Endocrine Abstracts

Objective: To test the hypothesis that poor adolescent diabetic control results in poor adult control.Methods: We conducted a retrospective case notes study involving 57 patients (M:F 30:27) in a teaching hospital. Patients who had diabetes atleast for a minimum period of 10 years were selected and their HbA1c when they were between 17 and 19 years of age were compared with the most recent HbA1c.The adolescent control was divided i...

IGF-I and -II influence cytotrophoblast proliferation by activating the type-I IGF receptor (IGF1R) in first trimester human placenta. Ligand access to receptors is regulated by IGF binding proteins (IGFBPs) 1-6. In humans, the most abundant IGFBPs at the maternal-fetal interface are IGFBP-1 and IGFBP-3; we hypothesised that these IGFBPs function to regulate the effects of IGFs in the placenta and used our placental explant model, in which proliferation and differentiation are...

Background: Most patients consulting an endocrinologist for hypercalcemia suffer from primary hyperparathyroidism. Rarely, toxic vitamin D levels can also induce hypercalcemia while suppressing parathyroid hormone (PTH) levels. Infantile hypercalcemia can be caused by mutations in CYP24A1 (24-hydroxylase), which are inherited in an autosomal recessive manner (1). This enzyme is responsible for the inactivation of 25-OH-vitaminD (25-OHD) and 1,25(OH)2vitaminD3</...

Objectives: The Diabetes Team at Birmingham Children’s Hospital modified the advanced bolus algorithm suggested by Bell (2015), to develop the KISS (Keep it Simple and Safe). KISS involves adding 25% extra insulin to meals identified as very high fat and protein, and spreading the insulin by a split bolus, 50% now and 50% over 2.5 hours. KISS also has an adjustment tool allowing extra insulin to be added and the split modified from monitoring. KISS is intended to be a sim...

Folliculo-stellate (FS) cells exert a paracrine regulation on their neighbouring endocrine cells in the anterior pituitary gland. FS cells are non-granular cells characterized by long cytoplasmic processes and form follicles with microvilli on their luminal cavity, suggesting a transport function. Moreover, FS cells form monolayers in primary culture and develop domes after reaching confluence, characteristics of polarized transport epithelia. However little is known about tra...

Background: Environmental factors play a role in the pathogenesis of autoimmune conditions. The incidence of type 1 diabetes is higher in winter. It is unclear whether autoimmune thyroid disease is similarly affected by seasonal variation. We aimed to study the variation in anti thyroid peroxidase (TPO) antibodies in relation to calendar month of sampling.Methods: We obtained TPO-antibody results for the 12 months (October 2009 till September 2010). Indi...

Fetal growth restriction is associated with abnormal placental cell (cytotrophoblast) proliferation. Using an explant model of human first trimester placenta, we have demonstrated that the IGFI and -II stimulate proliferation in cytotrophoblast and are probably essential for normal placental growth. IGF activates signalling through both Akt and ERK, so the regulation of these pathways in placenta is important for normal pregnancy outcome. The tissue contains high levels of mic...

In order to assess the frequency and timing of recurrence in a group of patients with Graves’ disease and the predictors of recurrence, 197 patients were sampled, who were first seen in the OCDEM clinic in either 2001 or 2002 and put on anti-thyroid medication. Graves’ disease was diagnosed by the presence of low TSH levels ± symmetrical goitre ± uniform radioactive iodine uptake ± eye disease ± high levels of thyroid hormones. Patients with <...

In 1999 Haddow et al (NEJM; 1999; 314:549) reported neuropsychological deficits in babies born to inadequately treated hypothyroid mothers. We have compared our management of treated hypothyroidism in 30 pregnancies in 24 mothers delivered before 2000 to 37 pregnancies in 33 mothers since.TSH levels were measured at booking in 22 (73%) in the pre-2000 group, 6 (27%) of which were raised; and 32 (86%) in the post-2000 group where 12 (38%) were raised. 7 m...

Hydrocortisone therapy should be individualised in patients with adrenal insufficiency to avoid over and under replacement. We assessed hydrocortisone absorbtion at different times of day which may impact on treatment regimens. We assessed the oral absorption of hydrocortisone in 48 patients (21M) aged between 6.1 and 20.3 years with congenital adrenal hyperplasia due to P450c21 deficiency. Hydrocortisone dosing ranged between 11.5 and 22.6 mg/m2 per day in three or...