Endocrine Abstracts

Pro-opiomelanocortin (POMC) neurons in the arcuate nucleus (ARC) of the hypothalamus are critical regulators of appetite, energy expenditure and glucose metabolism. POMC neurons are able to sense circulating hormones and nutrients informing about the energy status of the organism. However, the molecular mechanisms underlying nutrient-sensing in POMC neurons remain incompletely understood. Mitochondria are key organelles implicated in cellular nutrient/energy management and are...

Aldosterone exerts numerous pleiotropic functions, notably in the kidney where it controls hydroelectrolytic homeostasis and ultimately blood pressure. Aldosterone acts by activating the mineralocorticoid receptor (MR), a transcription factor that regulates target gene expression. Alteration of the mineralocorticoid signaling leads to various diseases including hypertension, cardiovascular, renal, metabolic or CNS disorders.Aldosterone mechanism of actio...

Mr RP is a 69 year old gentleman who presented to A&E following a fall. He described several weeks of lethargy, ataxia, confusion and polydipsia. He had a past medical history of hypertension and COPD, but was otherwise fit and well. On admission bloods revealed an adjusted calcium of 5.25, with a PTH of 2.4. He also had a significant AKI with an eGFR of 22. After initial management with IV fluids, a cautious dose of pamidronate was given. Basic investigations did not iden...

The relation between testosterone (T) production and action is complex, involving protein binding in the circulation affecting clearance and tissue availability, T production from precursors in peripheral tissues, deactivating and activating (to dihydrotestosterone and estradiol) metabolism within target tissues, besides factors affecting androgen responsiveness (receptor concentrations, cofactors, genetics,…). Yet, in absence of a useful independent marker of androgen a...

The relation between testosterone (T) production and action is complex, involving protein binding in the circulation affecting clearance and tissue availability, T production from precursors in peripheral tissues, deactivating and activating (to dihydrotestosterone and estradiol) metabolism within target tissues, besides factors affecting androgen responsiveness (receptor concentrations, cofactors, genetics,…). Yet, in absence of a useful independent marker of androgen a...

Background: Thyroid storm is a rare but dangerous condition which can lead to multi-organ failure if not treated aggressively. Currently accepted treatment is with anti-thyroid medications to convert patients to a euthyroid state before definitive treatment with thyroidectomy is performed 10–14 days later. We present a case that was managed medically for several months due to a delay in surgery for clinical reasons. At present there are few such cases in the literature.</...

The current indication for TRT is hypogonadism, a syndrome complex combining hypogonadal symptoms and low testosterone concentrations. The optimal formulation for the treatment of hypogonadism is one that generates a physiological testosterone concentration in the age adjusted reference range, as well as the concentration of its metabolites oestradiol and dihydrotestosterone, while ideally mimicking the circadian rhythm in younger subjects. Optimal treatment should lead to cor...

Pubertal exposure to rising blood concentrations of sex steroids, partly in concert with transiently increased activity of the somatotropic axis, is instrumental in a pubertal acceleration of bone growth and acquisition of bone mass, followed by growth inhibition and closure of the epiphyseal cartilages in late puberty. As is illustrated by experiments of nature, i.e. subjects with aromatase deficiency or lack of functional oestrogen receptor α, and with androgen insensit...

The discovery that IGF binding proteins (IGFBPs) are capable of action independently of ligand binding opened up a broad scope of investigation into the mechanisms by which the IGFBPs elicit their intrinsic cellular effects. Numerous studies have demonstrated the special role of IGFBPs in as diverse processes as cell proliferation, migration and survival/apoptosis. However, the pathways by which these actions occur have not been completely defined but interactions of IGFBPs wi...

Background: In men with obesity and the metabolic syndrome there is an increased prevalence of low serum testosterone. Overweight and moderate obesity is associated mainly with low total testosterone (T) secondary to decreased concentrations of SHBG, which are strongly inversely associated with indices of adiposity and insulin resistance, and preserved free T levels. In more severe obesity and metabolic abnormalities (often with type 2 diabetes) low total T can be accompanied ...