Endocrine Abstracts

Background: Increased cortisol levels in obesity may contribute to the associated metabolic syndrome. In obesity, the activated innate immune system leads to increased interleukin (IL)-1β, which is known to stimulate the release of adrenocorticotropin hormone (ACTH). We therefore hypothesised that in obesity IL-1 antagonism would result in downregulation of the hypothalamo-pituitary-adrenal (HPA) axis, leading to decreased cortisol levels.Methods: I...

Background: Low testosterone levels in men appear to be an independent cardiovascular risk factor closely associated with the metabolic syndrome. Reciprocally, the metabolic syndrome leads to a decrease in testosterone levels, suggesting a bidirectional relationship. It has been hypothesized that increased inflammation is causative for the development of obesity-associated hypogonadism. However, clinical evidence supporting this hypothesis is lacking. The aim of the present st...

Background: Dopamine agonists (DA) are included in the management algorithm of acromegaly. Studies on cabergoline monotherapy report IGF-1 normalisation in between 0% and 100% of the patients during treatment periods ranging between 2.6 and 24 months. However, in many of these studies, previous radiotherapy is a confounding factor. Furthermore, real world data applying the current disease control criteria (normal IGF-1 and GH<1 mg/l) are not available. The aim of this stud...

Background: Fibroblast growth factor-21 (FGF21), which has recently been identified as a central regulator of metabolism, is known to be increased in conditions of obesity, insulin resistance, and fatty liver. Likewise, there is evidence that FGF21 increases with systemic inflammation. The aim of this study was to evaluate whether chronic low-grade inflammation might be the underlying mechanism and whether an anti-inflammatory treatment decreases FGF21 levels in metabolic diso...

Background: Interleukin (IL)-1 antagonism decreases systolic blood pressure in obese individuals. However, the underlying mechanism is unknown. Based on experimental data in animals we hypothesised a blood-pressure lowering effect of IL-1-antagonism via modulation of the renin-angiotensin-aldosterone system (RAAS).Methods: In this post-hoc explorative study, we examined short- (2 days) and long-term effects (4 weeks) of IL-1 antagonism (anakinra/Kineret<...

BackgroundPrimary polydipsia, characterized by excessive fluid intake, carries the risk of water intoxication and hyponatremia, but treatment options are scarce. Glucagon-like peptide-1 (GLP-1) reduces appetite and food intake. In experimental models, they also play a role in thirst and drinking behavior. The aim of this trial was to investigate whether GLP-1 receptor agonists reduce fluid intake in patients with primary polydipsia.<p class="abstext"...

Background: Cabergoline monotherapy or in combination with somatostatin analogue (SSA) has been reported in few studies with IGF-1-normalization-rates 0%-100%(monotherapy) and 42%-60%(combination therapy). However, in these studies, inclusion of irradiated patients is a potential confounder and currently proposed disease control criteria (normal IGF-1, GH<1 mg/l) have not been applied.Aim: Investigate the efficacy of cabergoline monotherapy or as add...

Introduction: The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the predominant cause of hyponatremia but the available treatment options are unsatisfying and often of little efficiency. The selective sodium-glucose co-transporter 2 inhibitor empagliflozin promotes osmotic diuresis due to glucosuria and might be a novel treatment option for SIADH.Material and methods: From September 2016 through December 2018 we randomly assigned 88...

Background: It is controversial whether the attenuated increase of circulating cortisol to ACTH stimulation predicts treatment response to corticosteroids in patients with critical illness. We investigated whether ACTH testing predicts treatment response to corticosteroids in patients with community-acquired pneumonia (CAP).Methods: We performed a low dose (1 μg) ACTH test on admission in a prospective randomised, double-blind, placebo-controlled mu...

Background: Glucocorticoids are frequently prescribed in inflammatory diseases. We investigated the influence of prednisone on classical and novel inflammatory markers in community-acquired pneumonia (CAP).Methods: We evaluated levels of C-reactive protein (CRP), procalcitonin, leukocyte and neutrophil count in a prospective randomized, double-blind, placebo-controlled multicenter trial which compared prednisone 50 mg for 7 days to placebo in patients ho...