Endocrine Abstracts

The rate limiting steps of hepatic glucocorticoid clearance are via A-ring reduction by 5α- and 5β-reductases. Our recent in vitro studies suggested that products of 5α-reduction (eg 5α-tetrahydrocorticosterone) can activate glucocorticoid receptors and hence may contribute to glucocorticoid action in liver. Here we compared the effects of administering 5α-tetrahydrocorticosterone (5αTHB) in vivo with those of corticosterone (B)....

Background: Surgery, sometimes supported by adjunctive radiotherapy (RT) are the treatments of choice for patients with non-functioning pituitary adenomas (NFA). Previous studies have implicated these treatments in deficits of cognitive function, particularly memory and executive functioning, although this research has often been confounded by the inclusion of patients with hormone producing tumours. The aim of this study was to determine the impact of RT on psychometric funct...

PPARgamma-agonists improve insulin sensitivity and discourage visceral fat accumulation but mechanisms remain uncertain. In rodents, PPARgamma-agonists downregulate 11beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1) in adipose tissue (AT), thereby potentially decreasing intra-adipose glucocorticoid (GC) concentrations. We tested whether PPARgamma-agonists regulate 11b-HSD1 in humans, and if their insulin-sensitising effect is GC-dependent.12 healthy m...

Background: Fine needle aspiration biopsy (FNA) is the cornerstone of assessment of thyroid nodules. Cytological criteria for benign (THY2) and malignant (THY5) nodules are well-established and reliable. In a minority of patients cytology raises the possibility of a neoplasm (THY3) and only formal histological assesment can differentiate between benign and malignant lesions.Method: Retrospective review of histological and clinical data in a cohort of pat...

Obesity is associated with decreased hepatic reactivation of glucocorticoids (Gc) by 11β-hydroxysteroid dehydrogenase type 1 (11HSD) and increased metabolism of glucocorticoids by hepatic A-ring reductases, which may contribute to activation of the hypothalamic-pituitary-adrenal axis. Androgen action encourages central obesity and increased metabolic complications, possibly by altering Gc metabolism.This study investigates the role of gonadal androg...

A 30-year-old woman with long standing type 1 diabetes presented with recurrent severe hypoglycaemia. One month earlier she had given birth to her first child. Before pregnancy her HbA1c had been 7.8 to 9.2 percent (RR 3.1 to 5.0 percent) but improved by the third trimester to 6.8 percent. Before pregnancy her total daily insulin dose was 50 units and by the third trimester it had only increased by 25 percent to 60 units. The pregnancy and birth were uneventful with no hypogly...

Inhibiting 11beta-hydroxysteroid dehydrogenase type 1 (11HSD1) has been proposed to prevent local regeneration of cortisol from cortisone, and thus enhance hepatic and adipose insulin sensitivity. In healthy men and patients with type 2 diabetes, the non-selective 11HSD inhibitor carbenoxolone enhances hepatic insulin sensitivity but, paradoxically, does not increase peripheral glucose disposal. In obesity, 11HSD1 activity and mRNA are increased in adipose biopsies. We tested ...

A 22 years old woman presented with a few days history of nausea, vomiting and general lethargy. She was not on any treatment except the oral contraceptive pill (OCP). She was apyrexial, tachycardic at 140/min with a regular pulse and her blood pressure was 110/70. She was not pigmented. Her plasma sodium was 131 mmol/l, with normal potassium, creatinine and urea. Her arterial blood gas analysis showed a pH of 7.22 and bicarbonate of 12mmol/L. Her TFTs showed a thyrotoxic pict...

Obesity is associated with hypothalamic-pituitary-adrenal (HPA) axis activation. In obese humans and leptin-resistant obese Zucker rats, we have reported increased excretion of A-ring reduced glucocorticoid metabolites. We have now investigated regulation of hepatic A-ring reductases in the obese Zucker rat.Lean and obese Zucker rats (9wks) were studied either: 3-weeks after adrenalectomy (ADX) or sham surgery; or after 3-weeks treatment with metformin ...

A 69-year-old non-diabetic woman presented with 1 month of recurrent drowsiness and confusion secondary to hypoglycaemia, nocturnal and on fasting. On admission her CBG was 2.6 mmol/l, confirmed venously. Her history was of a large solitary fibrous tumour (SFT) of the chest wall first resected in 2011 with recurrent relapses requiring surgery in 2016 and 2017. Histology showed typical features of SFT. Despite palliative chemo-radiotherapy for a further relapses, there was prog...