Endocrine Abstracts

Mammalian differentiation of the external genitalia must be strictly dimorphic for reproductive success. In humans, this is established by a complex interplay of genetic and hormonal factors during 7–12 weeks post-conception (wpc). Despite being fundamental to normal human biology, understanding of human sexual differentiation remains limited. Our objective was to define the onset and regulation of androgen biosynthesis in the human fetal testis and correlate this to diff...

Materials and methodsTwenty-eight men with erectile dysfunction (ED) were investigated with TT, SHBG, albumin, fasting blood glucose, hormonal profile and a lipid profile. Free testosterone and bio-available testosterone (BAT) were calculated in all men using the calculator on the ISSAM website (http://www.issam.ch/freetesto.htm).Results: The mean age was 55...

Objectives: To evaluate the use of Antimüllerian hormone (AMH) measured on day 2 of spontaneous menstrual cycles in the prediction of ovarian hyperstimulation syndrome (OHSS).Design: Prospective observational study.Setting: IVF unit within a department of reproductive medicine and surgery.Patients: Women undergoing their first cycle of controlled ovarian hyperstimulation (COH) for IVF/ICSI.<p class="...

PCOS affects ~10% of women of reproductive age and is characterised by hyperandrogenism and ovulatory dysfunction. About 60% of women with PCOS are overweight, with an increased risk of developing type 2 diabetes mellitus.This Local Ethics Committee approved study aimed to determine the optimum composition of a weight reducing diet in management of women with PCOS. It compared the effect of a low carbohydrate with that of a low glycaemic index (GI) diet ...

Context: Weight loss and metformin therapy are beneficial in improving the hormonal and metabolic consequences of PCOS. Rimonabant has been found to reduce weight and improve the metabolic profile in patients with metabolic syndrome.Objective: To compare the effects of metformin and rimonabant on insulin resistance and biochemical hyperandrogenemia.Subjects: Twenty patients with PCOS and biochemical hyperandrogenemia were recruited...

Background: Kisspeptin is a peptide product of the KiSS-1 gene and a key regulator of the hypothalamo-pituitary-gonadal axis. Pregnancy is associated with raised plasma kisspeptin concentrations. However, there is significant variation in the plasma kisspeptin levels quoted in previous studies. We investigated the effects of pre-analytical factors including processing time and anticoagulant type on plasma kisspeptin-immunoreactivity (IR) measurement.Meth...

Background: Hirsutism carries with it significant cosmetic and psycho-social issues. Recent research has shown that various spearmint herbal tea preparations have anti-androgenic properties.What is not known are the specific biochemical reductions in androgen levels and also more importantly, the clinical effects – judged both subjectively and objectively – of the use of spearmint tea for patients with Hirsutism due to PCOS (REC approved).<...

Context: Rimonabant has been found to reduce weight and improve the metabolic profile in patients with metabolic syndrome as well as PCOS.Objective: To compare the effects of metformin and rimonabant in patients with PCOS with and without metabolic syndrome according to ATP III criteria.Design: A randomised open labelled parallel study comparing the effects on rimonabant and metformin in patients with PCOS.Su...

Background: Polycystic ovary syndrome (PCOS) is common with a suggested prevalence of 6–7% in Caucasian women of reproductive age. The presence of cardiovascular risk factors of obesity, insulin resistance and dyslipidaemia may predispose women with PCOS to coronary heart disease, although this remains controversial. This study aimed to contrast and compare the changes in lipid profile and hs-CRP following treatment with metformin, orlistat and pioglitazone in women with ...

The role of environmental and occupational toxins in the aetiology of unexplained infertility remains to be fully explored. Epidemiological studies have implicated heavy metals, including cadmium as having a pathogenic role with studies demonstrating associations between serum levels, testicular function and gonadotrophin levels in large cohort studies. Cadmium toxicity is associated with a complex spectrum of effects. Whilst the renal complications are well described, putativ...

Background: Fat distribution in women with polycystic ovary syndrome (PCOS) is thought to favour accumulation of abdominal visceral fat, but there has been no systematic comparison of fat distribution in PCOS and normal controls using MRI scanning.Aim: Our aim was to compare distributions of visceral, abdominal subcutaneous and gluteo-femoral subcutaneous adipose tissue in PCOS cases versus control women using a cross-sectional design.<p class="abste...

