Endocrine Abstracts

Propylthiouracil (PTU) treatment for thyrotoxicosis in pregnancy is common clinical practice. However maternal ingestion of PTU has been recognised to be associated with the development of foetal hypothyroidism and in rare cases at high doses of PTU, overt foetal goitre. Foetal goitre can be potentially dangerous due to mechanical obstruction and needs to be carefully monitored in utero. We report a case of development of goitre in utero secondary to maternal ingestion of PTU ...

Macroprolactinaemia, a common phenomenon variably expressed in different assays, influences interpretation of prolactin results, as recognised since 1978. The degree of macroprolactinaemia manifest over time is less well described. We examined how macroprolactin status (based on polyethylene glycol(PEG) precipitation prolactin % recovery) varied over serial measurements in hyperprolactinaemic individuals.Methods: All serum total prolacti...

Introduction: Between 5-10% of patients with hypothyroidism treated with levothyroxine (T4) continue to experience profound symptoms, despite achieving free T4/thyroid stimulating hormone concentrations within reference range. Liothyronine is sometimes added to levothyroxine, but its use is controversial due to uncertainties in clinical/cost effectiveness.Methods: An economic model was developed to estimate the incremental cost per quality-adjusted life ...

Background: Hyponatraemia is one of most common electrolyte abnormalities in acutely ill elderly patients. Severe hypothyroidism is often associated with hyponatraemia. The mechanism of hyponatraemia in hypothyroidism is not fully understood. It is suggested that hypothyroidism induces hyponatraemia either by inappropriate release of ADH or by decrease in GFR. Regardless of the mechanism, the net effect is impairment of water excretion. We report a case of severe hypothyroidis...

Introduction: Substrate accumulation, energy deficiency or complex molecule defects characterize inherited metabolic disorders (IMDs), accounting for their multi-system manifestations. One important aspect of this is endocrinopathy, which is relatively common but underestimated in IMDs, presenting in childhood following diagnosis or sometimes a presenting symptom in adults where there is multi-system or multi-gland involvement. Endocrinopathies may be secondar...

Introduction: Type 2 diabetes mellitus (T2DM) frequently associates with increasing multi-morbidity/treatment complexity. Some headway has been made to identify genetic and non-genetic risk factors for T2DM. However longitudinal clinical histories of individuals both before and after diagnosis of T2DM are likely to provide additional insight into both diabetes aetiology/further complex trajectory of multi-morbidity.Methods: This study utilised diabetes p...

Introduction: The androgen receptor (AR) mediates the peripheral effects of testosterone. The main mechanism of action for the AR is direct regulation of gene transcription. Available evidence suggests that the number of CAG repeats in exon-1 of the AR gene is negatively correlated with transcriptional activity of the AR and that CAG repeat number links to mortality rate in T2DM men. The aim of this analysis was to determine the association between CAG repeat number and all ca...

Objective: Thyroid hormones are essential for maintaining metabolic balance and particularly influence lipid synthesis and degradation. Metabolomics and in-depth lipid profiling may enable us to assess for differential effects of thyroid hormones and provide insight into tissue thyroid status, that cannot be captured by levels of serum free thyroid hormones alone.Methods: 4,347 children from the Avon Longitudinal Study of Parents and Children who had thy...

Introduction: Around 15% of people diagnosed with primary hypothyroidism remain significantly symptomatic despite TSH normalisation with levothyroxine (LT4). The Thr92Ala substitution (rs225014) in a key deiodinase that activates T4 to T3, DIO2 may influence tissue levels of T3 but previous studies have been inconsistent regarding symptoms on LT4 and the presence of this polymorphism.Methods: We assessed HADS anxiety and depression scores in the HUNT2 st...

Background: We previously showed that in first 6 months of the UK Covid-19(C19) pandemic >6.6million HbA1c tests were missed, including 1.4million in people with diabetes(DM). Furthermore, C19 more significantly impacts people with DM / socioeconomically disadvantaged individuals.Aim: To examine variability in recovery rate of HbA1c testing, and links to demographics, including deprivation status.Methods: We examined HbA1c test...