Searchable abstracts of presentations at key conferences in endocrinology

ea0018p12 | (1) | MES2008

Cushing's syndrome secondary to adrenocortical carcinoma without metastases at diagnosis

Miras Alexander , Palazzo Fausto , Naqvi Safdar

A 60-year-old gentleman of previously good health presented with a 6 months history of resistant hypertension, newly diagnosed Diabetes Mellitus, worsening obesity and proximal muscle weakness. Clinical examination revealed a buffalo hump, truncal obesity, paper thin skin with bruising and proximal muscle wasting. His biochemistry showed elevated midnight cortisol levels, no suppression of cortisol post high dose dexamethasone and an undetectable ACTH. Accompanying abnormaliti...

ea0048oc1 | Oral Communications | SFEEU2017

Which test should the bariatric physician use to test for postprandial hypoglycaemia – prolonged oral glucose tolerance test versus mixed meal test?

Tharakan George , Behary Preeshila , Al-Najim Werd , Chahal Harvinder , Miras Alexander , Ahmed Ahmed , Bloom Stephen , Tan Tricia

Background: An increasingly recognized complication of Roux-en-Y Gastric Bypass (RYGB) surgery is the development of postprandial hypoglycaemia (PPH). However, there remains no agreed standard on how to diagnose this condition. Commonly used tests include a prolonged oral glucose tolerance test (POGTT) and mixed meal tolerance test (MMTT). Little is known regarding how these tests compare in the post-bariatric population.Methods: Ten patients who had con...

ea0048o6 | Oral Communications | SFEEU2017

Using Kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea

Narayanaswamy Shakunthala , Vimalesvaran Sunitha , Yang Lisa , Prague Julia K , Miras Alexander D , Franks Stephen , Meeran Karim , Dhillo Waljit S

Case history: An 18-year-old Caucasian female presented with primary amenorrhoea after her younger sister aged 16 years old started menstruating. She had a normal childhood and progressed through puberty normally, with no past medical history or family history. BMI was 22.6 with a normal examination including secondary sexual characteristics (Tanner Stage 5) and no signs of hyperandrogenism.Investigations and Results: Bloods showed an elevated LH:FSH rat...

ea0077op4.2 | Metabolism, Obesity and Diabetes | SFEBES2021

3 mg Liraglutide ameliorates inflammation and improves hypothalamic regulation of energy homeostasis by modulation of Sphingosine-1-Phosphate signalling in super-responders

Spencer Lewis , Dimitriadis Georgios K , Duggirala Aparna , Bate Danielle , Davasgaium Allan , Al-Hasani Wiaam , D Miras Alexander , Le Roux Carel , Vincent Royce P , Randeva Harpal S , Tripathi Gyanendra

Background: Growing evidence suggests that hypothalamic lipid sensing plays a key role in controlling food intake, fat deposition and energy balance and that its dysregulation could lead to obesity and type 2 diabetes (T2D). Recent investigations reported that sphingosine-1-phosphate (S1P) is involved in the hypothalamic control of energy homeostasis. Intra-cerebroventricular administration of S1P decreased food intake and increased energy expenditure in rodents.<p class="...

ea0053cd2.1 | Case Discussions: complex clinical cases 2.0 | OU2018

Eating behaviour and psychological relationship to food following Roux-en-Y Gastric bypass surgery or VLCD intervention: insights into mechanisms of sustained weight loss

Alessimii Haya , Perez-Pevida Belen , Scholtz Samantha , Kenkre Julia , Doyle Chedie , Ahmed Ahmed , Purkayastha Sanjay , Miras Alexander D , Chahal Harvinder , Tan Tricia

Introduction/Aims: Currently, the most successful long term treatment for obesity is bariatric surgery, however the underlying mechanisms are not fully understood. Changes in gastrointestinal and central neuroendocrine signalling have been postulated as mediators of psychological and eating behaviour changes following bariatric surgery. We aimed to investigate changes in eating behaviour and psychological factors pre- and 1 month post-very low calorie diet (VLCD) and 3-month p...

ea0053cd2.2 | Case Discussions: complex clinical cases 2.0 | OU2018

Poor responsiveness after bariatric surgery: clinical and eating behaviour characteristics

