Endocrine Abstracts

Background: Increased levels of cortisol are associated with worse prognosis in heart failure (HF). The final step in cortisol production is catalysed by 11β-hydroxylase encoded by CYP11B1, which is highly homologous with CYP11B2. A common polymorphism in the aldosterone synthase gene (CYP11B2 −344T) is associated with a raised ratio of 11-deoxycortisol/ cortisol (S/F). We examined the relationship between −344C/T polymorphism and corticos...

Aim: To assess whether adults in Scotland currently receiving growth hormone (GH) meet the NICE criteria for starting and continuing GH replacement.Methods: We surveyed all endocrinologists in Scotland and identified the main centres using GH replacement. A cross-sectional case note review was carried out of all patients commenced on GH.Results: About 208 patients (51% women; 24% professionals, 90% Caucasian) were identified, 69 of...

Aldosterone has assumed increasing importance as a major cardiovascular risk factor. This is illustrated by the positive correlation between plasma aldosterone levels and blood pressure in a number of large population surveys, and the finding that approximately 10% of patients with high blood pressure have inappropriate aldosterone levels in relation to renin, consistent with primary aldosteronism. Evidence also supports the notion that aldosterone exerts particularly deleteri...

Primary aldosteronism is the most common secondary cause of hypertension. Less than 50% of patients with the disorder have a solitary aldosterone producing adenoma. In the most common presentation, patients present with bilateral hyper-secretion of aldosterone. The aetiology of this is uncertain. Studies within our own group have suggested that there is an underlying genetic predisposition to develop hypertension with a raised aldosterone to renin ratio (ARR) associated with v...

Aldosterone has important effects on blood pressure regulation and electrolyte haemostasis: recent data from Framingham confirm that plasma levels of the hormone predict subsequent development of hypertension in young adults, while our own data show that plasma aldosterone correlates with blood pressure in older subjects, and is inversely associated with birth weight. It is clear, therefore, that long-term regulation of aldosterone is important in setting blood pressure levels...

John Connell, MRC Blood Pressure Group, Glasgow, UK AbstractJohn Connell graduated in medicine from Glasgow in 1977. After initial training in endocrinology, he was appointed as a Clinical Scientist to the MRC Blood Pressure Unit, Western infirmary, Glasgow in 1983. He held an MRC Travelling Fellowship in the Howard Florey Institute for Experimental Physiology and Medicine from 1987, working with Professor John Coghlan...

We present the case of a 76 year old woman who was admitted to our hospital with severe Cushings syndrome, in association with hair loss and hypokalaemia. Plasma cortisol levels were elevated, and did not suppress with high dose dexamethasone. ACTH levels were detectable throughout the HDDST. MRI pituitary and CT adrenals were normal, but CT of chest revealed an area of nodularity in the right lung. With no specific treatment her symptoms settled, and her biochemistry returned...

There is a significant body of research that demonstrates an association between central (visceral) obesity, insulin resistance, endothelial dysfunction and accelerated atherosclerosis, but the molecular mechanisms underlying this link are incompletely understood. In cultured human aortic endothelial cell (HAEC) models, insulin stimulates an intracellular signalling cascade resulting in activating phosphorylation of Insulin Receptor Substrate-1, Protein kinase B (PKB/Akt) and ...

In population studies, premature cardiovascular disease is associated with cortisol dysregulation. Recently, recurrent hypoglycaemia in individuals with type 1 diabetes (T1D) was reported to be associated with increase carotid intima–media thickness. Hypoglycaemia is a potent activator of the hypothalamo-pituitary–adrenal axis (HPA axis) with eventual release of cortisol. We hypothesized that individuals with T1D who experience recurrent hypoglycaemia might demonstra...

Primary aldosteronism (PA) accounts for up to 15% of cases of hypertension, and associates with increased cardiovascular morbidity. Specific treatment options include mineralocorticoid antagonists or adrenalectomy; the latter offers cure although reported rates vary between 20–60%. The role of adrenal vein sampling (AVS) in diagnosing PA remains controversial. By reviewing casenotes of PA patients treated surgically and comparing with matched medically managed PA patients...