Clinical Endocrinology (Clin Endocrinol )

Publisher: Blackwell Publishing

Journal description

Clinical Endocrinology publishes papers and reviews which focus on the practical aspects of clinical endocrinology, such as protocols for investigation of endocrine disorders, imaging in endocrinology and the clinical application of molecular endocrinology. It also features reviews, current therapy papers and cases of the month. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.

Current impact factor: 3.35

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 3.353
2012 Impact Factor 3.396
2011 Impact Factor 3.168
2010 Impact Factor 3.323
2009 Impact Factor 3.201
2008 Impact Factor 3.398

Impact factor over time

Impact factor
Year

Additional details

5-year impact 3.26
Cited half-life 7.40
Immediacy index 0.87
Eigenfactor 0.02
Article influence 0.99
Website Clinical Endocrinology website
Other titles Clinical endocrinology (Oxford, England: Online)
ISSN 1365-2265
OCLC 46569692
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

  • Pre-print
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    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley'
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Our recent publication showed that for patients on long-term thyroxine, their serum TSH concentration dropped by a median of 0.21 mU/L after starting a statin (1). The paper also showed changes in TSH after starting Iron, calcium, proton pump inhibitors and possibly oestrogens. Diez and Iglesias showed that in patients with diabetes, statins did not seem to affect serum TSH in patients with newly diagnosed hypothyroidism, or in euthyroid patients (2). No relationship could be identified between serum TSH and statin use on multiple regression analysis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Gender dysphoria (GD) is characterized by discomfort with the assigned or birth gender and the urge to live as a member of the desired sex. The goal of medical and surgical treatment is to improve the well-being and quality of life of transpeople. The acquisition of phenotypic features of the desired gender requires the use of cross-sex hormonal therapy (CHT). Adult transmen are treated with testosterone to induce virilization. In adolescents with severe and persistent GD, consideration can be given to arresting puberty at Tanner Stage II and if dysphoria persists CHT is generally started after 16 years of age. Currently available short and long-term safety studies suggest that CHT is reasonably safe in transmen. Monitoring of transmen should be more frequent during the first year of cross-sex hormone administration reducing to once or twice per year thereafter. Long-term monitoring after sex reassignment surgery (SRS) includes annual check-ups as are carried out for natal hypodonadal men. In elderly transmen special attention should be paid to hematocrit in particular. Screening for breast and cervical cancer should be continued in transmen not undergoing SRS. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Klotho, a life span-influencing protein, exists in a membrane-bound (mKlotho) and in a soluble (sKlotho) form. mKlotho serves as a co-receptor for fibroblast growth factor 23 (FGF23, a bone-derived, phosphaturic hormone) and is mainly expressed in the kidneys(1) . Enzymes can split the extracellular part of mKlotho thereby forming sKlotho(1) . sKlotho is released into the circulation and can be measured by ELISA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Many lines of evidence indicate that dehydroepiandrosterone (DHEA) plays a distinct role in bone metabolism, and that its sulfated form (DHEA-S), which is easily measured in blood, may be a potential biomarker of osteoporosis-related phenotypes. However, most previous epidemiologic studies focused on postmenopausal women and reported conflicting results. We aimed to investigate the association between the serum DHEA-S level and bone mass in men. This large cross-sectional study included 1,089 healthy Korean men who participated in a routine health screening examination. Bone mineral density (BMD) at the lumbar spine, total femur, femur neck, and trochanter and serum DHEA-S level were obtained in all subjects. After adjustment for age, body mass index, lifestyle factors, and serum levels of calcium, phosphorus, testosterone, 25-OH-vitamin D3, and cortisol, higher serum DHEA-S concentrations were associated with higher BMD values at all skeletal sites. Consistently, compared to the subjects in the highest DHEA-S quartile (Q4), those in the lowest DHEA-S quartile (Q1) showed significantly lower BMD values. Multiple