Endocrine Abstracts

A 60-year-old gentleman of previously good health presented with a 6 months history of resistant hypertension, newly diagnosed Diabetes Mellitus, worsening obesity and proximal muscle weakness. Clinical examination revealed a buffalo hump, truncal obesity, paper thin skin with bruising and proximal muscle wasting. His biochemistry showed elevated midnight cortisol levels, no suppression of cortisol post high dose dexamethasone and an undetectable ACTH. Accompanying abnormaliti...

Background: Cortisol is a hormone produced by the adrenal cortex and is essential for the maintenance of metabolic homeostasis. Cortisol activation is catalysed by 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) and excess cortisol is associated with insulin resistance and hyperglycaemia. Previous studies from our group have shown that Vertical Sleeve Gastrectomy, a gastrointestinal procedure known to improve insulin sensitivity, causes cortisol inhibi...

Background: An increasingly recognized complication of Roux-en-Y Gastric Bypass (RYGB) surgery is the development of postprandial hypoglycaemia (PPH). However, there remains no agreed standard on how to diagnose this condition. Commonly used tests include a prolonged oral glucose tolerance test (POGTT) and mixed meal tolerance test (MMTT). Little is known regarding how these tests compare in the post-bariatric population.Methods: Ten patients who had con...

Case history: An 18-year-old Caucasian female presented with primary amenorrhoea after her younger sister aged 16 years old started menstruating. She had a normal childhood and progressed through puberty normally, with no past medical history or family history. BMI was 22.6 with a normal examination including secondary sexual characteristics (Tanner Stage 5) and no signs of hyperandrogenism.Investigations and Results: Bloods showed an elevated LH:FSH rat...

Background: Growing evidence suggests that hypothalamic lipid sensing plays a key role in controlling food intake, fat deposition and energy balance and that its dysregulation could lead to obesity and type 2 diabetes (T2D). Recent investigations reported that sphingosine-1-phosphate (S1P) is involved in the hypothalamic control of energy homeostasis. Intra-cerebroventricular administration of S1P decreased food intake and increased energy expenditure in rodents.<p class="...

Introduction/Aims: Currently, the most successful long term treatment for obesity is bariatric surgery, however the underlying mechanisms are not fully understood. Changes in gastrointestinal and central neuroendocrine signalling have been postulated as mediators of psychological and eating behaviour changes following bariatric surgery. We aimed to investigate changes in eating behaviour and psychological factors pre- and 1 month post-very low calorie diet (VLCD) and 3-month p...

Background: Bariatric surgery has been proven to produce substantial weight loss and amelioration of metabolic syndrome-associated co-morbidities. However, at five-year follow-up, only 20–40% of patients maintain diabetes remission and 40% of patients return to their baseline weight. The limiting factor in treating refractory diabetes following obesity surgery is the lack of knowledge about its aetiology.Aims: Evaluate the eating pattern and clinica...

Introduction: An excessively long blind-end of the alimentary limb following RYGB, known as a ‘candy cane’ (CC), may cause symptoms such as pain, gastrointestinal symptoms and weight regain. Very few studies have examined the efficacy of surgical resection of the CC. We aimed to assess symptom resolution following CC surgery.Methods: Single centre observational study of 28 CC revisions from 2010 to 2017 (mean age 45±8, female preponderance...

Chemerin, a chemoattractant protein, acts via a G-protein coupled chemokine receptor, i.e. Chemokine like Receptor 1/ChemR23; levels of which are elevated in pro-inflammatory states such as obesity and type 2 diabetes mellitus (T2DM). Obesity and T2DM patients are at high risk of developing cardiovascular disorders such as atherosclerosis. We have reported that chemerin induces human endothelial cell angiogenesis and since dy...

Chemerin, a chemoattractant protein, acts via a G-protein coupled chemokine receptor, i.e. Chemokine like Receptor 1/ChemR23; levels of which are elevated in pro-inflammatory states such as obesity and type 2 diabetes mellitus (T2DM). Obesity and T2DM patients are at high risk of developing cardiovascular disorders such as atherosclerosis. We have reported that chemerin induces human endothelial cell angiogenesis and since dy...