Endocrine Abstracts

The role of oestrogens and androgens on bone metabolism has been studied extensively. However, less is known about the effects of progestins. The progesterone receptor (PR) is expressed in human osteoblasts. Progestins have been found to stimulate osteoblast proliferation, differentiation and growth factor expression (e.g. IGFBP-5) and to increase bone formation. In postmenopausal women progestins combined with oestrogen increased bone density to a greater extent than oestroge...

Background: Adrenal crisis (AC) is a life-threatening complication in patients with congenital adrenal hyperplasia due to classical 21-hydroxylase deficiency (21-OHD). AC was defined as an acute state of health impairment which required i.v. glucocorticoid administration and hospital admission. No data on AC over life-time in 21-OHD is available.Study design: In a retrospective study AC was studied following two approaches: a) questionnaire-based: 122 ad...

Objective: The role of surgery for recurrent adrenocortical carcinomas (ACC) is not well defined. Therefore, we evaluated the outcome after surgery for tumor recurrence in patients from the German ACC Registry.Methods: Only patients with first recurrence after initial R0 resection were investigated. Progression–free and overall survival (PFS, OS) after first recurrence were analyzed by Kaplan–Meier method. Cox proportional hazards regression mo...

Background: Microsomal glucose-6-phosphatase-alpha (G6Pase-alpha) and glucose-6-phosphate transporter (G6PT) perform the terminal step in both glycogenolysis and gluconeogenesis. Deficiency of G6Pase-alpha leads to glycogen storage disease type 1a, whereas deficiency of G6PT leads to glycogen storage disease type 1b. Partial inhibition of G6Pase in rats results in increased hepatic triglyceride contents and de novo lipogenesis leading to hepatic steatosis. Hepatic steat...

During the luteal phase of the menstrual cycle aldosterone increases mainly due to the antagonistic properties of progesterone at the MR and due to estrogen-mediated stimulation of angiotensinogen. Little is known about other steroid-metabolizing enzymes that may influence steroid receptor binding, eg 11beta-HSDs, A-ring reductases. Therefore a group of ten normotensive female volunteers with regular menstrual cycles were studied on day 7 (follicular phase) and day 21 (luteal ...

Introduction: 11β-HSD1 is the key enzyme of intracellular glucocorticoid regulation by converting inactive cortisone to active cortisol. The latter binds to the glucocorticoid and mineralocorticoid receptor (MR) in the heart. Cortisol excess in Cushing’s syndrome leads to left ventricular hypertrophy. Also androgens cause myocardial remodelling. However, the impact of testosterone on the cardiovascular system is strongly disputed showing beneficial and deleterious ef...

Introduction: There is no difference in blood pressure between boys and girls, but following puberty, blood pressure increases more in men than in women. The higher blood pressure and stronger progression of hypertension in men is associated with a higher risk and mortality for cardiovascular diseases than in women. Androgens are known to play an important role in renal tubular epithelial cell growth, hypertrophy and erythropoetin production and may be important determinants o...

Prostanoids have been elucidated as potent adipogenic hormones. Cyclooxygenase (PTGS) is the rate-limiting enzyme of prostanoid biosynthesis and its product, prostaglandin (PG) H2 is a precursor of PGE2, PGF2, PGD2 and PGI2. PGH2 is also metabolised by prostaglandin D-synthase (PTGDS) to PGD2 which spontaneously converts to PGJ2 or can be enzymatically converted to PGF2alpha by AKR1C3. These two metabolites have opposite effect on adipogenesis; PGF2alpha is a PPARgamma antagon...

Background: Adrenocortical carcinoma (ACC) is a rare solid tumor with poor prognosis in advanced stages. The adrenolytic drug mitotane and cytotoxic chemotherapies are current treatment options with limited clinical efficacy. Animal experiments pointed to an adrenotoxic effect of sunitinib suggesting potential antineoplastic activity in ACC.Study population: Thirty-eight patients with advanced ACC progressing after mitotane and 1–3 cytotoxic chemoth...

Objective: There is evidence that current replacement regimens fail to restore well-being in patients with primary adrenal insufficiency (PAI). Few data is available on QoL in adult male and female patients with CAH.Methods: Patients with CAH or PAI were contacted and received a disease specific questionnaire and three standardized questionnaires (SF-36, GBB-24 and HADS). Reference data for SF-36 scores were obtained from the German National Health Surve...