logistic regression analyses revealed that the odds ratios for the risk of lower BMD (T-score <-1) increased in a dose-dependent manner across decreasing DHEA-S quartiles, and the odds for the risk of lower BMD was 2.59-fold higher in Q1 than in Q4. These findings support previous evidences that DHEA-S has favorable effects on bone mass in men and suggest that a low serum DHEA-S level may be a potential risk factor for male osteoporosis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: The treatment of transwomen relies on the combined administration of antiandrogens or GnRH analogues to suppress androgen production and thereby reduce male phenotypic characteristics together with estrogens to develop female characteristics. In transwomen synthetic estrogens such as ethinylestradiol, as well as conjugated equine estrogens (CEE), should be avoided in order to minimize thromboembolic risks especially in older transwomen and in those with risk factors. Currently available short and long-term safety studies suggest that cross-sex hormonal therapy (CHT) can be considered safe in transwomen improving the well-being and quality of life of these individuals. Long-term monitoring should aim to decrease cardiovascular risks and should include prostate and breast cancer screenings. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: We will like to thank Dr Lacout et al for their comments on our paper titled "Value of sonographic features in predicting malignancy in thyroid nodules diagnosed as follicular neoplasm on cytology". The main aim of our study was to stratify the risk of malignancy in thyroid nodules diagnosed as follicular neoplasms on cytology (Thy3F) using TIRADS. TIRADS was first proposed by Horvath et al(1) and various authors have subsequently suggested several modified versions.(23-5) The TIRADS used in our study did not include intranodular vascularity as one of its criteria. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: PCOS is associated with obesity and insulin resistance. Efforts have focused on whether an abnormal energy homeostasis contributes to the development of obesity in these patients. There are conflicting results in the literature regarding whether women with PCOS have an altered basal metabolic rate (BMR), thereby leading to difficulties in weight loss. The objective of this study is to compare basal metabolic rate (BMR) in women with PCOS and controls DESIGN: Cross-sectional study PATIENTS: 128 PCOS patients diagnosed by original NIH consensus criteria and 72 eumenorrheic and non-hirsute controls were recruited from an academic medical center. Assessment of BMR using the InBody portable bioelectrical impedance analysis (BIA) device and insulin resistance by HOMA-IR indices. PCOS women were younger than controls. As expected, PCOS subjects had higher body mass index (BMI), serum androgens, and estimated insulin resistance. After adjusting for age and BMI, there was no significant difference in BMR between PCOS subjects (adjusted mean 5807 kJ/day, 95% CI 5715-5899) and controls (adjusted mean 5916 kJ/day, 95% CI 5786-6046) (P=0.193). BMR was also comparable in a secondary analysis comparing PCOS women with and without insulin resistance. After adjusting for age and BMI, there was no difference in BMR between PCOS women and controls. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: To evaluate the associations between triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratios and the risks of gestational diabetes mellitus (GDM) and delivering large-for-gestational-age (LGA) infant. This was a single-center prospective observational study. Six hundred and thirty-six women with a singleton pregnancy were recruited. Lipids profile, HbA1c, and glucose were measured at the time of oral glucose tolerance test (OGTT) during 24-28 gestational weeks. TG/HDL-C ratios were calculated and clinical data including perinatal parameters were analysed. The prevalence of GDM was 17.30% (n=110) and LGA was 3.93% (n=25) in this study. TG/HDL-C ratios were found to be significantly higher in GDM group (P < 0.01) and LGA group (P = 0.045) compared with those in non-GDM group and non-LGA group, respectively. TG/HDL-C ratios were independently associated with the risks of GDM (OR = 1.64, P = 0.02) and LGA (OR = 2.87, P < 0.01). The area under the combined ROC curve of TG/HDL-C ratio and HbA1c to detect GDM was 0.705 (95% CI, 0.637-0.772). Furthermore, the area under the ROC curve of TG/HDL-C ratio combined with HbA1c and prepregnancy BMI to detect LGA was 0.806 (95% CI, 0.719-0.893). TG/HDL-C ratios in combination with HbA1c and prepregnancy BMI can be good markers to predict the risks of GDM and delivering LGA infant. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Predicting the outcome of patients operated on for Cushing's disease (CD) is a challenging task. Our objective was to assess the accuracy of immediate post-surgical plasma cortisol, desmopressin test and the coupled dexamethasone desmopressin test (CDDT) as predictors of outcome. Sixty-seven patients with initial remission and a minimal post-surgical follow-up greater than 18 months were included in this retrospective bicenter study. Follow-up included 3-6 months followed by yearly 24-h urinary free cortisol, ACTH and cortisol plasmatic levels, a 1 mg overnight dexamethasone suppression test (1 mg DST), desmopressin test and the CDDT. ROC curves were performed to define the optimal threshold of immediate post-surgical cortisol level, and 3-6 month desmopressin test and CDDT, as predictors of final outcome in comparison with classical biological markers of recurrence. Eleven patients presented recurrence. The patient's median follow-up was 52 months (range, 18-180). As early predictors of outcome, immediate post-surgical plasma cortisol level < 35 nmol/l predicted the lack of recurrence with 93% negative predictive value (NPV), whereas predictive positive value (PPV) was 25%. During the follow-up, the CDDT was more precise than the desmopressin test in predicting the lack of recurrence (100% NPV) when performed in the first 3 years after surgery. Positivity of the CDDT was defined based on ROC curves by ACTH and cortisol increments > 50%. The CDDT was highly reproducible, as the same response was observed every year in 91% of the patients. Adding the CDDT the first 3 years after surgery to immediate post-surgical cortisol evaluation should allow obtaining an optimal follow-up management of patients operated for Cushing's disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: The cause of Paget's disease of bone (PDB) is unknown, but genetic factors, particularly SQSTM1 mutations, and environmental factors are important. To investigate the development of PDB in asymptomatic relatives carrying SQSTM1 mutations to determine if a secular trend toward a less severe phenotype is evident, and to estimate prospectively the rate at which PDB emerged in this genetically-susceptible population. We recruited first degree relatives of patients with PDB (33 adult offspring [mean age 45] and 1 sibling) with a familial SQSTM1 mutation. We determined the presence of PDB with skeletal scintiscans and confirmatory radiographs. Those negative for PDB on the initial scan were investigated again a mean 5.1 years later. The initial skeletal scintiscan demonstrated PDB in 6 subjects; 26 of the remaining 28 unaffected subjects had a second scintiscan, with 2 new cases of monostotic PDB diagnosed in 134 patient-years of follow up. In the total 8 adult offspring diagnosed with PDB, the age of diagnosis was greater, by at least 10 years, than that in the 21 probands with clinically-identified PDB (p = 0.005). In adult offspring who were older at the time of skeletal scintigraphy than their affected parents were at the time of clinical diagnosis, the difference was even more marked (p <0.001). In adult offspring with PDB, the disease was significantly less extensive than in their affected parent, as judged by alkaline phosphatase and disease extent (p <0.003). These findings suggest a substantial gene-environment interaction: the emergence of PDB in offspring inheriting SQSTM1 mutations is delayed by at least a decade, has a substantially attenuated phenotype, and occurs at a low rate between the (mean) ages of 45 and 50 years. The nature of the environmental factor is unknown. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: To investigate the response of serum fibroblast growth factor 21 (FGF21) to a meal and to insulin infusion in haemodialysis (HD) patients. Meal study: in a cross-over design, 12 non-diabetic HD patients were randomly assigned to: 1) a non-HD day with one meal served, 2) a HD day with one meal served during HD, and 3) a HD day with two meals served during and after HD, respectively. Twelve healthy controls participated in an experiment identical to the non-HD day. Insulin infusion study: in a cross-over design, 11 non-diabetic HD patients were randomly assigned to receive a 4-h HD session with either: 1) no infusion, 2) glucose infusion, or 3) glucose-insulin infusion. A meal was served 2 h before HD start. Meal study: serum FGF21 was 23-fold higher in HD patients than controls (P < 0∙001). Postprandial FGF21 decreased on all four study days (P ˂ 0∙006), but the relative reductions from