Introduction: There are numerous conditions which can cause elevated testosterone levels in women. PCOS being the commonest. Other causes include ovarian/adrenal androgen secreting tumours, CAH, Cushing syndrome, hyperprolactinemia, virilisation during pregnancy and finally idiopathic cause.Objectives: Our objective was to look into the way in which women with elevated testosterone were evaluated. We looked into why testosterone levels were done, who req...

Background: Obesity plays an important role in the aetiology of polycystic ovary syndrome (PCOS). Variants in the fat-mass and obesity-associated (FTO) gene have recently been shown to influence adiposity and predispose to common obesity (Frayling et al., Science 2007 316 889–894).Aim: Our aim was to establish whether FTO variants are also implicated in PCOS-susceptibility.Methods: A genetic ...

Insulin resistance is common in women with PCOS. Insulin and IGF-1 affect glucose uptake and metabolism via insulin receptor substrate (IRS-1) and the phosphotidyl inositol-3-kinase (PI3K) pathway. Impaired glucose metabolism has been observed in granulosa-lutein cells from anovulatory (but not ovulatory) women with PCO (Rice et al. 2005). The aim of this study was to analyse IRS-1 protein expression in human preantral follicles in samples of normal and PCO. Immunohisto...

The aim of this study was to simultaneously profile, using electrospraionization liquid chromatography mass spectrometry (ESI-LC-MS), prostanoids (PG) produced in the pregnant labouring (L) and non labouring (NL) myometrium.Lower segment samples were obtained at Caesarean section from consenting pregnant women (18–36 years of age) at term gestation (38–41weeks). Samples were transported to the laboratory and immediately bathed in physiological ...

Raised body mass index (BMI) is seen in 95% of PCOS patients, which is characterised by hyperandrogenaemia, both clinically and biochemically. Weight loss, using calorie restricted diets, have previously been successful in improving androgen profiles and also restoring fertility in obese PCOS patients. A CB1 cannabinoid receptor antagonist, rimonabant is effective in achieving weight loss in subjects with a BMI >27 kg/m.This study aimed to...

Context: Obesity, diabetes and cardiovascular disease in men are associated with low testosterone levels. Leptin is produced in adipose tissue in proportion to obesity and is known to be negatively associated with testosterone in men. The shared association of testosterone and leptin with obesity is in line with the proposed adipocytokine–hypogonadal–obesity cycle which aims to explain the relationships between these variables.Methods: We inves...

Although oxytocin is a potent stimulant of myometrial contractions, its role in parturition is controversial. The aim of the present study was to elucidate the functional mechanisms of oxytocin receptors in isolated human myometrium before and after labour-onset.Myometrial biopsies were obtained from consenting women (aged 21–34 years) undergoing Caesarean section at term pregnancy, not in labour (n=6), or in early (n=6) or late (n<...

The oestrogen-receptor related orphan nuclear receptors (ERR) share significant sequence homology with oestrogen receptors (ER) alpha and beta but are unable to bind oestradiol. They are reported to constitutively regulate gene expression by binding to the ER response elements (ERE) or SF1 binding sites (SFRE) in gene promoters. However recent evidence from transgenic animal models point towards a role of these orphan nuclear receptors as regulators of energy-producing metabol...

Background/objective: We have shown that expression of maternal serum human chorionic gonadotrophin (hCG) oligossacharides in uncomplicated pregnancy differs from that seen in pregnancy complicated by maternal type1 diabetes mellitus. Whether this observed oligosaccharide heterogeneity in type1 diabetes is specific to hCG or represents a more general phenomenon amongst placental oligosaccharides is not known. The oligosaccharide distribution in placentas from pregnancies compl...

Cortisol is metabolised by two 11βHSD isoenzymes. Recently, we reported that 11βHSD1 and 11βHSD2 mRNA and protein are co-expressed in boar testis and throughout the male reproductive tract. However, enzyme activities were only detectable in boar testis, caput epididymidis, bulbourethral glands and penile urethra. The objective of the present study was to assess whether cortisol–cortisone metabolism in the boar testis and caput epididymidis could be regulate...

Background: Testosterone replacement therapy is available in a variety of preparations. Nebido, a long acting testosterone undecanoate injection offered at 3 monthly intervals, has recently become available thus reducing the need for frequent injections.Aim: To investigate the efficacy and safety of Nebido.Patients and methods: Eighteen patients aged between 22–77 years (median 44.5 years) with primary or secondary hypogonadis...