Endocrine Abstracts

A 50-year-old man presented with a week history of feeling unwell and urinary symptoms. He was confused. His wife gave H/O 2 stone weight loss. Recent investigation for haematuria showed 3.6 cm bladder tumour. He underwent TURBT and the histology was awaited. No other significant PMH or family H/O. Not on any medication and was an ex-smoker.Initial investigations showed leucocytosis and evidence of UTI. CXR showed chronic fibrotic changes. As a part of c...

A 24-year-old women (wt 63 kg, BMI 23) presented with history of secondary amenorrhea. Menarche occurred at age 16 years and was followed by a regular cycle (7/35). She started the combined oral contraceptive pill (OCP) at 18 years of age for menorrhagia and stopped this 16 months before her presentation, before undergoing elective surgery. Four months after discontinuing the OCP she experienced a single episode of PV bleeding, but otherwise remained amenorrhoeic. Past history...

Recently updated international guidelines recommend specialist surveillance of adults with Turner Syndrome (TS). In 2005, we established a dedicated TS clinic, attracting referrals from our general endocrine service and other specialities including primary care.Twenty-three patients currently attend of whom 9 were previously under endocrinology review. Karyotypes include 45XO (8/23), 45XO/46XrX (4/23), and 45XO/46XiXq (3/23). Mean (±S.D.</sma...

Primary hyperaldosteronism is now recognised as the most frequent underlying cause of hypertension. We recruited 94 patients (age (mean±S.D.) 56±11 years) with hypertension from primary care in order to study the role of corticosteroid hormone action in this cohort. Random, blood pressure (BP), plasma renin activity (PRA) and aldosterone (Aldo) was measured both on and off antihypertensive medication. In addition, a 24 h ambulatory blood pressure (ABP)...

Maternal nutrient restriction predisposes the adult offspring to metabolic syndrome. We investigated the effect of energy restriction during early or late gestation on glucose-insulin dynamics during a GTT (0.5 g/kg i.v. glucose) and/or an ITT (0.75 IU/kg) prior to and after significant gain in adipose tissue. 20 sheep were either fed to maintenance (1 M; CE, n=6) or to 0.65 M during early (0–65 days, term=147days, LEE, n=7) or late (65–125 days, LEL; <...

The epidemic of obesity, insulin resistance and type 2 diabetes has heightened the need to understand the mechanisms that contribute to their pathogenesis. Endogenous glucocorticoid (GC) production and metabolism have been implicated based upon parallels with Cushing’s syndrome. The interaction between GC metabolism and insulin sensitivity in the context of significant weight loss has not been explored. 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that gen...

Intra-abdominal adiposity is associated with insulin resistance and increased cardiovascular morbidity and mortality. Obesity occurs as a consequence of increased adipocyte size (hypertrophy) and number (differentiation or hyperplasia). Whilst differences in gene expression between omental (om) and subcutaneous (sc) adipose tissue have been described, the molecular mechanisms that underpin the differences in adipose tissue biology and the depot specific metabolic risks that th...

The adrenal steroid dehydroepiandrosterone (DHEA) and its sulphate ester, DHEAS have been shown to oppose the effects of glucocorticoids, thereby producing beneficial effects on insulin sensitivity in rodent models of diabetes and obesity and in hypoadrenal patients. Glucocorticoids, key regulators of adipose differentiation and insulin sensitivity, are reactivated locally by 11β-hydroxysteroid dehydrogenase type (11β-HSD1) oxoreductase activity, which increases with...

Type 2 diabetes manifests when pancreatic β-cells secrete inadequate insulin in response to elevated glucose. A known culprit in metabolic diseases is excessive exposure to glucocorticoids (GCs). GCs increase hepatic gluconeogenesis, decrease insulin sensitivity in skeletal muscle and adipose tissue and suppress the development of β-cells. In rodents, inactive GC 11-dehydrocorticosterone (A) is converted to active corticosterone (B) by the enzyme 11β-hydroxyster...

Introduction: Chronic hepatitis C has a high incidence in our country being a major public health issue.Aims and methods: To establish prognostic factors for developing thyroid dysfunction in patients with chronic hepatitis C receiving pegylated interferon and ribavirin therapy. A prospective study of patients with chronic hepatitis C on antiviral therapy was undertaken. 68 patients started on antiviral therapy in the period 1st January 2003 – 1st J...