Endocrine Abstracts

Introduction: Achieving glycaemic targets for young children with type 1 diabetes (T1D) is challenging due to rapidly changing physiology and behavioural patterns. An under-fives specialised multidisciplinary clinic (U5-MDT) was implemented in January 2022 due to poorer glycaemic control in this group compared to the rest of the clinic cohort. The U5-MDT aimed to optimise glycaemic control through access to technology while providing family support.<p clas...

The human endometrium is a complex multicellular tissue the prime function of which is to provide a receptive environment during a fertile cycle. The tissue responds to steroid hormones exhibiting dynamic cyclical regeneration, angiogenesis, differentiation (decidualisation) and inflammation. In the absence of an embryo the inner surface is shed and repaired without scarring (menstruation). The endometrium exhitbits spatial and temporal expression of androgen receptors (AR) in...

Endometrial cancer (EC) is the most common gynaecological malignancy. Obesity is a major risk factor for EC and is associated with elevated cholesterol. 27-Hydroxycholesterol (27HC) is a cholesterol metabolite that functions as an endogenous agonist for Liver X Receptor (LXR) and a selective estrogen receptor modulator (SERM). Exposure to estrogenic ligands increases risk of developing EC however the impact of 27HC on EC is unknown.Samples of stage 1 EC ...

Background: Adrenal incidentalomas are common and require investigation to exclude malignancy and evidence of hormone overproduction. Clinical guidelines recommend overnight dexamethasone suppression tests (ONDST) to assess for cortisol hypersecretion with cortisol levels of 50-138 nmol/l termed “mild autonomous cortisol secretion” (MACS). MACS may be associated with both cardiovascular and metabolic morbidity. We assessed cardiovascular risk in patients with MACS us...

Background: Adrenal incidentalomas are common amongst the general population, incidence increases with age. Radiological and biochemical assessment of all lesions >1 cm is standard practice to determine appropriate future management, as per current European guidelines. We report the experiences of a recently formalised adrenal multi-disciplinary pathway in a large UK teaching hospital, where all adrenal incidentalomas are referred and systematically assessed.<p cl...

Measurement of steroid metabolites in urine by gas chromatography-mass spectrometry remains the gold standard for biochemical diagnosis of steroidogenic disorders. In the UK, three laboratories offer steroid profiling for routine clinical testing, with the Supraregional Assay Service at King’s College Hospital being the largest and experiencing increased demand year-on-year for testing. In this study, we used our profiling database to audit 2021 workload. By direct compar...

A 51 year old female patient presented in 2000 with a 7 month history of diarrhoea and weight loss. Bloods revealed hypokalaemia (1.9). Infection and malabsorption screen negative, but patient remained hypokalaemic despite maximum iv and oral replacement. No abnormality was found endoscopically. Fasting gut hormone profile showed raised Vasoactive Intestinal Polypeptide (VIP) >400 (NR <30). CT scan confirmed 5cm mass in body of pancreas, no metastatic disease. Response...

The endometrium is a complex tissue with luminal and glandular epithelial cell layers supported on a multicellular stromal compartment; in women the inner (luminal) portion of the tissue breaks down and is shed during menstruation. The endometrium is exquisitely sensitive to the actions of sex steroids (oestrogens, progestogens and androgens) produced in ovarian and other extra gonadal tissues and delivered via blood vessels that rapidly develop and mature within the tissue (e...

Introduction: Oestrogen receptors (ER) are essential for reproductive function and fertility. ER46 is a 46 kDa truncated isoform of full length ERα (ER66) that binds oestradiol (E2) and can signal via nuclear or membrane-initiated signalling pathways. ER46 has been detected in breast cancer cell lines but expression in endometrial tissues has not been documented. The aims of this study were a) to determine whether endometrial cells express ER46, and b) to investigate a po...

Background: Many patients require IV insulin during their critical illness. Maintenance of insulin in St James’s Hospital ICU is governed by a local protocol. At the time of ICU discharge, IV insulin therapy is often stopped. Transitioning from IV to subcutaneous insulin is often done with endocrinology input. If this is unavailable inappropriate insulin dosing may increase the risk of hypo-/hyperglycaemia.Aims: To reduce the number of episodes of h...