Endocrine Abstracts

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GH deficiency (GHD) has implications throughout the lifespan. In childhood, reduced linear growth is the primary consequence of untreated GHD, while in adulthood, untreated GHD is associated with a number of abnormalities. The phenotype of GHD in adulthood differs depending on timing of onset. Childhood onset (CO) patients have reduced bone mineral content (BMC) and lean body mass (LBM) despite GH replacement therapy (GHRT) during childhood compared with adult onset. These dif...

In the UK 1 in 500 children will develop cancer in childhood. Survival from childhood cancer has more than doubled since the 1960s. Survivorship is increasingly on the agenda and the National Cancer Survivorship Initiative has been launched in the UK.During adolescence the endocrinologist is faced with four challenges in managing childhood cancer survivors:-1. Managing the immediate endocrine consequences of cancer therapy, in part...

The GH-IGF-1 axis alters through the menstrual cycle. During the periovulatory period when oestrogen levels have risen serum growth hormone (GH) levels increase 2-fold. IGF-1 levels have been reported as unchanged or modestly increased in the periovulatory period. Similarly exogenous oestrogens also increase GH levels while IGF-1 levels have been reported as reduced, unchanged or increased. Peripheral responsiveness to GH as reflected by the IGF-1 response to an acute bolus of...

The hypothalamic-pituitary-thyroid axis can be affected following therapy for brain tumours. Primary thyroid damage is frequent following craniospinal irradiation(CSI). Central hypothyroidism is less commonly reported following cranial irradiation(CI), however, some investigators have argued it is underdiagnosed and may be more prevalent than growth hormone deficiency(GHD). Utilising thyroid function tests(TFT) for the diagnosis of central hypothyroidism is notoriously difficu...

Decreased GH secretion and increased GH clearance contribute to low GH levels found in obesity; in spite of which IGF-1 levels are reported as normal. To explain the discordancy between GH and IGF-1 status in obese subjects, an increase in peripheral (hepatic) sensitivity to GH activity has been hypothesized. Previously peripheral responsiveness to GH in obesity has been investigated and reported to be increased, however the use of weight-based GH doses made interpretation dif...

IGF-1 generation tests (IGF-1GT) have been used extensively in children to investigate growth hormone (GH) responsiveness. To help understand differences in the GH/IGF-1 axis in health and disease in adulthood interest has turned to the use of the IGF-1GT in adults. Different designs of IGF-1GT have been used with no clear evidence delineating which is the most sensitive to describe subtle changes in GH responsiveness. In order to design an IGF-1GT we have performed the first ...

Survival figures following the treatment of brain tumours continue to improve. Patients receiving cranial radiotherapy (XRT) frequently suffer a progressive loss of anterior pituitary function secondary to radiation damage to the hypothalamic pituitary axis (HPA), therefore long-term follow up is required. The time frame of radiation damage to the HPA is not known. There is also a suggestion from animal data that the HPA is more sensitive to damage by radiation when treated at...

The most appropriate way to manage growth hormone replacement (GH) in the transition to adulthood in children treated with GH for GH deficiency (GHD) is controversial. The GH Research Society suggest that retesting of GH status at final height (FH) is unnecessary in the presence of 'severe organic GHD' and cranial irradiation falls into this etiological category. This recommendation has never been validated.To investigate whether patients diagnosed in ch...

Final height outcome is important in survivors of childhood brain tumours. Growth hormone replacement is indicated in those found to be GH deficient (GHD). More recently, GnRH analogues (GnRHa) have been introduced to delay early or rapidly progressing puberty. Studies to final height are important to determine the effectiveness of growth promoting strategies.SUBJECTS & METHODS Final height results in children receiving GH replacement for radiation i...