Endocrine Abstracts

Introduction: Children with adrenal insufficiency requiring hydrocortisone rely on compounded adult medication. This study aimed to evaluate the absorption, palatability and safety of Alkindi® (hydrocortisone granules in capsules for opening).Methods: The phase 3 study was an open-label, single-dose study in a total of 24 children (aged 0–6 years) with adrenal insufficiency. Fasted children were given a single dose of Alkindi&#1...

Background: Treatment of congenital adrenal hyperplasia (CAH) in childhood focuses on growth and development; however the relationship of childhood treatment with adult health outcomes is not established. We explored this by examining relationships between final height (FH) and cardiometabolic risk in CAH adults.Methods: Cross-sectional analysis of 65 men (80% salt wasting (SW) and 20% non-SW) and 134 women (74% SW and 26% non-SW), aged 18–69 years....

Background: Quality of life (QoL) has been variously reported as normal or impaired in congenital adrenal hyperplasia (CAH) adults. We found impaired QoL in UK CAH adults (Arlt et al. Journal of Clinical Endocrinology and Metabolism 2010 95 5110–5121) and now report the relationship between QoL (SF-36) and health outcomes in these patients.Methods: Cross-sectional analysis of 151 CAH adults with 21-hydroxylase defi...

Congenital adrenal hyperplasia (CAH) represents the most common inborn metabolic error and is associated with significant morbidity and mortality. There is a paucity of clinical data in adult patients, a lack addressed by congenital adrenal hyperplasia adult study executive (CaHASE), a multicentre cross-sectional study of the health status of adults with CAH that recruited 203 patients from 17 centres (54% of patients contacted). Psychometric evaluation was assessed by validat...

CaHASE is a multicentre cross-sectional study of the health status of adults with congenital adrenal hyperplasia (CAH). Although fertility is considered to be reduced in both sexes, few published series report the proportion that has actively sought pregnancy. About 203 patients were recruited from 17 centres. Four patients (3, 11-hydroxylase, 1 HSD3B2 deficient) were excluded from analysis. Demographics are shown in Table 1.<table boarder="1" cellpadding="3" cellspacing="...

Background: The majority of patients with GH insensitivity have defects in the extracellular domain of the GHR. We have identified a 47yr old woman homozygous for a 22bp deletion in the cytoplasmic domain of the GHR. The patient had high GH levels, and low IGF-1 of 8 ug/L (normal 54-389 ug/L), IGFBP-3 16nmol/L (normal 61-254 nmol/L) and GHBP 6.8 percent (normal greater than 10 percent) levels. We report functional studies for this mutation (GHR1-449) which results in premature...

We have previously demonstrated that a truncated GHR lacking the cytoplasmic domain of the receptor acts as a dominant negative regulator of receptor signalling. Glycosylphosphatidylinositol (GPI) anchors are a common mechanism by which cells direct and anchor proteins in the cell membrane. We have generated a GHR extracellular domain-GPI fusion protein and tested its biological activity as a receptor antagonist. The extracellular domain of GHR (growth hormone binding protein-...

We have previously reported dominant negative missense mutations (P467L, V290M) in human PPAR gamma (peroxisome proliferator-activated receptor gamma) in association with severe insulin resistance, early onset type 2 diabetes and hypertension. In a large UK kindred, where the proband presented at age 15 years with severe insulin resistance (acanthosis nigricans, hyperinsulinaemia, PCOS), we have identified a novel heterozygous frameshift premature stop mutation in the PPAR gam...

Background: Mutations in the GHR result in extreme short stature (Laron's syndrome). We have studied mutations from two patients with Laron's syndrome. Patient 1 (GHRextra) has a mutation in the GHR extracellullar domain due to a 108bp inframe pseudoexon between exons 6 and 7. Patient 2 (GHRintra) has a 22bp deletion in exon 10 of the GHR leading to premature termination of the GHR upstream of the intracellular STAT5 binding site.Aim: To compare GHR str...

Background: Congenital hyperinsulinism of infancy (CHI) is the most common cause of severe hypoglycaemia in children. CHI arises from mutations in ion channel genes (ABCC8/KCNJ11), which lead to inappropriate insulin secretion. CHI is also associated with increased cell proliferation and altered islet cell development. The aim of this study was to investigate the composition of the islet capsule in CHI and to relate this to the organisation of islet cells.</p...