Endocrine Abstracts

Bisphosphonates are the treatment of choice for Paget’s disease of bone (PDB). However, long-term effects on complications are unknown. The PRISM trial was a randomised controlled trial comparing symptomatic management and intensive bisphosphonate therapy for PDB, and involved 1324 patients followed for a median of 32 months (range 12–48). Patients allocated to symptomatic therapy (n=663) were untreated unless they had bone pain, at which point they received a...

Rationale, aims and objectivesThe GHRH/Arginine and Short Synacthen Tests (SST) have been validated as safer alternatives to the Insulin Tolerance Test for the assessment of the growth hormone reserve and Hypothalamic-Pituitary-Adrenal axis integrity, respectively. However, these two tests are performed separately. The objective of this study was to see whether the synacthen and GHRH/Arginine tests could be combined to save time, blood samples and minimi...

Although hydrocortisone is the standard replacement therapy for primary or secondary adrenal insufficiency (AI), there are limited data on dosage requirements and the value of salivary monitoring in this patient group. We assessed inter-individual variability in cortisol metabolism and relationships between plasma and salivary cortisol profiles in 27 patients. Ten (3 male) patients had primary AI and 17 (8 male) secondary AI. Salivary and plasma cortisol levels were measured a...

There is evidence that an unbalanced maternal diet, combining a high ratio of protein to carbohydrate with low intakes of folate and green vegetables imposes a metabolic stress on the mother and fetus leading to fetal growth retardation. Because recent studies have shown that high protein maternal diets are associated with raised offspring blood pressure, we have assessed whether this form of unbalanced maternal nutrition is also associated with glucose intolerance.<p clas...

Hydrocortisone is the standard replacement therapy in patients with primary or secondary adrenal insufficiency (AI) but there is no current consensus on the most appropriate replacement dose and the extent to which this varies between individuals. This study examines inter-individual variability in cortisol metabolism in patients taking hydrocortisone therapy and investigates the relationship between plasma and salivary concentrations.Subjects and Method...

Recent studies have highlighted a role for vitamin D in the prevention and treatment of breast cancer. The active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25D3), is a potent antiproliferative/proapoptotic agent and its nuclear receptor (vitamin D receptor, VDR) is well expressed in breast tissue. We have investigated whether or not VDR signalling in breast tumours is due to systemic (renal) 1,25D3 or, as with oestrogens, there is local sy...

Nonautoimmune hyperthyroidism (NAH) inherited as an autosomal dominant trait can result from activating germline mutations in the thyrotropin receptor (TSHR) gene. Clinical features described include nonremitting thyrotoxicosis, absence of the features of autoimmune thyrotoxicosis, advanced bone age and increased growth velocity. We report a family with a heterozygous germline mutation of the TSHR gene resulting in the substitution of serine (AGC) by asparagine (AAC) at codon ...

Studies in vitro have highlighted the potent anti-cancer effects of the active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25D3). However, the in vivo application of 1,25D3 and its synthetic analogs remains problematical due to persistent hypercalcaemic side-effects. Recent studies have shown that it may be possible to overcome this in an autocrine fashion via extra-renal synthesis of 1,25D3. In particular, analysis of prostate and co...

We hypothesised that normal regulation of 25(OH)D3-24-hydroxylase (encoded by CYP24) determines the autocrine/paracrine action of 1,25(OH)2D3 in normal breast and prostate epithelial cells. Furthermore, these processes are compromised in malignancy.We therefore studied the regulation of CYP24, amongst a panel of breast and prostate cancer cell lines (ZR-75-1, T47-D, MCF-7, MDA-MB-231 breast cells and LNCaP, PC-3 and DU-145 prostate cells) that display d...

Background: The inclusion of a youth worker within a transition service can be pivotal to its success.Objective: To assess the impact of a youth worker on diabetes care in adolescents with type 1 diabetes (T1DM) over a 6 month period by measuring HbA1c levels (primary outcome), Personal Development Tool score (PDT), hospital admissions and clinic attendance (secondary outcomes).Method: Prospective cohort study. 20 adolescents (age ...