Endocrine Abstracts

Obesity poses a major threat to health, increasing the risk of degenerative diseases and the burden of health costs. Those with severe and complex obesity (often with a BMI > 40 kg/m2) have the greatest burden of co-morbidity and reduced life expectancy are now 2% of the UK population. These patients comprise the majority of referrals to tier 3 obesity services in primary and secondary care. Bariatric surgery is recognised as an effective intervention for approp...

Introduction: This is a review of cognitive decline in male ageing.Methods: Literature review and analysis of cognitive data from the Healthy Old People of Edinburgh (born 1905–1919), Lothian Birth Cohort 1921 and Lothian Birth Cohort 1936 studies.Results: Cognitive scores in men increased relative to those of women between childhood and late adulthood, but changes in old age were little affected by sex once other factors, suc...

Serum magnesium concentration is regulated by the balance between intestinal absorption and renal excretion. Hypomagnesaemia is relatively common, with an estimated prevalence in the general population ranging from 2.5 to 15%. It may result from inadequate magnesium intake, increased gastrointestinal or renal loss, or redistribution from extracellular to intracellular space. Drug-induced hypomagnesaemia, particularly related to proton-pump inhibitor (PPI) therapy, is being inc...

The benefits of continuous subcutaneous insulin infusion (CSII, insulin pump therapy) in type 1 diabetes, compared to multiple dose insulin injections (MDI), include a reduction in HbA1c, the frequency of all grades of hypoglycaemia, insulin dosage and glycaemic variability, and improved patient satisfaction with therapy and improved quality of life. The evidence base for this is now well established from meta-analyses of randomised controlled trials (RCTs) and from clinical o...

The FRAXÒ algorithm represented a major step forward in absolute fracture risk assessment. It took advantage of globally derived information to predict fracture risk that used that as the basis for rational treatment recommendations for a large proportion of the international community. The extrapolation of FRAXÒ to different regional and geographic criteria has been based on two sets of data that can be obtained with relatively high accuracy; these being regional ag...

Aldosterone has assumed increasing importance as a major cardiovascular risk factor. This is illustrated by the positive correlation between plasma aldosterone levels and blood pressure in a number of large population surveys, and the finding that approximately 10% of patients with high blood pressure have inappropriate aldosterone levels in relation to renin, consistent with primary aldosteronism. Evidence also supports the notion that aldosterone exerts particularly deleteri...

Severe or morbid obesity is becoming more common and now affects about 2% of the UK population. Neuroendocrine disturbances are a common feature of morbid obesity and include male and female hypogonadism, deficiencies of the GH-IGF-1 axis and features suggestive of Cushing’s syndrome in some patients. Patients with neuroendocrine disturbance can broadly be considered in three main categories: 1. Those with genetic syndromes (eg Prader-Willi syndrome, leptin deficiency, MC...

Opportunities for applications of nanomedicine in diabetes are numerous. In type 1 diabetes, improved insulin replacement is urgently needed, but transplantation of islet cells is not routine, limited by availability of human islets and immune rejection. Longer survival of transplanted islets might be ensured by nano-encapsulation technologies which protect the islets from early cell death caused by the inflammatory in vivo environment and isolate against later immune r...

In humans, the adrenal gland develops from the intermediate mesoderm at around 4 weeks gestation and undergoes a series of distinct morphological and functional changes throughout pre- and post-natal life. Two key transcriptional regulators of adrenal development are the nuclear receptors DAX-1 (NR0B1) and steroidogenic factor-1 (SF-1, NR5A1, Ad4BP). Mutations or deletions of DAX-1 result in X-linked adrenal hypoplasia congenita (AHC). Boys with this condition ty...

In this talk I will describe several genes that have been implicated in the action of GH as it relates to aging. Much of the data is derived from two dwarf and one giant strain of mice produced in our laboratory that possess very different life spans. One of the dwarf lines contains a disruption of the GH receptor and binding protein gene (GHR/BP) (PNAS, 94:13215–13220, 1997). Homozygous GHR/BP ‘knockout’ mice (GHR/BP−/−) show severe postnatal growth...