Endocrine Abstracts

Although life expectancy is increasing, deterioration in many tissues with age can substantially impair quality of life. Muscle loss and weakness, decreased bone density leading to fractures, insulin resistance leading to diabetic complications and cognitive decline increase substantially with age. These features are also seen in patients treated with high doses of glucocorticoids raising the possibility that glucocorticoids could be involved in the ageing process. However, ci...

Most Europeans take drinking milk for granted; it’s the everyday consumption of an everyday drink. But for most adult humans, indeed, for most adult mammals, milk is very far from an everyday drink. Milk is something that we have specifically evolved to be able to consume in the relatively recent past. The ability to digest the sugar in milk is called Lactase Persistence and Darwin’s engine of evolutionary change, natural selection, has probably worked harder on this...

Amiodarone has been used widely for treating resistant tachyarrhythmias in the past three decades. It is an iodinated benzofuran derivative with a structural formula that closely resembles that of thyroid hormones and contains about 37% of organic iodine by weight, from which 10% is deiodinated to yield free iodide. Given the daily maintenance dose of amiodarone between 100–600 mg daily, about 3.5–21 mg of iodide are released into the systemic circulation, equivalent...

Type 1 diabetes (T1D) is part of a group of disorders termed ‘organ-specific autoimmune diseases’, involving destructive inflammation focused on the insulin-producing beta cells in the islet of Langerhans. Patients (frequently children) lose endogenous insulin production and are required to inject insulin several times per day for the remainder of their lives, and, after many years, frequently develop severe life-threatening complications affecting the kidneys, heart...

Osteogenesis imperfecta (OI) is a rare but serious genetic disorder of bone leading to increased fragility and greatly increased susceptibility to fracture. Some patients experience additional problems such as abnormally formed teeth, progressive deafness and scoliosis. The condition is divided into various subtypes with types I and IV being the commonest, type 2 is lethal in utero and type 3 is associated with most disability and deformity. Patients with OI typically h...

The aetiology of thyroid nodules is due to the interaction between genetic and environmental factors. Thyroid nodules are common. Epidemiological studies suggest that 1% of men and 5% of women have thyroid nodules detected clinically and that the frequency increases with age and in iodine-deficient populations. With the increasing use of sensitive imaging techniques, an increasing proportion of thyroid nodules are detected incidentally. Up to 50% of nodules >1 cm detected ...

Pituitary adenomas/ tumours remain the commonest cause of growth hormone deficiency (GHD; indeed recent studies from the UK and Belgium have reported higher than previously estimated prevalence of clinically significant pituitary adenomas). However, the aetiological spectrum of pituitary dysfunction has changed in recent years with endocrinologists increasingly reviewing patients with pituitary dysfunction secondary to radiation injury, traumatic brain injury and subarachnoid ...

Prolactinomas usually present because of reproductive/sexual dysfunction due to the hyperprolactinemia but they may also present because of mass effects. Prolactin (PRL)-secreting microadenomas enlarge in only about 7% of cases, so many can be followed without direct treatment, although sex steroid hormone replacement may be required. Dopamine agonists can normalize PRL levels in over 90% of cases and can reduce tumor size significantly in over 75%, with cabergoline being gene...

A critical aspect of the environment before birth and in infancy is nutrition. It is estimated that 850 m people in the world (820 m in developing countries) are hungry. This has long-term consequences for their later health and economic potential but also for their children. Such figures do not include those people who have unbalanced nutrition, both in terms of macronutrients and micronutrients. An unbalanced diet can lead to ‘malnutrition’ even in those who have a...

Critical illness is associated with dramatic changes in the glucocorticoid axis. These changes occur at all levels of the axis, are most obvious in the increased serum levels of glucocorticoid but also occur within the tissue. Frank impairment of these responses (e.g. in Addison’s disease or with drugs that block adrenal hormone secretion) is associated with an adverse outcome but it has recently been suggested that many critically ill patients develop subtle abnormalitie...