Endocrine Abstracts

Introduction: Fibroblast growth factor-21 (FGF-21) is a recently discovered hormone acting as a central regulator of metabolism via adaptation of glucose homeostasis, insulin sensitivity, and ketogenesis. While acute systemic inflammatory conditions come along with profound alterations of metabolism, the role of FGF-21 in these acute phase responses is still unknown.Methods: This is a secondary analysis of two randomized, controlled trials in patients pr...

Background: Hyponatremia is the most common electrolyte disorder in hospitalized patients with pneumonia. Different studies have shown an association of admission hyponatremia and worse in-hospital outcome, but no data are available about the impact of hyponatremia at discharge on outcome.Material and methods: Data from a double-blind randomized study including 725 patients hospitalized with community-acquired pneumonia were analyzed. The primary aim of ...

Background: Rapid and accurate risk stratification in patients with community-acquired pneumonia (CAP) is an unmet clinical need. Cortisol to DHEA ratio was put forward as a prognostic marker in sepsis. We herein validated the prognostic value of DHEA and DHEAS and of cortisol/DHEA- and cortisol-DHEAS – ratios, respectively, in patients with CAP as the most common (disease resulting) sepsis-defining illness.Methods: We assessed clinical parameters a...

Background: It is controversial whether the attenuated increase of circulating cortisol to ACTH stimulation predicts treatment response to corticosteroids in patients with critical illness. We investigated whether ACTH testing predicts treatment response to corticosteroids in patients with community-acquired pneumonia (CAP).Methods: We performed a low dose (1 μg) ACTH test on admission in a prospective randomised, double-blind, placebo-controlled mu...

Introduction: Fluid restriction (FR) is often the recommended first-line treatment for hyponatremia due to the syndrome of inappropriate antidiuresis (SIAD). However, FR not always leads to successful correction of hyponatremia, making predictive markers of treatment response desirable. The aim of this study was to evaluate routinely measured laboratory parameters, copeptin and pro-atrial natriuretic peptide (pro-ANP) as possible predictors of treatment success to FR.<p cl...

Background: Glucocorticoids are frequently prescribed in inflammatory diseases. We investigated the influence of prednisone on classical and novel inflammatory markers in community-acquired pneumonia (CAP).Methods: We evaluated levels of C-reactive protein (CRP), procalcitonin, leukocyte and neutrophil count in a prospective randomized, double-blind, placebo-controlled multicenter trial which compared prednisone 50 mg for 7 days to placebo in patients ho...

Background: Hyponatremia is common in hospitalized patients and its differential diagnosis and management challenging. An important mechanism is suppressed or adequately or inadequately secreted plasma arginine vasopressin (AVP). Therefore, plasma vasopressin levels may help in the differential diagnosis and in therapy management. Copeptin is secreted in an equimolar ratio to AVP and is more reliable to measure.Methods: In this prospective observational ...

Background: Hyponatremia is the most common electrolyte disturbance in hospitalized patients and associated with a substantial morbidity and mortality. Symptoms of severe hyponatremia vary among patients between nonspecific symptoms such as nausea or malaise or acute life threatening brain oedema. Prospective studies to assess symptoms and mortality in patients with severe hyponatremia are lacking.Methods: In this prospective multicentre observational st...

Introduction: Postoperative diabetes insipidus (DI) remains a common complication after pituitary surgery. AVP measurement might contribute to a straightforward diagnosis, though, its measurement is cumbersome. Copeptin, the stable C-terminal glycopeptide of the AVP prohormone, is a reliable surrogate of AVP.We aimed to elucidate whether copeptin is a helpful marker in the diagnostic approach of postoperative DI.Methods/design: Pro...

Introduction: Hyponatremia is the most common electrolyte abnormality in clinical practice and given its impact on mortality and morbidity a relevant medical condition. Nevertheless little is known about factors influencing long-term outcome.Methods: This is a prospective observational 12 months follow-up study of patients with profound hyponatremia (≤125 mmol/l) admitted to the medical emergency department of two tertiary care centers in Switzerla...