Endocrine Abstracts

Cardiovascular disease is the leading cause of morbidity and mortality in patients with diabetic renal disease. We did a retrospective study on our Joint Diabetic-Renal clinic, which has run for 12 years, to see if we could reproduce targets from clinical trials and local guidelines in routine practice for management of cardiovascular risk. We collected data using clinical notes and electronic records on 133 patients. Our cohort included 62% type 2 and 38% type 1 Diabetics. Me...

Background: Pituitary dysfunction is a recognised consequence of traumatic brain injury (TBI) causing significant cognitive, psychological and metabolic impairment. Hormone replacement offers an important therapeutic opportunity. Blast traumatic brain injury (bTBI) from improvised explosive devices (IEDs) is commonly seen in soldiers returning from recent conflicts. We investigated: i) the prevalence and consequences of pituitary dysfunction following moderate-severe bTBI, and...

Background: A diagnosis of Addison’s disease means lifelong dependence on daily glucocorticoid and mineralocorticoid therapy and is associated with increased morbidity and mortality, as well as a risk of unexpected adrenal crisis. We wished to explore whether immunomodulatory therapy at an early stage of autoimmune Addison’s disease could lead to preservation or improvement in adrenal steroidogenic function.Design: We conducted an open-label, p...

Background: The European Society of Endocrinology (ESE) published guidelines to standardise intravenous hypertonic saline (HTS) for severe symptomatic hyponatraemia in 2014. Two 150 mL boluses of 3.0% HTS are proposed, one after the other, to achieve an initial sodium rise of 5 mmol/l without waiting for an interval sodium result. ESE guidelines were adopted by our University Hospital in 2017. However, high rates of sodium overcorrection were observed, and the guidelines lacke...

Development of a functional human lung requires regulation of cell growth, proliferation and differentiation in specific germ layer compartments. Important endocrine regulators of respiratory development include glucocorticoid (GC) steroids and the potent synthetic GC betamethasone is commonly used antenatally to treat the deficits of very preterm human birth. Previous studies with conditional mouse knockouts of the glucocorticoid receptor (GR) gene have established the mesenc...

Glucocorticoid (GC) signalling via the glucocorticoid receptor (GR) is essential for normal lung development. Previous work using conditional mouse knockouts of the GR gene established that GR activity in the mesenchymal compartment of the lung is critical for normal respiratory development. Screens for GC-target genes with conditional mesenchymal GR deficient mouse lung (GRmeskO) identified Versican (Vcan), an important extracellular matrix (ECM) component and cell proliferat...

A 69-year-old woman was admitted with new uncontrolled diabetes, severe hypertension and bilateral leg oedema. Cushing’s syndrome was suspected when she developed resistant hypokalemic alkalosis on diuretic therapy. Detailed questioning also revealed a history of episodic sweating, palpitation and tremor.Investigation & management: ACTH-dependant Cushing’s syndrome was confirmed: Serum ACTH 516 ng/l; urine free cortisol 20 045 nmol/24 h; 09...

Background: Incidence of hypercalcaemia during pregnancy is difficult to estimate as routine calcium screening is not recommended. Literature is conflicting if hypercalcemia results in worse maternal and fetal outcomes.Objectives: Aim of this study is to determine frequency and association of hypercalcaemia in pregnancy with early maternal and fetal outcomes.Methods: This retrospective cohort study included gestations with expected...

Background: Immigrants from the Middle East to Sweden have a twice as high prevalence of type 2 diabetes (T2D) and obesity as native-born Swedes. Both obesity and T2D have been linked to increased incidence of cancer, cardiovascular disease (CVD) and all-cause mortality (ACM); however, data on differences between ethnicities are scarce. Aims: In a population-based cohort we aimed to study the impact of Middle Eastern and European ethnicity on ACM, cancer...

Introduction: Abnormalities of glycoregulation are frequent in acromegaly (15-38%) secondary to insulin resistance related to GH/IGF-1 hyper-secretion. The frequency of gestational diabetes (GD) in women with acromegaly was reported in the French multicenter study (JCEM, 2010, 95, 4680) as increased mainly in the absence of pre-gestational control of GH/IGF-1 hyper-secretion. The aim of this study was to evaluate the frequency of GD in a cohort of acromegalic women, and compar...