Endocrine Abstracts

Recent literature suggests anterior pituitary hormone deficiency (APHD) is common in paediatric patients with idiopathic cranial diabetes insipidus (CDI); this has been attributed to autoimmune panhypopituitarism.1 We therefore determined the frequency of coexisting APHD and autoimmune disease in our cohort of patients with idiopathic adult CDI.Eight patients with idiopathic CDI were reviewed (6 females mean age at diagnosis 30 years, range 7&...

Glucocorticoids (GC) are commonly prescribed and their use is associated with adverse metabolic side effects. 5a-reductase (5aR) inhibitors are also frequently prescribed mainly for their ability to inhibit the conversion of testosterone to dihydrotestosterone. However, they also have a role to inactivate and clear GCs. We hypothesised that 5aR inhibitors have the potential to exacerbate the adverse metabolic effects of GCs. We conducted a prospective, randomised, study in 19 ...

Glucocorticoids (GC) are commonly prescribed and their use is associated with adverse metabolic side effects. 5a-reductase (5aR) inhibitors are also frequently prescribed mainly for their ability to inhibit the conversion of testosterone to dihydrotestosterone. However, they also have a role to inactivate and clear GCs. We hypothesised that 5aR inhibitors have the potential to exacerbate the adverse metabolic effects of GCs. We conducted a prospective, randomised, study in 19 ...

Introduction: Glucocorticoids (GC) are prescribed to 2–3% of the population of the UK and USA. Their use is associated with a significant side effect profile that includes the development of central obesity, insulin resistance and type 2 diabetes. 5α-reductase (5αR) inhibitors (Finasteride and Dutasteride) are also commonly prescribed in the context of prostate disease, where they inhibit the conversion of testosterone to dihydrotestosterone. Additionally, they ...

Patients with craniopharyngioma have increased mortality attributed to cardiorespiratory disease, when compared to other hypopituitary populations. There is little data on the cause for excess of fatal respiratory disease in this condition. Clinical observation had identified sleep apnoea in some craniopharyngioma patients in our cohort. Sleep apnoea increases cerebrovascular and cardiovascular morbidity and mortality. Our hypothesis was that sleep apnoea could be a contributo...

Differentiation between non functioning pituitary macroadenomas (NFPA) and prolactinomas may be difficult as hyperprolactinaemia can also be present at diagnosis in NFPA cases due to pituitary stalk compression (disconnection hyperprolactinaemia). Some authors suggested that prolactin >2,000 mIU/l is almost diagnostic of a prolactinoma, while others use a higher cut-off of >5000 mIU/l. Our aim was to identify the level of prolactin above which a prolactinoma was more l...

Studies on the probability of recurrence of surgically treated but radiotherapy (RT) naïve non-functioning pituitary adenomas (NFPA) are inconsistent and selective as cases deemed to be at high risk of recurrence were prophylactically irradiated. We traditionally used very low rate of post-operative RT leaving us with a largely unselected cohort.We identified 223 surgically resected, histology-proven NFPA cases. Only 9% received post-operative RT an...

Increased adiposity is associated with insulin resistance, type 2 diabetes and metabolic dysfunction. Altered adipokine secretion, changes in local and systemic glucocorticoid metabolism and increased inflammation have all been postulated as contributory mechanisms. We have previously described changes in subcutaneous adipose tissue (SAT) gene expression that are associated with obesity and glucose intolerance in cross-sectional studies. However, the effects of longitudinal ch...

Background: The short Synacthen test (SST) is the most widely used dynamic assessment of adrenal reserve. In some situations, the SST may be difficult to perform. Random basal cortisol levels could provide an alternative screening assessment to rationalize which patients need dynamic testing. This is highly clinically relevant, given the large numbers of patients taking prescribed glucocorticoids who are at risk of iatrogenic adrenal suppression.Methods:...

In the pathogenesis of obesity, dysregulated tissue cortisol metabolism (controlled by 11β-HSD1), is postulated to be involved. Fifteen patients (seven mens, mean BMI 50.8±7 kg/m2) awaiting Roux En Y gastric Bypass (RYGB) surgery underwent assessment of 11β-HSD1 activity using cortisol generation profile. Corticosteroids in serum and subcutaneous adipose tissue microdialysis fluid and urinary corticosteroid metabolites were analysed by liquid and gas ...