Endocrine Abstracts

Glucocorticoid excess results in central obesity and insulin resistance/diabetes mellitus. At a pre-receptor level, 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) modulates glucocorticoid levels and has been implicated in the pathogenesis of the metabolic syndrome. 11beta-HSD1 is a bi-directional NADP(H) dependant enzyme, but keto-reductase activity predominates in-vivo. Recent studies indicate that the enzyme H6PDH ensures reductive metabolism (cortisone to c...

The vitamin D receptor (VDR) polymorphism, BsmI, has previously been associated with the efficacy of raloxifene therapy. The aim of this study was to examine associations between the BsmI and FokI polymorphisms of the VDR gene and bone density and bone turnover response to raloxifene. One hundred osteopenic postmenopausal women (ages 52 to 80 years, mean 64 years) were prescribed raloxifene (60mg/day) and calcium carbonate (500mg/day) for 48 weeks. Bone density at the lumbar s...

Recent advances in treatment of chronic myelogenous leukemia and gastrointestinal stromal tumors with selective tyrosine kinase inhibitors have generated interest in identifying other cancers that could be approached with similar strategies. Cancers derived from follicular (papillary thyroid cancer; PTC) and parafollicular thyroid C cells (medullary thyroid cancer; MTC) represent paradigms of solid neoplasms in which tumor initiation events are well defined, and involve activa...

Background: Use of metformin in women with polycystic ovary syndrome (PCOS) is becoming increasingly accepted and widespread but clinical practice is ahead of the evidence.Methods: We extracted results from the seven published studies of metformin use in PCOS that include control elements quantifiably similar to the experimental arm. We also restricted our analysis to the studies with a systematic longitudinal examination of ovulatory function and metabolic parameters....

Elevated circulating concentrations of non-esterified free fatty acids (NEFAs) are observed in states of insulin resistance and may be associated with increased cardiovascular risk. We hypothesised that NEFAs directly impair endothelial NO bioavailability via increased oxidative stress, in addition to their proposed indirect effect via VLDL. The study was designed to investigate the effect of monounsaturated and saturated fatty acids on endothelium-dependent and -independent v...

Background: The long-term prevalence of adrenal insufficiency after transsphenoidal surgery for GH secreting pituitary adenomas was unknown. However, recently a single study reported a high prevalence of adrenal insufficiency after surgical and/or medical treatment without postoperative radiotherapy in acromegalic patients.Aim: To assess the prevalence and incidence rate of adrenal insufficiency in consecutive patients during long-term follow-up after su...

Issue: The use of thyroglobulin (Tg) as tumor marker in differentiated thyroid cancer (DTC) is limited in the presence of thyroglobulin-antibodies (TgAb) but it is generally believed that this is true only for TgAb concentrations over the normal ‘cut off’ point.The aim: Of this study was to investigate if TgAb-s in the normal range, considered to be physiological, may also influence the accuracy and clinical relevance of Tg measurement.<p c...

Introduction: Once-daily liraglutide and once-weekly dulaglutide, both glucagón-like peptide-1 receptor agonists, improve glycemic control and reduce weight in patients with type 2 diabetes mellitus (T2DM) with a similar efficacy according to head-to-head trial AWARD-6. Nevertheless, there is a lack of evidence in a real-world setting. The focus of our study is to assess changes in glycemic control and weight resulting from switching from liraglutide to dulaglutide in pat...

Introduction: Hyponatraemia (serum sodium <136 mmol/l) is associated with significant morbidity and mortality. International guidelines suggest a clear algorithm for investigation, inclusive of measurements of paired urine sodium and osmolality, thyroid function tests and a morning cortisol. The aim of this study was to prospectively investigate the assessment, management and clinical outcomes associated with hyponatraemia on hospital admission.Metho...

Studies show conflicting results regarding possible excess risk of atypical fractures associated with bisphosphonate (BSP) use. Since BSP reduces bone remodeling, they freeze the skeleton allowing accumulation of microcracks over time leading to atypical fractures. We present two cases of atypical fracture and discuss on monitoring therapy and drug holiday in chronic BSP users.Methods: Over the period of last 8 months we diagnosed two cases of alendronat...