Endocrine Abstracts

Background: Obesity is a major risk factor to develop heart failure, in part due to possible lipotoxic effects of increased intramyocardial (MYCL) and/or pericardial (PERI) lipid accumulation. Recent evidence suggests that MYCL is highly dynamic and might rather be a surrogate marker for disturbed energy metabolism than the underlying cause of cardiac dysfunction. On the other hand, PERI might contribute directly by mechanic and paracrine effects. Therefore, we hypothesized th...

Introduction: Heterozygous inactivating mutations of the calcium sensing receptor (CaSR) gene cause mild alterations in calcium metabolism (familiar hypocalciuric hypercalcemia (FHH)). However, in addition to the parathyroid gland CaSR expression was recently identified in the myocardium and many other endocrine cells including pancreatic islet cells, entero-endocine cells and adipose tissue. So far, it is unknown whether FHH is associated with cardio-metabolic altera...

Glycogen storage disease type 1 (GSD1) is a rare inherited defect of endogenous glucose production. While children present with severe hypoglycemia the propensity for hypoglycemia may decrease with age in these patients. It was the aim of this study to elucidate the mechanisms for milder hypoglycemia symptoms in grown up GSD1 patients. Four patients with GSD1 (BMI: 23.2±6.3 kg/m2, age: 21±3 yr) and four healthy controls matched for BMI (23.1±3.0 kg/m<...

Background: Growth hormone (GH) plays an important role in modifying body composition. In acromegaly, a state of chronic GH/IGF-I excess, visceral and ectopic fat mass, especially in the liver, are significantly reduced. The aim of this study was to investigate the impact of GH/IGF-I on hepatocellular lipid content (HCL) and energy metabolism in a non-acromegalic cohort of patients with and without non-alcoholic fatty liver disease (NAFLD).Methods: We pe...

Background: Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore we assessed whether renin concentrations during routine GC and MC substitution therapy are associated with cardiac function and morphology.Methods: 17 patients with AI underwent magnetic resonan...

Background: Altered hepatic mitochondrial activity plays a key role in the development of non-alcoholic fatty liver disease (NAFLD). GH has been shown to stimulate mitochondrial function in skeletal muscle. Therefore we hypothesize that the time course of serum GH concentrations during an oral glucose tolerance test might be related to hepatic mitochondrial energy metabolism in vivo in humans.Methods: 15 volunteers (male/female: 7/8; 55±8 y...

We have recently shown that patients with growth hormone (GH) excess (acromegaly) exhibit inadequately low intrahepatic lipid content (IHL) despite marked insulin resistance. GH might increase mitochondrial oxidation capacity thereby counteracting ectopic lipid accumulation; however, up-regulation of mitochondrial function has been reported in early stages of non-alcoholic fatty liver disease. Up to now, data on mitochondrial activity in patients with acromegaly are missing.</...

Background: Metabolic inflexibility in T2DM might result in reliance on free fatty acids (FFA) as substrates to maintain myocardial energy metabolism compared to lean and healthy controls. Thus, we investigated the effects of an acute suppression of circulating FFA on myocardial lipid content and left ventricular function in extreme phenotypes.Methods: T2DM patients (age: 56±11a; BMI: 28±3.5 kg/m2; HbA1c: 7.29±0.88%) and nine he...

Background: Leptin reduces hepatic lipid content in lipodystrophic and overweight, relatively hypoleptinemic NAFLD patients. However, the underlying mechanism is unknown. In rodents, the anti-steatotic action of leptin is mediated by an increase in VLDL secretion and depends on an intact vagal innervation of the liver.Methods: In this randomized, placebo-controlled, crossover trial, we study the effects of a single metreleptin injection (0.1 mg/kg body w...

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a systemic, metabolic condition associated with increased morbidity and mortality. Defined by an increase in hepatic lipid content (HCL), NAFLD develops in consequence of lipid oversupply and/or a diminished disposal of hepatic lipids. The latter may include an impaired export of triglycerides (TG) via the secretion of very-low density lipoprotein1 (VLDL1) particles, an important mechanism of the liver to protect itsel...