baseline were significantly greater in controls (P < 0∙008). Postprandial changes in FGF21 were inversely related with triglycerides (P = 0∙042) and positively related with insulin-like growth factor binding protein-1 (IGFBP-1) (P < 0∙001). Serum FGF21 was only associated with changes in adiponectin (P = 0∙001) and free fatty acids (P = 0∙04) in the healthy controls. Insulin infusion study: as compared with no infusion, glucose and glucose-insulin infusion prevented the postprandial decrease in FGF21 and resulted in higher FGF21 concentrations by up to 25% (P = 0∙003). Serum FGF21 was highly elevated in HD patients but the response of serum FGF21 to meal intake and insulin infusion seemed to be intact. Our results indicate that FGF21 may play an important role in short-term metabolic homeostasis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Lower circulating androgens and poorer lung function are associated with increased cardiovascular risk and mortality in men. The association between androgens and lung function is unclear. We tested the hypothesis that circulating testosterone (T) and its metabolites dihydrotestosterone (DHT) and estradiol (E2) are differentially associated with lung function in men. Early morning serum T, DHT and E2 were assayed using mass spectrometry in 1,768 community-dwelling men from Busselton, Western Australia. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured using spirometry. Linear regression models adjusting for age, height, smoking, exercise, BMI, respiratory conditions and cardiovascular risk factors were used. Mean age was 50.1±16.8 years. 16.0% were current smokers, 14.1% reported a history of asthma and 2.7% chronic obstructive pulmonary disease. Current smokers had higher T compared with never smokers (age-adjusted mean 14.5 vs 13.5 nmol/L, p=0.002) and higher E2 (65.3 vs 60.1 pmol/L, p=0.017). In fully-adjusted analyses, T was associated with FEV1 (51 ml per 1-SD increase, p<0.001) as was DHT (62 ml, p<0.001), E2 was not (p=0.926). Similar results were seen for FVC (T: 76 ml, p<0.001, DHT: 65ml, p<0.001, E2 p=0.664). Higher DHT was marginally associated with the ratio FEV1/FVC (0.3% per 1-SD increase, p=0.047). Both T and DHT were independently associated with higher FEV1 and FVC in predominantly middle-aged community-dwelling men. Androgens may contribute to, or be biomarkers for, better lung function in men. Further research is needed to clarify whether androgens preserve lung function in ageing men. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: There are no consistent data on the prevalence and bone status of normocalcaemic hypoparathyroidism (NHYPO) as defined by normal adjusted calcium and low PTH level. Our aim was to determine the prevalence and the metabolic bone profile of NHYPO in older women, assessing its evolution over time. The second objective was to evaluate the prevalence of other calcium metabolic disorders. The Osteoporosis and Ultrasound Study (OPUS) is a 6-yr prospective study of fracture-related factors. A total of 2419 older women (age 55-79 yrs) and 258 younger women (age 30-40 yrs) participated. Complete follow-up data were available in 1416 subjects. After calculating the adjusted calcium according to James' formula, we identified 'abnormal' calcium and PTH using Mahalanobis Distances and allocated older women into different pathological categories using reference intervals from the healthy young women. We identified 57 subjects with NHYPO (2.4%). These women had lower than expected bone turnover as assessed by bone alkaline phosphatase (-14.5%, 95% CI: -26.2 to -3.0, p=0.007), CTX (-66.3%, 95% CI: -74.0 to -56.4, p<0.001) and osteocalcin (-36.8%, 95% CI: -45.6 to -26.6, p<0.001). After 6 years, of the 35 NHYPO subjects with follow-up data, none developed overt hypoparathyroidism and only 15 (0.6%) subjects had persistent evidence of NHYPO. We also identified 86 subjects (3.6%) affected by hyperparathyroid hypercalcaemia. This is the first large population-based study to investigate NHYPO in older women. NHYPO is fairly common, not always persistent and is characterised by low bone turnover. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: To examine associations between metabolic syndrome (MetS) and its individual components with risk of mild cognitive impairment (MCI) among community elderly and explore the age difference. Cross-sectional study. 