Endocrine Abstracts

Mechanisms underlying the association of low birth weight with the metabolic syndrome in adults remain poorly understood. Epidemiological studies suggest that obesity is not programmed by early life events, but amplifies the risks of intra-uterine growth retardation. We have explored the effects of dietary obesity in rats in which features of the metabolic syndrome have been programmed by prenatal dexamethasone.16 pregnant Wistar rats were treated with d...

Introduction: There has been a joint transition clinic in our tertiary centre for over 10 years. We have recently undertaken a questionnaire based review of this service.Methodology: The questionnaire comprised two components: what the young adults understood about their condition and the medications they were currently taking using both a written response and a score of 0–10 for how confident they felt in this. They were also asked to complete a co...

Background: Sotos syndrome is an uncommon condition characterised by rapid growth, large body size and acromegaloid facies.There is limited data on metabolic abnormalities in Sotos syndrome.Aims: We investigated insulin sensitivity and secretion rates in a 22 year old girl with Sotos syndrome, prompted by the observation of a flat glucose response after an oral glucose challenge.Methods: Glucose tolerance was assessed with a 75g 2-h oral glucose tolerance test (OGTT), ...

Glucocorticoids are potentially important in obesity; recent data suggest both circulating levels and tissue-specific changes in glucocorticoid responsiveness and metabolism may influence their effect. In obese Zucker rats, the phenotype is ameliorated by adrenalectomy, and shows the same pattern of altered glucocorticoid metabolism as in human obesity. However, previous reports suggest hepatic glucocorticoid receptor (GR) binding is impaired. We have now explored expression o...

Background: In mice, a methionine-choline deficient diet (MCDD) causes steatohepatitis and hepatic insulin resistance. In contrast, a simple choline-deficient diet (CDD) causes liver fat accumulation without steatohepatitis, insulin resistance or weight loss. We hypothesised that differences in liver and adipose fatty acid metabolism underlie the contrasting predisposition to steatohepatitis and hepatic insulin resistance.Methods: C57Bl6 mice (male, aged...

A Short Synacthen Test (SST) cannot be used to assess the pituitary-adrenal axis immediately post transphenoidal adenectomy (TSA). A 9am cortisol must be used to achieve a balance between avoiding hypoadrenalism and over treating with replacement steroids. In this study we have determined the cut-off levels at which an averaged cortisol is most accurate and at which patients can be safely discharged with/without regular steroids or an emergency pack.62 patients (M:F 34:28) wit...

5beta-Reductase is a key glucocorticoid metabolising enzyme. In humans, urinary steroid metabolite profiles suggest an inverse relationship between 5beta-reductase and 11beta-hydroxysteroid dehydrogenase (11HSD1) in obesity and congenital deficiency of 11HSDs. Indeed in the obese Zucker rat hepatic 11HSD1 is decreased and 5beta-reductase increased. Here we use animal models with well characterised alterations in 11HSD1 to explore the link between these enzymes.11HSD1 was m...

Obese humans and rats exhibit altered glucocorticoid metabolism; increased regeneration of glucocorticoid by adipose 11HSD1 and inactivation by hepatic A-ring reductases. The mechanisms remain unclear; candidates include resistance to insulin-mediated regulation, and secondary effects of adipose products eg TNFalpha. To explore temporal associations between changes in glucocorticoid metabolism, insulin resistance and obesity, we examined effects of high-fat feeding in rats.<br...

A 42 year old gentleman presented for a second opinion regarding management of Congenital Adrenal Hyperplasia (CAH) of the salt losing variety. The patient had been under long term follow up elsewhere but had discontinued his medication of his own accord 14 months prior to seeking consultation. Examination revealed a heavily pigmented male patient with protuberant belly. He had easily palpable masses in both flanks. An abdominal CT showed bilateral massive adrenal enlargement ...

Congenital isolated ACTH deficiency (IAD) is a rare inherited disorder that is clinically and genetically heterogeneous. Patients are characterised by low or absent cortisol production secondary to low plasma ACTH despite the absence of structural pituitary defects and normal secretory indices of other pituitary hormones. When tested, there is often no ACTH response to exogenous CRH. Onset may occur in the neonatal period, but often is first observed in later childhood. Candid...