Endocrine Abstracts

Introduction: Hypertension remains a significant co-morbidity in the population with diabetes, with a prevalence of 20–60%. In type 2 diabetes, hypertension is often present as part of the metabolic syndrome of insulin resistance. In type 1 diabetes, hypertension may reflect the onset of diabetic nephropathy.Aims: To investigate the prevalence of, and to stratify, hypertension in our diabetes clinic population. To investigate prevalence of risk fact...

Replacement mineralocorticoid(MC)therapy in patients with primary hypoadrenalism is titrated according to clinical and /or biochemical criteria. No single objective assessment is adequate for monitoring,though targets for plasma renin and serum electrolyte concentrations and blood pressure(BP)have been proposed.Plasma renin concentrations within the middle to upper normal range would suggest adequate MC replacement. We reviewed the case notes of 18 patients in order to identif...

Hormonal therapies in the form of oestrogens, anti-androgens and progestogens are often used in the treatment of male-to-female transsexuals. We present the case of a 36 year old phenotypic male with karyotype 46XY who presented with normoprolactinaemic galactorrhoea likely to be related to prior oestrogen administration. He had been self-administering oestrogen and progesterone preparations continuously for 7 years (aged 26 - 33 years) in an attempt to develop female phenotyp...

The binding characteristics of maternal serum human chorionic gonadotrophin (hCG) to immobilised lectins, specifically Concanavalin A (Con A), Lens culinaris agglutinin (LCA) and Wheat germ agglutinin (WGA), have been shown be compatible with the proposed glycosyl structures of hCG as inferred from other analytical methods. We have shown that serum hCG from groups of pregnant women with or without type 1 diabetes show identical affinity for Con A and LCA, but serum hCG from th...

Regulation of the epithelial sodium channel (ENaC) trafficking in cells of the distal nephron is of major importance in the control of sodium reabsorption. Mutations in the genes compromising the molecular pathway by which corticosteroids regulate ENaC sodium reabsorption cause several hypertensive syndromes in humans. The molecular events underpinning ENaC exo- and endocytosis and the hormonal effects on ENaC trafficking are poorly understood. To start elucidating these pathw...

Cellular sensitivity to circulating glucocorticoids is critical and is principally determined by the level of glucocorticoid receptor (GR). GR expression is most potently regulated by glucocorticoids themselves, although the mechanism is unknown. The rat GR gene encodes at least eleven alternate and untranslated exons 1, eight of which lie in a 3kb CpG island close to exon 2. We have recently shown that individual exons 1 are subject to tissue specific expression and regulatio...

Background: Self-management is essential for patients with adrenal insufficiency (AI) to achieve optimal outcomes of glucocorticoid (GC) replacement therapy by minimising adverse effects from over- or under-replacement and appropriately adjusting the dose in intercurrent illness to prevent adrenal crisis. Evidence suggests that many patients report deficits in self-management especially concerning ‘sick day rules’, prevention and management of adrenal crisis and have...