2,102 aged 60 and older community residents in Beijing metropolitan area, China. Cognitive function was assessed by Mini-Mental State Examination (MMSE). MetS was defined by the 2009 harmonizing definition. Overnight fasting blood samples were obtained to measure biochemistry indicators. The prevalence of MetS and MCI were 59.1% and 15.9% respectively. After adjusting age, gender, other demographic factors, lifestyle variables and medication use, participants with MetS or its individual components are at significantly elevated risk for MCI. In terms of MMSE score, as the continuous depend variable, the β (95%CI) of MetS was -0.68(-0.99,-0.37). For prevalence of MCI, as the dichotomy depend variable, The Odds Ratio (OR) of Mets is 1.52 compared to control group (or baseline) with 95% confidence interval (CI) of 1.16 to 1.95. The multivariate association only showed significant results among participants aged less than 80 years old. MetS is associated with worse cognitive function among younger elderly. Managing MetS, as well as its components, may contribute to control cognitive decline and reduce related disease and social burden. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Objective Acutely restricting sleep worsens insulin sensitivity in healthy individuals whose usual sleep is normal in duration and pattern. The effect of recovery or weekend ‘catch-up’ sleep on insulin sensitivity and metabolically active hormones in individuals with chronic sleep restriction who regularly ‘catch-up’ on sleep at weekends is as yet unstudied.Design19 men (mean±SEM age 28.6±2.0years, BMI 26.0±0.8kg/m2) with at least 6 months’ history (5.1±0.9years) of lifestyle driven, restricted sleep during the working week (373±6.6 min/night) with regular weekend ‘catch up’ sleep (weekend sleep extension 37.4±2.3%) completed an in-laboratory, randomised, cross-over study comprising 2 of 3 conditions, stratified by age. Conditions were 3 weekend nights of 10 hours, 6 hours or 10 hours time-in-bed with slow wave sleep suppression using targeted acoustic stimuli.MeasurementsInsulin sensitivity was measured in the morning following the 3rd intervention night by minimal modelling of 19 samples collected during a 2 hour oral glucose tolerance test. Glucose, insulin, c-peptide, leptin, peptide YY, ghrelin, cortisol, testosterone and luteinising hormone (LH) were measured from daily fasting blood samples; HOMA-IR, HOMA-β and QUICKI were calculated.ResultsInsulin sensitivity was higher following 3 nights of sleep extension compared to sustained sleep restriction. Fasting insulin, c-peptide, HOMA-IR, HOMA-β, leptin and PYY decreased with ‘catch-up’ sleep, QUICKI and testosterone increased, while morning cortisol and LH did not change. Targeted acoustic stimuli reduced SWS by 23%, but did not alter insulin sensitivity.Conclusions Three nights of ‘catch-up’ sleep improved insulin sensitivity in men with chronic, repetitive sleep restriction. Methods to improve metabolic health by optimising sleep are plausible.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Objective Demonstration of unilateral aldosterone production by adrenal venous sampling (AVS) is required to select appropriate candidates for adrenalectomy in patients with primary aldosteronism (PA). During AVS, aldosterone and cortisol levels are measured to assess successful cannulation and lateralisation. In patients with aldosterone-producing adenoma (APA), concurrent autonomous cortisol secretion might confound AVS results.Design and patientsWe retrospectively examined results in eight patients with cortisol-producing adenoma (CPA), but without PA, who underwent AVS.ResultsIn all eight, cortisol was higher on the CPA side than contralateral (CL) (median 6.7 fold [range 2.4-27.2]; p=0.012]). By cortisol criteria, CL catheter placement would have been labelled inadequate in six despite adrenal venous aldosterone levels markedly higher than peripheral (41.6 fold [7.2-510.5]; p<0.001), suggesting successful cannulation. In all eight, adrenal venous aldosterone/cortisol (A/C) ratios on the CL side were indicative of increased aldosterone production (≥2 times peripheral), but in only three patients on the CPA side (difference CL side 44.5 fold [6.0-109.0] vs CPA side 1.65 fold [1.0-23.0]; p=0.017). A/C ratios were higher on the CL versus the CPA side in seven (20.0 fold [4.7-76.0]).Conclusion These results in patients with CPA suggest that in patients with APA, concurrent autonomous unilateral cortisol hypersecretion could confound AVS accuracy by increasing cortisol levels (reducing A/C ratio) on the CPA side, while reducing levels (increasing A/C ratio and suggesting failed cannulation) on the CL side. Misclassification of PA subtype or repeat AVS could result, underscoring the importance of adequately assessing cortisol production prior to AVS and the need to consider alternatives.