Endocrine Abstracts

Background: In the UK, NICE guidelines for familial hypercholesterolaemia (FH) recommend a greater than 50% reduction in low-density lipoprotein-cholesterol (LDL-C) as the therapeutic target. However, despite the availability of a range of lipid lowering medication, this target is often difficult to achieve and, more importantly, maintain life-long. Understanding factors that affect LDL-C target achievement is key to reducing cardiovascular disease (CVD) risk. Currently, there...

Background: Cardiovascular disease (CVD) risk in familial hypercholesterolaemia (FH) is driven by cumulative exposure to high low-density lipoprotein cholesterol (LDL-C) levels. Previously, LDL-C burden has been loosely approximated using the cholesterol year score (CYS) based on two LDL-C readings only. We aimed to determine whether a more sophisticated LDL-C burden score based on serial LDL-C measurements, could more accurately predict major atherosclerotic cardiovascular ev...

Background: Lipoprotein(a) (Lp(a)) is an independent, causal, genetic risk factor for cardiovascular disease (CVD). Coronary artery calcium (CAC), measured by computerised tomography (CT) scans, is a known marker for atherosclerosis. CT Agatston scores, also known as CAC scores, are thought to be better predictors of CVD than traditional risk factors. There is conflicting data regarding the relationship between Lp(a) levels and CAC. A preliminary study has suggested a positive...

Introduction: Failure to recognise critically ill patients delays escalation to intensive care units (ICU) and results in increased mortality. Objectively identifying the sickest patients on admission remains challenging for healthcare professionals. This study proposes a novel Metabolic Index as a marker of metabolic disturbance based on a patient’s sodium, potassium and bicarbonate. The Metabolic Index is proposed as a predictor of outcome in patients presenting to A&#3...

Background: Primary hyperparathyroidism (PHPT) and familial hypercalcaemic hypocalciuria (FHH) can both present with hypercalcaemia, but their management and prognosis are quite distinct. The 24 h urine calcium: creatinine clearance ratio (CCCR) is used to distinguish FHH from PHPT, where patients with FHH have a CCCR of <0.01. This study compares the use of a spot urine sample to measure CCCR with the gold-standard 24-h urine CCCR.Objective: To eval...

Background: Hydrocortisone day curves (HCDCs) are commonly used to assess hydrocortisone replacement for patients with adrenal insufficiency (AI).Methods: HCDCs were obtained for 216 adrenally insufficient patients between 2004 and 2012 at Imperial College Healthcare NHS Trust. The area under the curve (AUC) was calculated for each patient’s day profile. Lipid profiles and glycated haemoglobin (HbA1c) values were recorded for each patient at both th...

Background: Glucocorticoid-induced osteoporosis is one of the major clinical concerns of long-term steroid treatment. Previous studies have shown that immunosuppressive doses of glucocorticoid can lead to osteoporosis. This study investigated whether there is a relationship between cortisol exposure and the development of osteoporosis in patients receiving replacement doses.Methods: Hydrocortisone day curves (HCDCs) performed a...

Background: Hydrocortisone day curves (HCDCs) are commonly used to assess hydrocortisone replacement for patients with adrenal insufficiency (AI).Methods: HCDCs were obtained for 216 adrenally insufficient patients between 2004 and 2012 at Imperial College Healthcare NHS Trust. The area under the curve (AUC) was calculated for each patient’s day profile. Lipid profiles and glycated haemoglobin (HbA1c) values were recorded for each patient at both th...

Background: Glucocorticoid-induced osteoporosis is one of the major clinical concerns of long-term steroid treatment. Previous studies have shown that immunosuppressive doses of glucocorticoid can lead to osteoporosis. This study investigated whether there is a relationship between cortisol exposure and the development of osteoporosis in patients receiving replacement doses.Methods: Hydrocortisone day curves (HCDCs) performed a...

Introduction: Macroprolactin is a physiologically inactive form of prolactin, usually composed of a prolactin monomer and an IgG or anti-prolactin antibody molecule. Whilst clinically non-reactive, it interferes with immunological assays used for prolactin detection. It is identified by polyethylene glycol (PEG) precipitation, and levels of macroprolactin are generally believed to remain stable over time.Case: We present the case of a 36-year-old gentlem...