Endocrine Abstracts

Adrenal incidentalomas are tumours of the adrenal incidentally discovered during evaluation for non-adrenal disease. The National Institute of Health consensus definition usually excludes lesions found during evaluation for malignancy. We present a case of an initially non-secretory adrenal incidentaloma that progressively increased in size over 6 years and became hormonally active.A 78-year-old hypertensive male was found to have a right adrenal mass du...

Serum Crosslaps is a bone resorption specific marker already validated in adults for osteoporosis helping in decision and therapeutic. Not yet clinically evaluated in children, we wanted to analyse the usefulness of this marker in paediatric practice, easier to collect than the other bone resorption markers which need urinary collection often uncertain in children.Patients and methods: Serum Crosslaps were measured using the One Step ELISA immunoassay (O...

Glucocorticoid (GC) excess is characterized by central obesity, insulin resistance and in some cases, type 2 diabetes mellitus. Whilst it is accepted that GCs cause insulin resistance, both insulin and GCs act synergistically to promote adipocyte differentiation. We have previously shown that acute treatment (24 h) with GCs enhances insulin signalling in human adipocytes. We hypothesise that the generation of cortisol from inactive cortisone by 11β-hydroxysteroid dehydrog...

A 50-year-old man presented with a week history of feeling unwell and urinary symptoms. He was confused. His wife gave H/O 2 stone weight loss. Recent investigation for haematuria showed 3.6 cm bladder tumour. He underwent TURBT and the histology was awaited. No other significant PMH or family H/O. Not on any medication and was an ex-smoker.Initial investigations showed leucocytosis and evidence of UTI. CXR showed chronic fibrotic changes. As a part of c...

A 24-year-old women (wt 63 kg, BMI 23) presented with history of secondary amenorrhea. Menarche occurred at age 16 years and was followed by a regular cycle (7/35). She started the combined oral contraceptive pill (OCP) at 18 years of age for menorrhagia and stopped this 16 months before her presentation, before undergoing elective surgery. Four months after discontinuing the OCP she experienced a single episode of PV bleeding, but otherwise remained amenorrhoeic. Past history...

Recently updated international guidelines recommend specialist surveillance of adults with Turner Syndrome (TS). In 2005, we established a dedicated TS clinic, attracting referrals from our general endocrine service and other specialities including primary care.Twenty-three patients currently attend of whom 9 were previously under endocrinology review. Karyotypes include 45XO (8/23), 45XO/46XrX (4/23), and 45XO/46XiXq (3/23). Mean (±S.D.</sma...

Primary hyperaldosteronism is now recognised as the most frequent underlying cause of hypertension. We recruited 94 patients (age (mean±S.D.) 56±11 years) with hypertension from primary care in order to study the role of corticosteroid hormone action in this cohort. Random, blood pressure (BP), plasma renin activity (PRA) and aldosterone (Aldo) was measured both on and off antihypertensive medication. In addition, a 24 h ambulatory blood pressure (ABP)...

Maternal nutrient restriction predisposes the adult offspring to metabolic syndrome. We investigated the effect of energy restriction during early or late gestation on glucose-insulin dynamics during a GTT (0.5 g/kg i.v. glucose) and/or an ITT (0.75 IU/kg) prior to and after significant gain in adipose tissue. 20 sheep were either fed to maintenance (1 M; CE, n=6) or to 0.65 M during early (0–65 days, term=147days, LEE, n=7) or late (65–125 days, LEL; <...

The epidemic of obesity, insulin resistance and type 2 diabetes has heightened the need to understand the mechanisms that contribute to their pathogenesis. Endogenous glucocorticoid (GC) production and metabolism have been implicated based upon parallels with Cushing’s syndrome. The interaction between GC metabolism and insulin sensitivity in the context of significant weight loss has not been explored. 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that gen...

Intra-abdominal adiposity is associated with insulin resistance and increased cardiovascular morbidity and mortality. Obesity occurs as a consequence of increased adipocyte size (hypertrophy) and number (differentiation or hyperplasia). Whilst differences in gene expression between omental (om) and subcutaneous (sc) adipose tissue have been described, the molecular mechanisms that underpin the differences in adipose tissue biology and the depot specific metabolic risks that th...