Endocrine Abstracts

Bariatric surgery has become one of the fastest growing areas of medicine. However, the surgical procedure is only one step in the management of obesity. How should the clinical pathway for the obese individual be designed to ensure optimal results and provide the healthcare savings predicted by the health economic studies?The Health and Social Care Act 2012 redesigned the NHS in England with local commissioning of clinical services and national commissi...

Polycystic ovary syndrome (PCOS) is a common disorder which has considerable phenotypic variability and this has led to controversy over its exact definition and diagnosis. Over the past years a number of definitions have been developed by professional associations. These consensus statements have used a combination of clinical, laboratory and imaging studies as the defining criteria. However, the statements imply that these measures are dichotomous variables without consideri...

Advances in instrument technology and automation have simplified tasks in laboratory diagnostics and improved the quality of test results. However, errors occurring during the preanalytical phase – from the time the test is ordered by the physician until the sample is ready for analysis – can account for up to 93% of the errors currently encountered during the total diagnostic process.The precision of analytical problems has been significantly ...

Background: Conn’s syndrome accounts for 35% of primary hyperaldosteronism. Elevated plasma aldosterone concentration to renin activity is widely used as a screening diagnostic tool. However, we report an unusual presentation of Conn’s syndrome with normal plasma renin aldosterone ratio.A 48-year-old man was seen in endocrine clinic with uncontrolled hypertension and severe hypokalemia. Primary hyperaldosteronism was suspected with blood pressu...

Introduction: Identification and treatment of central hypothyroidism in hypopituitarism is crucial particularly in patients with significant lethargy under consideration for GH replacement. Early Identification of TSH deficiency can be challenging particularly when both the TSH and fT4 lie within the normal range.Methods: 26 362 TFTs derived from ambulatory community dwelling individuals represented the control group. TFTs from 227 patients with a putati...

Introduction: Identification and treatment of central hypothyroidism in hypopituitarism is crucial particularly in patients with significant lethargy under consideration for GH replacement. Early Identification of TSH deficiency can be challenging particularly when both the TSH and fT4 lie within the normal range.Methods: 26 362 TFTs derived from ambulatory community dwelling individuals represented the control group. TFTs from 227 patients wi...

Background: NEQAS data demonstrate a divergence in bias of cortisol immunoassays over the last 10 years. Despite this, a serum cortisol of 50 nmol/l has been universally applied as the cut-off for the overnight dexamethasone suppression test (ONDST), the commonest screening test for Cushing’s syndrome.Aims: To assess the effect of assay bias on interpretation of the ONDST and determine the necessity for a method-specific cut-off.<p class="abstex...

Background: Growth Hormone (GH) and insulin-like growth factor 1 (IGF-1) are the biomarkers used to assess disease activity in acromegaly. Consensus guidelines from the Endocrine Society (2014) recommend a normal (age/sex-adjusted) IGF-1 in combination with a suppressed random GH<1 μg/l for biochemical remission. However, these results are discordant in some patients. The clinical significance of the IGF-1/GH dichotomy in the follow-up of these patients is unclear and...

Background: Acromegaly is characterised by growth hormone (GH) and insulin-like growth factor (IGF-1) hypersecretion. The disease is associated with increased cardiovascular, cerebrovascular and metabolic co-morbidities, resulting in excess mortality. A target GH <1 μg/l and normalised IGF-1 values correlate with mortality risk reduction. However, there is lack of consensus over which biomarker, GH or IGF-1, better predicts increased morbidity and/ or mortality.<p...