Endocrine Abstracts

The TNF members sRANK-L & Osteoprotegerin (OPG) are essential paracrine mediators of osteoclast function in vitro. The aim of this study was to establish the relationship between 25-hydroxyvitamin D and sRANK-L and OPG in plasma of osteoporotic patients.The study population consisted of 185 osteoporotic women (mean age 62.4 years), with bone mineral density (BMD) more than 2.5 SD below the young adult value, and 185 age-matched controls, with normal ...

The Osteoprotegerin (OPG) RANK and RANK-L system is a novel paracrine system that forms part of the mechanism of bone turnover. The aim of this study was to explore if the OPG/ RANK-L system, detectable in blood, is related to bone mineral density.The study population consisted of 185 osteoporotic women (mean age 62.4 years), with bone mineral density (BMD) more than 2.5 SD below the young adult value, and 185 age-matched controls, with normal bone miner...

Adverse effects of steroid excess on bone metabolism are well established but presentation of Cushing's syndrome with metabolic bone disease is reported to be uncommon. We describe a case of Cushing's syndrome presenting with pathological fractures probably present for 8 years before diagnosis.A 33 year old nurse first sustained spontaneous stress fractures of her metatarsals in 1994, with repeated fractures occurring up to 2002. In 2001 she developed hypertension, acute l...

IntroductionRecent studies have confirmed that IGF-I is an important determinant of future glucose homeostasis and cardiovascular risk. Insulin-like growth factor binding protein-3 (IGFBP-3) is the principal carrier protein for IGF-I in the circulation. Therefore we tested the relationship of IGF-I and IGFBP-3 to insulin resistance in an ethnic group with a high incidence of type 2 diabetes and cardiovascular disease.Methods. In a population-based study 100 subjects of...

BackgroundPatients with Growth Hormone Deficiency (GHD) are known to have an excess risk of vascular disease. Previous work has shown an increase in their arterial stiffness. The effect of GH on blood pressure is still unclear.Materials and Methods16 patients with GHD (6 males) and no history of existing vascular disease or hypertension, between the ages of 18 and 65 were recruited (mean 45.4 plus/minus 3.5 y...

If calcium intake and absorption are insufficient plasma calcium is maintained but bone loss ensues. The relationship between calcium intake and parathyroid hormone (PTH) levels in serum of 186 women (mean age 62.4 years) with bone mineral density >2.5 SD below the young adult value and 586 age-matched controls with normal bone mineral density was studied.The approximate calcium intake from dairy products was assessed by a simple questionnaire. All 77...

Case ReportA 36 year old Asian female presented to the Accident and Emergency with a sudden collapse.On examination, the patient was pyrexial at 38.3 degC and had a Glasgow Coma Scale of 4 associated with nuchal rigidity. The patient was ventilated and transferred to ITU. An MRI head scan revealed a large ring enhancing lesion in the hypothalamus which extended to the third ventricle. There was also diffuse lepto-meningeal enhancement with hydrocephalus....

Graves' disease (GD) is an autoimmune disorder of the thyroid gland, of which the aetiology is unknown, but susceptibility to disease is thought to result from both genetic and environmental factors. Familial clustering data suggests that GD is a polygenic disorder, with laboratory studies identifying the HLA gene region and the CTLA-4 gene region as susceptibility loci. However, together the HLA region and the CTLA-4 gene regions only contribute about 50% towards the genetic ...

Graves’ orbitopathy or thyroid eye disease (TED) represents the most common extra thyroidal manifestation of Graves’ disease. Smoking and radioactive iodine therapy are the most important modifiable risk factors. Thyrotropin receptor and insulin-like growth factor-1 receptor crosstalk, orbital inflammatory infiltration and activation of orbital fibroblasts lead to perpetuation of orbital inflammation a...

The management of adults with congenital adrenal hyperplasia due to classic 21-hydroxylase deficiency (21OHD) is a challenging balance of hormone replacement, disease control, and avoidance of adverse effects. The approach should emphasize the clinical evaluation and patient goals, and laboratory tests are used secondarily as ancillary data. Upon transition from pediatric to adult care, the concerns shift from growth and pubertal development to fertility, neoplasia formation, ...