Endocrine Abstracts

Introduction: We offer patients needing glucocorticoid replacement in primary and secondary adrenal insufficiency the choice of either once daily prednisolone or thrice daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers, including glucose, weight, body mass index (BMI), systolic and diastolic blood pressure and waist circumference, although they did suggest an increase in cholesterol and low densit...

Introduction: We offer patients needing glucocorticoid replacement in primary and secondary adrenal insufficiency the choice of either once daily prednisolone or thrice daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers, including glucose, weight, body mass index (BMI), systolic and diastolic blood pressure and waist circumference, although they did suggest an increase in cholesterol and low densit...

The prevalence of primary hyperparathyroidism (PHPT) is increasing and the majority (over 85%) are now asymptomatic and remain untreated. In order to know whether or not they can be left safely without surgery, issues on disease progression need to be addressed. We aimed to update the natural history of PHPT, with a focus of serum calcium progression in mild untreated patients, selected from a large pre-defined cohort of PHPT in Tayside, Scotland. Possible predictors of progre...

Glucocorticoid (GC) excess is characterized by increased adiposity, skeletal myopathy and insulin resistance. Despite the increasing use of GCs as therapeutic agents, the molecular mechanisms that underpin GC mediated changes in insulin signalling are not clear. Within skeletal muscle, the microsomal enzyme, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive GC, 11-dehydrocorticosterone (A) to active corticosterone (B) and thus regulates GC availabi...

Glucocorticoid (GC) excess is characterized by increased adiposity, skeletal myopathy and insulin resistance. Despite the increasing use of GCs as therapeutic agents, the molecular mechanisms that underpin the GC mediated changes in insulin signalling are not clear. The majority of previous studies have used rodent models and have shown regulation at the level of the insulin receptor (IR), IRS-1 and PI3 kinase.Primary cultures of human skeletal myocytes ...

Introduction: Minimally invasive surgical treatment of primary hyperparathyroidism (PHPT) requires optimal preoperative localisation imaging. Parathyroid four-dimensional CT (4D-CT) has been reported to provide greater sensitivity than MIBI-SPECT/CT in localizing parathyroid adenomas. We analysed the additional value of 4D-CT in our cohort of PHPT patients.Materials and methods: Patients who attended our parathyroid clinic between February 2016 and April...

Introduction: Minimally invasive surgical treatment of primary hyperparathyroidism (PHPT) requires optimal preoperative localisation imaging. Parathyroid four-dimensional CT (4D-CT) has been reported to provide greater sensitivity than MIBI-SPECT/CT in localizing parathyroid adenomas. We analysed the additional value of 4D-CT in our cohort of PHPT patients.Materials and methods: Patients who attended our parathyroid clinic between February 2016 and April...

Mitotane (o,p’DDD) is the first-line treatment for metastatic adrenocortical carcinoma (ACC) and is also regularly used in the adjuvant setting after presumed complete removal of the primary tumour. Mitotane is considered an adrenolytic substance, but no information is available regarding distinct steroidogenic effects. Here we carried out steroid metabolomics by gas chromatography/mass spectrometry in 24-hour urine samples from 106 patients with ACC and with samples coll...

Adrenal tumors have an incidence of 2–3% in the general population and the work-up of incidentally discovered adrenal masses represents a major burden to the health system. Differentiating adrenocortical adenoma (ACA) from adrenocortical carcinoma (ACC) represents a continuous challenge, with unfavorable sensitivities and specificities provided by tumor size, imaging and even histology. Here, we aimed to develop a reliable screening tool for the detection of adrenal malig...

Patients with adrenal insufficiency require increased hydrocortisone (HC) replacement doses during surgery, trauma and infection to avoid life-threatening adrenal crisis. However, currently administered HC doses are chosen empirically rather than on rational grounds, with huge variability in administration modes, total dose and dosing intervals. To conclusively determine serum cortisol levels observed under stress conditions, we firstly collected blood samples from healthy con...