Endocrine Abstracts

Background: Adrenal incidentalomas are common and require investigation to exclude malignancy and evidence of hormone overproduction. Clinical guidelines recommend overnight dexamethasone suppression tests (ONDST) to assess for cortisol hypersecretion with cortisol levels of 50-138 nmol/l termed “mild autonomous cortisol secretion” (MACS). MACS may be associated with both cardiovascular and metabolic morbidity. We assessed cardiovascular risk in patients with MACS us...

Lactation promotes infant development and confers long-term health benefits to mothers and infants. However, the endocrine and paracrine mechanisms mediating milk synthesis remain to be fully elucidated. Hormones such as prolactin and progesterone trigger the onset of lactation, whereas local mammary factors are considered to play a greater role in the maintenance of milk synthesis. We hypothesised that mammary epithelial cytokines are required for established lactation, and u...

Volume 82, Issue 1, January 2015, Pages 2–11. DOI: 10.1111/cen.12603...

Glucocorticoids (GC) drive multiple adverse effects in skin e.g. epidermal thinning, dermal atrophy and impaired wound healing (WH). Our previous findings indicate increased expression of the GC-activating enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) in primary human dermal fibroblasts (HDF), full-thickness skin from older donors and during the inflammatory phase of mouse skin WH. We also reported protection from age-induced dermal atrophy and improved W...

The emergence of prostate cancer and the progression of the disease are significantly driven by the androgen receptor (AR) in combination with other transcription factors. The evolution of aggressive disease requires tumours to become resistant to metabolic stress and subsequently therapeutic stress. Given the role of the prostate gland has a secretory organ characterised by high rates of protein synthesis particularly in AR-positive luminal epithelial cells there are inherent...

Glucocorticoids (GC) are critical to stress adaptation but in excess (Cushing’s syndrome) drive metabolic dysfunction. 11β-hydroxysteroid dehydrogenase type 1(11β-HSD1) amplifies intracellular GC signaling with 11β-HSD1KO mice protected from the side-effects of GC excess. Brown adipose tissue (BAT) function is impaired by GC’s, which repress UCP1 and beta-adrenergic stimulated thermogenesis. Identifying mechanisms regulating BAT function is important a...

Introduction: Patients with adrenal insufficiency (AI) (primary (PAI), secondary to pituitary disease (PIT) and congenital adrenal hyperplasia (CAH)) have reduced life expectancy with reported standardized mortality ratios of ~2:1 but given the rarity of AI, the underlying explanation remains largely unknown.Objective: To evaluate patient characteristics, prevalence of concomitant conditions and hospitalization incidence in patients with AI compared to a...

Introduction: The clinical outcome of patients with adrenal insufficiency (AI) has been shown to be less favorable than previously thought. Clinical studies have shown increased mortality, reduced cardiovascular and skeletal health and compromised quality of life, but the impact of this upon healthcare burden is unknown. This research utilised real-world evidence to compare comorbidities, healthcare utilization and expenditures in patients with AI.Method...

Introduction: There is growing evidence that 11β-HSD1 expression/activity increases with age in key target tissues including adipose tissue, bone, and skin, implicating local amplification of glucocorticoids in the pathophysiology of related disease. We have previously shown that 11β-HSD1KO mice are protected from both the adverse metabolic effects of excess glucocorticoids and age-associated muscle weakness. We investigated changes in global activity and skeletal mu...

2–3% of the UK population are prescribed glucocorticoid (GC) therapy and their adverse effects contribute to a significant health burden. Suppression of endogenous GC secretion is a recognized complication of therapy, but the magnitude of the problem, together with its clinical consequences have not been determined. We conducted a retrospective study across all specialties in a large secondary–tertiary care center identifying 2782 patients who underwent 3666 250 &#95...