EUROPEAN ENDOCRINE DISEASE – VOLUME 2 – WINTER 2006

Welcome to the inaugural edition of Business Briefing: European Endocrine Review. This publication comprises a series of articles that tackle many of the important issues relevant to endocrinologists and diabetologists throughout Europe.

Diabetes mellitus is becoming one of the most common diseases in the world. The number of people with diabetes is estimated to double in the next 20 years, reaching 350 million affected people by 2025 (see Figure 1). This will be accompanied by an increased number of diabetic patients with long-term complications, causing a phenomenal […]

Point-of-care testing (POCT) is defined as laboratory testing that is performed at or near the site of patient care. The principal justification for POCT is that rapid turnaround for patient test results can be achieved, facilitating medical decisions and improving the quality of care. Familiar POC tests include blood glucose, pregnancy tests and urine dipsticks. […]

Insulin resistance and the metabolic syndrome (MeS or syndrome X) are common in patients with chronic kidney disease (CKD). Moreover, the presence of MeS is an independent predictor of subsequent development of CKD, and MeS in patients with CKD predicts subsequent cardiovascular events and cardiovascular mortality, as is the case in the general population.

The number of patients with chronic kidney disease (CKD) and the subsequent need for renal replacement therapy (RRT) has reached epidemic proportion and is anticipated to rise further.

Diabetes poses a major public health problem, and its impact on resources will escalate in the next 25 years. By 2030, it is predicted that more than 350 million people worldwide will be suffering from diabetes (principally type 2 diabetes); this represents 4.4% of the world’s population.1 The emergence of this diabetes epidemic can be […]

Chronic kidney disease (CKD) is a complex, progressive condition that develops slowly in some individuals, but rapidly in others. In addition to the underlying cause of renal failure, the rate of disease progression may be dictated by the presence of CKD risk factors. The principal outcomes of CKD include progressive loss of kidney function leading […]

Recombinant erythropoietin (EPO) is a 165-amino-acid glycoprotein with a molecular weight of 30.4 kilo Dalton (kDa) and approximately 40% carbohydrates. It binds to a single receptor that is widely distributed within the body, but bone marrow is the main target of EPO, where it stimulates both the production and the survival of erythrocytes. Recombinant EPOs […]

Adult-onset growth hormone deficiency (AO-GHD) is most often caused by pituitary or hypothalamic tumours or their treatment, and may serve as a model where the effect of chronic GH deficiency on skeletal metabolism can be studied. While the low bone mass in adults with childhood-onset GHD (CO-GHD) may be explained by deficient bone accretion during […]

Traditionally, short stature is defined as a height that lies more than two standard deviations (SD) below the mean for age compared with gender-specific standards based on an appropriate healthy population. In multi-ethnic societies, it is important to compare children with controls from an appropriate ethnically matched normal population. Additionally, the genetic background of an […]

For instance, if cognitive impairment in patients suffering from growth hormone deficiency (GHD) mainly results from impaired brain development, there would seem to be little point in administering GH to normalise brain function. In light of this, it is important to be aware that GHD patients can be diagnosed as belonging to one of a […]

The cytological examination of the thyroid gland is based on microscopic assessment of a material obtained by means of fine-needle aspiration biopsy (FNAB). The main goal of FNAB is to classify the examined lesion as malignant, suspicious or benign and, thus, to select the patients who should be treated surgically. Nowadays, FNAB is a central […]

Hormone replacement therapy (HRT) comprises natural oestrogens, including oestradiol 17β, conjugated equine oestrogens and oestrone sulphate, given in a continuous fashion, with the addition of a progestogen, either cyclically or continuously, in women who have not undergone hysterectomy. HRT may be administered systemically through tablets, transdermal patches and gels, subcutaneous implants, intra-nasal sprays or vaginal […]

Prolactin (PRL) is a single-chain peptide hormone secreted from lactotroph cells of the anterior pituitary. The main physiological role of PRL is to promote milk secretion after childbirth.1 PRL secretion is tonically inhibited by dopamine (DA) from neurons in the hypothalamus. Physiology and Pathophysiology of Hyperprolactinaemia

The isolation of human prolactin (PRL) in the 1970s and the recognition that hyperprolactinaemia resulted in a syndrome of amenorrhoea or galactorrhoea was a significant advance. Subsequently, it has been shown that hyperprolactinaemia may be the cause of secondary amenorrhoea in up to one-third of young women. PRL is a 199-amino-acid polypeptide with a molecular […]

Prolactin (PRL)-secreting tumours represent the most common subtype of pituitary adenoma, usually causing menstrual disturbances and/or galactorrhoea in women of reproductive age and loss of libido or impotence in men. While large adenomas may also produce symptoms that are caused by compression of the surrounding nervous structures, microprolactinomas (i.e. tumours with a maximum diameter of […]

Prolactin (PRL) is a peptide hormone secreted by lactotroph cells of the anterior pituitary. PRL is predominantly under inhibitory influence of hypothalamic dopamine, whereas thyrotropin-releasing hormone (TRH), among other endogenous substances, is the main PRL-releasing factor. In physiological conditions, PRL secretion is also affected by numerous exogenous influences, such as stress, physical effort, hypoglycaemia, lactation […]

Androgen deficiency in the ageing male (ADAM) has become a topic of much interest and debate. With an increasing percentage of the male population now falling into the older age bracket, the principal questions raised are whether older hypogonadal men affected by late-onset hypogonadism (LOH) will benefit from testosterone treatment and what will be the […]

Late-onset hypogonadism (LOH) is a clinical and biochemical syndrome associated with advancing age and characterised by typical symptoms and a deficiency in serum testosterone levels.

