Endocrine Abstracts

The proglucagon-derived hormone, glucagon-like peptide–1 (GLP-1), augments both beta cell function and mass. However, GLP-1 is rapidly degraded in plasma, thereby limiting its potential as a treatment for diabetes. One approach to circumvent this problem would be to stimulate synthesis of GLP-1 locally in the islet.Emerging evidence suggests that pancreatic alpha cells, which normally produce glucagon, can adapt to produce GLP-1. This phenomenon may...

The recent recommendations from the joint ESHRE/ASRM expert panel regarding the definition of PCOS (the so-called Rotterdam Criteria) have given rise to considerable controversy, particularly over the inclusion of anovulatory women with polycystic ovaries (PCO) but without evidence of androgen excess. We reviewed the results of a large series of anovulatory women with PCO who have been treated with low-dose FSH at our centre with the aim of investigating the impact of serum te...

Glucocorticoids (Gcs) act through the ubiquitously expressed glucocorticoid receptor (GR). Transcriptional activation by the GR involves interaction with co-modulator proteins, the expression level of which can mediate Gc sensitivity. The aim of this study was to identify additional GR interacting proteins that may influence Gc sensitivity.Using a yeast two-hybrid screen we identified a novel GR interacting protein, R59, which showed an enhanced interact...

Neuronal glucose and insulin signals are integrated by hypothalamic neurons to regulate energy balance. These signalling mechanisms are not clearly defined in the hypothalamus, and may be altered in obesity and diabetes. This study aimed to analyse quantitatively hypothalamic expression of candidate genes in signal transduction pathways and investigate dysregulation using Zucker and Zucker Diabetic Fatty (ZDF) models.Taqman RT-PCR was used to compare exp...

Primary adrenal insufficiency is a relatively rare endocrine condition requiring life-long glucocorticoid and mineralcorticoid replacement therapy. Unlike other endocrine conditions - such as diabetes - complications associated with early mortality are unusual and well-medicated patients can expect to have a normal life span. Nevertheless, patients typically report a variety of symptoms which reduce their quality of life.Data from an international survey...

Peripheral metabolic signals such as leptin, glucose and insulin are integrated by neurons in the hypothalamus to regulate both short and long term energy balance. However, the signal transduction mechanisms by which neurons sense glucose and insulin levels are unclear and specific parts of the pathways may be distinct from those in the pancreas. The aim of this study was to quantitatively analyse hypothalamic expression of genes known to be involved in pancreatic glucose/insu...

Growth in utero depends on adequate development and function of the fetal / maternal interface. During pregnancy, the insulin-like growth factors (IGFs), which are known to be critically involved in placental development, are controlled by a binding protein - IGFBP-1 - produced by maternal decidualised endometrium. We have recently found that decidua also produces a protease which cleaves IGFBP-1 into fragments that are unable to bind ligand. This study aimed to identif...

Background: Evidence shows that in an emergency, prompt and appropriate treatment of patients with adrenal insufficiency (AI) significantly improves outcomes and mortality risk. However, patient feedback and evidence suggest shortfalls in care and treatment of AI due to lack of knowledge and understanding from clinical staff. The aim of this survey was to explore frontline nursing knowledge and understanding of AI, to identify gaps for future training purposes...

Case history: We present the case of a 72-year-old female who was referred to the endocrinology service following the identification of a pathogenic germline mutation in the SDHA gene (c.91C>T, p.Arg32*) as part of a genetic panel for hypertrophic cardiomyopathy. There was no personal or family history of phaeochromocytoma or paraganglioma (PPGL), gastrointestinal stromal tumours or pituitary adenoma.Investigations: Our patient was reviewed ...

We have reviewed the outcome of a low-dose step-up regimen for induction of ovulation in clomiphene-unresponsive women with PCOS and in women with hypothalamic hypogonadism (HH), treated at a single centre. Data from 366 women with PCOS and 80 with HH (1165 records) were entered into a FileMakerPro database, refined and constrained to allow stratification and analysis of relevant data. 85% of cycles were ovulatory in both PCOS and HH. PCOS patients were more likely to have cyc...