Endocrine Abstracts

Objective: Diamorphine and methadone administration are associated with dysfunction of the hypothalamo pituitary gonadal axis in premenopausal women. However, the effects of less potent opioids on this axis remain unclear.Methods: We report a case of a 42 year old woman referred with secondary amenorrhoea and low oestradiol levels (oestradiol <50 iu/l). She started menarche aged 14, followed by regular menstrual cycles, two successful pregnancies, tw...

Limited data exist describing direct volumetric measures of BMD (g/cm3) in adults with severe GHD or GH-insufficiency. We measured BMD in 30 GHD adults (peak GH to stimulation <3 mcg/l), 24 GH-insufficient adults (GHI, pGH 3 - 7 mcg/l), and 30 age/gender matched control subjects by DXA and pQCT.DXA performed at the lumbar spine, femoral neck, and total hip confirmed GHD adults to have reduced BMD (g/cm2) at all sites (p = 0.05, p...

Adult survivors of haematological malignancies are subject to a number of putative insults to the skeleton. Adverse impacts on bone mass include sex-hormone deficiency, radiotherapy, chemotherapy, inadequate nutrition and a generalised catabolic state. We assessed BMD using DXA at the lumbar spine (LS) and femoral neck (FN) in 34 women with POF, defined by secondary amenorrhoea, elevated gonadotropins, and low oestradiol levels. Mean age at diagnosis was 29.7 (range 14–45...

The optimal oestrogen dose required to maintain bone mass in young women who develop POF is contentious. We reviewed longitudinal BMD data in 21 women with POF resulting from multi-modality cancer therapy for haematological malignancies. The 21 women were of mean age 30.6 (range 17–45) years at onset of amenorrhoea and weight 64.1+/−11.2 kg. Primary diagnoses were acute myeloid leukaemia (n=12), chronic myeloid leukaemia (n=5), acute lymphocytic leukae...

We have previously shown that adults with partial GHD have increased total body and truncal fat mass, an adverse lipid profile, and insulin resistance. In this study we have gone on to analyse suggogate markers of vascular risk and carotid IMT. We defined GH status using the combination of two stimulation tests, the ITT and arginine stimulation test, in to patients with severe GHD (pGH<3 ng/ml, n=30) or GH insufficiency (pGH 3–7 ng/ml, n=24). Thirty age ...

Use of somatostatin (SRIF) analogs in acromegaly indicates greater lowering of IGF-I than predicted from GH reduction. Studies using hypophysectomized rats suggest a direct SRIF action on GH-induced IGF-I, however, interpretation is complicated by effects of SRIF on other hormonal axes. In isolated rat hepatocytes we showed SRIF and octreotide to have a direct inhibitory effect, via hepatic SSTRs, on GH-induced IGF-I production. GH (500 ng/ml) caused ~4 fold induction of IGF-I...

Objective: Radiotherapy (RT) can achieve tumour control rates of over 90% in pituitary adenomas. The commonest toxicity of irradiation is hypopituitarism. The exact incidence is variable and requires long-term testing for deficiency of all hypothalamic-pituitary axes (HPA). The aim of this study is to determine the time to onset of individual hormonal deficiencies and establish a timeframe for endocrine testing post-RT.Methods: We retrospectively assesse...

A few studies have suggested that radiation-induced growth hormone neurosecretory dysfunction (GHNSD) exists in children irradiated for leukemia (18–24 Gy). The presence or absence of GHNSD in adult cancer survivors has not been studied before. Thus, 24-hour spontaneous GH secretion was studied by 20 min sampling both in the fed state (n=16; 6 women) and the last 24 hours of 33-hour fast (n=10; 3 women) in adult cancer survivors, of normal GH status defined ...

Background: Endoscopic trans-sphenoidal surgery is a technical advance for treatment of pituitary tumours. We present the outcomes of patients with Acromegaly or Cushing’s disease undergoing selective pituitary adenomectomy in a regional neurosurgical centre.Methods: Retrospective cohort study August 2010-August 2017. Imaging, histology and pituitary hormone assessments were collated pre and post-operatively to...

Background: Endoscopic trans-sphenoidal surgery is a technical advance for treatment of pituitary tumours. We present the outcomes of patients with Acromegaly or Cushing’s disease undergoing selective pituitary adenomectomy in a regional neurosurgical centre.Methods: Retrospective cohort study August 2010-August 2017. Imaging, histology and pituitary hormone assessments were collated pre and post-operatively to...