Endocrine Abstracts

Human obesity is characterised by an increase in both the number of adipocytes and by an increase in their size, which is determined by adipogenesis. Adipogenesis can be induced in vitro in preadipocytes cultured in differentiation medium containing 3-isobutyl-1-methylxanthine, insulin, dexamethasone, and triiodothyronine but the signalling pathways important in adipogenesis are not well characterised. The p38 mitogen-activated protein kinase (MAPK) signalling pathway i...

The adrenal cortex produces aldosterone, cortisol and adrenal androgens. ACTH regulates the production of both cortisol and adrenal androgens. However there are physiological and pathophysiological conditions where the production of these steroids is divergent. We examined the effect angiotension II (A-II) and insulin on the relative production of cortisol and adrenal androgens in the human adrenal H-295 cell line. We determined the ability of these secretogogues to regulate t...

The adrenal cortex produces aldosterone, cortisol and adrenal androgens in response to secretogogues including ACTH, angiotensin II(A-II) and insulin. Differential regulation of adrenal steroids is through the modulation of specific key steroidogenic enzymes. The capacity of the adrenal to produce cortisol is controlled in part by the transcription of 3beta-hydroxysteroiddehydrogenase (3beta HSD) and production of adrenal androgens by 17 hydroxylase/17-20 lyase (CYP17). Protei...

Perinatal glucocorticoid (GC) treatment accelerates lung maturation but may compromise health in adulthood, possibly via changes in hypothalamo-pituitary adrenal (HPA) activity. This study used western blot analysis and a well established in vitro method to investigate the effects of perinatal GC treatment on the expression and function of annexin 1 (ANXA1), a 37kDa protein which mediates facets of GC action in the neuroendocrine and host defence systems. Male rats were treate...

Insulin resistance is an established consequence of glucocorticoid excess. In rats, administration of the synthetic glucocorticoid dexamethasone decreases the sensitivity of glucose oxidation to insulin in soleus muscle strips, but sensitivity of lactate formation is unimpaired. In rats, cortisol impairs pyruvate tolerance and, in man, dexamethasone decreases whole-body glucose oxidation. The present study explored possible mechanisms that might underlie these effects. Activat...

Case History: We report the case of a 59-year-old lady with a persistently elevated serum thyroglobulin following a total thyroidectomy for multifocal papillary thyroid carcinoma. She subsequently underwent radioiodine therapy following which her serum thyroglobulin remained elevated. However, it was later found to be almost undetectable at 0.3 μg/l after a change in laboratory method. This discrepancy prompted further investigation, and repeat analysis using the original assa...

Introduction The diagnosis of carcinoid heart disease (CHD) is often made late and the patients are often deconditioned, with symptoms of fatigue, weight loss and refractory carcinoid symptoms. The challenge is then to improve the patient's condition by an enhanced pathway of prehabilitation and interventions, in order to consider surgical and medical therapies that can improve the patient's quality of life and prognosis. In 2018 due to the complexity of patients and increased...

Background: Adrenal incidentalomas (AI), the finding of asymptomatic adrenal lesion on unrelated imaging, represent an increasing number of endocrine referrals. In 2022, we introduced a nurse-led pathway to manage AI.Aim: To assess the cost savings and patient experience of a telephone nurse-led AI service at Musgrove Park Hospital.Methods: Records for patients seen in the AI clini...

Background: Patient Support Groups (PSG) play a key role in the support, education, research and training for patients and clinicians alike, as well as providing invaluable input to key documents e.g. Defining the Future of Endocrinology (DfE), highlighting the importance of a closer working relationship with SfE.About the PSG Network: Established in Sept 2021, the network includes representation from SfE affiliated PSG ...

Background: Advances in insulin pumps and continuous monitoring mean that, where indicated sensor augmented pump therapy (SAPT) can be prescribed for children under NHS care in England. National Paediatric Diabetes Audit (NPDA) data shows improved diabetes outcomes (in terms of HBA1c) in children managing their diabetes in this way. Use of this technology is significantly lower in children in the lower deprivation quintiles and in patients from non white ethni...