Endocrine Abstracts

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...

Vitamin D deficiency is a particular concern in pregnancy as it can affect both mother and infant, with problems lasting into childhood. A high prevalence of deficiency during pregnancy has been reported among known risk groups. Current guidelines on supplementing pregnant women are conflicting, with universal replacement recommended by the Department of Health but not supported by NICE guidelines. We aimed to determine the prevalence of vitamin D deficiency in a West London p...

Background: Vitamin D deficiency is a common feature of primary hyperparathyroidism (PHP). However, replacement of vitamin D is not routinely performed in clinical practice, due to concerns about its safety. Furthermore, it is not clear whether vitamin D deficiency worsens the biochemical derangements observed in patients with PHP.Aim: To determine the relationship between 25(OH) vitamin D status and biochemical markers in patients with PHP.<p class=...

Background: Patients with acromegaly require lifetime monitoring due to the excess mortality and morbidity associated with untreated disease, and the propensity for disease relapse following treatment. There is controversy whether GH or insulin-like growth factor 1 (IGF1), better predicts the onset of cardiovascular complications such as cardiomyopathy and ischaemic heart disease (IHD) in acromegalic patients.Aim: To examine associations of overall GH an...

Background: A cardinal feature of acromegaly is insulin resistance. Patients with acromegaly are therefore predisposed to developing impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). It is therefore imperative to develop better biomarkers predicting the onset of IGT and T2DM in treated acromegalic patients. There is controversy whether GH or insulin-like growth factor 1 (IGF1) better predict the onset of IGT or T2DM in treated acromegalic patients. However ...

Aim: Population studies have shown that basal calcitonin concentrations are below 10 ng/l in the normal population. Ten nanograms per liter is used as a diagnostic cut-off by most laboratories and patients with levels higher than this are offered a pentagastrin stimulation test to exclude medullary thyroid carcinoma. However, these guidelines were adopted from studies that used the Cisbio Immunoradiometric assay for measuring calcitonin. Most laboratories have now moved to che...

Background: Temporary hypocalcaemia occurs in up to 40% of patients following a total thyroidectomy. Serum calcium and parathyroid hormone (PTH) measurements are currently used to predict post-thyroidectomy hypocalcaemia. However, immediate access to PTH measurement is expensive and not widely available. Serum phosphate responds rapidly to changes in circulating PTH levels and its measurement is readily available in all hospitals. We evaluated the use of serum phosphate to pre...

Context: Hydrocortisone day curves (HCDC) are used to monitor hydrocortisone replacement by obtaining serum samples to measure cortisol levels throughout the day. Salivary measurement of free cortisol offers a non-invasive alternative to serum measurements.Objective: To validate salivary cortisol measurement as an alternative method to assess the adequacy of hydrocortisone replacement in patients with hypoadrenalism.Setting, patien...

Background: Kisspeptin is a novel hypothalamic hormone with powerful stimulatory effects on the hypothalamo-pituitary–gonadal (HPG) axis. Inactivating mutations in the kisspeptin receptor lead to pubertal failure. We have previously demonstrated that injection of kisspeptin-54 stimulates LH release in healthy men and women. Recent studies in animals suggest that endogenous kisspeptin may be involved in stimulating the GnRH pulse generator. Determining whether exogenous ad...

Kisspeptin, the endogenous ligand of the GPR54 receptor, is a key regulator of the hypothalamo-pituitary-gonadal (HPG) axis. GPR54-null mice exhibit reproductive dysfunction and exogenous kisspeptin potently stimulates the HPG axis in rodents, primates and human males. The effects of kisspeptin administration to human females are not known.Aim: To investigate the effects of kisspeptin on luteinising hormone (LH) release during the menstrual cycle in fema...