Searchable abstracts of presentations at key conferences in endocrinology

ea0009p115 | Endocrine tumours and neoplasia | BES2005

A novel finding of activation of the hypothalamic-pituitary-adrenal axis with increased cortisol production rates and circulating cortisol concentrations in 24-hour profiling study in cranially irradiated adult cancer survivors

Darzy K , Shalet S

Cortisol profiling at 20-min intervals over 24 hours during the fed state and in the last 24 hours of a 33-hr fast were undertaken in 34 ACTH-replete adult cancer survivors irradiated for non-pituitary brain tumours and 33 matched normal controls. Compared with normals, patients had significantly higher (mean ± SEM) minimum (nadir) cortisol concentration (37.8 ± 2.5 vs. 29.7 ± 2.9 nmol/L, p = 0.03), maximum cortisol concentration (547 ± 18 vs. 495 &...

ea0009p160 | Thyroid | BES2005

Abnormalities in basal and stimulated TSH secretion in cranially irradiated euthyroid adult cancer survivors: Does 'hidden' central hypothyroidism exist?

Shalet S , Darzy K

It has been claimed that the use of the TRH test and the nocturnal TSH surge test might uncover the diagnosis of the so-called 'hidden' central hypothyroidism, in a substantial proportion of euthyroid cranially irradiated children. In our study of 37 euthyroid adult cancer survivors and 34 matched normal controls, patients had significantly (P<0.05) higher basal and stimulated TSH levels and a slightly slower TSH decline between 20 and 60 min during the TRH test; none had b...

ea0003p179 | Neuroendocrinology | BES2002

Time dependency of somatotroph dysfunction following radiation damage of the hypothalamic-pituitary axis

Darzy K , Ghigo E , Shalet S

Radiation-induced growth hormone neurosecretory dysfunction (GHNSD) is, primarily, the result of radiation-induced hypothalamic damage. Consequently, reduced hypothalamic growth hormone releasing hormone (GHRH) secretion results in secondary somatotroph atrophy and attenuated peak GH responses to a bolus of exogenous GHRH. For the first time we have studied the presence of GHNSD and/or somatotroph atrophy in cranially irradiated adult survivors of childhood cancer. We have uti...

ea0009p116 | Endocrine tumours and neoplasia | BES2005

The dynamics of GH secretion in adult cancer survivors with severe radiation-induced GH deficiency

Darzy K , Pezzoli S , Thorner M , Shalet S

We have used a sensitive chemiluminescence GH assay to analyse 24-hour GH profiles (20 minute sampling) from 11 adult cancer survivors with severe GH deficiency acquired following brain irradiation in childhood for non-pituitary brain tumours and 30 matched healthy normal volunteers. Cluster analysis revealed that the area under the curve for GH (AUCGH), absolute (maximum) GH peak height, mean peak height, maximum pulse area, mean pulse area, absolute (minimum) nadi...

ea0004p1 | Bone | SFE2002

Osteoporosis - A Disappearing Manifestation of Cushing's Syndrome.

Searle E , Darzy K , Adams J , Shalet S

Osteoporosis is considered to be a cardinal feature of Cushing's syndrome with a reported incidence as high as 90%. We conducted a cross-sectional analysis of baseline bone mineral density (BMD) in 21 patients (4 males) aged 19-63 (median, 37) years with untreated Cushing's syndrome. 18 patients had pituitary dependent disease and 3 adrenal adenomas. Dual energy x-ray absorptiometry (DEXA) was used to measure the BMD at the lumbar spine (L1-L4), left femoral neck (LFN) and tot...

ea0002p50 | Growth and development | SFE2001

Growth hormone (GH) deficient survivors of childhood cancer: the role of GH replacement during adult life

Murray R , Darzy K , Gleeson H , Shalet S

Childhood survivors of cancer are prone to a number of adverse sequelae related to the therapeutic interventions used. Growth hormone deficiency (GHD) is common after cranial irradiation, and it is unclear to what extent GHD contributes to the abnormalities observed in adult survivors of childhood cancer, and whether GH replacement can reverse these anomalies. We compared 27 GHD survivors of childhood cancer with 27 adult age- and sex-matched controls, and went on to replace G...

ea0007p163 | Neuroendocrinology and behaviour | BES2004

Primary therapy with somatostatin analogues in acromegaly does not restore orderly GH secretion

Parkinson C , Darzy K , Peacey S , Thorner M , Veldhuis J , Trainer P , Shalet S

Tumoural GH secretion in acromegaly is characterised by increased non-pulsatile (basal) release, pulse amplitude and pulse frequency. We have studied the effect of primary therapy with Sandostatin LAR on GH pulsatility in 9 patients with acromegaly who achieved disease control (mean serum GH<2ug/L) on therapy (7 males; median (range) age 67 (43-75). Data obtained were compared with 16 healthy subjects (10 males, age 50 (30-75)). Spontaneous 24-h GH secretion (20 minute samp...

ea0019p304 | Steroids | SFEBES2009

Modified-release hydrocortisone to provide circadian cortisol profiles

Debono M , Ghobadi C , Rostami-Hodjegan A , Huatan H , Campbell MJ , Newell-Price J , Darzy K , Merke DP , Arlt W , Ross RJ

Background: A basic tenet for hormone replacement is to replicate physiology but this is rarely if ever achieved. The adrenal glucocorticoid, cortisol, has a distinct circadian rhythm regulated by the brain’s central pacemaker. Loss of the cortisol circadian rhythm is associated with metabolic abnormalities, depression, fatigue and a poor health-related quality of life. Based on pharmacokinetic modelling we have developed a modified-release hydrocortisone (MR-HC) and test...