Endocrine Abstracts

Introduction: The prevalence of abnormal liver function tests (LFTs) in the general population has been estimated to be 8.1–9.8%. Abnormal LFTs are common in diabetes although there are still few studies describing the exact prevalence. AST-to-platelet-ratio-index (APRI) and Fibrosis-4-score (FIB4) are scoring systems which can be used to estimate the degree of liver fibrosis. An APRI score >1 has a sensitivity of 76% and a specificity of 72% for predicting cirrhosis ...

Background: Neuroendocrine tumours (NET) can affect various tissues and organs, have different clinical presentation and prognosis, depending on the primary tumour site, grading, differentiation and functional status. Reported prevalence of bone metastases (BM) from NETs has been increasing with improved imaging modalities, reaching >40% in some reports. The BM diagnosis is associated with reduced overall survival; however, this was not confirmed by all studies.<p clas...

Increased adiposity is associated with insulin resistance, type 2 diabetes and metabolic dysfunction. Altered adipokine secretion, changes in local and systemic glucocorticoid metabolism and increased inflammation have all been postulated as contributory mechanisms. We have previously described changes in subcutaneous adipose tissue (SAT) gene expression that are associated with obesity and glucose intolerance in cross-sectional studies. However, the effects of longitudinal ch...

Introduction: Patients with subclinical Cushing’s syndrome (SCS) present with increased cardiovascular morbidity and mortality, however, the beneficial effect of adrenalectomy on cardiovascular risk factors is uncertain.Objective: Systematic meta-analysis to determine the effect of adrenalectomy vs conservative follow-up on cardiovascular risk factors in patients with adrenal tumors and SCS.Methods: We searched 6 databases thr...

Background: The short Synacthen test (SST) is the most widely used dynamic assessment of adrenal reserve. In some situations, the SST may be difficult to perform. Random basal cortisol levels could provide an alternative screening assessment to rationalize which patients need dynamic testing. This is highly clinically relevant, given the large numbers of patients taking prescribed glucocorticoids who are at risk of iatrogenic adrenal suppression.Methods:...

Introduction: Patients with MEN1 have increased morbidity and mortality compared to those patients with sporadic NETs. No genotype-phenotype correlation is described and age-related clinical penetrance surpasses 50 and 90% by 20 and 40 years, respectively. The aim of the audit was to compare the screening programme for MEN1 patients with MEN1 clinical guidelines.Methods: Case notes of MEN1 patients attending a tertiary NET-multidisciplinary team (MDT) in...

Dysregulation of the enzymes that control local tissue steroid metabolism has been implicated in the pathogenesis of obesity and insulin resistant states, however longitudinal changes in glucocorticoid metabolism over time have not been investigated. This study was designed to evaluate the role of pre-receptor glucocorticoid metabolism in the development of insulin resistance and obesity. 24 h urinary glucocorticoid and mineralocorticoid metabolites were measured by gas chroma...

Polycystic ovary syndrome (PCOS) is a clinical triad of anovulation, insulin resistance, and androgen excess. Hyperandrogenism may correlate with metabolic risk but PCOS consensus criteria currently define androgen excess on the basis of serum testosterone only. Here we studied the utility of the androgen precursor serum androstenedione in conjunction with serum testosterone as a predictor of metabolic dysfunction in PCOS.86 PCOS patients fulfilling Rott...

The causative link between circulating glucocorticoid excess and osteoporosis is established. Although circulating cortisol levels do not change significantly with age, local tissue metabolism may be implicated in age-related bone loss. The enzyme11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) increases local cortisol production, is expressed in human osteoblasts and its activity increases with age leading to a decrease in bone formation. We hypothesised that sele...

A 48-year-old man was referred for investigation of uncontrolled hypertension on four agents (olmesartan, felodipine, hydrochlorothiazide and spironolactone) and a 3 cm right-sided adrenal adenoma (pre-contrast Hounsfield units 25). Endocrine investigation for the hypertension and adrenal mass included: androstenedione 19.9 nmol/l 2.8–10.5) (elevated on two occasions on a Siemens Coat-A-Count assay), DHEA 0.7 μmol/l (2.1–15.2), 1 mg overnight dexamethasone suppr...