Endocrine Abstracts

Background: Diabetes is a metabolic disorder characterized by chronic hyperglycaemia as a result of defective insulin secretion, insulin action or a combination. Poor glycaemic control increases the risk of microvascular and macrovascular complications. For group two driving license holders with diabetes there are specific requirements set out by the Driver and Vehicle Licensing Agency. It is therefore hypothesised that this patient group is likely to aim for less tight glycae...

Cutaneous and subcutaneous metastases are very rare in well differentiated neuroendocrine tumours with a handful of case reports available to date. Head & neck and bronchial NET seem to show this feature most commonly. Such metastases can be very painful and display allodynia (pain occurring on exposure to non-painful stimuli), even if growing very slowly. We describe the case of a young patient who underwent surgical resection of a typical bronchial NET who developed pain...

Background: Gestational diabetes (GDM) leads to an increased risk of delivering large-for-gestational-age infants (LGA), which has been linked to altered placental vascular development. Women with GDM who deliver LGA infants have temporal periods of mild hyperglycaemia, detectable by continuous glucose monitoring (CGM), compared to women who deliver appropriate-for-gestational-age infants (AGA). This study aimed to assess the impact of physiological periods and levels of hyper...

Introduction: Blood chimerism is the condition characterized by the presence of cells from at least 2 zygote lineages in only the lympho-hematopoietic system. It is very rare in humans and is most commonly seen in monozygotic monochorionic twins through placental anastomoses.Case report: A 12 years old young girl, one of dichorionic dizygotic twins, had a genetic test performed for paternity issues. CGH array showed 46XY genotype (90%) and another genoty...

Introduction: Obesity is a growing health concern in developed countries. Patients undergoing treatment for hyperthyroidism frequently express concerns regarding excessive weight gain, especially when offered treatment with I-131.Methods: We investigated 1047 patients with overt hyperthyroidism attending a specialist thyroid clinic to determine the extent of weight changes and to identify risk factors for weight gain following treatment. Weight differenc...

Obesity is a global health concern and the proportion of overweight and obese people in the UK is rapidly increasing. Patients undergoing treatment for hyperthyroidism frequently express concerns regarding excessive weight gain, especially when offered treatment with I-131. We investigated 1047 patients with overt hyperthyroidism to determine the extent of weight changes and to identify risk factors for weight gain following treatment. Overall, 727 (69.4%) patients gained &#88...

The high dose short Synacthen (corticotropin) test (SST) is widely used to investigate suspected secondary adrenal insufficiency but concern remains about falsely reassuring results with potentially serious clinical consequences.In order to evaluate the long-term safety of the SST, we retrospectively evaluated the clinical outcome in 178 patients who achieved 30-minute cortisol values in the lowest 15th percentile of normal healthy responses. This subgro...

The global epidemic of obesity has heightened the need to understand the mechanisms that underpin its pathogenesis. Clinical observations in patients with Cushing's syndrome have highlighted the link between cortisol and central obesity. However, whilst circulating cortisol levels are normal or reduced in obesity, local regeneration of cortisol, from inactive cortisone, by 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) has been postulated as a pathogenic mechanism. W...

Human obesity is characterised by an increase in both the number of adipocytes and by an increase in their size, which is determined by adipogenesis. Adipogenesis can be induced in vitro in preadipocytes cultured in differentiation medium containing 3-isobutyl-1-methylxanthine, insulin, dexamethasone, and triiodothyronine but the signalling pathways important in adipogenesis are not well characterised. The p38 mitogen-activated protein kinase (MAPK) signalling pathway i...

The diagnosis of Cushing’s syndrome (CS) remains a major clinical challenge especially in a proportion of patients that have discordant results in the available tests. Although the measurement of 24-h urine free cortisol (UFC) is a useful test for the diagnosis of CS, 10–15% of patients have at least one measurement within the normal range and multiple measurements may be required in order to raise its sensitivity. In this study we sought to evaluate the value of the...