Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2016

Brighton, UK
07 Nov 2016 - 09 Nov 2016

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07 Nov 2016 to 09 Nov 2016 Brighton, UK Further information

Poster Presentations

Bone and Calcium

ea0044p42 | Bone and Calcium | SFEBES2016

The mechanistic role of fibroblast growth factor 21 in growth hormone resistance secondary to chronic childhood conditions

Narendra Mistry Jayna , Ruiz-Babot Gerard , Guasti Leonardo , Dunkel Leo

Background: Both undernutrition and chronic inflammation impair linear growth through resistance to GH. Fibroblast growth factor 21 (FGF21) is known as an important regulator of the metabolic adaptation to fasting. Elevated expression of FGF21, secondary to prolonged undernutrition has been identified to develop GH resistance and subsequent attenuation of skeletal growth and growth plate chondrogenesis in both mice and human. However, the mechanism of FGF21’s actions rema...

ea0044p43 | Bone and Calcium | SFEBES2016

The influence of gender on the bone health of adolescent patients with hormonal deficiencies

Whittingham Pauline , Grounds Kerrie , Ahmad Aftab , Didi Mo , Corlett Pamela

Introduction: Previous audits demonstrated low bone mineral density (BMD) in adolescent patients with hormone deficiencies. We wanted to ascertain if gender had any relationship with the development of low BMD.Method: A retrospective analysis of 42 Transitional clinic patients who underwent DEXA scanning was made using case notes and hospital systems. Follow-up data was gathered as previous audit of 25 transitional patients had shown a significant number...

ea0044p44 | Bone and Calcium | SFEBES2016

The calcilytic SHP635 rectifies hypocalcaemia and reduced parathyroid hormone concentrations in a mouse model for autosomal dominant hypocalcaemia type 1 (ADH1)

Hannan Fadil , Babinsky Valerie , Gorvin Caroline , Hough Tertius , Joynson Elizabeth , Stewart Michelle , Wells Sara , Cox Roger , Nemeth Edward , Thakker Rajesh

Autosomal dominant hypocalcaemia type 1 (ADH1) is a systemic disorder of calcium homeostasis caused by gain-of-function mutations of the calcium-sensing receptor (CaSR). ADH1 may lead to symptomatic hypocalcaemia, inappropriately low parathyroid hormone (PTH) concentrations and hypercalciuria. Active vitamin D metabolites are the mainstay of treatment for symptomatic ADH1 patients, however their use predisposes to nephrocalcinosis, nephrolithiasis and renal impairment. Calcily...

ea0044p45 | Bone and Calcium | SFEBES2016

Immunomodulation by vitamin D is associated with regulation of microRNAs

Li Danyang , Jeffery Louisa E. , Raza Karim , Hewison Martin

The active form of vitamin D, 1,25-dihydroxyvitamin D (1,25D), acting via the vitamin D receptor (VDR) is a potent regulator of gene expression, with effects on skeletal and extra-skeletal physiology. We have shown that actions of 1,25D on bone-forming osteoblasts also involve regulation of microRNAs (miRNAs) that play a key role in the functional development of these cells. In the current study, we have investigated miRNAs as mediators of innate and adaptive immune responses ...

ea0044p46 | Bone and Calcium | SFEBES2016

Ionised calcium from blood gas measurements, often overlooked

Kalidindi Sushuma , Dhas Bonnie , Nayak Ananth , Jose Biju

Introduction: Evidence suggests that ionised calcium (iCa) and not total calcium is the physiologically relevant blood calcium component. Most blood gas (BG) analysers calculate iCa, but this is often ignored. We report our findings from a retrospective audit in medical in-patients and the potential benefit of this underused resource.Methods: A retrospective audit of admissions to two general medical/endocrine wards during January and February 2016. Data...

ea0044p47 | Bone and Calcium | SFEBES2016

Studies of an Autosomal Dominant Hypocalcemia type-1 (ADH1) associated calcium-sensing receptor (CaSR) mutation, Arg680Gly, provides insights into biased signalling

Gorvin Caroline , Babinsky Valerie , Schou Anders , Nissen Peter , Hannan Fadil , Thakker Rajesh

The CaSR, a G-protein-coupled receptor that regulates extracellular calcium (Ca2+o), predominantly signals via G-protein-αq/11 (Gαq/11), initiating IP3-mediated intracellular calcium (Ca2+i) accumulation, and mitogen-activated protein kinase (MAPK) signalling. CaSR also activates MAPK signalling via Gαi/o, or by associating with the scaffolding protein β-arrestin. CaSR g...

ea0044p48 | Bone and Calcium | SFEBES2016

Emergency management of hypercalcemia (an audit of SfE guidance in Oxford)

