Endocrine Abstracts

Vitamin-D binding protein (VDBP) is the main reservoir of circulating vitamin D and its metabolites in blood. VDBP deficiency leads to a benign phenotype of undetectable vitamin D in the blood without remarkable effects in the calcium and bone metabolism if dietary vitamin D is sufficient ((Safadi et al 1999, Banerjee et al 2021)). This paradoxical phenotype is probably explained by the free-hormone hypothesis, which suggest that only the unbound vitamin D fr...

Purpose: We aimed to validate the diagnosis and estimated national incidence of acromegaly reported in the Swedish National Patient Register (NPR), based on clinically reported International Classification of Diseases (ICD-codes), in comparison with the Swedish Pituitary Register (SPR).Methods: All patients in NPR or SPR between 1991-2018 with the ICD-9 or ICD-10 diagnosis of acromegaly and age >18 years at diagnosis were included. The diagnosis was ...

Background: Neuropsychiatric symptoms and cognitive dysfunction are common in Cushing´s disease (CD), and seem only partly reversible after biochemical remission has been achieved.Aim: To investigate prescription of drugs associated with neuropsychiatric morbidity in a large national cohort of CD patients.Methods: Patients in the Swedish Pituitary Registry, diagnosed with CD between July 2006 and January 2018 were included, <e...

Introduction: Cushing’s syndrome is rare, but assessment of patients with clinical suspicion of Cushing’s and/or adrenal incidentaloma is frequently required. Thus, there is a need for biochemical screening methods that with high sensitivity and specificity identifies or rule out hypercortisolism. Analysis of late night salivary cortisol allows an easy sampling procedure performed at home and is independent of variations in plasma CBG levels. Analysis by liquid chrom...

Adrenal hormones possess both circadian and ultradian rhythms, making interpretation of single time point measurements difficult, particularly in the context of suspected endocrine disease. Attempting to capture either normal or pathological rhythms in detail by traditional measurement of blood is impractical and generally unfeasible. However, minimally invasive microdialysis sampling of free tissue hormones coupled with a portable fraction collector (U-RHYTHM), and a targeted...

Background & Objective: Late night salivary cortisol (LNSC) and 1 mg overnight dexamethasone suppression test (DST) are two of the three recommended screening tests for Cushing’s syndrome (CS). The classical DST uses serum cortisol, but analysis of salivary cortisol and cortisone has shown high diagnostic accuracy at DST (1). Salivary cortisol can be analysed with immunoassays, which suffer from variable degree of cross reactivity with other steroids, or with LC-MS/MS...

Background: Due to the rarity and the slow progress of the disease, there is a considerable diagnostic delay in acromegaly, contributing to increased morbidity and mortality. Voice analysis may decrease this delay as patients with acromegaly often develop a dark voice and unclear speech due to macroglossia, enlarged lips and edema in the pharynx and larynx. Modern technology offers higher speed and power of voice analysis and increased the interest in voice as a biomarker to i...

Background: Recently, we have shown that ambulatory 24-hour dynamic steroid profiling using the newly developed U-RHYTHM system is possible and presented the circadian and ultradian rhythmicity of adrenal hormones in a healthy cohort. With U-RHYTHM, multiple hormones can be sampled simultaneously, and the free active hormones can be measured in local tissue where the effect is exerted. Thus the hormone fingerprint resulting from replacement therapy in individual patients can b...

Background: It is still undetermined whether patients with Cushing’s disease (CD) in remission have an increased mortality. Most previous studies are limited by small numbers of patients and/or short follow-up time.Objective: To study mortality in a nation-wide cohort of patients with CD during long-term follow-up.Methods: Patients with ICD codes for Cushing’s syndrome and/or CD, between 1987 and 2013, were identified in ...

Background: Acromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Guidelines regarding treatment algorithms and follow-up vary considerably.Aim: To evaluate consensus on the treatment and follow-up of acromegaly in the Scandinavian countries.Methods: To map the landscape of acromegaly management in the Scandinavian countries, ...