Searchable abstracts of presentations at key conferences in endocrinology
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23rd Joint Meeting of the British Endocrine Societies with the European Federation of Endocrine Societies

ea0007p1 | Bone | BES2004

Failure to normalise PTH during the treatment of osteomalacia

Peacey S , Wright D , Harries M

Although treatment of osteomalacia is cheap and effective, there are few data on the long-term outcomes. Studies suggest that a minority of patients fail to normalise parathyroid hormone (PTH), due to autonomous parathyroid activity and primary hyperparathyroidism is sometimes 'unmasked' during therapy. This study examined the impact of a recommended oral regimen of calcium 1000 milligrams and vitamin D3 800 international units (20 micrograms) daily, on PTH levels. ...

ea0007p2 | Bone | BES2004

Does leptin regulate bone turnover in adult growth hormone deficiency?

Joseph F , Ahmad A , Wallace A , White H , Durham B , Fraser W , Vora J

Leptin stimulates osteoblastic cell proliferation, differentiation and mineralisation and inhibits osteoclast generation; leptin secretion and bone turnover are altered in adult growth hormone deficiency, a condition associated with osteoporosis. The aim of this study was to investigate leptin circadian rhythm and its association with bone turnover in untreated AGHD and following growth hormone replacement (GHR).We sampled peripheral venous blood at half...

ea0007p3 | Bone | BES2004

Oral bisphosphonates may reverse the decline in bone mineral density in adults with cystic fibrosis

Cawood T , Smith D , Wen Y , Gibney J , Dodd J , Au-Yeoung M , McKenna M , Fitzgerald O , Gallagher C , O'Shea D

IntroductionLow Bone Mineral Density (BMD) is highly prevalent in adults with cystic fibrosis (CF) and is associated with increased fracture rates. We sought to establish how BMD changes with time in adults with CF and to determine what factors influence this change.MethodsA retrospective analysis of interval bone densitometry using Dual Energy X-ray Absorptiometry (DXA) scanning in 86 adults with CF was unde...

ea0007p4 | Bone | BES2004

The role of the growth hormone-insulin-like growth factor-I (GH-IGF-I) axis in the aetiology of male idiopathic osteoporosis

Patel M , Arden N , Masterson L , Phillips D , Swaminathan R , Syddall H , Wood P , Cooper C , Holt R

Growth hormone (GH) has profound anabolic effects on bone, but its use as a treatment for patients with osteoporosis has only resulted in small increases in BMD. The low serum IGF-I demonstrated in men with idiopathic osteoporosis may be important in the aetiology of this disease and has been attributed to GH hypo-secretion, though there are conflicting reports of this. Insensitivity to the actions of GH has also been suggested. We studied the GH-IGF-I axis in otherwise health...

ea0007p5 | Bone | BES2004

Growth hormone replacement is important for the restoration of PTH circadian rhythmicity in older adult growth hormone deficient patients

White H , Ahmad A , Joseph F , Prabhakar V , Patwala A , Whittingham P , Durham B , Fraser W , Vora J

Adult Growth Hormone Deficiency (AGHD) is associated with osteoporosis. PTH circadian rhythmicity is important for bone remodelling. Abnormalities in PTH circadian rhythms, including a blunted nocturnal rise, have been reported in AGHD and may contribute to osteoporosis development. GH replacement (GHR) results in improvement of PTH circadian rhythmicity and bone mineral density (BMD). In health, increasing age is associated with declining GH secretion and the appropriateness ...

ea0007p6 | Bone | BES2004

Parathyroid hormone and phosphate circadian rhythms are altered in osteopaenic adult growth hormone deficient patients

White H , Ahmad A , Joseph F , Chandran S , Corlett P , Durham B , Fraser W , Vora J

Alterations in PTH circadian rhythmicity have previously been reported in Adult Growth Hormone Deficiency (AGHD) and may contribute to the pathogenesis of AGHD-related osteoporosis. However, changes in PTH circadian rhythm have not been correlated with bone mineral density (BMD) in AGHD. Serum phosphate is a likely determinant of PTH rhythm. We examined the PTH and phosphate circadian rhythms in AGHD patients with reduced (defined as femoral neck T-score <-1.0) and normal B...

ea0007p7 | Bone | BES2004

Transdermal testosterone replacement in men with evidence of borderline gonadal failure

Merza Z , Mah P , Blumsohn A , Meads D , Mckenna S , Wylie K , Eastell R , Ross R

Background: Hypogonadism in men is associated with osteoporosis and low libido. Serum testosterone in men falls after the age of 40 years; however the benefits of replacement therapy are not established. We conducted a double-blind, placebo-controlled trial to investigate the effect of testosterone transdermal patches on bone turnover, body composition, quality of life (QoL) and well-being in men with borderline hypogonadism.Methods: 38 borderline hypogo...

