Endocrine Abstracts

The neuroendocrine cascade regulating episodic growth hormone (GH) secretion plays a central role in post-natal growth and metabolism. Intermingling of GH cells with other pituitary cell types and the complex distribution of the hypothalamic GHRH neurons makes both the cell types difficult targets for selective physical or chemical manipulation. On the other hand, they are excellent targets for physiological transgenesis since their major secretory products derive from highly ...

Hypophosphataemia is a common mineral metabolic abnormality affecting 2-3% of all hospital in patients and up to 34% of ICU patients. The causes are numerous. Over the last two decades following the identification of Fibroblast growth factor-23 (FGF-23) as the phosphaturic hormone responsible for Autosomal Dominant Hypophosphataemic Rickets (ADHR) in 2000 there has been an explosion in the understanding of phosphate homeostatic physiology and disorders of phosphate homeostasis...

Insulin-like growth factor-1 (IGF-I) is a 70-amino acid peptide hormone which is the principal mediator of the effects of growth hormone (GH). Pituitary GH is secreted in a pulsatile manner and is subjected to various environmental and physiological stimuli. In contrast, IGF-I is synthesised in a more stable manner and has a longer half-life therefore it is a more reliable biomarker of GH status. Hence IGF-I measurements are essential for the diagnosis and treatment of GH defi...

Following the roll-out of the I-DSD Registry in the 2000s, there was a consensus view that there was a need for a registry for congenital adrenal hyperplasia (CAH) and this was launched in 2014 as a dedicated module within the original registry. There are approximately 150 centres from 50 countries that are currently using the I-DSD/I-CAH/I-TS family of registries and between them there are almost 3,000 cases of CAH that have now been entered. In addition to supporting and pro...

Considerable overlap in IGF-I levels exists between normal and severely GHD subjects; the mechanisms underlying this observation remain poorly understood. Under various clinical circumstances therefore, IGF-I estimation is an unreliable marker of GH status. A polymorphism in the IGF-I gene influences IGF-I levels in normal populations; a higher IGF-I is associated with the presence of 2 wild type alleles of the IGF-I gene (WTG). The possibility that an IGF-I gene polymorphism ...

INTRODUCTION: Although IGF-I is considered to reflect the daily GH secretion, its value in establishing the diagnosis of adult growth hormone deficiency (GHD) and in predicting the presence of further anterior pituitary deficits has not been elucidated in a large series.AIM: To evaluate the diagnostic utility of a subnormal IGF-I in patients with GHD and to investigate whether a low IGF-I is associated with the presence of further anterior pituitary defi...

Hirsutism is one of the most common clinical features encountered in women attending endocrine clinics. It can also be extraordinarily difficult and challenging to manage well. In this brief presentation I will discuss management of hirsutism, using three major challenges as a scaffold:Challenge 1: diagnosing the underlying cause: Hirsutism, the presence of terminal hairs distributed in a male-like pattern in women, affects between 5 and 10% of women. Po...

Introduction: Pseudohypoparathyroidism (PHP) is a rare disorder characterized by parathormone (PTH) resistance, caused primarily by genetic defects involving the alpha-subunit of the stimulatory G protein. Biochemical and molecular analysis classify pseudohypoparathyroidism into types I-a, I-b, I-c and 2. We report a case of PHP I-b in an adolescent presenting with a neurological disorder.Case Report: 11 years old female patient, with no relevant persona...

Introduction and aims: Following treatment for acromegaly, both growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels are predictive of mortality. These data are derived from studies of either a single GH or the mean circadian GH, with a threshold of 2 mcg/l. However, consensus target criteria (Giustina et al. 2000) require: a nadir GH of <1 mcg/l on OGTT and IGF-I within the age/sex-adjusted normal range. We aimed to determine the degree to which norm...

Approximately 50% of patients with severe AGHD (defined by the international consensus criteria, peak GH <3 ng/ml) have a normal age- and gender-related IGF-I. It remains unclear whether in these individuals IGF-I is GH-dependent. We performed a double-blind, randomised, placebo-controlled, cross-over study on the effect of pegvisomant (20 mg daily for 14 days) on the relationship between GH and IGF-I in 3 age-, gender- and BMI-matched cohorts (Norms: 5 GHD patients with n...