Endocrine Abstracts

A 35 year old otherwise healthy gentleman from Togo, was referred to our clinic with new onset diabetes and a glycated haemoglobin (Hba1c) of 119mmol/mol (13.1%). He initially presented to his general practitioner with polyuria and polydipsia, and 5 kg of weight loss. He denied any change in bowel habit and had no recent illnesses. Both parents had Type 2 Diabetes Mellitus (T2D). Initial blood tests revealed a blood glucose of 22.84 mmol/l, with positive ketones (1.2 mmol/l). ...

Background: Children with undiagnosed coeliac disease are at risk of low bone mineral density (BMD), but whether this translates to fracture predisposition is unclear. In adults with coeliac disease anti-osteoprotegerin (anti-OPG) antibodies have been identified. OPG inhibits RANK ligand activation of osteoclastic bone resorption, and thus anti-OPG antibodies promote bone loss. We report a case of osteoporosis with elevated anti-OPG antibodies in a child with coeliac disease.<...

Autoimmune immunoglobulins directed against peptide hormones are well-described. These are often clinically benign, but may cause a deleterious effect on the accuracy of clinical immunoassays. A notable exception is Insulin Autoimmune Syndrome (IAS, also known as Hirata disease), where antibody-binding has a direct effect on insulin kinetics resulting in aberrant glucose control. Current methods to diagnose IAS rely on crude immune-subtraction techniques such as polyethylene g...

Glucocorticoids (GCs) are steroid hormones used to treat inflammatory diseases such as rheumatoid arthritis, but their clinical efficacy is hampered by development of side effects such as impaired wound healing. GCs bind the glucocorticoid receptor (GR) to mediate cellular effects. The inactive GR is held in multi-protein complex in the cytoplasm and upon ligand binding undergoes a conformational change, interacts with cytoplasmic enzymes to mediate non-genomic effects (within...

Glucocorticoids act through the glucocorticoid receptor (GR) to regulate cell function. GR gamma (GRγ) is a constitutive exon3/4 splice variant, contributing 4–8% of the total GR transcripts and is highly conserved through mammalian evolution, but its biological function remains unknown. Using microarray analysis we identified the transcriptome response for GRγ in stable HEK-Flp cells. This revealed that although GRγ effectively modulated gene expression in...

Background/aims: Saxagliptin is a potent, selective dipeptidyl peptidase-4 (DPP-4) inhibitor, specifically designed for extended inhibition of the DPP-4 enzyme. Saxagliptin is cleared by both metabolism and renal excretion. The aims of this study were to determine the effect of renal impairment (RI) and haemodialysis (HD) on the pharmacokinetics of saxagliptin.Methods: This open-label, parallel-group study was conducted in subjects with normal renal func...

Glucocorticoids (Gcs) act via the intracellular glucocorticoid receptor (GR) to regulate cellular homeostasis. GR is a ligand-activated transcription factor which mediates effects within the nucleus or cytoplasm to regulate genomic or non-genomic events. Localisation of the GR to a specific cellular compartment is therefore an important determinant of the cellular response to Gcs.Live cell imaging of GR trafficking in cells transfected with fluorophore-t...

The differential diagnosis of raised circulating thyroid hormones with normal TSH includes familial dysalbuminaemic hyperthyroxinaemia (FDH), a benign, inherited disorder caused by a variant albumin with increased affinity for thyroxine (T4) or triiodothyronine (T3). Three different albumin gene mutations, generating mutant proteins with increased affinity for either T4 (R218H,R218P) or T3 (L66P) have been commonly described. Typically, serum total T4 is raised and free T4 mea...

Objective: The aim of our investigation was the study of blood adiponectin and leptin levels in patients with menopausal metabolic syndrome (MMS) and their correlation with the parameters of MMS features.Methods: 40 females with menopausa have been investigated. In 38 cases diabetes mellitus type 2 has been registered, and in 2 – impaired glucose tolerance. Mean duration of postmenopausal period was 11.1±7.4. Control group consisted of 10 femal...

We present a 32-year-old woman with recurrent hypoglycaemic episodes and a history of juvenile onset SLE. Over months, she experienced severe hypoglycaemic episodes with unconsciousness, occuring mainly in the early morning resulting in several hospital admissions. The patient had to take precautions like eating snacks between meals and before going to bed, and even setting an alarm clock to eat a bowl of porridge at 0200 h. She was of normal weight, did not present with any h...