Endocrine Abstracts

Hypopituitarism is a potential complication of trans-sphenoidal adenomectomy (TSA). Prediction of pituitary function (PF) recovery would inform hormonal replacement strategies. However, the frequency of re-testing of PF is variable across centres. The aim of this study was to determine rates, time and predictors of 6-weeks (6 w) recovery of hypothalamo-pituitary adrenal (HPA) and gonadal function after TSA.Methods: We performed a single-centre, retrospec...

Polycystic ovary syndrome (PCOS) is prevalent metabolic disorder in women, associated with androgen excess and insulin resistance. These two major features are closely correlated, but the direction of causality remains unclear. Aldoketoreductase type 1C3 (AKR1C3) converts the androgen precursor androstenendione to testosterone (T), and is highly expressed in subcutaneous (SC) adipose tissue. We hypothesised that adipose tissue represents an important site linking androgen acti...

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD), is present in over 90% of obese patients undergoing bariatric surgery. It is a spectrum of pathology ranging from steatosis through to inflammation (Non-Alcoholic Steatohepatitis, NASH) and fibrosis. Bariatric surgery is currently the most effective treatment for NAFLD, but post-operative hepatic decompensation can occur and therefore pre-operative stratification of liver disease severity is beneficial. Several non-invas...

Abstract: Idiopathic intracranial hypertension (IIH) is a devastating neurological condition, with elevated intracranial pressure of unknown aetiology. IIH is largely a disease of obese females of reproductive age. The clinical phenotype of IIH overlaps with polycystic ovary syndrome (PCOS), with prevalent obesity, hyperandrogenism and anovulation. In this study, we aimed to delineate the androgen excess phenotype of IIH women compared to those with PCOS and simple obesity. Wo...

Introduction: Dysregulation of glucocorticoid (GC) metabolism is implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). The only available treatment for NAFLD is weight loss and the gold standard diagnostic test is liver biopsy, which is invasive and resource intensive. NAFLD ranges from simple steatosis, to inflammation (steatohepatitis/NASH), fibrosis and cirrhosis. It may be regarded as the hepatic manifestation of the metabolic syndrome and is strongl...

Introduction: Dysregulated glucocorticoid (GC) metabolism has been implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). NAFLD extends from simple steatosis, to inflammation (steatohepatitis/NASH), fibrosis and consequent cirrhosis. It is often regarded as the hepatic manifestation of the metabolic syndrome and is independently associated with increased liver and cardiovascular mortality. Changes in GC metabolism have thus far been described in small num...

Steroid hormones and BAs are established regulators of metabolic phenotype. 5β-reductase (AKR1D1) is highly expressed in the liver where it inactivates steroid hormones and catalyses a fundamental step in bile acid (BA) synthesis. We have hypothesised that AKR1D1 plays a crucial regulatory role in hepatic metabolic homeostasis. Genetic manipulation of AKR1D1 was performed in human liver HepG2 and Huh7 cells. Expression changes were confirmed by qPCR and western blotting, ...

Background: Hypopituitarism can occur post trans-sphenoidal adenomectomy(TSA). Accurate prediction of HPA axis recovery would inform hydrocortisone replacement strategies but there are limited studies on this. In our centre, HPA axis is assessed with pre-operative short synacthen test (SST), day-8 post TSA 9am cortisol and 6-week post-TSA SST. Patients are commenced on hydrocortisone post TSA until 6 weeks review.Methods: We performed a single-centre, lo...

5α reductases 1 and 2 (SRD5A1 and SRD5A2) metabolise cortisol into inactive 5α-dihydrocortisol contributing to the regulation of cortisol availability in addition to their established role in the generation of dihydrotestosterone from testosterone. Dutasteride and finasteride are commonly prescribed to patients with benign prostatic hyperplasia but their potential metabolic effects have only recently been identified. Dutasteride inhibits both SRD5A1and SRD5A2 whilst ...

Non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the commonest cause of liver cirrhosis and leading indication for liver transplant worldwide. It is tightly associated with obesity and type 2 diabetes, yet the precise mechanisms that drive its aetiology are not fully defined. Dysregulation of both glucocorticoid and androgen metabolism has been implicated in its pathogenesis. The availability of these hormones to bind and activate their receptors is mainly regulat...