Endocrine Abstracts

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Background: Correctly identifying glucocorticoid-induced adrenal insufficiency in patients tapering prednisolone treatment to ≤5 mg daily is crucial. Pausing prednisolone before an ACTH-test is standard, yet the optimal pause duration is uncertain.Aim: To determine the outcome of an ACTH-test after 1 vs 2 days’ prednisolone pause before the test.Methods: Baseline data from an ongoing randomised clinical trial (EudraCT:20...

Introduction: The plasma cortisol response to the ACTH test is known to vary significantly by assays. An automated cortisol immunoassays with increased specificity due to the shift from polyclonal to MABs, and standardized against mass spectrometry was recently introduced, with an expected decrease in cortisol concentrations by 20%. Cut-offs used in clinical practice for patient evaluation will thus have to be adjusted. We aimed to assess the normal cortisol response to ACTH s...

Objective: Exogenous estradiol increases cortisol binding globulin (CBG) and total cortisol (TC), and therefore it is debated if estradiol supplementation should be paused before evaluation of the adrenal axis. The aim was to evaluate how oral and transdermal estradiol influence TC in hypogonadal women with, or at risk of developing, adrenal insufficiency (AI)Methods: This was a crossover study in 17 women with secondary hypogonadism who were tested with...

Objective: To determine the effects of long-term growth hormone (GH) treatment on heart anatomy and function among adult GH deficient patients.Design: A retrospective observational study at Copenhagen University Hospital, Rigshospitalet, Denmark between 1999 and 2015.Patients: All patients with available echocardiography data at treatment baseline, 3–5 years and 8–10 years follow up. We included 25 naïve GH deficient...

Hypothesis and aim: Acromegaly is frequently associated with impaired glucose tolerance and diabetes, and concomitant hyperprolactinaemia was suggested to add to this effect. We hypothesized that pituitary prolactin (PRL) histopathology and plasma hyperprolactinaemia has a prognostic value in predicting the risk of glucose metabolic disturbances in acromegalic patients. The aim of this study was to examine glucose metabolic outcomes in acromegalic patients with and without his...

Objective: To describe body-composition, lipid profile, and health-related quality of life (HRQL) in patients with traumatic brain injury (TBI) in relation to the development of posttraumatic hypopituitarism.Design: Cross-sectional with a nested prospective sub-study.Patients: The cross-sectional cohort included 104 hospitalized patients with TBI (26F/78M; age: median 41 years (range 18–64); BMI: 25 kg/m2 (17–3...

Background: Secondary adrenal insufficiency is usually treated with hydrocortisone replacement therapy twice or thrice daily in varying doses to mimic the physiological rhythm of cortisol release. However, despite efforts to optimize treatment regimens patients report impaired quality of life (QoL), including important aspects such as fatigue. A possible explanation is a suboptimal imitation of cortisol release resulting in an inadequate substitution at certain times during th...

Introduction: Subarachnoid haemorrhage (SAH) is associated with a mortality rate of 30% and the survivors face significant morbidity including fatigue, isolation, depression and sleep disorders; factors affecting general health related quality of life (QoL). QoL is also known to be decreased in pituitary-hypothalamic insufficiency and tends to improve after treatment. SAH has been suggested to be a common cause of hypopituitarism by some whereas not by others. We aimed to inve...

Background: Replicating the physiological cortisol secretion is key in treatment of glucocorticoid insufficient individuals. A sub-optimal replication may explain the impaired quality of life experienced by these individuals. The study investigates fatigue measured by ecological momentary assessments in patients treated with conventional hydrocortisone compared with a once-daily dual-release formula of hydrocortisone (Plenadren) that follows the cortisol physiology more closel...