Endocrine Abstracts

A 69-year-old man presented in a life threatening hypoglycaemic coma which following resuscitation required continuous intravenous dextrose to maintain euglycaemia. Random blood sugar was confirmed at 0.7 mmol/l. Past medical history included a large (19×14.5 cm) recurrent malignant fibrous tumour of the pleura which was resected in 1989 but recurred in 2006. At that time the tumour was thought not to be responsive to chemotherapy and radiotherapy and debulking surgery wa...

We present the case of a 32-year-old gentleman who was initially referred to the urologists with erectile dysfunction, low libido and infertility. There was no history of headache, visual difficulty, galactorrhea and his smell sensation was fine. Blood tests done in February 2007 showed normal renal, liver and thyroid function. His Prolactin was elevated at 3086 mU/l, with no detectable macroprolactin. He had hypogonadotrophic hypogonadism (testosterone=1.8 nmol/l (10–40)...

Background: Insulin-induced hypoglycaemia (ITT) is considered the gold standard method for the evaluation of the hypothalamo-pituitary-adrenal axis. The standard short Synacthen test (SST) has been proposed as an alternative, but it may be associated with falsely reassuring results and potentially serious sequelae.Aim: To compare the serum cortisol response achieved in the SST with the one obtained during the ITT in patients with hypothalamo-pituitary di...

A 45-year-old professional jockey presented as an emergency with a 10 day history of polyuria and polydipsia in excess of 10 l daily. 10 days previously he had suffered a head injury complicated by concussion while horse racing in Norway. There was no significant past medical or drug history but he admitted to the use of ‘wasting’ methods prior to a race to maintain his body weight. Examination was unremarkable. Renal function, liver function, thyroid function, serum...

Background: Surgery, sometimes supported by adjunctive radiotherapy (RT), is the treatment of choice for patients with non-functioning pituitary adenoma (NFA). Previous studies have shown that patients treated with pituitary RT have doubling of mortality ratio due to cerebrovascular disease (CVD) but the reason for this excess is unclear. Transcranial Doppler (TCD) can be used to measure blood velocity in the middle cerebral arteries (MCAs) within the circle of Willis and also...

Context: Obesity, diabetes and cardiovascular disease in men are associated with low testosterone levels. Leptin is produced in adipose tissue in proportion to obesity and is known to be negatively associated with testosterone in men. The shared association of testosterone and leptin with obesity is in line with the proposed adipocytokine–hypogonadal–obesity cycle which aims to explain the relationships between these variables.Methods: We inves...

Serum testosterone level is known to inversely correlate with insulin sensitivity and obesity in men. Furthermore, there is evidence to suggest that testosterone replacement therapy reduces insulin resistance and visceral adiposity in Type 2 diabetic men. Adipocytokines are hormones secreted by adipose tissue and contribute to insulin resistance. We report a double-blind placebo controlled crossover study in 20 hypogonadal Type 2 diabetic men examining the effect of testostero...

Serum testosterone level is known to inversely correlate with insulin sensitivity and obesity in men. Furthermore, there is evidence to suggest that testosterone replacement therapy reduces insulin resistance and visceral adiposity in Type 2 diabetic men. Adipocytokines are hormones secreted by adipose tissue and contribute to insulin resistance. We report a double-blind placebo controlled crossover study in 20 hypogonadal Type 2 diabetic men examining the effect of testostero...

Thyroid hormone and TSH levels change during pregnancy yet most laboratories use reference ranges derived from subjects who are not pregnant and male. Does this lead to an underestimation of thyroid disorders in pregnancy?We have derived our own reference range for Free T4 and TSH levels in pregnancy. The hormones were measured in 82 euthyroid mothers at booking and 68 at 28 weeks of pregnancy. Mean (95%CI: reference range of +2SD) FT4 levels were...

Low testosterone levels are a common in men with coronary artery disease and Type 2 diabetes (DM2). Testosterone replacement therapy improves insulin sensitivity and glycaemic control in men with diabetes and improves numerous other cardiovascular risk factors. Interest in testosterone as a potential treatment for cardiovascular disease continues to grow. Low HDL cholesterol (HDL-C) levels are recognised as an independent cardiovascular risk factor and comprise part of the met...