Endocrine Abstracts

Lord Reith famously characterised the BBC’s purpose as ‘to educate, inform and entertain’ (EIE). News and current affairs is a multibillion dollar industry that is rapidly expanding beyond traditional print, audio and vision formats, allowing the media to reach out even to the most isolated and disadvantaged populations worldwide. The media have an insatiable appetite for stories about medicine, healthcare and related scientific advances, because these strongly ...

The most common form of congenital adrenal hyperplasia is 21-hydroxylase deficiency (21OHD). The treatment for classic (severe) 21OHD differs from treatment of most other types of adrenal insufficiency in that not only must one replace the glucocorticoid and mineralocorticoid deficiency but also attenuate the high adrenal-derived androgen production. In order to reduce the adrenocorticotropin (ACTH) driven androgen production, supraphysiologic doses of gluco...

Autopsy studies report a reservoir of small, occult, and undiagnosed breast cancers in up to 15.6% of 40–80-year-old women dying from unrelated causes. Modeling of the biologic behavior of these occult tumors facilitates interpretation of the effects of hormone therapy in menopausal women. We used iterative and mathematical techniques to develop a model of occult tumor growth (OTG) whose parameters included prevalence, effective doubling time (EDT), and detection threshol...

Klinefelter syndrome (KS) is defined by at least one extra X chromosome in the male karyotope. The phenotype is highly-variable, but a degree of progressive testicular dysfunction is universal. 47XXY is the most common sex chromosome aneuploidy in humans and, together with much rarer forms (e.g. 48XXY and 48XYY) occurs in 0.1–0.2% live male births. However the prevalence of diagnosed KS among adult males in the UK and elsewhere is much lower, indicating only around 25% of...

The fractures that result from postmenopausal osteoporosis have a major public health impact. We have a number of drugs we can use to reduce the risk of these fractures. Most of these drugs are anti-resorptive, such as the bisphosphonates (alendronate, ibandronate, risedronate and zoledronate), raloxifene, oestrogen, and denosumab. Until recently the only anabolic agent available was teriparatide. However, in the last couple of years two new agents have been approved in some c...

I received a clinical fellowship from the Medical Research Council to study osteoporosis at the University of Edinburgh in 1978. I furthered my clinical research training by working at the Mayo Clinic under the supervision of Dr B L Riggs where I worked for five years. I developed a number of new approaches for studying osteoporosis while at the Mayo Clinic including the use of stable (non-radioactive) isotopes to measure the absorption of calcium from food, the use of an infu...

Osteoporosis is a silent disorder characterized by reduced bone strength predisposing to increased fracture risk. Although osteoporosis affects women more often than men, ~20% of the 44 million Americans who have osteoporosis or low BMD are men. Between 30 and 40% of fractures due to osteoporosis occur in men; the lifetime risk of fracture for men aged 50 or older is between 13 and 30%. Osteoporosis in men causes significant morbidity and mortality. The major mechanism underly...

CAH is the commonest inborn endocrine disorder and associated with significant morbidity. The health status of CAH adult patients has recently been reported by the UK Congenital adrenal Hyperplasia Adult Study Executive, CaHASE (Arlt et al. JCEM 2010 95 5110–5121). Compared to the health survey for England, metabolic abnormalities were common in adult patients with CAH: obesity (41%), hypercholesterolemia (46%), insulin resistance (29%),...

Chronic hypovolemic hyponatriemia is typical for Addisonian crisis and may provoke brain edema but its rapid correction may lead to myelinolysis. We report 2 newly diagnosed cases of primary adrenal insufficiency (PAI) associated with severe hyponatriemia which correction was complicated by osmotic myelinolysis.Case 1: Twenty four-year-old female was admitted with vomiting, sopor, shock. Serum sodium was 83, glucosae 3.6 mmol/l. Serum cortisol 34 nmol/l ...

Cortisol is an essential stress hormone and replacement with oral hydrocortisone is lifesaving in patients with adrenal insufficiency. Cortisol has a diurnal rhythm regulated by the central body clock and this rhythm is a metabolic signal for peripheral tissue clocks. Loss of cortisol rhythmicity is associated with fatigue, depression and insulin resistance. A general principle in endocrinology is to replace hormones to replicate physiological concentrations; however the pharm...