Endocrine Abstracts

Permanent hypoparathyroidism is rare after total thyroidectomy. However, our experience is that often patients remain on alfacalcidol and calcium supplements long-term after thyroidectomy.A study was initiated in our centre in 2004, whereby all patients on alfacalcidol or calcium supplements post thyroidectomy underwent a gradual alfacalcidol and calcium reduction programme. Of 57 patients thus enrolled, we report on 22 who were initially on alfacalcidol...

A multidisciplinary team is responsible for the management of over 1,200 NET patients per year in our hospital. Tumor board decisions for peptide receptor radiotherapy (PRRT) are based on the Bad Berka Score which takes into account molecular imaging features and clinical aspects. The therapy plan for each patient is individualized. Retrospective analysis was performed in 1048 patients (age 4–85 years) with progressive NETs treated at our center since 2004 using Lu-177 (<...

In acromegaly, an excessive GH secretion by pituitary adenoma, minimal active disease may be defined as slow progression of characteristic signs and symptoms at presence of slightly elevated or normal IGF1 levels and lack of GH suppression after glucose load. Nadir post-glucose GH level defining active disease is under permanent discussion and depends on assessment methods. IGF1 reference range is wide, must be age-adjusted and often is sex-dependent. From mid-00’s excess...

In humans the most abundant source of 11 beta-hydroxysteroid dehydrogenase type 2 is the placenta, notably placental trophoblast. This enzyme catalyses the conversion of cortisol (F) to cortisone (E) and is thought to protect the fetus from maternal hypercortisolaemia, thereby impacting on fetal growth and development. During gestation placental trophoblast is exposed to dramatic changes in oxygen tensions ranging from ~2% - 12%, changes thought to be pivotal in stimulating an...

11 beta-hydroxysteroid dehydrogenase type 2 (11 beta-HSD2) is responsible for the conversion of hormonally active cortisol (F) to inactive cortisone (E), and is expressed in mineralocorticoid target tissues (kidney, colon). However, the most abundant source of this enzyme is human placenta, notably placental trophoblast where it is thought to protect the fetus from maternal hypercortisolaemia and play a role in fetal growth and development. During gestation placental trophobla...

AIMS: Postmenopausal oestrogen replacement therapy (ERT) has been shown to lower serum insulin-like growth factor 1 (IGF-1) levels, requiring the use of higher doses of growth hormone (GH) replacement. Soy derived phytoestrogens (PE) are in widespread usage as a natural alternative to ERT. No data exists on the effects of PE on serum IGF-1 levels. The aim of this pilot study was to determine the effects of Phytoestrogen dietary supplementation on the serum IGF-1 level in postm...

The global epidemic of obesity has heightened the need to understand the mechanisms that underpin its pathogenesis. Clinical observations in patients with Cushing's syndrome have highlighted the link between cortisol and central obesity. However, whilst circulating cortisol levels are normal or reduced in obesity, local regeneration of cortisol, from inactive cortisone, by 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) has been postulated as a pathogenic mechanism. W...

Radioidine (RI) has been implicated as an adverse factor causing deterioration of Thyroid-Associated Ophthalmopathy (TAO). Oral steroids administered after RI appear to protect patients' eyes, and this practice is now widespread. Two factors may confound the controversy surrounding the effects of RI on TAO. Firstly hypothyroidism, which is common after RI and is independently detrimental to the eyes, and secondly studying patients who are in different phases of the natural his...

IntroductionWe have previously demonstrated profound effects of hormone replacement treatment (HRT) in post-menopausal women on the IGF-system. HRT is widely used to prevent osteoporosis. The IGF-system has been implicated in bone formation. IGFBP-4 and IGFBP-5 are known to be important in modulation of IGF activity in bone. In this larger study we have examined the effects of HRT on circulating IGFBP-4 levels.MethodOral conjugated equine estrogen (CEE) alone or in...

Serum IGF-I is increasingly used, and IGFBP-3 has been proposed, as a marker of treatment efficacy in patients with acromegaly. IGF-I bioactivity and half-life are dependent on the degree of IGF-I incorporation into 150kDa ternary complexes with IGFBP-3 and ALS. When serum GH is lowered in patients with acromegaly all three ternary complex components decline, but effects on ternary complex formation have not been described. We investigated GH action on ternary complex formatio...