Endocrine Abstracts

Introduction: Growth hormone (GH) replacement is widely used in the management of patients with adult-onset (AO) GH deficiency (GHD). In most cases, AO-GHD arises as a result of pituitary/peri-pituitary tumours and/or their treatment. The aim of this study was to examine the effect of GH replacement on growth/recurrence of non-anterior pituitary parasellar tumours.Methods: Fifty consecutive patients (21 males; mean age 45.9) with severe AO-GHD (peak seru...

Selective Parathyroid Venous Sampling in Patients with Complicated Primary HyperparathyroidismCM Ogilvie, PL Brown, M Matson, R Carpenter, WM Drake, PJ Jenkins, SL Chew, JP MonsonCentre for Endocrinology and Departments of Surgery and Radiology, St Bartholomew's Hospital, QMUL, London EC1A 7BEThe role of pre-operative localisation of abnormal parathyroid glands remains controversial but is particularly releva...

Large databases facilitate the examination of those factors, which may determine response to treatment, potentially to develop prediction models. We have used KIMS (Pfizer's international metabolic database of GH-treated adults), to examine parameters that might predict clinical response to GH therapy in hypopituitary adults.Patients/methods: Patients with non-functioning pituitary adenoma on GH titrated to maintain serum IGF-I between minus 2 and 2 SDS,...

We report the efficacy, safety, and effects on glucose homeostasis of converting patients with acromegaly from slow release octreotide (OT, treated for >3 months) to pegvisomant (Peg), a GH receptor antagonist. 52 patients (median age 49, range 23-81, 13 with diabetes) who had previously participated in a Peg clinical trial and subsequently treated with OT were enrolled in a 32-week, open-label, multicentre study. Peg 10 mg/d was started 4 weeks after the last dose of OT (w...

Carpal tunnel syndrome (CTS) in acromegaly is caused, in part, by median nerve (MN) swelling. Pegvisomant (Peg), a growth hormone receptor (GHR) antagonist, lowers serum insulin-like growth factor-I (IGF-I) concentrations in patients with acromegaly, but serum GH levels rise and Peg is detected by most GH assays. Demonstrating that normalisation of serum IGF-I by Peg is associated with improvement/reversal of the consequences of GH excess is desirable. We documented changes in...

Vascular endothelial growth factor (VEGF) is involved in the activation of the matrix metalloproteinase system (MMP) which in turn degrades the extracellular matrix involved in development, morphogenesis and tissue remodelling. Increased activity of MMPs has been implicated in atherosclerosis and cardiovascular disease. This study assessed plasma MMP and VEGF levels in patients with active acromegaly (IGF-I >130%ULN), and on treatment with pegvisomant.<p class="abstext"...

NICTH is a well-recognised syndrome associated with overproduction of pro-IGF-II, usually secreted by large mesenchymal tumours. The determination of pro-IGF-II is currently laborious and cumbersome. The aim of the present study was to therefore establish a quick method for determining serum pro-IGF-II. Serum samples from 13 patients with NICTH were obtained after informed consent and these samples were studied and compared to sex- and age-matched controls. Serum concentration...

Pegvisomant is a novel medical therapy for acromegaly that functions as a GH receptor antagonist. Insulin resistance is an important factor in the increased cardiovascular morbidity and mortality associated with acromegaly. The aim of this study was to compare insulin sensitivity (IS) in a group of 7 patients with acromegaly (3 male, mean age 59+/-13 years, SD), treated first with a stable dose of depot octreotide (OT) (median dose 20mg four weekly, range 10-20) for at least t...

Obstructive sleep apnoea (OSA)is associated with increased cardiovascular morbidity and mortality and is an independent risk factor for the development of hypertension. A recent study demonstrated elevated urinary catecholamine excretion in hypertensive males with OSA. However, we have recently observed the phenomenum whereby OSA can rarely induce catecholamine production of sufficient severity to mimic the clinical and biochemical presentation of phaeochromocytoma.<p clas...

Obstructive sleep apnoea (OSA)is associated with increased cardiovascular morbidity and mortality and is an independent risk factor for the development of hypertension. A recent study demonstrated elevated urinary catecholamine excretion in hypertensive males with OSA. However, we have recently observed the phenomenum whereby OSA can rarely induce catecholamine production of sufficient severity to mimic the clinical and biochemical presentation of phaeochromocytoma.<p clas...