Endocrine Abstracts

Precocious pubertal development is generally defined as the clinical manifestation of secondary sex characteristics above the 99.6th centile for age. In the UK this corresponds to 8 years in girls and 9 years in boys. The UK growth charts divide at these ages to remind us that a child who plots on the left sided panel and who has pubertal signs is precocious and warrants medical review. The vertical puberty lines have reminders of precocity (and delay). Stage lines on the RCPC...

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Introduction: Gynaecomastia (GM) is common in boys with Klinefelter syndrome (KS) during adolescence. It develops due to the relatively higher diurnal oestradiol–testosterone ratio in early to mid puberty. The physiological mid-late pubertal rise in testosterone causes the GM to disappear in chromosomally normal boys, but it persists in boys with KS if this rise in testosterone is blunted.Aim: As a previous longitudinal RCT of testosterone in boys w...

Background: We aim to investigate the influence of GH on pubertal growth in children receiving GH replacement therapy for GH deficiency.Methods: We analyse a large dataset of children (n=236) with GH deficiency from the international KIGS database. We examine the relationship between pubertal growth and treatment with GH replacement therapy using linear regression and repeated measures analysis, and the incremental cost benefit of increasing doses...

Gonadotropin-releasing hormone analogues (GnRHa) are prescribed to adolescents with gender dysphoria under age 15 who have reached Tanner stage 2/3 to prevent progression through puberty and allow them time to consider their gender identity. The possible effects of the therapy on the pubertal growth spurt are poorly understood. A height more congruent with their identified gender is desired by transgender individuals, thus it is crucial that they are fully informed of its pote...

Introduction: Gynaecomastia (GM) is a major contributor to psychological morbidity in adolescent boys, yet there is a lack of evidence for effective treatment. It is known to develop due to the relatively higher diurnal oestradiol–testosterone ratio in early to mid puberty.Aims: We retrospectively looked to identify possible criteria for the selection of patients to predict optimal management of GM. We also examined the effect on the persistence of ...

Background/Aims: More young people with gender dysphoria are undergoing hormonal intervention with GnRHa treatment. The impact on bone density is not known in the very young transgender adolescents, with guidelines mentioning that Bone Mineral Density (BMD) should be monitored without a suggestion on how. This study aimed to investigate whether there were any changes in BMD or Bone Mineral Apparent Density (BMAD) whilst on GnRHa therapy.Methods: A retros...

Background: Recombinant human growth hormone (r-hGH) has been used for more than 30 years and indications for r-hGH have multiplied worldwide. There has been concern that it might raise mortality, but published data are limited.Methods: The cohort comprised of 3902 UK patients over 18 years of age in 2009, treated with childhood r-hGH at all the major UK growth centres. The total European cohort was 24 232 from eight countries (including the UK), with > ...

Introduction: Adolescents with persistent gender dysphoria (GD) receive GnRH analogues to achieve pubertal arrest. It is unclear whether this is adequate to achieve biochemical suppression of gonadotrophin (LH, FSH) and sex hormone production.Methods: Gonadotrophins, testosterone and oestradiol were measured in GD patients (15–18 years) before and after monthly Gonapeptyl treatment (3.75 mg i.m.). Patients administered other analogues and/or cross-s...

Prohormone convertase 1/3 (PC1/3) deficiency is rare, caused by homozygous or compound heterozygous mutations in the PCSK1 gene. PCSK1 encodes a serine protease important in cleavage of several proneuropeptides and prohormones. Despite a variety of known endocrine associations, paediatric diabetes mellitus is rare, described only once before. Previous understanding was that biological activity of elevated proinsulin (<5% of the activity of insulin) confers protection from ...