Surchi Haval , Grant Paul

Background: Acute hypercalcaemia of biochemical and symptomatic nature is a relatively common emergency medical presentation. Its management has tended to vary significantly and this can affect patient’s outcomes and length of hospital stay.Aim: To assess the acute management of hypercalcaemia in relation to the new Society for Endocrinology guidance.Method: A retrospective audit of all cases of hypercalcaemia admitted to Oxfo...

ea0044p49 | Bone and Calcium | SFEBES2016

The impact of primary hyperparathyroidism and its treatment on bone mineral density, bone mineral parameters, insulin resistance, body composition and quality of life – A prospective pilot study from India

Paul Thomas V , Shetty Shrinath , Kapoor Nitin , Shetty Sahana , Paul M J , Abraham Deepak , Ramakant Pooja , Dian Joseph , Thomas Nihal

Aims: To study changes in bone mineral density (BMD), bone mineral parameters, metabolic profile, body composition and quality of life at base line and 6 months following parathyroidectomy, in subjects with primary hyperparathyroidism (PHPT).Material and methods: This prospective study was conducted over 18 months with first 12 months of recruitment and next 6 months for follow-up. Sixty-eight patients with PHPT who underwent surgery were compared with 1...

ea0044p50 | Bone and Calcium | SFEBES2016

Impact of hepatitis B-related chronic liver disease and its therapy on bone health

Paul Thomas V , Kapoor Nitin , Gangadharan Sajith Kattiparambil , Shetty Sahana , Goel Ashish , Zachariah Uday , Eapen Chundamannil E

Objective: To study the impact of HBV related chronic liver disease (CLD) and its treatment with Tenofovir on bone health in Indian subjects.Methods: This cross-sectional study included men between 18 and 60 years and comprised of three groups: Group 1 was treatment naïve HBV-related CLD (n=79), Group 2 – those with HBV-related CLD on tenofovir for at least 1 year duration (n=136), Group 3 – normal age, sex and BMI-matche...

ea0044p51 | Bone and Calcium | SFEBES2016

An audit of the management of patients with hypoparathyroidism

Sighakoli Sameer , Wheatley Trevor

Introduction: Primary Hypoparathyroidism is a rare endocrine disorder characterized by hypocalcaemia associated with an inappropriately low parathyroid hormone concentration. As currently there are no UK guidelines for the management of this condition, we performed an audit comparing our performance with published European guidelines (1). These state that• Patients should be educated both t...

ea0044p52 | Bone and Calcium | SFEBES2016

Continuous synthetic PTH1-34 replacement therapy in the treatment of autosomal dominant hypoparathyroidism type 1

Jahagirdar Vidhya , Stirling Heather , Sankar Sailesh

A young female with autosomal dominant hypoparathyroidism type 1 who had inherited the gene defect from her mother was under the care of paediatric endocrinologist. Since childhood she was on a large dose of calcium (elemental calcium 5 g) along with Vitamin D, potassium and magnesium replacements. Despite careful monitoring there was significant fluctuations in serum calcium levels which led to recurrent hospital admissions with hypercalcaemia and acute kidney injury or sever...

ea0044p53 | Bone and Calcium | SFEBES2016

Importance of bone mineral density care in transitional endocrine service

Yogeswaran Karunya , Ahmad Aftab

Background: The principal cause for increased osteoporosis risk in young adults is the underlying endocrine condition that can severely compromise the prime bone building stage occurring during adolescence. As this could lead to a diminished quality of life from a relatively early stage, emphasis lies on correcting the endocrine condition with appropriately tailored management that can prevent its deterioration. Examples of treatments include replacing deficit hormones such as...

ea0044p54 | Bone and Calcium | SFEBES2016

Surgical management of primary hyperparathyroidism in East Sussex Healthcare NHS Trust (retrospective audit of patients had parathyroidectomy over 2 years in East Sussex NHS Trust)

Karunakaran Vanitha , Ahmad Shakeel , Ali Simeen , Govindan Rajesh , Kirkland Paul , Sathiskumar Periasamy

Retrospective audit of Patients had Parathyroidectomy over 2 years in East Sussex NHS trust; 73 patients had Parathyroid surgery for Primary hyperparathyroidism during this period. We have collected the data using case notes and hospital electronic records. Fifty-six patients were females and 17 were Males. Ninety-three per cent of patients were more than 50 years old. Common presenting symptoms were Lethargy (51%), bone pain (44%) and other symptoms were polyuria, polydipsia....

ea0044p55 | Bone and Calcium | SFEBES2016

Preoperative localisation for parathyroid surgery in primary hyperparathyroidism: a study to evaluate the clinical utility of different imaging modalities

