Endocrine Abstracts

Background: A cardinal feature of acromegaly is insulin resistance. Patients with acromegaly are therefore predisposed to developing impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). It is therefore imperative to develop better biomarkers predicting the onset of IGT and T2DM in treated acromegalic patients. There is controversy whether GH or insulin-like growth factor 1 (IGF1) better predict the onset of IGT or T2DM in treated acromegalic patients. However ...

Background: The hypothalamus is a critical area of the brain involved in the regulation of appetite. Cerebellin1 (Cbln1) is a highly conserved 16 amino acid neuropeptide. High levels of Cbln1 mRNA expression are found in specific hypothalamic areas involved in appetite regulation.Aim: To examine the effects of Cbln1 on food intake in rodents.Methods: 1. Ad libitum fed rats were injected intracerebroventricularly (ICV) with Cbln1 (1...

A 59-year-old lady presented with significant weight gain, and a history of hypertension for investigation of possible Cushing’s syndrome. Her BMI was 29, with mainly central obesity. Initial tests revealed elevated untimed cortisol on two separate occasions, at 905 nmol/l and 893 respectively with detectable midnight cortisol, at 548 and 481. Of 24-hour urinary free cortisol (UFC) was also elevated on two separate occasions, at 931 nmol/24 h and 827 respectively. ACTH wa...

Background: Secondary adrenal insufficiency is a common complication of transsphenoidal hypophysectomy (TSS) for pituitary adenoma. It is therefore imperative to rapidly and accurately identify patients requiring glucocorticoid replacement, thus minimising risks of adrenal insufficiency or unnecessary glucocorticoid exposure. The gold-standard test of HPA axis reserve, the insulin tolerance test (ITT), cannot be performed safely until after post-operative recovery. Nine am cor...

Hypophysitis describes inflammatory pituitary lesions which can be classified into lymphocytic (autoimmune), granulomatous or xanthomatous. Rathke’s cleft cysts (RCC) are usually assymptomatic, benign tumours derived from remnants of Rathke’s pouch. We present a case of lymphocytic hypophysitis secondary to a ruptured RCC and the first reported case of post-surgical recurrence.A 34-year-old female presented with secondary amenorrhoea and fatigu...

BackgroundSR141716 (Rimonabant) has been shown to significantly inhibit food intake and reduce body weight in rodents and humans by antagonising CB1 receptors. The gut hormones peptide YY3–36 (PYY3–36) and oxyntomodulin (OXM), released from L-cells in the small intestine inhibit food intake in both rodents and humans and this effect is thought to be mediated via the hypothalamus.Objective<...

Neuropeptide S (NPS) is a recently discovered peptide shown to be involved in the modulation of arousal and fear responses. It has also been shown that lateral ventricle administration of NPS causes a significant decrease in food intake. Neuropeptides involved in the modulation of arousal have been shown to be involved in the regulation of the hypothalamo-pituitary adrenal (HPA) axis and food intake.Objective: To examine the effect of NPS on the regulati...

The definition of early cure post transphenoidal surgery (TSS) for Cushing’s disease continues to be debated. The low dose dexamethasone suppression test with corticotrophin releasing hormone (LDDST-CRH) is a test for diagnosis of Cushing’s; however it has not been validated in early post TSS to determine remission. The aim of this study was to determine whether the combined LDDST-CRH test could be used in post TSS patients.The combined LDDST-C...

The rising prevalence of obesity and type II diabetes makes the diagnosis of Cushing’s syndrome increasingly difficult. The dexamethasone-suppressed corticotrophin-releasing hormone (CRH) test, which involves CRH administration immediately following a standard low dose dexamethasone suppression test (LDDST), has been reported to diagnose Cushing’s syndrome with 100% sensitivity and specificity. We adapted our LDDST protocol to include CRH administration post-dexameth...

Agouti-related protein (AgRP) and neuropeptide Y (NPY) are co-localised in hypothalamic arcuate nucleus neurons that have been implicated in the regulation of energy balance. Both AgRP and NPY stimulate food intake when administered into the third ventricle and are up-regulated in states of negative energy balance e.g. fasting. AgRP/NPY neurones are thought to play a role in the integration of information received from circulating satiety factors and signals of energy store st...