Endocrine Abstracts

Malignant neoplasm of the Adrenal gland is rare and carries a poor prognosis. Presentation is with either symptoms of hormone excess; Cushings Syndrome (Steroids), Conns Syndrome (Aldosterone), Virilisation (Androgens), Feminisation (Oestrogens), Phaeochromocytoma (Catecholamines) or abdominal mass, and patients often present with hypertension. Laboratory investigations confirm clinical suspicion of isolated hormone excess. Surgical resection offers the best chance for long-te...

We present two cases of postmenopausal, gonadotrophin-dependent androgen excess.Case 1: A 59-year-old postmenopausal female presented with a 4-year history of hirsuitism and male pattern balding. Past medical history included Type II diabetes, hypertension, and polycystic ovarian syndrome. Investigations revealed androgen excess (testosterone 8.9 nmol/l [ref range<2.5], free androgen index 31.8 [ref 0-7], androstenedione 13.7 nmol/l [ref<6.8], DH...

Insulin resistance states are associated with endothelial dysfunction, but the molecular mechanisms underlying this association are incompletely understood. Impairment of insulin stimulated endothelial NO production is proposed to be a key mechanism in this process. In cultured human aortic endothelial cell (HAEC) models, insulin stimulates an intracellular signalling cascade resulting in activating phosphorylation of Insulin Receptor Substrate-1 (IRS-1), Protein kinase B (PKB...

The PROactive study recently demonstrated that pioglitazone, a thiazolidinedione class drug, reduces macrovascular morbidity and mortality in patients with type 2 diabetes. This class of drug has been reported to exert PPAR gamma receptor dependent as well as receptor independent effects, possibly via AMP kinase activation (AMPK) but the precise mode of action resulting in improved cardiovascular outcome remains uncertain.We studied the effects of rosigl...

The fusion of insulin-stimulated GLUT4-containing vesicles (GSV) with the plasma membrane (PM) of adipose or skeletal muscle cells is governed by regulated exocytosis. In all such membrane fusion events cognate t- and v-SNAREs interact in an ordered way to allow vesicles to first dock with, and then fuse with the plasmalemma. In neurons, the best-studied example of this well conserved process, the protein species responsible for directing the final (rate-limiting) fusion step ...

Hypopituitary patients on conventional hormone replacement, excluding GH have a reduced quality of life (QoL) and an increased risk of cardiovascular mortality. NICE guidelines on criteria for initiation and maintenance of therapy rely on QoL score defined by the Adult GHD assessment (AGHDA) questionnaire. However, it is uncertain how this score is related to other biological effects such as vascular risk.Methods: Sixteen hypopituitary patients were recr...

A common NOS3 polymorphism (the gene which encodes endothelial nitric oxide synthase), a variable number of tandem repeats within Intron 4 has been associated with cardiovascular disorders in which nitric oxide bioactivity is impaired including myocardial infraction. Consistent characteristic changes in the pressure pulse wave shape have been associated with ageing, risk factors for cardiovascular disease and impaired NO bioactivity. Therefore pulse waveform analysis can be ut...

The major glucocorticoids (cortisol in man and corticosterone in the rat) play an important role in obesity and its attendant hypertension. However, there is no consistent evidence of glucocorticoid excess in simple obesity, suggesting that its role in the regulation of adipose tissue mass results from a more complex mechanism than adrenal hypersecretion of glucocorticoid. Glucocorticoid biosynthesis is not limited to the adrenal cortex; mRNA and enzymatic activity of 11β...

Hydrocortisone is the standard replacement therapy in patients with primary or secondary adrenal insufficiency (AI) but there is no current consensus on the most appropriate replacement dose and the extent to which this varies between individuals. This study examines inter-individual variability in cortisol metabolism in patients taking hydrocortisone therapy and investigates the relationship between plasma and salivary concentrations.Subjects and Method...

Background: National Institute for Clinical Excellence (NICE) guidelines for the use of Growth Hormone (GH) replacement in adults with GH deficiency (GHD) were published in 2003, and subsequently ratified for use in Scotland.Aim: To identify all adults in Scotland currently receiving GH and to assess whether they meet the NICE criteria for starting and continuing GH replacement.Methods: All endocrinologists in Scotland were surveye...