Endocrine Abstracts

Neonatal salt wasting can present in neonates with a life-threatening state of hyponatraemia, hyperkalaemia, dehydration and metabolic acidosis. The differential diagnosis of neonatal salt wasting includes congenital adrenal hyperplasia (CAH) most commonly due to 21-hydroxylase deficiency, pseudohypoaldosteronism (PHA), X-linked adrenal hypoplasia congenital (AHC) and aldosterone synthase defects. Diagnostic work up should include serum measurement of ACTH, Cortisol, 17OH-prog...

A 13 year old female presented with a two day history of abdominal pain and vomiting which responded to analgesia. Pelvic ultrasound showed complex ovarian cysts and a pre-pubertal uterus. Initial blood tests were consistent with hypergonadotrophic hypogonadism (LH 31.5 U/l, FSH 14.3 U/l and oestradiol <70 pmol/l) and karyotype was 46 XX. Bone age was slightly delayed (measured 12.4 years, chronological age 13.7 years). On referral to paediatric endocrinology, the patient ...

Background: High-resolution magnetic resonance imaging (hrMRI) can assess trabecular bone microarchitecture but the number of image slices required for reliable assessment is unclear.Methods: MRI was performed just below the growth plate of the proximal tibia from 20 healthy controls (all females; median age 21 years (range 18.35) and ten cases (3M:7F; median age 19.5 years (range 16.48) with known bone abnormalities including osteogenesis imperfecta and...

Introduction: Metformin is widely used as oral anti-hyperglycaemic agent to treat type 2 diabetes, with increasing reports of an additional, potential bone protective role.Objective: We investigated the role of AMPK in mediating the effects of metformin on the differentiation of mesenchymal stem cells (MSCs) to either osteoblasts or adipocytes.Methods: Confluent murine MSCs (C3H10T1/2) were treated with metformin (500 μM), a k...

Aim: To review trends in bisphosphonate use in children with secondary osteoporosis attending a Tertiary Paediatric Endocrine Unit (2004–July 2015).Methods: Data were gathered from a combination of a clinical and pharmacy database. Results reported as median (range).Results: A total of 42 children (19M) commenced on bisphosphonates treatment over the 11-year period, median age 11.8 years (3.3–18.4). 19 were on pamidronate...

Background: Vertebral Fractures (VF) are recognized as an important aspect of bone health in children and adolescents. The clinical utility of vertebral fracture assessment (VFA) using dual-energy X-ray absorptiometry (DXA) has not been evaluated in the paediatric population.Method: VFA was performed independently by two non-radiologist observers, in 165 patients (77M/88F) as part of their investigation for low bone mineral density. Lateral thoracolumbar...

Background: Recombinant human GH (rhGH) may improve bone mass in paediatric inflammatory bowel disease (IBD).Objective: To investigate rhGH on bone and body composition in paediatric IBD.Method: Bone biomarkers were evaluated in 12 children, 11CD (10M), median age 14.4 year (8.9, 16.2) who received rhGH (0.067 mg/kg per day) as part of a 6 months RCT. Eight received rhGH for 24 months and had DXA evaluation. Results were reported a...

Introduction: Insulin sensitising agents are reported to have a diverse range of effects on bone with metformin exerting positive effects and thiazolidinenediones (TZDs) exerting negative effects. 5′AMP-activated protein kinase (AMPK) plays a critical role in cellular energy homeostasis. It is widely expressed in the body and can be activated by metformin.Aim: We investigated the role of AMPK pathway in mediating the effects of metformin on the ost...

Introduction: Bisphosphonate therapy (BPT) reduces osteoclast activity and may be associated with adynamic bone turnover. The extent of suppression of bone turnover and its determinants are unclear.Methods: Markers of bone metabolism were evaluated in 15 children (9M/6F) receiving cyclical BPT intravenously for osteoporosis. The median age at first biochemical assessment was 10.8 years (0.16, 16.3). Serum type I collagen cross-linked C-telopeptide (CTX),...

Background: There are limited data in paediatric population on the association between vitamin D deficiency/treatment and glucose/insulin metabolism.Objective and hypotheses: This study aimed to investigate the effect of vitamin D therapy on glucose homeostasis, insulin resistance and bone turnover, in children with vitamin D deficiency.Method: 22 children aged 3 months to 10 years (nine males) who were diagnosed with vitamin D def...