Endocrine Abstracts

Epidemiologic studies have associated low testosterone levels with increased cardiovascular mortality in men, the mechanism of which is unclear. However, low testosterone levels have been linked to the development of cardiovascular risk factors including metabolic syndrome, regardless of the definition employed. This relationship has been observed in epidemiologic studies of community-dwelling men as well as in men with prostate cancer treated with androgen-deprivation therapy...

Gene arrays are a powerful tool to search for novel targets of drug action and disease-specific patterns of gene expression. GH has pleiotropic actions and thus a wide range of potential gene targets. Using an accessible tissue, namely peripheral blood mononuclear cells (PBMNCs), we have started to explore the use of gene arrays in the context of the in-vivo response to GH treatment.PBMNCs were obtained with consent and ethical permission from 2 prepuber...

Adrenal/periadrenal sarcomas are very rare entity of adrenal tumours. An epidemiological analysis of primary adrenal cancers found prevalence of adrenal sarcoma of 1.3% compared to adrenocortical carcinoma (ACC) 43.8%, neuroblastoma 39.7%, pheochromocytoma 10.9% and non-Hodgkin’s lymphoma 4.3% (1). In 2021, 26 adrenalectomies in adults were performed in our institution. 12/26 had malignant histology. 9/26 lesions were > 6 cm. 7/9 lesions > 6 cm were malignant (2 a...

Background: Adrenal insufficiency (AI) is a life-threatening condition which requires long term glucocorticoid (GC) replacement. Patient misdiagnosis results in inappropriate GC use, which has significant adverse effects and is associated with an increased mortality risk. The insulin tolerance test (ITT) is the gold standard test for diagnosis, but the widely accepted cut-off value of ≤550 nmol/l used to diagnose AI is founded on outdated immunoassays. Use of this cut-of...

Positive interference in free thyroxine (fT4) and free triiodothyronine (fT3) immunoassays is well known, however we report a rare case of negative interference in the Roche fT4 and fT3 immunoassays in a 3-year-old girl with undetectable fT4 and fT3. She presented with increasing tiredness, abdominal pain, pain in her lower limbs and constipation. Examination was unremarkable. Thyroid func...

A 54-year-old gentleman presented to his GP in July 2019 with significant weight loss, polyuria and nocturia for two to three months. His HbA1c was 78 mmol/mol. He was diagnosed with diabetes and started on Metformin 500 mg BD. Upon consultant review in September 2019, he reported a 26 kg weight loss over the preceding four years, much of which was apparently intentional, and right abdominal discomfort. His paternal grandmother died of pancreatic cancer, as did his paternal au...

Cortisol is regenerated from cortisone by 11βHSD1 reductase in cells from VAT. Mice overexpressing 11βHSD1 in adipocytes have more glucocorticoids in the portal vein (PV) and hepatic insulin resistance. In humans, hepatic vein (HV) sampling during D4-cortisol tracer infusion confirmed substantial splanchnic cortisol generation, and indirect modelling suggested major contributions from both liver and VAT. PV sampling in dogs, however, did not reveal cortisol release f...

Adrenocortical carcinoma (ACC) is a rare malignancy with an incidence of 0.7–2.0 cases/million habitants/year, often with a dismal prognosis. Patients present with abdominal symptoms or symptoms of hormone excess. However, 15% are diagnosed incidentally. (1) A 59y male was referred with progressive lethargy, weight loss, dyspepsia and abdominal distension over the past 2 years. He was dismissive of ‘the elephant in the room’ and in denial. He was pushed to seek ...

Olfactory neuroblastoma (ONB) is a rare neuroendocrine tumour with a slow onset of symptoms, and classically a propensity for recurrence and a poor prognosis. Due to its rarity, there is no agreed standard therapy, but treatment will usually include surgical resection, adjuvant radiotherapy and/or chemotherapy. However, such tumours very often show positive uptake on somatostatin receptor radionuclide scanning, and selective use of peptide receptor radionuclide therapy (PRRT) ...

Background: Accurate early risk prediction for gestational diabetes mellitus (GDM) would target intervention and prevention in women at the highest risk. We evaluated maternal risk factors and parameters of body composition to develop a prediction model for GDM in early gestation.Methods: A prospective observational study was undertaken. Pregnant women aged between 18–50 y of age with gestational age between 10–16 weeks were included in ...