Seejore Khyatisha , Stephenson John , Tun Ei Mon Zin , Martin-Hirsch Dominic , Al-Zwae Khaled , Moisey Robert S

Background: Primary hyperparathyroidism (PHPT) is caused by a solitary benign adenoma in 80–85% of cases, but may also be due to multi-gland or ectopic disease, hyperplasia, and rarely parathyroid carcinoma. Preoperative localisation studies are important to identify patients suitable for minimally invasive parathyroid surgery. The aim of this study was to evaluate the accuracy of ultrasound (US), parathyroid scintigraphy (MIBI) and computed tomography (CT) utilised in th...

ea0044p56 | Bone and Calcium | SFEBES2016

An audit of vertebral fracture assessment (VFA) selection criteria: Implications for the service and impact on clinical decision making

Dehghan Aaron , Brain Henrietta , Magliano Malgorzata

Background and aims: Vertebral fractures are the most common type of osteoporotic fracture but approximately three quarters remain undiagnosed. Densitometric VFA is a recognised imaging modality for vertebral fracture identification. The International Society for Clinical Densitometry (ISCD) has published separate criteria in 2007 and 2013 to identify patients suitable for VFA. The aim of this audit is to determine the potential impact on the service of introducing VFA with ea...

ea0044p57 | Bone and Calcium | SFEBES2016

Initial experience of a newly established intra-operative PTH service

Lekkakou Leoni , Kandaswamy Leelavathy , Rolli Alain , Ford Claire , Garnham Andrew , Spinou Catherine , Liew Lenny , Buch Harit

Background: A minimally invasive approach to primary hyperparathyroidism (PHPT) is equivalent to bilateral exploration when intraoperative parathyroid hormone (iPTH) monitoring is used. We have recently established an iPTH service jointly with Surgical and Clinical Chemistry teams and the aim of the study was to evaluate our initial results with its use.Patients and methods: We collected data from 18 operations for PHPT from October 2015, including one r...

ea0044p58 | Bone and Calcium | SFEBES2016

Procollagen N-terminal propeptide in children

Costache-Outas Mariana , Procopiuc Camelia , Dumitrescu Cristina , Caragheorgheopol Andra , Costache Cosmina Raluca , Fica Simona

Aim: Somatic growth results from the generation of new support and connective tissue. Since collagen is the major protein constituent of connective tissue, its synthesis must be a prerequisite for the normal growth. The aim of the study was to determine age-related reference intervals for P3NP, a collagen – formation marker in a group of normal height prepubertal children and to compare to IGF1 levels.Subjects: Forty-three prepubertal children, male...

ea0044p59 | Bone and Calcium | SFEBES2016

Primary hyperparathyroidism and concomitant vitamin D deficiency: Study of diagnosis and management outcomes

Khan Uzma , Al-Sharefi Ahmed , Partha Praveen , Kamaruddin Shafie , Tarigopula Giridhar , Peter Paul

Introduction: Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder; its evaluation includes biochemical investigations and imaging studies prior to surgical intervention. Imaging is advised as an aide to surgery and not for diagnostic purposes. Coexistence of PHPT and vitamin D deficiency is common; however, the exact nature of the relationship (causal vs secondary) is not clear.Subject and methods: We conducted a retrospective ...

ea0044p60 | Bone and Calcium | SFEBES2016

Would a 10% fracture risk threshold for direct access to dual energy densitometry (DXA) exclude patients with low bone mineral density?

Wilson Clare , Loughrey Paul , Cummings Bernie , McNally Colette , Lindsay John

The SIGN guideline group recently suggested a fracture risk threshold of 10% as an indication for DXA. Patients who do not have a 10 year fracture probability of 10% or more would therefore not meet the criteria for direct access to DXA. In order to assess whether implementing these guidelines would impact overall management, we undertook a prospective audit of our direct access DXA and health promotion service. Charts from 61 consecutive patients were reviewed (54F/7M, Mean a...

ea0044p61 | Bone and Calcium | SFEBES2016

FGF23, iron and vitamin D metabolism in chronic kidney disease

Piec Isabelle , Chipchase Allison , Nicholls Holly , Tang Jonathan , Washbourne Christopher , Fraser William D

Introduction: In CKD, net effects of declining kidney function and increasing FGF23 (and PTH) concentrations on vitamin D catabolism and iron metabolism are not clear.Objectives: Compare the Biomedica to the Immutopics’ immunoassay for measurement of cFGF23. Determine the relationship between iron status; vitamin D and intact FGF23 (iFGF23) and c-terminal (cFGF23) concentrations in blood.Method: Samples from routine care and a...