Endocrine Abstracts

Chemical-analytical methods are currently in use as the gold standard approach for the detection of androgens, designer androgens and selective androgen receptor modulators (SARMs) in serum and urine samples from athletes as well as in sports supplements. These methods are exquisitely sensitive and selective. However, they have the disadvantage in that the androgens that being surveyed for must have delineated structures. Designer androgens or SARMs that have divergent structu...

Therapeutic glucocorticoids are used in rheumatoid arthritis (RA) to reduce inflammation and bone destruction. We recently reported that primary synovial fibroblasts generate active glucocorticoids via expression of 11beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1). This enzyme activates cortisol from inactive cortisone (and prednisolone from prednisone) and this activity is up-regulated by inflammation. We have now examined glucocorticoid metabolism in synovial tissu...

A role for local corticosteroid metabolism by 11beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1) has been proposed in bone and adipose tissue physiology. In vivo, 11b-HSD1 predominantly converts inactive cortisone to active cortisol and enzyme activity is critically dependent on substrate concentration. To examine 11b-HSD1 activity in vivo we have analysed the relationship between serum cortisone and markers of bone turnover, BMD and adipose tissue mass in a c...

Adiponectin, an exclusive adipose-derived hormone, circulates at high concentration, and exerts metabolic effects. Adiponectin levels in the circulation correlate negatively with BMI, and low adiponectin concentrations are associated with the low grade inflammation and metabolic dysfunction that accompanies obesity. Adiponectin has been reported to have potent anti-inflammatory activities, and to exert these effects by regulating macrophage function. The mechanism of adiponect...

Glucocorticoid (GC) excess adversely affects many aspects of skin homeostasis, characteristics of which are also seen during ageing (e.g. poor wound healing). The mechanisms underlying this remain unclear. The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) regenerates cortisol, independently of circulating concentrations, and we have previously demonstrated increased 11β-HSD1 expression in human dermal fibroblasts (HDF) from aged donors. We have now e...

Concerns have been raised that undergraduate medical education in Endocrinology/Diabetes (E&D) is not preparing students adequately for clinical practice. This project assessed trainer perceptions of the delivered D&E curriculum and identified areas for improvement. We surveyed E&D consultants at the 12 hospitals which accept students from our medical school using an online questionnaire. Emails were sent to 50 consultants. The response rate was 46% (23/50 recipien...

Harvey Cushing’s work informed us of the deleterious consequences of circulating cortisol excess – hypertension, osteoporosis and obesity that contributes to diabetes and premature mortality. Conversely, Hench, Kendall and Reichstein were Nobel Laureates in Physiology 1950 for the discovery of cortisone and demonstrating efficacy in patients with Rheumatoid Arthritis – in effect the birth of the anti-inflammatory actions of glucocorticoids.<p class="abstext"...

Background: Measurements of thyrotropin (TSH), free thyroxine (FT4) and triiodothyronine (FT3) are widely used diagnostic methods for thyroid function evaluation. However, some serum samples will demonstrate a nonspecific binding with assay reagents that can interfere with the measurement of these hormones. Few case reports of TSH interfering antibodies have described the presence of such interferences resulting in reported abnormal concentrations of thyroid hormones. Unusual ...

Background: Postural hypotension has been commonly described in elderly. Common causes include medication, fluid loss, adrenal insufficiency and autonomic dysfunction. Hyponatremia is not a disease in itself, but a manifestation of a variety of disorders and side-effects of diuretics; alternatively, it may be the only manifestation of certain disorders. We present a case of primary hypothyroidism presenting as collapse with postural hypotension and severe hyponatremia.<p c...

Background: Sunitinib is a tyrosine kinase inhibitor used in the treatment of metastatic GIST and renal cell carcinoma. Tyrosine kinase receptors are involved in tumour growth, angiogenesis and metastatic invasion. It can cause hypothyroidism but few cases have actually been reported. Mechanisms suggested for the incidence of hypothyroidism include antithyroperoxidase activity,1 and blocking uptake of iodine in the thyroid gland,2 or it may induce destruc...