Endocrine Abstracts

Objective: Many patients receiving thyroid hormone replacement therapy complain of persistent lethargy and related symptoms even with normal TSH levels. However, it remains unclear whether this is related to thyroxine replacement or coincidental psychological morbidity.Design: Using general practice computer records, 961 patients on thyroxine (minimum of 4 months) and their age- and sex-matched controls were identified and sent a two-page questionnaire, comprising the shor...

Patients with acromegaly treated with medical therapy intermittently discontinue therapy to allow assessment of underlying disease activity. This is particularly so in patients treated with pituitary irradiation. Typical 'washout' times include 5 weeks for bromocriptine and 2 weeks for short-acting sc octreotide; longer periods are required for cabergoline and slow-release somatostatin analogues. Pegvisomant is a novel medical therapy for acromegaly that functions as a GH rece...

Journal of Endocrinology, 2022, 252(1), 59-70 (DOI: https://doi.org/10.1530/JOE-21-0298): ...

Background: Somatic and bi-allelic DICER1 mutations have been reported in subsets of sporadic thyroid tumors, affirming a clear involvement of this gene in the development of thyroid tumors. As a recent study has highlighted associations between DICER1 mutations and macrofollicular patterns, abortive changes, and papillary structures, we aimed to investigate these observations in a bi-institutional cohort.Methods: A total of 61 thyroid lesions (...

The pathological expansion of white adipose tissue (WAT) in obesity involves adipocyte hypertrophy accompanied by expansion of collagen-rich pericellular extracellular matrix (ECM) and the development of crown-like structures (CLS). Traditionally, WAT morphology is assessed through immunohistochemical analysis of WAT sections. However, manual analysis of large histological sections is time-consuming, and available digital tools for analyzing adipocyte size and pericellular ECM...

Hypoparathyroidism is a rare endocrine disorder characterized by inadequate production of parathyroid hormone to maintain normal blood calcium levels. Hypoparathyroidism is most frequently caused by damage to or removal of the parathyroid glands but can also be associated with genetic etiologies. Genetic forms of hypoparathyroidism can present as isolated or as part of a syndrome and include disorders of parathyroid gland formation, parathyroid hormone secretion, and damage to...

Protein stimulates insulin release and improves post-prandial glycaemic excursions. The underlying mechanism has previously been attributed to gastric emptying, incretin release and direct pancreatic stimulation. However, our studies suggest the calcium sensing receptor (CaSR) in the vagus nerve plays an important role. The CaSR has a well characterised role in calcium homeostasis, but also acts as a protein metabolite sensor. In response to the amino acid products of protein ...

Growing evidence implicates gut microbiota-derived metabolites in metabolic homeostasis. Gut microbial dysbiosis occurs in obesity, while high-fibre and high-protein diets, which improve glucose tolerance and induce weight loss, are associated with the generation of microbial metabolites. Understanding how the gut responds to microbial metabolites may identify mechanisms that induce satiety and improve glucoregulation, revealing novel therapeutic targets. Indole is generated f...

Neurotensin is a 13-amino acid peptide expressed in both the brain and the gastrointestinal tract where it acts as a neuropeptide and gut hormone, respectively. Centrally, neurotensin plays a role in appetite, analgesia and thermoregulation, whereas peripheral neurotensin regulates lipid absorption, gastric emptying and exocrine pancreatic secretion. The role of neurotensin in the control of glucose homeostasis currently remains unclear. We found peripheral administration of n...

Autosomal dominant hypocalcemia type 1 (ADH1), caused by gain-of-function calcium-sensing receptor gene (CASR) variants, is characterized by low parathyroid hormone (PTH) levels, hypocalcemia, hypercalciuria, hyperphosphatemia and hypomagnesemia. Conventional therapy (calcium and active vitamin D) worsens hypercalciuria, which may result in renal complications. Calcilytics, such as encaleret, are negative allosteric modulators of the calcium-sensing receptor (CaSR). T...