Endocrine Abstracts

Improvements in circulating cytokine levels have occurred in patients with endometriosis and chronic heart disease when prescribed the type 2 diabetes (T2D) drug metformin. However it is unclear how metformin exerts these effects and whether or not they are related to antihyperglycaemic effects in T2D. The purpose of this study is to investigate the relationship between anti-inflammatory and anti-hyperglycaemic effects of metformin in the liver, the main target tissue of the d...

The synthesis and metabolism of bile acids and steroid hormones are conflicted at several levels. We investigated potential interactions using a feeding paradigm to stimulate bile acid secretion and salivary steroid measurements to monitor post-prandial changes.The study followed a randomised cross over design; both cortisol and cortisone were measured by specific ELISAs to assess effects on 11 beta-hydroxysteroid dehydrogenase activity (11βHSD). At...

Objective: X-linked adrenoleukodystrophy (X-ALD) is a rare, sometimes devastating disorder caused by-mainly inherited- mutations in the ABCD1 gene. Cerebral X-ALD can be prevented or modified if diagnosed presymptomatically. Mutation can lead to very long chain fatty acid (VLCFA) accumulation in adrenocortical cells, which can cause antibody negative primary Addison’s disease (ANPAD). There are recommendations that all males affected by ANPAD should have VLCFA analysis. W...

Clinical Endocrinology 2013 79 27–34. DOI: 10.1111/cen.12206...

Thyrotoxicosis results in osteoporosis and thyroid hormone (T3) stimulates osteoclastic bone resorption by unknown mechanisms. We previously demonstrated that knockout mice lacking thyroid hormone receptor α (TRα0/0) are euthyroid but have high bone mass, whereas mice lacking TRβ (TRβ−/−) are thyrotoxic and have osteoporosis. Tartrate resistant acid phosphatase (TRAcP) staining revealed osteoclast numbers were re...

Case: A 41 year-old-Indian woman with type 2 diabetes treated with liraglutide was admitted to the Emergency Department with abdominal pain, nausea, vomiting and bloated abdomen. She was found to have raised amylase at 706 U/l. Abdominal ultrasound and CT scan did not reveal any abnormalities in the pancreas or billary tract and the patient was discharged.She had diabetes for 9 years duration treated with metformin, pioglitazone and liraglutide. Over 2 y...

Thyroid hormones regulate adult bone turnover. Thyrotoxicosis results in high turnover osteoporosis whilst hypothyroidism leads to low bone turnover with increased bone mass and mineralisation. T3-target tissues express thyroid hormone receptor alpha (TRα), thyroid hormone receptor beta (TRβ)or both receptors. TRα1 mediates the actions of T3 in bone and in skeletal cells TRα1 mRNA expression is 12-fold higher than TRβ1. Accordingl...

Childhood hypothyroidism results in delayed skeletal maturation and impaired growth. Thyroid hormones act via thyroid hormone receptors α (TRα) and TRβ which are tempo-spatially regulated. In the skeleton, TRα is the predominant receptor, thus we hypothesise that the skeletal effects of hypothyroidism are mediated by TRα. To investigate this we assessed the response of wild type (wt), TRα knockout (TRα0/0) and TRβ knockout (TR...

Cyclical Cushing’s syndrome is typically detected by collecting sequential daily early morning urine (EMU) samples for cortisol to creatinine ratio over a 28 day period. More recently nocturnal salivary cortisol (NSC) measurement has been shown to be a sensitive means of screening for Cushing’s syndrome. The Endocrine Society have suggested that NSC may be used to assess patients for cyclical Cushing’s however there is limited evidence that it correlates with th...

Aberrant and upregulated eutopic receptors have been identified in vitro in patients with primary aldosteronism (PA). We previously identified an exaggerated aldosterone response to synacthen in patients with PA versus healthy controls. In this study we aimed to evaluate whether the synacthen test differentiates between patients with PA and essential hypertension (EH).The 250mcg intramuscular synacthen test was performed after 30 minutes recumbenc...