and diagnostic outcome of AVS was analysed retrospectively in 59 patients with PHA who underwent AVS at the U...

Context: The polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism and associated with obesity and impaired glucose metabolism. Despite the high prevalence of PCOS and the considerable clinical impact, the precise interplay between metabolism and hyperandrogenemia is not entirely clear. We therefore aimed to analyse the relation between circulating free fatty acids (FFAs) and androgen metabolism in vivo in women.Design and partic...