Endocrine Abstracts

Background: Recent studies have indicated that macroprolactinaemia accounts for up to 26% of biochemical hyperprolactinaemia depending on the assay in use. Delayed metabolic clearance of macroprolactin together with detection by most automated prolactin immunoassay systems leads to pseudo-hyperprolactinemia in patients harbouring this form of complexed prolactin.We here describe the use of serial macroprolactin measurement to assist in the management of ...

Background: Virilising congenital adrenal hyperplasia (CAH) is the most common cause of genital ambiguity, and 90–95% of CAH cases are caused by 21-hydroxylase deficiency. Associated inefficient cortisol synthesis results in increased CRH and ACTH levels, leading to production of excess sex hormone precursors. These are further metabolized to active androgens and to a lesser extent oestrogens. We recently reported that one of these androgens, DHEA-S or its metabolites sig...

IntroductionInsulin-like growth factors-I (IGF-I) and -II (IGF-II) are important in regulation of metabolism and growth. We previously reported in normal weight normoglycaemic individuals that low circulating IGF-II predicts future weight gain. We subsequently investigated whether such relationships persisted in circumstances of abnormal glucose tolerance.MethodIn 224 type 2 diabetes subjects we assessed the ...

Clinic based studies have shown that patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulphate in addition to glucocorticoids and mineralocorticoids. DHEA is thought to have beneficial effects on energy level and mood, independent of circulating testosterone levels. Thus there may be a direct link betwe...

IntroductionThe metabolic syndrome is associated with an increased risk of cardiovascular disease and diabetes. The insulin-like growth factor (IGF) system has been implicated in the pathogenesis of cardiovascular disease and glucose intolerance. We have previously shown that a low IGFBP-1 concentration coupled with a low circulating IGF-I predicts worsening glucose tolerance. In this study we further investigated relationships between the IGF-system and...

OBJECTIVE Measurement of serum testosterone level is an integral part of the assessment of men presenting to endocrine clinics. Little is known about variation of testosterone level by ethnic group. The principal determinant of testosterone bioavailability is sex hormone binding globulin (SHBG) which itself is a marker for insulin sensitivity. Our aim was to examine variations in testosterone and SHBG levels across three ethnic groups in relation to ethnic differences in insul...

Background: CMA showed price paid for liothyronine tablets rose from £15.15 in 2009 to £258.19 in 2017; a £100 million fine against suppliers was made public December 2021. BTA published guidance on use of liothyronine for appropriate patients in May 2023 suggesting daily dose 5-10mg at possible split twice day. This report investigated link between amounts and costs of T3 prescribing for different dose levels over the last 6 years.<p class=...

Introduction: Glucagon-like peptide-1(GLP-1) agonists are widely used for treatment of type 2 diabetes(T2D). To date a number of reports have described improvements in glucose control with the addition of a GLP-1 agonist to the insulin regime in treatment of type 1 diabetes(T1D). From a physiological perspective there is credence to the notion that a GLP-1 agonist will lower glucose levels in people with T1D as they do in T2D. GLP-1 is an endogenous hormone th...

Design: Macroprolactinemia may influence the interpretation of serum prolactin levels – a recognised phenomenon since 19781. The degree of macroprolactinaemia over time is less well described. We determined how macroprolactin status (based on polyethylene glycol (PEG) precipitation varied by analysing serial measurements in hyperprolactinaemic individuals over nine years.Patients and Measurements: Results from 1810 individuals were includ...

Background: Inherited metabolic disorders (IMDs) are a group of heterogenous genetic disorders resulting in substrate accumulation, energy deficiency or complex molecular defects due to the failure of specific molecules to act as enzymes, cofactors, transporters, or receptors in specific metabolic pathways. The pathophysiological changes seen in IMDs sometimes impact on the endocrine system. We here describe our experience at one UK centre where patients are seen jointly by an...