Perez-Pevida Belen , Aldhwayanand Madhawi , Gibson Rachel , Scholtz Samantha , Miras Alexander D , McGlone Emma , Kamocka Anna , Khan Omar , Greener Veronica , McGowan Barbara , Rubino Francesco , Bloom Steve , Tan Tricia

Background: Bariatric surgery has been proven to produce substantial weight loss and amelioration of metabolic syndrome-associated co-morbidities. However, at five-year follow-up, only 20–40% of patients maintain diabetes remission and 40% of patients return to their baseline weight. The limiting factor in treating refractory diabetes following obesity surgery is the lack of knowledge about its aetiology.Aims: Evaluate the eating pattern and clinica...

ea0053cd2.3 | Case Discussions: complex clinical cases 2.0 | OU2018

Surgical revision of candy cane after Roux-en-Y gastric bypass (RYGB)

Kamocka Anna , McGlone Emma Rose , Pevida Belen Perez , Purkayastha Sanjay , Moorthy Krishna , Hakky Sherif , Chahal Harvinder , Tsironis Christos , Miras Alexander , Tan Tricia , Ahmed Ahmed

Introduction: An excessively long blind-end of the alimentary limb following RYGB, known as a ‘candy cane’ (CC), may cause symptoms such as pain, gastrointestinal symptoms and weight regain. Very few studies have examined the efficacy of surgical resection of the CC. We aimed to assess symptom resolution following CC surgery.Methods: Single centre observational study of 28 CC revisions from 2010 to 2017 (mean age 45±8, female preponderance...

ea0050p211 | Diabetes and Cardiovascular | SFEBES2017

Nuclear factor-kappa beta activation and monocyte-endothelial adhesion lead to chemerin induced endothelial cell inflammation

Dimitriadis Georgios K , Kaur Jaspreet , Mytilinaiou Maria , Davasgaium Allan , Sambrook Diane , Hewins Claire , Nalawade Nilisha , Miras Alexander D , Randeva Harpal S

Chemerin, a chemoattractant protein, acts via a G-protein coupled chemokine receptor, i.e. Chemokine like Receptor 1/ChemR23; levels of which are elevated in pro-inflammatory states such as obesity and type 2 diabetes mellitus (T2DM). Obesity and T2DM patients are at high risk of developing cardiovascular disorders such as atherosclerosis. We have reported that chemerin induces human endothelial cell angiogenesis and since dy...

ea0050p211 | Diabetes and Cardiovascular | SFEBES2017

Nuclear factor-kappa beta activation and monocyte-endothelial adhesion lead to chemerin induced endothelial cell inflammation

Dimitriadis Georgios K , Kaur Jaspreet , Mytilinaiou Maria , Davasgaium Allan , Sambrook Diane , Hewins Claire , Nalawade Nilisha , Miras Alexander D , Randeva Harpal S

Chemerin, a chemoattractant protein, acts via a G-protein coupled chemokine receptor, i.e. Chemokine like Receptor 1/ChemR23; levels of which are elevated in pro-inflammatory states such as obesity and type 2 diabetes mellitus (T2DM). Obesity and T2DM patients are at high risk of developing cardiovascular disorders such as atherosclerosis. We have reported that chemerin induces human endothelial cell angiogenesis and since dy...

ea0048oc3 | Oral Communications | SFEEU2017

The early improvement of glycaemia following RYGB can be mimicked by a Very Low Calorie Diet in obese volunteers with diabetes

Behary Preeshila , Tharakan George , Al-Najim Werd , Brown Adrian , Miras Alexander , Stoenchev Kostadin , Chahal Harvinder , Purkayastha Sanjay , Moorthy Krishna , Ahmed Ahmed , Bloom Steve , Tan Tricia

Introduction: Improvement in glycaemia is observed early after Roux-en-Y Gastric Bypass surgery (RYGB) in patients with diabetes. Commonly cited mechanisms to account for these changes include the elevation of gut hormones, increase in bile acids levels, changes in the gut microbiota and calorie restriction. Calorie restriction is believed to play a role in improving hepatic insulin sensitivity and reduce hepatic glucose output early after RYGB, in the context of non-significa...