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Addison's disease is associated with low bone mineral density and increased risk of hip fractures. Causes are multi-factorial, contributed by underlying adrenocortical hormonal deficiency, associated autoimmune endocrinopathies, electrolyte disturbances, and in some patients, supra-physiologic glucocorticoid replacement. Recent realisation of physiologic cortisol production rate has revised downwards glucocorticoid replacement dosages. Meanwhile, new research has emerged suggesting complex interplay between sodium and calcium homeostasis under the influence of mineralocorticoid and parathyroid hormone that may impact bone health. As the prevalence of Addison's disease is rising, and osteoporosis and fractures are associated with significant morbidity and increased mortality, attention to bone preservation in Addison's disease is of clinical relevance and importance. We suggest an approach to bone health in Addison's disease integrating physiologic adrenocortical hormonal replacement with electrolyte and mineral homeostasis optimisation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Objective It has been reported that the positive feedback mechanism of estrogens and progesterone is preserved, although attenuated, in late postmenopausal years. Whether this is also true for the positive feedback effect of estrogens alone has not been investigated.DesignProspective intervention study.PatientsThirty healthy postmenopausal women.MeasurementsThe women were divided into three groups according to the years since menopause (group I: 2-8y, group II: 9-17y, group III: 18-25y). They were studied during a period of 41 days. Two acute experiments (EP) of exogenous estradiol, given (via skin patches), were performed from days 1-7 (EP1) and from days 35-41 (EP2) in order to induce an LH surge. Between the two experiments (days 7 to 34), estradiol was given at the dose of 100μg every 3 days, while oral progesterone was added from day 21 to day 34 in order to simulate a luteal phase. Blood samples were taken every 6 hours during EP1 and EP2 as well as on days 8, 13, 20, 21, 27 and 34. FSH, LH, estradiol and progesterone were measured in all blood samples.ResultsAn LH surge occurred as a result of the estradiol positive feedback mechanism in group I and in group II, in both EP1 and EP2. Peak LH values during the surge were significantly lower in group II than in group I in both experiments. None of the patients in group III displayed an LH surge.Conclusions These results demonstrate for the first time a gradual attenuation of the pituitary response to estrogenic provocation over a certain period following the menopause, with complete abolition after 20 years. It is suggested that the reserves of pituitary gonadotrophs diminish with age.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;
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    ABSTRACT: Background Recent studies have identified common genetic variants associated with TSH, free T4 and thyroid peroxidase antibodies, but it is unclear if these differ between patients with Hashimoto's disease and Graves’ disease.Objective To examine whether 11 common genetic variants differ between Graves’ disease and Hashimoto's disease.Patients and measurementsWe genotyped 11 common variants in a discovery cohort of 203 Australian patients with autoimmune thyroid disease (AITD). Two variants with significant or suggestive associations were analysed in a replication cohort of 384 Danish patients.ResultsFor rs753760 (PDE10A), the minor allele frequency in Graves’ disease and Hashimoto's disease was 0.38 vs. 0.23 respectively (P=6.42 x 10-4) in the discovery cohort, 0.29 vs. 0.24 (P=0.147) in the replication cohort and 0.32 vs. 0.24 in combined analysis (P=0.0021; all analyses adjusted for sex). In healthy controls from Busselton, the frequency was 0.29, significantly different from Hashimoto's disease but not Graves’ disease. For rs4889009 (MAF gene region), the frequency of the minor G allele in Graves’ disease and Hashimoto's disease was 0.48 vs. 0.36 (P=0.0156) in the discovery cohort, 0.48 vs. 0.34 (P=1.83 x 10-4) in the replication cohort and 0.48 vs. 0.35 in the combined analysis (P=7.53 x 10-6); in controls the frequency was 0.38, significantly different from Graves’ disease but not Hashimoto's disease. After further adjustment for smoking, associations with rs4889009 remained significant, whereas those with rs753760 were not.Conclusion Common variants in PDE10A and MAF gene regions may influence whether patients with AITD develop Graves’ disease or Hashimoto's disease.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015;