Endocrine Abstracts

For investigation of mild glucocorticoid resistance, dexamethasone may be inappropriate because, unlike cortisol, it crosses the blood-brain barrier and suitably low doses are difficult to titrate. Prednisolone has been proposed as an alternative but assay of cortisol as an endpoint is subject to cross-reaction with prednisolone in most ligand assays. Using capillary gas chromatography, we can distinguish urinary cortisol and prednisolone metabolites. We have compared this app...

Acute cortisol increase in man, whether from endogenous or exogenous sources, is associated with changes in cortisol:cortisone equilibrium. We have examined these during normal daily circadian rhythms and following treatment with hydrocortisone. Following local ethical committee approval, four adult volunteers (2 male) collected urine samples over 3 hour periods starting from midnight and over hourly periods between 0600 & 0900 to define the morning cortisol peak. They pro...

Diabetes mellitus like all chronic illnesses requires lifelong management (self or guided) with regular health professional support and supervision. Non-attendance at outpatient clinics (OPD) is a common cause of inefficiency in our current health care system causing undue wastage of clinician time and resources and potentially lengthening waiting times.Aim: The aim of our pilot project was to improve our diabetes OPD from the current attendance of 78% t...

Radioidine (RI) has been implicated as an adverse factor causing deterioration of Thyroid-Associated Ophthalmopathy (TAO). Oral steroids administered after RI appear to protect patients' eyes, and this practice is now widespread. Two factors may confound the controversy surrounding the effects of RI on TAO. Firstly hypothyroidism, which is common after RI and is independently detrimental to the eyes, and secondly studying patients who are in different phases of the natural his...

A South Asian woman aged 44 years presented with longstanding hirsutism. Her periods had always been regular and she had two children. She had been treated with spironolactone and Dianette without clinical benefit and the hirsutism was managed cosmetically. Investigations showed a high serum testosterone of 6.1 nmol/l ( 1-3nmol/l) and androstenedione 25nmol/l (2-10nmol/l). Serum sex hormone binding globulin was elevated at 96 nmol/l (23-85nmol/l), with normal DHEA sulphate, 4....

Objective: To investigate pancreatic beta cell morphology and function in rat adult offspring of dams fed a high fat diet in pregnancy.Methods: Female Sprague Dawley rats were fed either a control breeding diet (4% fat) or a high fat diet (20% animal fat) balanced for vitamins and nutrients. Experimental diets were fed for 10 days prior to mating, throughout pregnancy and weaning. Weaned pups were fed standard low fat chow throughout adult life. The time...

Normal pregnancy is associated with significant but reversible changes in thyroid function. However, maternal thyroid dysfunction during early pregnancy has been associated with neuro-intellectual impairment of the child. The CATS study, a randomised controlled study, has been initiated in order to ascertain if screening for abnormalities in thyroid function in early pregnancy (8 - 16 weeks gestation), with thyroxine replacement in appropriate cases, would be effective in redu...

INTRODUCTION: Hyperprolactinaemia frequently causes secondary hypogonadism through central suppression of gonadotropin secretion. Macroprolactinomas (>1cm diameter) may additionally cause more generalised hypopituitarism; a recent series finding the prevalence of TSH and ACTH deficiencies to be 35% and 9%, respectively. Recovery of the thyrotropic and/or corticotropic axes is well described following surgery to pituitary tumours, but remains poorly defined in relation to me...

Graves' disease (GD) is inherited as a complex trait and previous studies have identified linkage and association of both GD and type 1 diabetes to markers on chromosome 18q21. A candidate gene for autoimmunity that is contained within the critical interval on 18q21 is the apoptosis regulator 'Deleted in Colorectal Carcinoma' (DCC).317 Graves' disease probands and 311 controls were genotyped for a single nucleotide polymorphism that encodes a glycine to ...

Introduction: The clinical features and complications of Cushing’s syndrome result from chronic excess of circulating cortisol, typically quantified by 24-h urinary free cortisol (UFC). LCI699 is a potent inhibitor of 11β-hydroxylase. Since 11β-hydroxylase catalyzes the final step of cortisol synthesis, LCI699 is a potential new treatment for all forms of Cushing’s syndrome.Methods: Adult patients with mild-to-severe Cushing’s di...