Endocrine Abstracts

Acute adrenal insufficiency requires immediate treatment with high-dose glucocorticoid and represents a life-threatening emergency. Previous research suggests that primary hypoadrenalism patients (Addison’s disease) are more vulnerable to adrenal emergency than steroid-dependent pituitary patients (Arlt & Allolio 2003).In 2006, we surveyed the membership of the UK Addison’s disease Self-Help Group, comprising 982 hypoadrenalism patients, an...

Adrenal insufficiency (AI) patients who are deprived of regular steroid replacement therapy rapidly become unwell. However, the interval for which AI patients might safely be withdrawn from steroid medication for clinical purposes, such as re-assessment of adrenal reserve, is largely a matter of speculation, since it would be difficult to construct an ethical trial on this matter. Valuable insights into this dilemma can be gained from the case studies of an early clinical rese...

Isolated change in serum TSH concentration occurs in 15% of hospitalised patients in response to non-thyroidal illness or various drugs, which interfere with thyroidal synthesis and secretion, thyroid hormone metabolism and absorption. Significant change in concentration of either suppressed (<0.1 mU/l) or elevated (>10 mU/l) TSH level is seen in 1–2% of them but only less than half have underlying thyroid disorder.UK Guideline for use of TF...

Introduction: Adult Growth Hormone Deficiency (AGHD) is associated with osteoporosis. Underlying mechanisms involved in the pathogenesis include reduced target-organ sensitivity to the effect of PTH. Growth Hormone Replacement (GHR) in AGHD leads to increased PTH target-organ sensitivity and consequently increased bone turnover and bone mineral density (BMD).Aims: We determined the effect of alendronate, given in addition to GHR, on PTH target-organ sens...

The nuclear receptor co-factor RIP140 has an essential role in metabolic regulation. Genetically manipulated mice lacking RIP140 show reduced fat accumulation, increased energy expenditure and increased insulin sensitivity. They gain less weight on high fat feeding than wild type littermates, and are protected from both age and high fat diet induced insulin resistance.RIP140 is a repressor of transcription and in its absence metabolic gene networks are u...

Adult Growth Hormone Deficiency (AGHD) is associated with osteoporosis. PTH is secreted in a circadian rhythm and temporal fluctuations in PTH concentration, particularly at night, appear to be important in the regulation of bone turnover. Serum phosphate is an important determinant of PTH, with changes in phosphate preceding fluctuations in PTH concentration. We examined the difference in PTH and phosphate circadian rhythmicity in AGHD patients with normal and reduced bone mi...

Adult Growth Hormone Deficiency (AGHD) is associated with reduced bone mineral density (BMD) and bone turnover. Abnormalities in PTH circadian rhythmicity, including blunted nocturnal rise in PTH concentration have been reported in AGHD and may underlie the pathogenesis of osteoporosis. Serum phosphate is an important regulator of PTH, with changes in phosphate concentration preceding fluctuations in PTH. We examined the effect of oral phosphate therapy on PTH circadian rhythm...

Human obesity is characterized by abnormalities in sympathetic cardiovascular control. We present two cases to demonstrate the relationship between weight, BP and catecholamines (UC).Case 1: A 39 year-old man reported symptoms of flushing and palpitations. His BMI was 50 kg/m2, consistent BP of 240/140 mmHg, with normal renal, thyroid function and normal fasting glucose. Urinary noradrenaline (UNA820 nmol/24 hrs) and dopamine (UDA-4500 nmol/24...

Pro-opiomelanocortin (POMC) is endoproteolysed by prohormone convertase-1 (PC1) to ACTH within the secretory pathway in pituitary cells, where the regulation of ACTH release is essential for mediating the stress response. However POMC is present in the human circulation, indicating that not all POMC is processed. This suggests that regulation of trafficking and processing of POMC are important in determining ACTH release. To investigate this, we analysed steady-state release o...

Glucocorticoids (Gcs) exert their pleiotropic effects through activation of the ubiquitously expressed glucocorticoid receptor (GR). The mechanism of transcriptional activation by the GR involves interaction with co-modulator proteins. Glucocorticoid sensitivity is mediated by the expression level of these co-modulator proteins and GR concentration. Therefore, the aim of this study was to identify additional GR interacting proteins that may influence glucocorticoid sensitivity...