Endocrine Abstracts

Galanin-like peptide (GALP) is a novel peptide isolated from the porcine hypothalamus. Within the hypothalamus GALP mRNA is confined to the arcuate nucleus from which GALP immunoreactive fibres project to the medial preoptic area. Previous studies indicate that GALP may be regulated by leptin. Intracerebroventricular administration of GALP has been shown to stimulate luteinising hormone release. Low circulating levels of leptin lead to the down regulation of the hypothalamic-p...

Pegvisomant is a novel medical therapy for acromegaly that functions as a GH receptor antagonist. Insulin resistance is an important factor in the increased cardiovascular morbidity and mortality associated with acromegaly. The aim of this study was to compare insulin sensitivity (IS) in a group of 7 patients with acromegaly (3 male, mean age 59+/-13 years, SD), treated first with a stable dose of depot octreotide (OT) (median dose 20mg four weekly, range 10-20) for at least t...

Hypothalamic regulation of the appetite and reproductive neuroendocrine axes is modulated by nutritional feedback from the periphery, potentially via shared mechanisms. Ghrelin is a recently identified orexigenic hormone secreted by the stomach that has been implicated in meal-time hunger, energy homeostasis and body weight regulation. In rodents, intracerebroventricular (ICV) injection acutely stimulates food intake and one study has shown that it can also transiently suppres...

Cocaine and amphetamine regulated-transcript (CART) is highly expressed in the hypothalamus and was originally reported to be an endogenous satiety peptide. Intracerebroventricular injection of CART can result in motor abnormalities and recent studies have demonstrated increased food intake after intra-nuclear CART administration. To help clarify the situation CART was over-expressed in the hypothalamus using recombinant adeno-associated virus (rAAV-CART). Recombinant adeno-as...

AIM: To assess efficacy of GH replacement and safety of stopping treatment in patients aged over 60 years.METHODS: GH-deficient patients were started on GH 0.13 miligram per day and the dose titrated over 4 months to a serum IGF-1 in the upper half of the age-related normal range. After 4 months titration, patients were randomised to either continuing GH or placebo in a double-blind, cross-over study with 2 x 4 month periods of either GH or placebo treatment.RESULTS: 1...

There is little information on the effects on pituitary function of cranial irradiation for non-pituitary tumours. We have studied anterior and posterior pituitary function in 17 patients (6 males), with a median age 19 years (range 5-48) at the time of radiotherapy. 16 patients had primary brain tumours and one had acute lymphocytic leukaemia. The patients were selected by the radiotherapists for investigation . Pituitary functions were assessed at a median of 60 months (rang...

The variables which might affect the reproductive function in recovered patients with anorexia nervosa (AN) were investigated. We studied 12 patients with partially (n=6) and fully recovered AN (n= 6). They were matched for age (22.5 plus/minus 1.8 vs. 23.2 plus/minus 1.7 yrs; p>0.05), body weight (50.3 plus/minus 2.1 vs. 56.7 plus/minus 2.3kg; p>0.05) and BMI (19.7 plus/minus 0.2 vs. 20.3 plus/minus 0.6 kg/m2, p>0.05). Partially recovered AN were amenorrhoeic while f...

The route of oestrogen replacement has an important influence on growth hormone (GH) sensitivity, but it remains unclear whether the route of testosterone treatment in hypopituitarism influences the response to GH replacement. We have compared IGF-I levels, body composition and BMD in hypopituitary male patients with severe GH-deficiency receiving either oral testosterone undecanoate (T.U.)(80-160 milligrams per day) or intramuscular testosterone (I.M.) (250-500 milligrams per...

Background: Anecdotally patients with chronic pain on opioid analgesia have functional hypopituitarism, and studies in opioid addicts show suppressed pituitary function. We conducted a prospective observational study to determine the endocrine status of patients with chronic pain on opioid analgesia. Methods: 37 consecutive patients with chronic back pain attending the pain clinic were enrolled. 22 patients (age 45+/-9 years) were on long-term opioid analgesia and 15 (age 53 +...

The clinically available somatostatin (SRIF) analogues, octreotide and lanreotide, are the mainstay of treatment for patients with acromegaly in whom surgery has failed to adequately control GH and IGF-I levels or where surgery is contra-indicated. Both analogues exhibit selective high affinity for SRIF receptor subtype 2 (SSTR2). GH and TSH secretion are regulated by SSTR subtypes 2 & 5, with an additional effect on GH secretion via SSTR1. Prolactin is regulated by SSTR5 ...

Pituitary apoplexy is a rare but potentially life-threatening condition caused by pituitary infarction or haemorrhage. We have retrospectively analysed 16 patients (10 male, 6 female) with pituitary apoplexy, who presented to our institutions between 1992-2002. The mean age at presentation was 49 years (range 24-72). Only two (12%) patients had previously known pituitary tumours. Pituitary apoplexy was precipitated by major surgery in two patients (coronary artery bypass graft...

BackgroundA fear of rising serum prolactin concentrations (PRO) and pituitary tumour enlargement undoubtedly result in over-treatment of some patients with pathological hyperprolactinaemia. In recent years, our unit has adopted pragmatic criteria for discontinuing dopamine agonist (DA) therapy in selected patients. These include: small (or no) abnormality of pituitary imaging; presentation PRO<2,000milliunits per litre; small DA dose; stable PRO; women with a history of...

Acromegalic patients have increased morbidity and mortality, which correlate with post-treatment growth hormone (GH) level. Target post-treatment plasma GH level should be less than 2.5 nanograms per millilitre, which predicts normal life expectancy.We evaluated the prevalence of complications and treatment outcome in 76 acromegalic subjects who attended our unit for surgery between 1978-2002. 60 patients are followed up in a specialised pituitary clinic in Beaumont Hospit...

The results of transsphenoidal surgery for acromegaly by a single neurosurgeon (MP) operated between 1981 and July 2002 were examined retrospectively. 141 database and case note records for patients with a clear pre-operative diagnosis of acromegaly were reviewed. Patients with incomplete pre- or postoperative data on growth hormone (GH) status were excluded from further analysis (n=14). The remaining 127 formed the audit group.Pituitary imaging data was available in 84 of...

Obesity is a life-threatening, yet common condition that often lies at the root of other serious illnesses such as diabetes, cardiovascular disease and other neuroendocrine disorders. The central nervous system signalling pathways regulating food intake are complex and the precise mechanisms remain to be determined. Cocaine- and amphetamine- regulated transcript (CART) is a CNS neuropeptide involved in the regulation of feeding.Development of a two-site immunometric assay ...

Adults with brain tumours experience changes in multiple aspects of quality of life and this is associated with their medical condition and its treatment. There is some evidence to suggest that the mode of treatment is also a significant factor in the development of affective symptomatology. The primary aim is to explore within our cohort of patients treated for pituitary tumours, whether there are significant differences in multiple domains of quality of life and the severity...