Endocrine Abstracts

Heart failure is a leading cause of death in man, and stress is increasingly associated with adverse cardiac outcomes. Glucocorticoids are primary stress hormones, but their direct role in cardiovascular health and disease is poorly understood. To determine the in vivo function of glucocorticoid signaling in the heart, we generated mice with cardiomyocyte-specific deletion of the glucocorticoid receptor (GR). The cardioGRKO mice appear normal early in life but die pre...

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Multiple endocrine neoplasia (MEN) syndromes are rare autosomal-dominant disorders that predispose affected individuals to benign and malignant tumours involving two or more endocrine glands. Four major forms of MEN are recognised, each associated with the occurrence of specific tumours. MEN1 is due to germline-inactivating mutations of the MEN1 tumour-suppressor gene, and is associated with the occurrence of parathyroid, pancreatic islet and anterior pituitary tumours. MEN2 (...

Treatment of hyperthyroidism with antithyroid drugs has recently been shown to have an effect on MMI/Carbimazole embryopathy at a specific early window in gestation. This has important implications for management.There is agreement that untreated overt gestational hypothyroidism is associated with significant adverse obstetric and fetal/neonatal effects. Although there is also substantial evidence that gestational subclinical hypothyroidism (SCH) is asso...

The human adrenal gland develops from around 4 weeks post conception and undergoes rapid growth and differentiation in early fetal life. At birth, the adrenal gland consists of a mature adult type cortex capable of mineralocorticoid and glucocorticoid production, as well as a fetal zone that involutes in the first few months. Disruption of the HPA axis development can cause adrenal hypoplasia. This is classically broken down into secondary causes (ACTH insufficiency); ACTH-res...

Objectives: There is uncertainty about the best approach to management of type 1 diabetes (T1D) in clinically well children at diagnosis. This study, investigated the impact of home and hospital management on biopsychosocial and economic outcomes.Methods: Multi-centred randomised controlled trial. 203 newly diagnosed children aged 0–17 years from eight UK centres were randomised for treatment initiation at home (n=101) or in hospital (n...

GH receptor-binding protein gene disrupted mice GHR(−/−) are dwarf, obese, insulin sensitive, and long-lived whereas GH transgenic mice are giant, glucose intolerant, lean, and short lived. When challenged with a high-fat (HF) diet, all mice became hyperinsulinemic with similar percent weight gains and increases in percent body fat and size of the epididymal, retroperitoneal, and subcutaneous fat depots. For GH mice, the increase in adipose tissue was relatively sm...

Pituitary apoplexy is an uncommon emergency. It presents often with sudden thunder clap headaches and requires multidisciplinary team involvement. This includes an experienced neurosurgeon, endocrinologist, radiologist – the pituitary multidisciplinary team.Urgent treatment should be given often involving steroids (after a blood cortisol has been taken). Assessment includes neurological signs which if severe may merit urgent surgery.<p class="ab...

Obesity is a chronic relapsing disease with significant adverse implications for current and future health. Whilst guidelines recommend first line treatment with lifestyle interventions that include restriction of energy intake, increased physical activity and behavioural modification, these only demonstrate an average decrease of 3–5% initial body weight over 12 months, and weight regain is common. Bariatric surgery is effective, but is generally only offered to people w...

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...