Endocrine Abstracts

Background: The incidence of type 1 diabetes mellitus is increasing worldwide with recent European data suggesting annual increases ranging from 0.6 to 9.3%, the overall rate being 3.9%. It was thought that the Republic of Ireland (ROI) had one of the lowest disease incidences in Europe. The first Irish study of T1DM incidence which provided a measure of case ascertainment, confirmed a high incidence rate (IR) at 16.6 per 100 000 placing this population, in the upper quartile ...

Archipelago/hCdc4/Fbw7 is the F-box protein specific for recognising and binding phosphorylated cyclin E and targeting it for ubiquitination. Mutations in Archipelago that prevent it from binding to phoshorylated cyclin E have been described in various human cancers including breast, ovarian and endometrial tumours. Previous studies have suggested that cyclin E is over-expressed in corticotroph tumours and other pituitary adenoma subtypes, and we postulated that this may be se...

In the ovary, 11βHSD enzymes inter-convert cortisol (F) with its inert metabolite, cortisone (E). Porcine follicular fluid from antral follicles and spontaneous ovarian cysts contains hydrophobic compounds that inhibit NADP(H)-dependent cortisol metabolism by 11βHSD1. The aim of this study was to measure intra-follicular F:E ratios in porcine antral follicles and ovarian cysts, and determine whether F:E ratios correlate with the inhibition of 11βHSD1 by porcine ...

INTRODUCTIONThe plasma concentrations and urinary excretion rates of 18-OH-F and 18-oxo-F are high in Conn's syndrome and glucocorticoid suppressible hyperaldosteronism, reputedly because aldosterone synthase (AS) has abnormal access to cortisol (F). However, both compounds are also excreted in normal subjects. Two enzymes, 11beta-hydroxylase (11OH) and AS, located in the zona fasiculata (ZF) and zona glomerulosa (ZG) respectively, are capable of 18-hydroxylation but only ...

The duty biochemist at Barts Health noted a testosterone result of 17 nmol/l on a 20-year-old female, measured by Roche E170 electrochemiluminescence immunoassay. Laboratory policy is that all female testosterone results >2.5 nmol/l by immunoassay (upper reference limit 1.92 nmol/l) are checked by LCMS to exclude analytical interferences. The LCMS result on this sample was below the limit of quantification (<0.5 nmol/l).Clinical details were &#14...

Introduction: Estradiol is an important parameter in the evaluation of female fertility. Moreover, the measurement estradiol is essential in determining the right moment for oocyte retrieval in modified natural cycle IVF (MNC-IVF). Estradiol is measured by an immunochemical method and a change between immunoassays usually comes with a change in reference values due to differences in antibodies used and the lack of harmonization. In our hospital we changed in 2014 from the Auto...

The Endocrine Society guidelines recommend initial testing for Cushing’s syndrome (CS) can be based on non-invasive late-night salivary cortisol measurement (NSC). In the BHSCT NSC (11pm), measured using the IBL ELISA kit has been found to be highly discriminative in identifying patients with CS. However it is a labour intensive test and the need for analysing samples in batches delays turnaround time, limiting its use in the routine work-up for CS. Roche provide an autom...

Introduction: POEMS syndrome is a rare multisystemic disorder including polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma-proliferative disorder and skin changes. We aim to describe the course of the endocrine disease in the context of this paraneoplastic syndrome.Methods: 69 patients with POEMS have been under the MDT care in our hospital. Data is currently available for 32 patients who attended the joint haematological/neurological/endocr...

Introduction: The limit of quantification (LOQ) is defined as the lowest analyte concentration that can be reproducibly measured with defined imprecision expressed as CV (coefficient of variation). Low concentrations of hormones estradiol, LH, FSH and testosterone are essential in diagnosis and monitoring of various endocrine disorders. Automated immunoassays have well known advantages, but still limited in achieving necessary analytical sensitivity. The major concern is to pr...

Introduction: In 2017 the Roche cortisol assay underwent a generation update. The increased specificity of this assay was expected to lower cortisol results by approximately 30%. Based on a local consensus, the 30 min short Synacthen Test (SST) cortisol was lowered from 550 to 420 nmol/l. With the previous assay, a morning cortisol of ≥375 nmol/L gave a 99% PPV of an SST ‘pass’.Aims: • To compare the numbers of SSTs and the SST pass ...