Endocrine Abstracts

Background: BIPSS is considered the gold-standard procedure for differentiating autonomous pituitary [Cushing’s Disease (CD)] and ectopic ACTH syndrome (EAS) sources of ACTH hypersecretion. A basal (i.e. unstimulated) pituitary:peripheral ACTH ratio >2, and/or a CRH stimulated pituitary:peripheral ACTH ratio >3, have been proposed as indicative of CD, with a range of sensitivities and specificities cited in the literature. Ad...

Background: Cross-sectional imaging (e.g. CT/MRI) can not always reliably identify the site of ACTH secretion in Cushing’s disease (CD) or the ectopic ACTH syndrome (EAS). We report our experience of localising the source of ACTH-dependent Cushing’s syndrome, using functional imaging with 11C-methionine positron emission tomography (Met-PET).Methods: Forty consecutive patients with: (i) de novo ...

Background: BIPSS is considered the gold-standard procedure for differentiating autonomous pituitary [Cushing’s Disease (CD)] and ectopic ACTH syndrome (EAS) sources of ACTH hypersecretion. A basal (i.e. unstimulated) pituitary:peripheral ACTH ratio >2, and/or a CRH stimulated pituitary:peripheral ACTH ratio >3, have been proposed as indicative of CD, with a range of sensitivities and specificities cited in the literature. Ad...

Introduction: Patients with neuroendocrine neoplasia (NEN) may experience psychological distress related to secretory effects of the tumour. 5-hydroxyindoleacetic acid (5-HIAA) is a metabolite of serotonin, the most important secretory product in carcinoid syndrome. This study aims to determine if urine 5-HIAA levels correlate with health-related quality of life (HRQoL) in patients with NEN.Methods: A retrospective single-centre cohort study was conducte...

Introduction: Previously published UK Cancer Registry data showed incidence of Neuroendocrine Neoplasms rising between 2001 and 2015. This was higher than had been thought (Genus et al.). We report more recent data with more accurate coding (ICD-O-3).Aim: To analyse National Cancer Registration and Analysis Service (NCRAS) data on Neuroendocrine Neoplasias (NENs) in England including years 2015–2017.Methods: Public He...

Introduction: Carcinoid crisis, as an entity is poorly defined, but can be seen in patients with small bowel NET tumours after open bowel surgery or tumour unrelated procedures as cardiovascular instability (CI). Recent evidence suggests that cardiovascular instability (CI) during NET surgery is more common than previously considered.Aims and methods: We audited the incidence of CI during procedures and determined the relationship to perioperative octreo...

Introduction: There remains controversy about which patients benefit from removal of their primary small bowel tumour and whether this should be performed in a specialist tertiary referral hospital as an elective procedure. Part of the decision making and consenting process in patients with metastases will be a shared decision about surgery with the patient in light of symptoms, morbidity from surgery and survival. The aim of this study was to elucidate important institution s...

Adipose tissue inflammation may be an important mechanism in the development of systemic insulin resistance, such that modulation of this system may be a therapeutic target for type 2 diabetes and obesity-related disorders. AMPK has anti-inflammatory properties, yet the anti-inflammatory actions of AMPK in adipocytes remain poorly characterised. We questioned whether AMPK activation influences pro-inflammatory responses in cultured adipocytes in basal and stimulated conditions...

The increasing global prevalence of obesity requires urgent intervention to limit the anticipated surge of associated cardiometabolic morbidity and mortality. The energy sensor AMP-activated protein kinase (AMPK) is one proposed target for treating metabolic disorders and is downregulated in adipose tissue of obese insulin resistant individuals. Given the strong relationship between metabolic syndrome and overactivity of the renin-angiotensin-aldosterone system (RAAS) we inves...

Introduction: In vitro assessments of osilodrostat (LCI699), a potent oral inhibitor of 11β-hydroxylase suggested potential drug–drug interactions (DDIs) with cytochrome P450 (CYP) enzyme metabolism. This clinical study evaluated the effect of osilodrostat on the pharmacokinetics (PK) of CYP1A2, CYP2C19, CYP2D6, and CYP3A4 probe substrates, caffeine, omeprazole, dextromethorphan, and midazolam, respectively.Methods: A single-centre, op...