Endocrine Abstracts

Introduction: Visfatin/PBEF is a novel adipokine circulating inversely proportional to visceral fat mass and exerts insulin-mimetic effects; it is expressed in normal, inflamed and tumour tissues. Visfatin/PBEF has also been identified as NMPRTase, a key intracellular enzyme involved in NAD+ metabolism, replenishing NAD+ during cellular respiration. Inhibition of NMPRTase by the anti-cancer agent FK866 has been shown to induce apoptosis in tumours. Prosta...

Endocrine diagnostic tests have long taken place in centres both with and without dedicated endocrine units. Problems with reliability have however been encountered, including difficulty in interpretation, the need for repeat tests with an inevitable delay of diagnosis, poor cost effectiveness and added stress to the patient. With the advent of the Endocrine Nurse post at the Royal Berkshire Hospital, the endocrine diagnostic tests were reviewed. To optimise the quality of the...

A pre-diabetes state, Impaired Glucose Tolerance (IGT), is recognised as a natural stage in the development of diabetes with blood glucose levels gradually rising over time until levels consistent with diabetes are reached. In addition, people with IGT have a 2–3 times greater risk of macrovascular disease than euglycaemic subjects. Three recent studies demonstrate benefits of intensive lifestyle modification in people with IGT in preventing diabetes. Hence, education of ...

Background: In November 2017, a nurse-led Adrenal Incidentaloma (AI) clinic was launched at the University Hospital of Wales (UHW), Cardiff, based upon the 2016 European Society of Endocrinology AI management guidelines.Objectives: To evaluate the effectiveness of a nurse-led clinic in managing AI patients at UHW.Methods: Retrospective analysis of electronic records of patients see...

Background: Advances in insulin pumps and continuous monitoring mean that, where indicated sensor augmented pump therapy (SAPT) can be prescribed for children under NHS care in England. National Paediatric Diabetes Audit (NPDA) data shows improved diabetes outcomes (in terms of HBA1c) in children managing their diabetes in this way. Use of this technology is significantly lower in children in the lower deprivation quintiles and in patients from non white ethni...

Introduction: Low levels of vitamin D are associated with higher mortality in critically ill patients. Studies on vitamin D levels in adult burn patients and their influence on clinical outcomes are scarce. Therefore, vitamin D status following thermal injury is often overlooked as its clinical implications are poorly understood.Aim: To examine the relationship of major thermal injury on the vitamin D axis and the influence of ...

Reduced renal synthesis of 1,25-dihydroxyvitamin D (1,25(OH)2D) from 25-hydroxyvitamin D (25OHD) in end stage renal disease (ESRD) results in low serum 1,25(OH)2D. This appears to be due to reduced renal cell function and elevated serum fibroblast growth factor 23 (FGF23). Treatment strategies have therefore focussed on 1,25(OH)2D or its synthetic analogues, alfacalcidol or paricalcitol. However this overlooks 25-hydroxyv...

Introduction: Low levels of vitamin D are associated with higher mortality in critically ill patients. Studies on vitamin D levels in adult burn patients and their influence on clinical outcomes are scarce. Therefore, vitamin D status following thermal injury is often overlooked as its clinical implications are poorly understood.Aim: To examine the relationship of major thermal injury on the vitamin D axis and the influence of ...

Reduced renal synthesis of 1,25-dihydroxyvitamin D (1,25(OH)2D) from 25-hydroxyvitamin D (25OHD) in end stage renal disease (ESRD) results in low serum 1,25(OH)2D. This appears to be due to reduced renal cell function and elevated serum fibroblast growth factor 23 (FGF23). Treatment strategies have therefore focussed on 1,25(OH)2D or its synthetic analogues, alfacalcidol or paricalcitol. However this overlooks 25-hydroxyv...

Advancements in medical care have significantly improved survival rates following major traumatic injury. An understanding of the hormonal, inflammatory and metabolic changes that occur following trauma is still evolving but it is clear that they impact significantly upon patient prognosis. To date, studies that have examined trauma-induced changes in steroid metabolism have analysed samples taken from patients post-hospital admission, culminating in marked variability in the ...