Endocrine Abstracts

Glucocorticoids regulate transcription of many genes through the binding to the glucocorticoid receptor (GR) however, their intracellular levels are tightly regulated by the microsomal enzyme 11beta-hydroxysteroid dehydrogenase. Two isozymes of this enzyme have been cloned and characterised; 11beta- hydroxysteroid dehydrogenase type 1 (11beta-HSD1) which is mainly expressed in the liver and adipose tissue and 11beta-HSD type 2 expressed in the kidney and placenta. Within 2.5kb...

Obese humans and rats exhibit altered glucocorticoid metabolism; increased regeneration of glucocorticoid by adipose 11HSD1 and inactivation by hepatic A-ring reductases. The mechanisms remain unclear; candidates include resistance to insulin-mediated regulation, and secondary effects of adipose products eg TNFalpha. To explore temporal associations between changes in glucocorticoid metabolism, insulin resistance and obesity, we examined effects of high-fat feeding in rats.<br...

A 42 year old gentleman presented for a second opinion regarding management of Congenital Adrenal Hyperplasia (CAH) of the salt losing variety. The patient had been under long term follow up elsewhere but had discontinued his medication of his own accord 14 months prior to seeking consultation. Examination revealed a heavily pigmented male patient with protuberant belly. He had easily palpable masses in both flanks. An abdominal CT showed bilateral massive adrenal enlargement ...

An 18 year old young man was first seen in the ENT department with bilateral swelling of the supraclavicular fossae. A clinical diagnosis of Cushing's syndrome was made and the patient was referred to the Endocrine team. Examination showed a BP of 150/100 and clinical features of gross Cushing's syndrome. Initial investigations revealed normal electrolytes, fT4 8.7 pmol/L, TSH 0.69 mIU/L and a basal prolactin of 68280 mIU/ml. A 24 hr urinary free cortisol (UFC) was 3860 nmol/L...

Congenital isolated ACTH deficiency (IAD) is a rare inherited disorder that is clinically and genetically heterogeneous. Patients are characterised by low or absent cortisol production secondary to low plasma ACTH despite the absence of structural pituitary defects and normal secretory indices of other pituitary hormones. When tested, there is often no ACTH response to exogenous CRH. Onset may occur in the neonatal period, but often is first observed in later childhood. Candid...

Elevated cortisol in Cushing's syndrome or ageing is associated with cognitive dysfunction. 11beta-HSD1 is expressed in rodent hippocampus and frontal cortex, regions important for cognition. In cultured rat hippocampal neurons, 11beta-HSD1 regenerates corticosterone from inert 11-dehydrocorticosterone and its inhibition by carbenoxolone is neuroprotective. 11beta-HSD1 knockout mice are protected against age-related cognitive dysfunction. We hypothesised that in elderly humans...

(This poster is based on OC41)...

Sodium transport across the human ocular non-pigmented ciliary epithelium (NPE) is fundamental to the production aqueous humour and maintenance of intraocular pressure. In sodium transporting tissues, serum and glucocorticoid regulated kinase isoform 1 (SGK1) has been identified as an early corticosteroid target gene in the activation of pre-existing epithelial sodium channels (ENaC). We previously demonstrated the presence of both the mineralocorticoid (MR) and glucocorticoid...

Introduction: In sheep, modest maternal nutrient restriction over the period of rapid placental growth followed by normal feeding to term results in offspring with a larger placenta and increased expression of the glucocorticoid receptor in a range of tissues. The aim of the present study was to determine whether this subsequently alters the relationship between basal cortisol and blood pressure in later life.Methods: Fourteen Welsh Mountai...

Introductions: Gender Identity Disorder (GID) occurs when a person’s gender identity differs from their biological sex, causing distress (gender dysphoria). GID presenting in childhood can dissipate at puberty. If it persists, they may progress to physical interventions. This involves the use of a GnRH analogue (GnRHa) for one year followed by cross sex hormones.Methods: As part of the clinical assessments, adolescents have body composition measurem...