Endocrine Abstracts

IntroductionWe have previously demonstrated profound effects of hormone replacement treatment (HRT) in post-menopausal women on the IGF-system. HRT is widely used to prevent osteoporosis. The IGF-system has been implicated in bone formation. IGFBP-4 and IGFBP-5 are known to be important in modulation of IGF activity in bone. In this larger study we have examined the effects of HRT on circulating IGFBP-4 levels.MethodOral conjugated equine estrogen (CEE) alone or in...

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Osteoporosis has increasingly been recognised as a major healthcare problem. In the past diagnosis was predicated upon the results of bone density measurements with the WHO threshold of a T score of -2.5 being taken as diagnostic. This approach is being called into question as the importance of factors other than bone density upon the risk of fracture have emerged. It is likely that treatment for osteoporosis will soon be decided upon the basis of estimated fracture risk rathe...

Primary hyperparathyroidism is one of the most common endocrine conditions affecting upto 2% of postmenopausal women. Diagnosis is primarily biochemical and is usually secure when a persistently elevated plasma calcium is found together with parathyroid hormone (PTH) concentrations above the middle of the normal range. The only other circumstance which can produce a similar picture is familial benign (hypocalciuric) hypercalcaemia (FBH) which is an inherited disorder oc calciu...

Chronic pancreatitis (CP) may lead to deficiency of fat soluble vitamins such as vitamin D; little is known of the extent of this in chronic pancreatitics.In order to assess the extent and severity of vitamin D deficiency in CP we examined the notes of 111 patients with CP. In addition to clinical information and calcium, vitamin D and PTH levels, exocrine function was evaluated using the PABA test to obtain a pancreatic excretion index (PEI: normal &#62...

Cinacalcet, a calcimimetic, is licensed for the management of primary hyperparathyroidism (PHP) where surgery is deemed inappropriate. It is unclear when patients might be deemed more appropriately managed by medical treatment rather than surgery. We report two cases in which cinacalcet has been used to predict the effect of parathyroidectomy and a choice to be made between surgery and conservative management.A 43-year-old woman had a parathyroid adenoma...

A 57 year old Caucasian woman complained of severe back pain and arthralgia of large joints. Her arthralgia gradually got worse and she also noticed proximal muscle weakness. Blood tests showed normal CRP but elevated alkaline phosphatase of 521 iu/l with normal Gamma GT. Phosphate was low at 0.75 mmol/l with normal corrected calcium of 2.6 mmol/l. A DEXA scan suggested osteoporosis (Spine T −2.5). Isotope bone scan revealed increased activity in the right tibia and plai...

Primary hyperparathyroidism (PHP) can be isolated or a part of MEN especially in the younger patient. We report a 20-year lady presenting in early July-08 with vomiting, abdominal pain and general ill-health. On admission she was pale and dehydrated, with Hb 10.1 g/dl, urea 9.1 mmol/l, creatinine 105 μmol/l, alkaline phosphatase 1568 μ/l (30–130 μ/l) and adjusted calcium 3.92 mmol/l. Her sister reportedly has been investigated in a different hospital for PH...

Osteoblasts and adipocytes are derived from the same stem cell in adult marrow and plasticity exists between the two lineages. In Osteoporosis there are reduced osteoblast numbers and increased adipocyte numbers suggesting a disturbance in the normal balance of the cells' differentiation pathways, leading to defective osteoblastogenesis and favouring adipogenesis. The stage of adipocytic differentiation at which plasticity is lost and commitment is established is not known. We...

Osteoblasts and adipocytes are derived from the same stem cell in adult marrow and plasticity exists between the two lineages. In Osteoporosis there are reduced osteoblast numbers and increased adipocyte numbers suggesting a disturbance in the normal balance of the cells' differentiation pathways, leading to defective osteoblastogenesis and favouring adipogenesis. The stage of adipocytic differentiation at which plasticity is lost and commitment is established is not known. We...