Endocrine Abstracts

Long acting somatostatin analogues (SSA) such as Sandostatin LAR and Lanreotide Autogel are the most commonly used drugs in the management of neuroendocrine tumours (NETs) due to their ability to control symptoms and prolong survival. SSAs use is associated with changes in glucose metabolism. However, there is lack of data for such effects in patients with NETs. We evaluated the effects of SSA on BMI and HbA1c in our cohort of patients with NETs.Methods:...

Background: Adrenocortical carcinoma (ACC) has an aggressive but variable behaviour. ENSAT tumour stage and Ki67 proliferation index are used to predict clinical outcome but they are limited in distinguishing patients with best outcome. We aimed to investigate the prognostic role of clinical/histopathological parameters alone or in combination according to previously proposed points-based score (mGRAS, Lippert JCEM 2018).Methods: We assessed 112 patients...

11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an NADPH-dependant oxo-reductase located in the sarcoplasmic reticulum (SR) lumen of skeletal muscle. Here it generates active glucocorticoids to regulate permissive and adaptive metabolism, and can mediate the pathological effects of glucocorticoid excess. Hexose-6-phosphate dehydrogenase (H6PD) in the SR interacts with 11β-HSD1 to generate an appropriate NADPH/NADP+ ratio to support activity. H6PD depletion...

A 41-year-old woman was referred with 9 months history of secondary amenorrhoea and galactorrhoea. She was otherwise well and not taking any medications. Biochemical evaluation showed prolactin 2000 mU/l but otherwise unremarkable. Pituitary MRI revealed a 30 mm pituitary lesion with right cavernous sinus invasion, presumed to be a craniopharyngioma due to the presence of calcification. Surgical intervention was recommended, but the patient declined. She was commenced on caber...

Background: Adrenocortical carcinoma (ACC) is a rare endocrine cancer. We aimed to develop machine learning (ML) models for predicting clinical outcomes of patients with ACC and deploy them as a web-based decision support tool. Methods: The S-GRAS dataset1 was used as a training cohort (n=942), while the COMBI dataset2 and new patients were used as a validation cohort (n=220). We used S-GRAS parameters previously d...

Background: Benign adrenal incidentalomas (AI) are found in 3-5% of adults. All patients should undergo a 1 mg -overnight dexamethasone suppression test (1 mg -DST) to exclude cortisol excess (non-functioning adrenal tumours, NFAT; serum cortisol ≤50 nmol/l) or diagnose possible mild autonomous cortisol secretion (MACS; serum cortisol >50 nmol/l). Current guidelines discourage repeating hormonal work-up in patients with benign AI. However, data underpinning this reco...

Background: Standard treatment for advanced adrenocortical carcinoma (ACC) is mitotane in monotherapy or combined with etoposide, doxorubicin and cisplatin (EDP), yet biomarkers predictive of treatment response are lacking. Inflammation-based scores were proposed as predictors for gemcitabine+capecitabine efficacy, used as second-line in progressive ACC. We investigated the role of inflammation-based scores in predicting response to first-line treatment in advanced ACC.<p ...

Background: The detection of phaeochromocytomas evolved from autopsy finding to presentation in symptomatic/hypertensive, and genetically-predisposed individuals. Increasingly, phaeochromocytomas are diagnosed in incidental adrenal masses and the impact on the clinical, biochemical, and radiological features is unclear.Methods: Retrospective review of patients with phaeochromocytomas seen at a large tertiary referral centre between January 2010 and May 2...

Introduction: The endoplasmic reticulum (ER) lumen enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) obtains NADPH from hexose-6-phosphate dehydrogenase to reduce cortisone to the active glucocorticoid cortisol. Cells depleted in NAD+ (parent molecule of NADPH) have impaired 11β -HSD1 activity, which can be rapidly rescued with supplementation of the NAD+ precursor nicotinamide riboside. This suggests the existence of an ER-specific pathway to NAD(P)(H)....

Adrenocortical carcinoma (ACC) is a rare malignant tumour with heterogeneous outcome. Prognostic classification relies on individual clinical/histopathological parameters that have limited performance. Recent studies proposed the use of selected DNA-based biomarkers to improve prognostication of ACC. Aim of the study was to perform a comparative analysis of DNA-based biomarkers (BM) for prognostic assessment of ACC by evaluating their added value to the established prognostic ...