Endocrine Abstracts

BackgroundCushing’s disease (CD) is caused by high levels of blood cortisol resulting from excess secretion of adrenocorticotropic hormone (ACTH) from an anterior pituitary corticotroph adenoma. Clinical manifestations include diabetes, hypertension, osteoporosis, and depression. If untreated, CD has an increased mortality of five-fold owing to cardiovascular comorbidities, stroke or raised vulnerability to infection. Currently, transsphenoidal surg...

Background: Timely diagnosis and management of neonatal hypoglycaemia is important due to associated short and long-term sequelae including neurodevelopmental delay. Hyperinsulinism should be distinguished from other causes of hypoglycaemia as management and acceptable glycaemic parameters may be different.Aims: To characterize admissions with hypoglycaemia and assess the use of hypoglycaemia screen to detect hyperinsulinism.Method...

Thyrotoxicosis results in osteoporosis and thyroid hormone (T3) stimulates osteoclastic bone resorption by unknown mechanisms. We previously demonstrated that knockout mice lacking thyroid hormone receptor α (TRα0/0) are euthyroid but have high bone mass, whereas mice lacking TRβ (TRβ−/−) are thyrotoxic and have osteoporosis. Tartrate resistant acid phosphatase (TRAcP) staining revealed osteoclast numbers were re...

Activation of the hypothalamic–pituitary–adrenal (HPA) axis and altered tissue glucocorticoid action in obesity and metabolic syndrome has been attributed to altered peripheral cortisol metabolism. In human obesity, cortisol clearance is increased with up-regulation of A-ring reductases and down-regulation of cortisol-regenerating 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) in liver, while in adipose tissue 11β-HSD1 is up-regulated. Rodent studi...

Background: Levothyroxine is the standard treatment for central hypothyroidism (CH). Studies assessing the optimal dose are limited and include subjects with other untreated pituitary hormone deficits, affecting the interpretation of results. A reliable comparison with the dose used in primary hypothyroidism (PH) has not been reported.Aims: To evaluate daily and body-weight-adapted levothyroxine dose (BWA-dose) in a cohort of patients with CH on appropri...

Primary hyperaldosteronism is now recognised as the most frequent underlying cause of hypertension. We recruited 94 patients (age (mean±S.D.) 56±11 years) with hypertension from primary care in order to study the role of corticosteroid hormone action in this cohort. Random, blood pressure (BP), plasma renin activity (PRA) and aldosterone (Aldo) was measured both on and off antihypertensive medication. In addition, a 24 h ambulatory blood pressure (ABP)...

Radioidine (RI) has been implicated as an adverse factor causing deterioration of Thyroid-Associated Ophthalmopathy (TAO). Oral steroids administered after RI appear to protect patients' eyes, and this practice is now widespread. Two factors may confound the controversy surrounding the effects of RI on TAO. Firstly hypothyroidism, which is common after RI and is independently detrimental to the eyes, and secondly studying patients who are in different phases of the natural his...

IntroductionWe have previously demonstrated profound effects of hormone replacement treatment (HRT) in post-menopausal women on the IGF-system. HRT is widely used to prevent osteoporosis. The IGF-system has been implicated in bone formation. IGFBP-4 and IGFBP-5 are known to be important in modulation of IGF activity in bone. In this larger study we have examined the effects of HRT on circulating IGFBP-4 levels.MethodOral conjugated equine estrogen (CEE) alone or in...

Introduction: Achieving glycaemic targets for young children with type 1 diabetes (T1D) is challenging due to rapidly changing physiology and behavioural patterns. An under-fives specialised multidisciplinary clinic (U5-MDT) was implemented in January 2022 due to poorer glycaemic control in this group compared to the rest of the clinic cohort. The U5-MDT aimed to optimise glycaemic control through access to technology while providing family support.<p clas...

Introduction: Carcinoid heart disease (CHD) develops in patients with small bowel NETs with carcinoid syndrome. Currently NT-proBNP (NTP) is suggested as the best current biomarker to screen for CHD and monitor heart failure. A number of other markers have been investigated for heart failure, however, none of these have been explored in NET patients with CHD or carcinoid syndrome. Galectin-3 (GAL3) promotes fibroblast proliferation and correlates with worse outcomes in heart f...