Endocrine Abstracts

Background: Primary hypothyroidism affects about 3% of the general population (5.1% women and 0.9% men). The majority of people are treated adequately with levothyroxine. However about 5–10% of hypothyroid patients (representing between 75 000 and 150 000 adults in the UK) continue to experience profound and sometimes disabling symptoms, such as fatigue/depression/impaired cognition, in spite of being adequately replaced biochemically. Before any trial of alternatives to ...

Introduction: The successful prevention of type 1 diabetes (T1D) is a major clinical goal. The pathogenesis is multifactorial, with genetic and environmental influences that lead to a break in immune tolerance toward pancreatic beta cells. Through a number of prospective cohort studies, it is now understood that the presence of two or more diabetes-associated autoantibodies is highly predictive of future T1D diagnosis. In addition to the genetic rationale (insulin gene sequenc...

Introduction: Osteogenesis imperfecta (OI) is a rare, heterogeneous, genetic connective tissue disorder that manifests clinically as bone fragility, brittleness and growth disorder. Effective diagnosis is important (although often challenging) to enable institution of early and effective multidisciplinary management.The case: A 19-year-old woman was referred to the Endocrine clinic at the Warwickshire Institute for the Study of Diabetes, Endocrinology an...

Alterations in maternal metabolism can programme disease in the offspring. Intrahepatic cholestasis of pregnancy is a liver disease of pregnancy that presents with increased maternal serum bile acids (BA) and dyslipidaemia. We aimed to investigate whether cholestatic pregnancy affects the subsequent health of the offspring. We developed a cholestatic mouse model by supplementation of a normal chow (NC) diet with 0.5% cholic acid during pregnancy. 18 weeks old female and male o...

Defending body weight is a fundamental homeostatic process. Indeed, countless studies have demonstrated weight-maintaining hyperphagia in response to either increased energy expenditure or a reduction in the caloric density of available food. The principal effector of this adaptive food intake is thought to be the adipose tissue-derived hormone, leptin. According to the classical ’adipostat’ model, the hypoleptinemia resulting from weight loss drives food intake to r...

Dietary fat intake is an important source of energy and in excess can drive the development of obesity. Investigating how dietary fat intake alters neuronal activity in the brain and drives behavioural changes may help us understand the mechanisms behind high fat diet induced obesity. 2-oleoyglycerol (2-OG) is a naturally occurring unsaturated long chain fatty acid produced by fat digestion in the gut and a ligand of G protein-coupled receptor 119 (GPR119). Published data has ...

Background: There are several good practices to improve DKA management across hospitals. However, the lack of a unified system limits comparisons and learning from each other.Objectives: To establish a DKA registry to identify best practices across centres in the West Midlands.Methods: All people admitted with DKA at four hospitals in the West Midlands (named A, B, C, D for anonymity) from 1st January 2020 to 31st December 2020 wer...

Kisspeptin is integral to hypothalamo-pituitary-gonadal (HPG) axis function and overall fertility. Functional deficiency of GnRH/lH secretion in the central reproductive disease, hypothalamic amenorrhoea (HA), indicates diminished kisspeptin signalling. Clinical trials have shown kisspeptin to be a viable therapeutic intervention. However, repeated administration led to the development of tachyphylaxis and so is likely a problem for future implementation. Indeed, elevated LH r...

Introduction: Diabetes-related ketoacidosis (DKA) is an acute endocrine emergency requiring immediate diagnosis and management. Common misconception is that DKA is associated with type 1 diabetes only. We explored the proportion of people with type 2 diabetes, and compared the management, complications and outcome of DKA between people with type 1 and type 2 diabetes.Methods: We conducted a retrospective study on people admitted with DKA across six hospi...

Background: Hyperosmolar hyperglycaemic state (HHS) is an acute metabolic complication of diabetes that can lead to significant morbidity and mortality if managed incorrectly. With <1% prevalence, there is limited published literature available on HHS and most management guidelines worldwide are based solely on expert advice and opinions.Aims: To study the precipitating causes and identify baseline practises of HHS management, to highlight areas for ...