Endocrine Abstracts

Abnormal fetal growth remains a problem in pregnancies, complicated by diabetes and is associated with increased maternal and offspring mortality and morbidity. Insulin-like growth factors (IGFs) are important regulators of fetal growth. Their effects are controlled by binding proteins (IGFBPs). IGFBP-1 is particularly important in pregnancy. Phosphorylated IGFBP-1 (pIGFBP-1) has a high affinity for IGF-I and inhibits IGF-I actions, whereas de-phosphhorylated IGFBP-1 has a low...

Introduction: IGF-I and its binding proteins may modulate cardiovascular risk. As part of our Manchester Mothers’ Cardiovascular study, we tested in pre-menopausal women the hypothesis that higher circulating IGF-I concentrations would be associated with lesser arterial stiffness and lower cardiac (LV) mass, while higher IGFBP1, reflecting less pre-hepatic insulin, would be positively related to small vessel function.Methods: About 193 women aged 32...

A 68-year-old woman presented with hypertension, oedema, weight gain and moon face. She had signs of proximal muscle weakness, thinning of scalp hair and bruising on her legs. Initial tests showed 24 hour urine free cortisol elevated at 946 nmol (0–300 nmol).Serum cortisol showed no circadian fluctuation (0900: 1094 nmol/l, 2400 hrs: 886 nmol/l) and no suppression by dexamethasone (2 mg/24 h for 48 h: 1067 nmol/l). ACTH levels were slightly raised (...

A 36-year-old male presented to neurologists with tiredness and clumsy gait. Examination revealed normal cranial nerves, spastic paraparesis and bilateral extensor plantar response, absent vibration sense and ataxia. He was thought to have an inherited form of Spino-Cerebellar ataxia. His mother had developed similar neurological problems in her 50 s, and his maternal uncle had Addison’s disease.He was referred to endocrinologists because of the fin...

Pituitary apoplexy is an acute medical emergency but there are no evidence based management guidelines, especially for neurosurgical intervention.A 35-year old male presented with sudden onset severe headache. On examination blood pressure was 180/120 without any lateralising neurological signs. He appeared acromegalic with a short history of enlarging hands & feet. Emergency CT scan and a MR scan later confirmed haemorrhagic pituitary adenoma, 3 cm ...

Management of patients with gender dysphoria (transsexualism) is often difficult, and most patients are routinely managed outwith specialist gender identity clinics. We carried out a retrospective case-note survey of 21 patients attending a routine adult endocrine clinic (ages 24–64 y; 13 male-to-female (MF) and 8 female-to-male (FM)).All MF and 6 of 8 FM patients were on hormonal treatment. 6 of 13 MF patients took oestrogen alone, 6 used oestrogen...

IntroductionInsulin-like growth factors-I (IGF-I) and -II (IGF-II) are important in regulation of metabolism and growth. We previously reported in normal weight normoglycaemic individuals that low circulating IGF-II predicts future weight gain. We subsequently investigated whether such relationships persisted in circumstances of abnormal glucose tolerance.MethodIn 224 type 2 diabetes subjects we assessed the ...

Clinic based studies have shown that patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulphate in addition to glucocorticoids and mineralocorticoids. DHEA is thought to have beneficial effects on energy level and mood, independent of circulating testosterone levels. Thus there may be a direct link betwe...

BACKGROUND Human and animal evidence indicates that poor maternal nutrition leads to programmed endothelial dysfunction and hypertension in offspring. In humans, endothelial dysfunction has been observed in independent cohorts studied aged 7 and 11, but explanatory molecular mechanisms are lacking. Endothelial function, and synthesis of nitric oxide (NO) by endothelial nitric oxide synthase (eNOS), relies on nutrient supply of L-arginine, with maternal dietary restriction in r...

IntroductionThe metabolic syndrome is associated with an increased risk of cardiovascular disease and diabetes. The insulin-like growth factor (IGF) system has been implicated in the pathogenesis of cardiovascular disease and glucose intolerance. We have previously shown that a low IGFBP-1 concentration coupled with a low circulating IGF-I predicts worsening glucose tolerance. In this study we further investigated relationships between the IGF-system and...