Endocrine Abstracts

Background: Central hypothyroidism can be difficult to diagnose as TSH values often reside within the normal range. The Endocrine Society clinical guideline for hormone replacement in hypopituitarism suggests levothyroxine is indicated for treatment of secondary hypothyroidism where fT4 levels decrease by ≥20%. To determine the reliability of this biochemical marker of secondary hypothyroidism we evaluated evolution of TFTs over time within a cohort of NFPA.<p class=...

Introduction: There is a strong association between testosterone deficiency and the incidence of type 2 diabetes (T2D) in men. Physiological testosterone replacement (TRT) improves insulin resistance and glycaemic control in hypogonadal men. The mechanism by which testosterone mediates these beneficial actions are unknown but may be due to an effect on major metabolically active tissues such as liver and muscle. This study investigates the expression of key regulatory targets ...

Testosterone deficiency increases risk for cardiovascular disease (CVD) and type 2 diabetes. Testosterone replacement (TRT) improves insulin resistance, glycaemic control and cholesterol in hypogonadal men. Liver X receptor (LXR) is a nuclear receptor which regulates lipid and glucose metabolism. LXR agonists protect against atherosclerosis but cause hepatic steatosis. We have previously shown that TRT protects against hepatic steatosis and atherosclerosis in high-fat diet-fed...

Objective: Determinants of why only a subset of patients with adrenal insufficiency (AI) experience recurrent adrenal crises (AC) and intercurrent illnesses are not well understood. This study aimed to identify whether residual adrenal function (RAF), defined by the peak response to a provocative test undertaken before commencing glucocorticoids, may help explain differences in prevalence.Design and Methods: Patients wit...

Acromegaly, a chronic disorder of excessive growth hormone secretion, leads to functional limitation and impaired mobility most commonly due to arthropathy. Patients with biochemically controlled acromegaly have reported persistent impairment in prior studies. We aimed to compare the functional differences in patients with biochemically controlled acromegaly to those with uncontrolled disease by means of validated questionnaires. Between March 2017 and May 2022, patients over ...

Acromegaly is caused by excessive growth hormone (GH) and insulin-like growth factor (IGF-1) secretion. Arthropathy is a leading cause of morbidity and impaired quality of life in acromegalic patients, often persisting despite therapeutic interventions and biochemical control. This cross-sectional study aimed to characterise the extent and impact of arthropathy in terms of pain and functional impairment. Validated questionnaires, including DASH (Disabilities of the Arm, Should...

One of the most prevalent clinical manifestations of acromegaly is arthropathy which persists despite adequate symptom and biochemical control, and contributes to impaired quality of life. Patients with acromegaly have high psychiatry morbidity and increased prevalence of depression and poor psychological wellbeing. In a large cohort we aim to determine the effects of joint disease and disease control on quality of life in acromegaly. Eighty-five patients (45 women; median age...

Background: Following vaccination for SARS-CoV-2 a significant proportion of individuals experience moderate to severe symptoms. In patients with adrenal insufficiency (AI) this has been reported to translate in to need for increased glucocorticoids and incipient or frank adrenal crises. We assessed occurrence of symptoms, need for glucocorticoid dose adjustment and crises in a large cohort of patients with AI following vaccination for SARS-CoV-2.Methods...

Background: The published data on the natural history of (presumed) non-functioning pituitary microadenomas (micro-NFAs) is possibly compromised by small sample sizes, short follow-up and inclusion of cases with other pathologies in the analyses.Objective: To clarify the long-term outcomes of micro-NFAs in a large cohort of patients.Methods: We conducted a multi-centre, retrospective, cohort study involving 22 UK endocrine departme...

Background: Large series of patients elucidating the natural history of conservatively managed non-functioning pituitary macroadenomas (macroNFPAs) and relevant prognostic factors are not available.Objectives: Clarify long-term outcomes of macroNFPAs in large cohort of patients.Methods: Multi-centre [21 UK endocrine departments-UK NFPA consortium], retrospective, cohort study of ca...