Endocrine Abstracts

Adrenal crisis (AC) is a rare but life-threatening complication in chronic adrenal failure. Here we evaluated frequency, causes and potential risk factors of AC in a large sample of patients with primary AI (PAI) or secondary AI (SAI).In a cross-sectional study 883 patients with AI were contacted by mail. 526 patients agreed to participate and received a disease specific questionnaire. Diagnoses and co-morbidities were verified by review of medical recor...

Objective: There is evidence that current replacement regimens fail to restore well-being in patients with adrenal insufficiency (AI). No data is available on the effect of different therapeutical regimes (hydrocortisone, prednisolone and cortisone acetate) on the quality of life in these patients.Methods: Eight hundred and eighty three patients with adrenal insufficiency were contacted, 526 patients participated (60%) and received a disease specific que...

Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy with incompletely understood pathogenesis and poor prognosis. Recent data from the German ACC Registry (n=377) demonstrate an overall 5-year survival of 46%. Survival is clearly stage-dependent (P<0.01) with a 5-year survival of 85% in stage 1, 56% in stage 2, 42% in stage 3, and 16% in stage 4, respectively.In stages I –III open surgery by an expert surgeon aimi...

Background: Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy with incompletely understood pathogenesis and poor prognosis. Computerized tomography (CT) and magnetic resonance imaging (MRI) are routinely performed for imaging of the adrenal mass and for standard staging of chest and abdomen as lung and liver are the primary organs for metastatic spread in ACC. Contrast ultrasound is a non-invasive procedure which has been shown to have a high sensitivity an...

Insulinoma causes fasting hypoglycemia due to inappropriate insulin secretion. The diagnosis of insulinoma is based on Whipple’s triad (1. symptoms precipitated by fasting with 2. associated blood sugars of 50 mg/dl or less and 3. relief of symptoms by glucose administration) during a supervised 72 h fasting test. After introducing reliable assays for measurement of insulin and proinsulin, there is an ongoing debate whether a 48 h fasting test is sufficient for diagnosis ...

The role of oestrogens and androgens on bone metabolism has been studied extensively. However, less is known about the effects of progestins. The progesterone receptor (PR) is expressed in human osteoblasts. Progestins have been found to stimulate osteoblast proliferation, differentiation and growth factor expression (e.g. IGFBP-5) and to increase bone formation. In postmenopausal women progestins combined with oestrogen increased bone density to a greater extent than oestroge...

The role of 11beta-HSD2 is to provide selective access of aldosterone to the mineralocorticoid receptor (MR) by inactivating cortisol. Evidence suggests impaired 11beta-HSD2 activity in some patients with hypertension but also in patients with renal disease where it may contribute to sodium retention, oedema and hypertension. To date these studies have relied upon urinary cortisol metabolite analyses as markers of renal 11beta-HSD2 activity. We have directly analysed renal 11b...

Studies in rats suggest that androgens are involved in sex-specific differences in blood pressure. In human studies there is no difference in blood pressure between boys and girls, but following puberty, men present with a higher blood pressure than women. Modulation of sodium reabsorption through the ENaC is an important component in the control of sodium balance. This is clearly demonstrated by rare genetic disorders of sodium-channel activity (Liddle's syndrome and pseudohy...

The crucial role of vitamin D in mineral homeostasis is well known. However recent evidence has documented its importance for immunomodulation and inflammation. The kidney is the main source for the endocrine synthesis of the active metabolite 1,25-dihdroxyvitamin D3 (1,25D3), with expression of the key enzyme, 25-hydroxyvitamin D 1alpha-hydroxylase (1alpha-OHase). Our aim was to investigate the alteration of the vitamin D hormonal system in renal failure and assess the impact...

The role of 11beta-HSD2 is to provide selective access of aldosterone to the mineralocorticoid receptor by inactivating cortisol. Evidence suggests impaired 11beta-HSD2 activity in some patients with hypertension but also in patients with renal disease where it may contribute to sodium retention, oedema and hypertension. To date these studies have relied upon urinary cortisol metabolite analyses as markers of renal 11beta-HSD2 activity.We have directly a...