Endocrine Abstracts

Paget’s disease of bone (PDB) is the second commonest bone disease. The original disease description in 1876 by Sir James Paget remains an incisive, accurate report of the pathophysiology of PDB, which is characterised by focal regions of increased bone remodelling with initial excessive bone resorption and osteolytic lesions followed by long term increased bone formation and sclerosis. The majority of patients are elderly, many are asymptomatic. Those that are referred t...

One of the most significant health measures implemented during the COVID-19 pandemic has been extended periods of lockdown. Vitamin D is essential for many biological functions including pregnancy and bone health and modulate the immune system. Many studies also suggested a beneficial effect of replenished stores of vitamin D (25(OH)D >50 nmol/l) against severe and long term COVID-19 and self-supplementation is recommended by the government. Here we report on the vitamin D...

Background: Volumetric absorbent microsampling (VAMS) provides a less intrusive alternative to venepuncture when collecting blood samples for diagnostic testing. A small, precisely determined amount of capillary blood from a single finger-prick is absorbed into a medium for storage, from which it can later be extracted and analysed. In this study, we developed methods to measure four commonly requested endocrine/bone biomarkers for finger-prick blood samples analysis, and inve...

A 33 year-old man was referred to the endocrine bone clinic following presentation with a 4 mm kidney stone and hypercalcaemia. Apart from mild fatigue, he had no other hypercalcaemic or concerning symptoms. He was not on any medications or supplements. He had a positive family history for kidney stones and reported that his grandmother had been noted to have hypercalcaemia in the past. There was significant consanguinity in his family. Examination was entirely normal while bl...

Introduction: In CKD, net effects of declining kidney function and increasing FGF23 (and PTH) concentrations on vitamin D catabolism and iron metabolism are not clear.Objectives: Compare the Biomedica to the Immutopics’ immunoassay for measurement of cFGF23. Determine the relationship between iron status; vitamin D and intact FGF23 (iFGF23) and c-terminal (cFGF23) concentrations in blood.Method: Samples from routine care and a...

Introduction: It is recognised that osteocytes, by secreting sclerostin plays a more central role in bone homeostasis. Sclerostin is a physiological inhibitor of bone formation. By binding to the LRP5/6 receptor sclerostin inhibits the Wnt signalling pathway. A cross-sectional study was undertaken to ascertain whether an endogenous sclerostin circadian rhythm exists in healthy individuals.Subjects and methods: Six healthy young men with normal BMD were a...

Introduction: Osteotropic hormones demonstrate circadian rhythms which are integral to bone homeostasis. Sclerostin is a physiological inhibitor of bone formation. We have established that Sclerostin has a distinct circadian rhythm with a nocturnal peak. Analysis was performed to determine the relationship of Sclerostin levels to PTH, Calcium, Phosphate, βCTX and P1NP in healthy young men.Methods: Six healthy young men with normal BMD were admitted ...

Burosumab has become available as a treatment for children with X-linked hypophosphatemia (XLH) and is a recombinant fully human IgG1 against FGF23. By binding to the active FGF23, burosumab inhibits its effect and symptoms (growth retardation, rickets, enthesiopathy, low phosphate) may improve, however, not in all children. Concomitantly paediatricians are keen to measure FGF23, in treated children, to avoid overtreatment with burosumab, associated with potential calcificatio...

Background: Zoledronate is a nitrogen-containing bisphosphonate (BP) recognised for its antiresorptive potency. The pharmacokinetic/pharmacodynamic of zoledronate remains unclear. Although adverse events from overuse of BP is rare, there have been reports of over-treatment resulting in pathophysiological consequences. The current administration regimen is not tailored to the individual’s therapeutic response to zoledronate. Quantifying post-dose serum con...

Background: The active form of vitamin D, 1,25(OH)2D, plays a key role in regulating calcium and phosphorus metabolism and bone homeostasis. In paediatrics, maintaining optimal 1,25(OH)2D levels is crucial for supporting musculoskeletal growth. The hormone also serves as a diagnostic indicator for multiple disorders such as vitamin-D dependent rickets. Current Literature lacks comprehensive reporting of age-specific reference ranges in pa...