ea0007p8 | Bone | BES2004

Application of new indices of bone activity for evaluation of the response to treatment of hyperthyroidism and Paget's disease

Smith D , Murray B , Gibney J , O'Shea D , McKenna T

While it is generally acknowledged that hyperthyroidism and Paget's disease are states of increased bone turnover and that treatment reduces this, whether treatment entirely corrects or reverses abnormalities has not been established. A variety of biomarkers for bone formation which include serum levels of bone alkaline phosphatase (BAP), osteocalcin (OC) and amino terminal procollagen type 1N propeptide (PINP) and resorption biomarkers which include urinary excretion of deoxy...

ea0007p9 | Bone | BES2004

Outcome of parathyroidectomy for primary hyperparathyroidism in 249 consecutive patients

Ma Y , Toogood A , Campbell D , Ready A , Gittoes N

Much has been written on the attributes of preoperative localisation and minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism. A recent 'summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century' (Bilezikian et al, 2002) suggested however that in experienced hands, conventional open parathyroidectomy with visualisation of all four glands was still the gold standard. In light of this we have carried o...

ea0007p10 | Bone | BES2004

Inactivating progesterone metabolism in human osteoblasts

Kaur K , Cooper M , Arlt W , Stewart P , Hewison M , Quinkler M

The role of oestrogens and androgens on bone metabolism has been studied extensively. However, less is known about the effects of progestins. The progesterone receptor (PR) is expressed in human osteoblasts. Progestins have been found to stimulate osteoblast proliferation, differentiation and growth factor expression (e.g. IGFBP-5) and to increase bone formation. In postmenopausal women progestins combined with oestrogen increased bone density to a greater extent than oestroge...

ea0007p11 | Bone | BES2004

Utility of biochemical screening in the context of evaluating patients with a presumptive diagnosis of osteoporosis

Rajeswaran C , Spencer J , Orme S

Osteoporosis is a reduction in bone mass, with micro-architectural deterioration, leading to an increased risk of fragility fractures. A secondary cause for osteoporosis (caused by a specific well-defined clinical disorder) is found in a proportion of patients, which varies in different patient populations.We evaluated the utility of a 'standard panel' (FBC, PV, plasma protein electrophoresis & BJP, thyroid function tests, U&Es, calcium and bone ...

ea0007p12 | Bone | BES2004

Investigation of seasonal reference intervals for 25-Cholecalciferol (Vitamin D)

Donaldson A , Leung Y , Jackson D , Hill P , Chapman R

Vitamin D is essential to the control of calcium homeostasis and is mainly provided by exposure to sunlight. In the UK circulating Vitamin D is subject to seasonal variation with peak values occurring in early Autumn and trough values in late Spring. Requests for Vitamin D assays are increasing but few laboratories quote seasonal reference ranges and many commercial suppliers quote reference ranges for populations living in warmer, sunnier climates. This study established seas...

ea0007p13 | Bone | BES2004

The role of local corticosteroid generation in inflammation-associated bone loss

Cooper M , Filer A , Moore J , Emery P , Buckley C , Hewison M , Stewart P

Generalised and periarticular osteoporosis are common features of inflammatory arthritides. These effects appear due to high levels of pro-inflammatory cytokines. 11beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1) is an intracellular enzyme that generates active cortisol from inactive cortisone and is an important determinant of the effects of glucocorticoids on osteoblasts. In vitro, osteoblastic 11b-HSD1 expression is induced by pro-inflammatory cytokines. We thus ...

ea0007p14 | Bone | BES2004

Adenosine stimulates IL-6 but inhibits osteoprotegerin secretion by osteoprogenitor cells

Evans B , Elford C , Ham J

Nucleotide receptors can be classified into two groups: P1 receptors where adenosine is the primary ligand, and P2 receptors where the main ligands are ATP, ADP, UTP and UDP. The presence of the P2 family members in osteoblasts and osteoclasts has been known for some time, but there have been no published studies on the role of adenosine in bone physiology.We have demonstrated the presence of the four P1 adenosine receptor subtypes (A1, A...

ea0007p15 | Bone | BES2004

Growth retardation following prenatal GC exposure is more pronounced in the female offspring and is associated with raised serum IGF-1

Mushtaq T , Farquharson C , Nyirenda M , Seawright E , Seckl J , Ahmed S

Background: GCs retard growth prenatally in many mammals. Little is known of the prenatal effects of GCs in mice though this species is optimal for genetic and transgenic studies. IGFBP-2 is the predominant prenatal IGF binding protein and it may influence IGF action.Aim: To determine the weights, crown rump lengths (CRL) and serum IGF-I, Insulin and IGFBP-2 levels on 1 day old mice exposed to GC prenatally.Methods: Pregnant mice w...