Endocrine Abstracts

I will talk about my own experience pursuing a PhD, postdoctoral research and ultimately an Intermediate Clinician Scientist Fellowship alongside training in Diabetes and Endocrinology with GIM. I will talk about the particular barriers and challenges commonly reported by clinical academics and how universities and funding bodies are working to provide tailored support to help the furious juggle of research, grants, papers, on-calls, clinics and, yes, a home life....

Background: Tumour growth is critically dependent on blood perfusion, its source of oxygen and nutrients. Therefore, tumour vascularization has become an attractive target for the treatment of many cancers types. The study of endocrine-responsive tumours, in particular, needs improved platforms to screen drugs targeting vascularization that have better resolution and that do not compromise on inter-individual variability.Aim: Hence, we’ve set out to...

Background: Elevated low-density lipoprotein cholesterol (LDL-C), which arises due to genetic and environmental factors, has a causal role in the pathogenesis of cardiovascular disease (CVD). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are approved for patients with familial hypercholesterolaemia (FH) and patients at high risk of CVD due to non-familial hypercholesterolaemia (non-FH). In clinical trials, PCSK9 inhibitors are well-tolerated and lead to redu...

Background: Studies suggest that glucocorticoid hypersecretion alongside primary hyperaldosteronism (PA) is common and may contribute to the adverse metabolic phenotype. Adrenal crisis post-surgery for PA is rare.Aim: To determine the prevalence of cortisol co-secretion in PA in patients at Imperial College London NHS Trust, Hammersmith Hospital (a tertiary referral centre for adrenal tumours).Methods: Am...

Background: Studies suggest that glucocorticoid hypersecretion alongside primary hyperaldosteronism (PA) is common and may contribute to the adverse metabolic phenotype. Adrenal crisis post-surgery for PA is rare.Aim: To determine the prevalence of cortisol co-secretion in PA in patients at Imperial College London NHS Trust, Hammersmith Hospital (a tertiary referral centre for adrenal tumours).Methods: Am...

Introduction: Recent evidence supports the use of high dose steroids for 28 days in acute alcoholic hepatitis. We present a patient with Childs Pugh C liver cirrhosis, who developed adrenal axis suppression following such treatment. We discuss the complex aetiology and biochemistry of hypocortisolism in liver disease.Case: 48 year-old female admitted with alcoholic hepatitis, treated with a non-tapering 28-day course of 40 mg prednisolone. The patient wa...

A 36-year-old man, presenting to his GP with severe intermittent headaches, was found to have a blood pressure of 210/110 mmHg. He had been diagnosed with familial adenomatous polyposis (FAP) in early childhood, and had had a total colectomy with ileo-rectal anastamosis at the age of 17. Routine surveillance CT imaging the following month revealed an incidental finding of bilateral adrenal masses (right 4×2 cm, left 2.7×2.9 cm).On assessment in...

Neurotensin is widely expressed in the brain and gastrointestinal tract. Centrally, neurotensin acts as a neuropeptide to suppress appetite, induce hypothermia and modulate analgesia. Peripherally, neurotensin inhibits gastric emptying and is reported to aid lipid absorption. There is also evidence that neurotensin can influence glucose homeostasis, though this role is contentious. We have found that neurotensin acutely improves insulin release and glucose tolerance in mice, a...

Hyperaldosteronism is a significant cause of secondary hypertension, but there are often delays in obtaining the diagnosis. The recent BES publication of Guidelines for the investigation and management of this condition represent a move to standardise the work-up of these patients.We present an audit of cases, dating back to 2000, with confirmed biochemical hyperaldosteronism (on the basis of plasma aldosterone/renin activity ratio or lack of aldosterone...

Protein stimulates insulin release and improves post-prandial glycaemic excursions. The underlying mechanism has previously been attributed to gastric emptying, incretin release and direct pancreatic stimulation. However, our studies suggest the calcium sensing receptor (CaSR) in the vagus nerve plays an important role. The CaSR has a well characterised role in calcium homeostasis, but also acts as a protein metabolite sensor. In response to the amino acid products of protein ...