Endocrine Abstracts

Introduction: Adequate hormone replacement therapy in adrenal insufficiency is essential. Patients should have basic knowledge about their condition and what to do in situations which could trigger an adrenal crisis. Education on how and when hydrocortisone replacement therapy should be adjusted as well as instruction and practice an emergency injection are considered important measures to prevent an adrenal crisis. A standardized nurse-led group-based education programme (GEP...

The key metabolic hormone, leptin, acts in part through the liver to regulate glucose homeostasis, as well as the maturation of both adipocytes and osteoblasts. These actions have been demonstrated to be mediated by insulin-like growth factor binding protein 2 (IGFBP-2), independent of its ability to bind IGF1. The effects of IGFBP-2 on adipocyte and osteoblast maturation can be localized to a short peptide sequence within the unique heparin binding domain (HBD-1) of IGFBP-2. ...

Background: Efficacy and safety of combination treatment of pasireotide LAR with pegvisomant (PEGV) has not been studied yet. Switching to Pasireotide LAR in patients previously controlled with long-acting somatostatin analogues (LA-SSAs) and PEGV could reduce the required PEGV dose to normalize serum IGF1 levels, while the effect on glucose metabolism is unknown.Methods: We enrolled 60 acromegaly patients >18 years with acromegaly who had normal IGF...

Objective: Acromegaly is caused by a growth hormone (GH)-secreting pituitary tumor and its signs are linked to increasedGH-dependent hepatic insulin-like growth factor I (IGF-I) synthesis. A eucaloric very low-carbohydrate ketogenic diet (euVLCK; < 50 g/day) induces ketosis and reduces portal insulin concentrations, which down-regulate hepatic GH receptors and reduce IGF-I synthesis. Somatostatin receptor ligands (SRLs) reduce GH secretion by the pituitary tumor,resul...

Ghrelin, the endogenous GH secretagogue, has an important role in metabolic homeostasis. It exists in two major molecular forms: acylated (AG) and des-acylated (DAG). Many studies suggest different roles for these two forms in energy balance regulation. In the present study, we compared the effects of acute intracerebroventricular (ICV) administration of AG, DAG and their combination (AG+DAG) to young adult Wistar rats on food intake and central melanocortin system modulation....

Introduction: Pegvisomant (PEGV) has an efficacy of >90% to control insulin-like growth factor (IGF-1), however in everyday practice a limited efficacy of 63% was reported.Aim: To assess efficacy in the largest single center cohort of acromegalics using PEGV.Methods: A 112 subjects (65 male) were not controlled with high-dose somatostatin analogues (LA-SRIF) for at least 6 months. To control acromegaly, 109 subjects added PEGV ...

Introduction: Pegvisomant (PEGV) has an efficacy of >90% to control insulin-like growth factor-1. Main safety issues are elevated transaminases that seem to be related to Gilbert’s polymorphisms (GiPism) or gender and tumor-size increase (1).Aim: To assess safety in the largest single center cohort of acromegalics using PEGV.Methods: Results are expressed as median (interquartile-range).One-hundred a...

Background: We previously reported on the efficacy, safety and Quality of Life of long-acting somatostatin analogs (SSA) and (twice) weekly pegvisomant (PEG-V) in acromegaly and improvement after the addition of PEG-V to long-acting SSA.Objective: To assess the long term safety in a larger group of acromegalic patients over a larger period of time; 29.2 (1.2–57.4) months (mean (range)).Design: Pegvisomant was added to SSA mono...

Introduction: Cortistatin (CST) is a 17 amino-acid neuropeptide involved in sleep regulation. Due to its structural resemblance to somatostatin (SS), CST binds with high affinity to the 5 known SS receptors. CST also binds to the putative MrgX2 receptor. Previously we demonstrated that various types of human immune cells and tissues as well as lymphoid cell lines express CST mRNA. We suggested that CST plays a regulatory role in immune cell function both in physiological and p...

Introduction: Growth hormone (GH) is not only important for growth during childhood. Also, for (young) adults, growth hormone is important for bone mass, muscle strength and metabolism. GH deficiency (GHD) is a condition that can cause a broad range of adult health issues, if left untreated. Therefore on one hand, it is important to confirm and treat GHD after transfer to adult care. On the other hand, the personal and financial burden of unnecessary growth hormone in...