Endocrine Abstracts

Background: Patients with acromegaly require lifetime monitoring due to the excess mortality and morbidity associated with untreated disease, and the propensity for disease relapse following treatment. There is controversy whether GH or insulin-like growth factor 1 (IGF1), better predicts the onset of cardiovascular complications such as cardiomyopathy and ischaemic heart disease (IHD) in acromegalic patients.Aim: To examine associations of overall GH an...

Background: A cardinal feature of acromegaly is insulin resistance. Patients with acromegaly are therefore predisposed to developing impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). It is therefore imperative to develop better biomarkers predicting the onset of IGT and T2DM in treated acromegalic patients. There is controversy whether GH or insulin-like growth factor 1 (IGF1) better predict the onset of IGT or T2DM in treated acromegalic patients. However ...

Background: Adrenal Insufficiency (AI) presents a diagnostic and clinical challenge. While short Synacthen Tests (SSTs) are most commonly utilised to diagnose AI, the value of a baseline cortisol is being explored. We aimed to review indications for performing an SST and to determine the baseline cortisol that predicted a preserved cortisol response to Synacthen.Methods: Eight hundred and sixty SSTs performed in 621 individuals at a tertiary endocrinolog...

Autosomal dominant hypoparathyroidism (ADH) is caused by gain-of-function mutations in the calcium-sensing receptor (CaSR), increasing its sensitivity to extracellular calcium, suppressing PTH and resulting in hypocalcaemia. In contrast to idiopathic hypoparathyroidism, treatment to correct serum calcium results in high urine calcium excretion, causing nephrocalcinosis, stones and renal impairment. Unlike surgical hypoparathyroidism where calcium should be maintained, patients...

Background: Anti-Müllerian Hormone (AMH) and Antral Follicle Count (AFC) are both principally used as markers of ovarian reserve and available in all UK hospitals. The utility of these markers in the binary diagnosis of Polycystic Ovarian Syndrome (PCOS) by published criteria, such as Rotterdam, has been previously reported. We evaluated their utility in the evaluation of oligo/amenorrhoea in healthy young non-obese women.Methods: Women with both ov...

Introduction: Macroprolactin is a physiologically inactive form of prolactin, usually composed of a prolactin monomer and an IgG or anti-prolactin antibody molecule. Whilst clinically non-reactive, it interferes with immunological assays used for prolactin detection. It is identified by polyethylene glycol (PEG) precipitation, and levels of macroprolactin are generally believed to remain stable over time.Case: We present the case of a 36-year-old gentlem...

Background: Kisspeptin stimulates hypothalamic GnRH secretion resulting in gonadotrophin release and has the potential as a future therapeutic for infertility. Previous studies have observed that kisspeptin increases LH and to a lesser degree FSH when administered to healthy women, which may limit its therapeutic potential. However, studies in women with hypothalamic amenorrhoea show that i.v. infusions of kisspeptin-54 stimulated both LH and FSH equally. Chronic s.c. infusion...

Background: Kisspeptin is an RF amide peptide hormone critical for reproductive function. Kisspeptin is also abundantly expressed in the placenta, where it has an important physiological role in regulating placental invasion. Accordingly, plasma kisspeptin levels rise dramatically during normal pregnancy. Lower plasma levels of kisspeptin are associated with poor pregnancy outcomes such as recurrent miscarriage, intrauterine growth restriction and pre-eclampsia. Urinary measur...

A decade ago, genetic disruption of the kisspeptin signalling pathway was observed to cause hypogonadotrophic hypogonadism. Hypothalamic kisspeptin acts by stimulating secretion of endogenous GnRH. Our research has investigated the physiological effects of kisspeptin in women, with the overarching aim of determining if kisspeptin could be used to treat women with infertility.We initially observed that s.c. bolus injection of kisspeptin acutely stimulated...

Background: Kisspeptin is an RF amide peptide hormone critical for reproductive function. Kisspeptin is also abundantly expressed in the placenta, where it has an important physiological role in regulating placental invasion. Accordingly, plasma kisspeptin levels rise dramatically during normal pregnancy. Lower plasma levels of kisspeptin are associated with poor pregnancy outcomes such as recurrent miscarriage, intrauterine growth restriction and pre-eclampsia. Urinary measur...