Endocrine Abstracts

Background: Adult hypopituitarism is associated with premature vascular mortality for which the underlying mechanisms are unknown but untreated GH deficiency is proposed as a potential contributor.Objectives: To characterise vascular risk, including paraoxonase-1 (PON1; an antioxidant enzyme which preserves LDL against oxidation), in adults with treated panhypopituitarism.Study subjects: The study had full ethics approval. Data are...

Adrenocortical carcinoma are rare, highly vascular tumours with a generally poor prognosis. We have studied the use of the antiangiogenic drug, thalidomide (TH), in 6 patients with metastatic adrenocortical carcinoma (5 patients had adrenalectomy and one patient was inoperable#). The response to thalidomide treatment is summarized in the following Table. Assuming the residual/metastatic tumours to have a spheroidal form, the tumour volume (V) was calculated using the eq...

Background: Adult hypopituitarism is associated with premature vascular mortality for which the underlying mechanisms are unknown but untreated GH deficiency is proposed as a potential contributor.Objectives: To characterise vascular risk, including paraoxonase-1 (PON1; an antioxidant enzyme which preserves LDL against oxidation), in adults with treated panhypopituitarism.Study subjects: The study had full ethics approval. Data are...

It has been suggested that primary medical treatment of patients with acromegaly using somatostatin analogues (SSA) is as effective at controlling GH levels as post-operative SSA therapy.We have carried out a prospective study in patients harbouring GH secreting macroadenomas to see, in a within-patient comparison, whether debulking pituitary surgery improved GH control on lanreotide compared with that obtained pre-operatively. Local Ethical Committee ap...

Approximately 50% of patients with severe AGHD (defined by the international consensus criteria, peak GH <3 ng/ml) have a normal age- and gender-related IGF-I. It remains unclear whether in these individuals IGF-I is GH-dependent.We performed a double-blind, randomised, placebo-controlled, cross-over study on the effect of pegvisomant (20 mg daily for 14 days) on the relationship between GH and IGF-I in 3 age-, gender- and BMI-matched cohorts (Norms:...

Approximately 50% of patients with severe AGHD (defined by the international consensus criteria, peak GH <3 ng/ml) have a normal age- and gender-related IGF-I. It remains unclear whether in these individuals IGF-I is GH-dependent. We performed a double-blind, randomised, placebo-controlled, cross-over study on the effect of pegvisomant (20 mg daily for 14 days) on the relationship between GH and IGF-I in 3 age-, gender- and BMI-matched cohorts (Norms: 5 GHD patients with n...

Tumoural GH secretion in acromegaly is characterised by increased non-pulsatile (basal) release, pulse amplitude and pulse frequency. We have studied the effect of primary therapy with Sandostatin LAR on GH pulsatility in 9 patients with acromegaly who achieved disease control (mean serum GH<2ug/L) on therapy (7 males; median (range) age 67 (43-75). Data obtained were compared with 16 healthy subjects (10 males, age 50 (30-75)). Spontaneous 24-h GH secretion (20 minute samp...

We report the efficacy, safety, and effects on glucose homeostasis of converting patients with acromegaly from slow release octreotide (OT, treated for >3 months) to pegvisomant (Peg), a GH receptor antagonist. 52 patients (median age 49, range 23-81, 13 with diabetes) who had previously participated in a Peg clinical trial and subsequently treated with OT were enrolled in a 32-week, open-label, multicentre study. Peg 10 mg/d was started 4 weeks after the last dose of OT (w...

Carpal tunnel syndrome (CTS) in acromegaly is caused, in part, by median nerve (MN) swelling. Pegvisomant (Peg), a growth hormone receptor (GHR) antagonist, lowers serum insulin-like growth factor-I (IGF-I) concentrations in patients with acromegaly, but serum GH levels rise and Peg is detected by most GH assays. Demonstrating that normalisation of serum IGF-I by Peg is associated with improvement/reversal of the consequences of GH excess is desirable. We documented changes in...

Vascular endothelial growth factor (VEGF) is involved in the activation of the matrix metalloproteinase system (MMP) which in turn degrades the extracellular matrix involved in development, morphogenesis and tissue remodelling. Increased activity of MMPs has been implicated in atherosclerosis and cardiovascular disease. This study assessed plasma MMP and VEGF levels in patients with active acromegaly (IGF-I >130%ULN), and on treatment with pegvisomant.<p class="abstext"...