Endocrine Abstracts

The nature of the hypothalamic factors which control GH secretion in animals and man have emerged since the description of somatostatin (SS) in the early 1970s. Confusion originally arose when the ubiquitous distribution and apparent non-specificity of the actions of SS were established. Understanding of the paracrine nature of SS's action and the dependence of the specificity of its effects upon the locus of secretion and its short half-life in the circulation provided for an...

The contribution of conventional hormone replacement to the clinical features attributed to adult growth hormone deficiency (GHD) is poorly defined. We measured baseline bone mineral density (BMD/DXA) at the lumbar spine and femoral neck in patients with isolated GHD (IGHD, 16 patients, 14 female, 4 childhood onset, mean age 39, range 19- 63 years) and patients with multiple pituitary hormone deficiencies (MPD, 135 patients, 94 female, 14 childhood onset, mean age 44, range 19...

Mutations of parafibromin, which is a 531 amino acid protein, are associated with the hyperparathyroidism-jaw tumour (HPT-JT) syndrome. HPT-JT is an autosomal dominant disease that is characterised by the occurrence of parathyroid tumours, which are commonly malignant, and ossifying fibromas of the jaw bones. To date 13 different inactivating germline mutations (3 nonsense, 9 frameshift and one missense altering the initiation codon) of PARAFIBROMIN have been identified in HPT...

The contribution to adult growth hormone deficiency (GHD) of hormone replacement and other aspects of hypopituitarism are poorly defined. We compared baseline characteristics and response to GH treatment of patients with isolated GHD (IGHD, 16 patients) to patients with multiple pituitary hormone deficiencies (MPD, 135 patients). At baseline, MPD patients showed significantly greater waist-hip ratios (0.87 plus/minus 0.007 vs. 0.82 plus/minus 0.02, mean plus/minus SD; P < 0...

The route of oestrogen replacement has an important influence on growth hormone (GH) sensitivity, but it remains unclear whether the route of testosterone treatment in hypopituitarism influences the response to GH replacement. We have compared IGF-I levels, body composition and BMD in hypopituitary male patients with severe GH-deficiency receiving either oral testosterone undecanoate (T.U.)(80-160 milligrams per day) or intramuscular testosterone (I.M.) (250-500 milligrams per...

Transsphenoidal surgery results in biochemical cure of approximately 50% of all acromegalic patients, depending on tumour size and surgical expertise. It is uncertain whether prior treatment with somatostatin analogues would result in tumour shrinkage and therefore improve the efficacy of subsequent surgery. Aims: To determine whether 6 months de novo treatment with Sandostatin LAR results in tumour shrinkage. Methods: 6 patients (mean age 53 yr; range 42-...

Introduction: Growth hormone (GH) replacement is widely used in the management of patients with adult-onset (AO) GH deficiency (GHD). In most cases, AO-GHD arises as a result of pituitary/peri-pituitary tumours and/or their treatment. The aim of this study was to examine the effect of GH replacement on growth/recurrence of non-anterior pituitary parasellar tumours.Methods: Fifty consecutive patients (21 males; mean age 45.9) with severe AO-GHD (peak seru...

Carpal tunnel syndrome (CTS) in acromegaly is caused, in part, by median nerve (MN) swelling. Pegvisomant (Peg), a growth hormone receptor (GHR) antagonist, lowers serum insulin-like growth factor-I (IGF-I) concentrations in patients with acromegaly, but serum GH levels rise and Peg is detected by most GH assays. Demonstrating that normalisation of serum IGF-I by Peg is associated with improvement/reversal of the consequences of GH excess is desirable. We documented changes in...

NICTH is a well-recognised syndrome associated with overproduction of pro-IGF-II, usually secreted by large mesenchymal tumours. The determination of pro-IGF-II is currently laborious and cumbersome. The aim of the present study was to therefore establish a quick method for determining serum pro-IGF-II. Serum samples from 13 patients with NICTH were obtained after informed consent and these samples were studied and compared to sex- and age-matched controls. Serum concentration...

Pegvisomant is a novel medical therapy for acromegaly that functions as a GH receptor antagonist. Insulin resistance is an important factor in the increased cardiovascular morbidity and mortality associated with acromegaly. The aim of this study was to compare insulin sensitivity (IS) in a group of 7 patients with acromegaly (3 male, mean age 59+/-13 years, SD), treated first with a stable dose of depot octreotide (OT) (median dose 20mg four weekly, range 10-20) for at least t...