Erectile dysfunction (ED) is a highly prevalent disease that is expected to affect 322 million men by 2025. Risk factors include ageing, cardiovascular disease (CVD), diabetes, hyperlipidaemia, smoking, absence of physical exercise and obesity. ED is associated with depression and has a negative impact on patients’ and partners’ quality of life. Potentially reversible causes include […]

Diabetes mellitus is becoming one of the most common diseases in the world. The number of people with diabetes is estimated to double in the next 20 years, reaching 350 million affected people by 2025 (see Figure 1). This will be accompanied by an increased number of diabetic patients with long-term complications, causing a phenomenal […]

Traditionally, short stature is defined as a height that lies more than two standard deviations (SD) below the mean for age compared with gender-specific standards based on an appropriate healthy population. In multi-ethnic societies, it is important to compare children with controls from an appropriate ethnically matched normal population. Additionally, the genetic background of an […]

For instance, if cognitive impairment in patients suffering from growth hormone deficiency (GHD) mainly results from impaired brain development, there would seem to be little point in administering GH to normalise brain function. In light of this, it is important to be aware that GHD patients can be diagnosed as belonging to one of a […]

Point-of-care testing (POCT) is defined as laboratory testing that is performed at or near the site of patient care. The principal justification for POCT is that rapid turnaround for patient test results can be achieved, facilitating medical decisions and improving the quality of care. Familiar POC tests include blood glucose, pregnancy tests and urine dipsticks. […]

Chronic kidney disease (CKD) is a complex, progressive condition that develops slowly in some individuals, but rapidly in others. In addition to the underlying cause of renal failure, the rate of disease progression may be dictated by the presence of CKD risk factors. The principal outcomes of CKD include progressive loss of kidney function leading […]

Behavioral and psychosocial aspects of health problems have proven to be critically important.

Erectile dysfunction (ED) is a highly prevalent disease that is expected to affect 322 million men by 2025. Risk factors include ageing, cardiovascular disease (CVD), diabetes, hyperlipidaemia, smoking, absence of physical exercise and obesity. ED is associated with depression and has a negative impact on patients’ and partners’ quality of life. Potentially reversible causes include […]

The isolation of human prolactin (PRL) in the 1970s and the recognition that hyperprolactinaemia resulted in a syndrome of amenorrhoea or galactorrhoea was a significant advance. Subsequently, it has been shown that hyperprolactinaemia may be the cause of secondary amenorrhoea in up to one-third of young women. PRL is a 199-amino-acid polypeptide with a molecular […]

The cytological examination of the thyroid gland is based on microscopic assessment of a material obtained by means of fine-needle aspiration biopsy (FNAB). The main goal of FNAB is to classify the examined lesion as malignant, suspicious or benign and, thus, to select the patients who should be treated surgically. Nowadays, FNAB is a central […]

Prolactin (PRL)-secreting tumours represent the most common subtype of pituitary adenoma, usually causing menstrual disturbances and/or galactorrhoea in women of reproductive age and loss of libido or impotence in men. While large adenomas may also produce symptoms that are caused by compression of the surrounding nervous structures, microprolactinomas (i.e. tumours with a maximum diameter of […]

Prolactin (PRL) is a peptide hormone secreted by lactotroph cells of the anterior pituitary. PRL is predominantly under inhibitory influence of hypothalamic dopamine, whereas thyrotropin-releasing hormone (TRH), among other endogenous substances, is the main PRL-releasing factor. In physiological conditions, PRL secretion is also affected by numerous exogenous influences, such as stress, physical effort, hypoglycaemia, lactation […]

Recombinant erythropoietin (EPO) is a 165-amino-acid glycoprotein with a molecular weight of 30.4 kilo Dalton (kDa) and approximately 40% carbohydrates. It binds to a single receptor that is widely distributed within the body, but bone marrow is the main target of EPO, where it stimulates both the production and the survival of erythrocytes. Recombinant EPOs […]

Androgen deficiency in the ageing male (ADAM) has become a topic of much interest and debate. With an increasing percentage of the male population now falling into the older age bracket, the principal questions raised are whether older hypogonadal men affected by late-onset hypogonadism (LOH) will benefit from testosterone treatment and what will be the […]

Jongsma et al.1 demonstrated that proliferation of prostatic cancer cell lines under the condition of androgen depletion can be modulated by neuropeptides, which are known to be produced by neuroendocrine (NE) cells. This androgen suppression or depletion can lead to an induction of NE differentiation. If NE cells are androgen-independent, it is reasonable to suppose […]

Heart disease remains the most common cause of death in the developed world, with one in 10 patients still dying of a myocardial infarction (MI).1 With the advent of assays to measure cardiac troponins (cTns), the diagnosis and prognostication of acute coronary syndromes (ACS), including MI, has greatly improved. Katus et al.2 were the first […]

Growth hormone (GH) therapy was introduced in the 1950s, but the initial GH preparations extracted from human cadaver pituitaries were reserved the treatment of GH deficiency (GHD) children.1 Since 1985, only recombinant DNA-derived biosynthetic human GH free from, for example, Creutzfeldt-Jakob prions has been used.2

Insulin resistance and the metabolic syndrome (MeS or syndrome X) are common in patients with chronic kidney disease (CKD). Moreover, the presence of MeS is an independent predictor of subsequent development of CKD, and MeS in patients with CKD predicts subsequent cardiovascular events and cardiovascular mortality, as is the case in the general population.

C-Reactive Protein – A Vital Protein

Northern Ireland has approximately 40,000 people who have been diagnosed with diabetes and it is estimated that a further 25,000 people are as yet undiagnosed.

Definition