Endocrine Abstracts

5α reductases 1 and 2 (SRD5A1 and SRD5A2) metabolise cortisol into inactive 5α-dihydrocortisol contributing to the regulation of cortisol availability in addition to their established role in the generation of dihydrotestosterone from testosterone. Dutasteride and finasteride are commonly prescribed to patients with benign prostatic hyperplasia but their potential metabolic effects have only recently been identified. Dutasteride inhibits both SRD5A1and SRD5A2 whilst ...

Context: Patients with hypopituitarism have increased morbidity and mortality. There is ongoing debate around the optimum glucocorticoid replacement therapy.Objective: To assess the effect of glucocorticoid replacement in hypopituitarism on corticosteroid metabolism and its impact on body composition.Design and patients: We assessed the urinary corticosteroid metabolite profile (using gas chromatography/mass spectrometry) and body ...

Background: The short Synacthen test (SST) is the most widely used dynamic assessment of adrenal reserve. In some situations, the SST may be difficult to perform. Random basal cortisol levels could provide an alternative screening assessment to rationalize which patients need dynamic testing. This is highly clinically relevant, given the large numbers of patients taking prescribed glucocorticoids who are at risk of iatrogenic adrenal suppression.Methods:...

Non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the commonest cause of liver cirrhosis and leading indication for liver transplant worldwide. It is tightly associated with obesity and type 2 diabetes, yet the precise mechanisms that drive its aetiology are not fully defined. Dysregulation of both glucocorticoid and androgen metabolism has been implicated in its pathogenesis. The availability of these hormones to bind and activate their receptors is mainly regulat...

Objective: Glucocorticoids exert their effects through the glucocorticoid receptor (GR). The local, cell-type specific glucocorticoid effect is modulated by the 11β-hydroxysteroid dehydrogenase enzymes (HSD11B) responsible for the interconversion of cortisone and cortisol. Individual sensitivity against glucocorticoids and activity of the HSD11B enzymes are at least partly determined by genetic factors.Aim: To test whether SNPs of GR and HSD11B1 gen...

In recent years measurement of steroid hormones like testosterone, androstenedione, cortisol, and cortisone has become increasingly important in both patient care and research. This is mainly due to the simple and non-invasive sample collection. We investigated in twenty healthy volunteers whether there is a difference between steroid hormone concentrations in unstimulated and parotid gland saliva as well as stimulated saliva collected while chewing without aid, using cotton a...

Pituitary patients with different aetiologies of hypopituitarism exhibit differing phenotypes despite optimal replacement therapy. We hypothesised that differential regulation of the isoenzyme 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1), which mediates the autocrine conversion of cortisone to cortisol in adipose tissues and liver may play a role.We prospectively studied 11β-HSD1 activity through analysis of 24 h urine cortisol/cortisone ...

Background: Patients taking hydrocortisone replacement for primary or secondary adrenal failure require individual adjustment of their dose. Previous observations in our department suggest that total serum cortisol levels achieved following an afternoon or evening dose of 5 mg hydrocortisone are almost as high as those that result from a 10 mg dose in the early morning; and that the ‘area under the cortisol curve’ (AUC) generated by an evening 5 mg dose is broader th...

Introduction: The duration and doses of glucocorticoids (GC) are significant prognostic factors of carbohydrate metabolism disturbance (CMD).Description of methods: 165 patients with systemic lupus erythematosus (32.1% patients), systemic vasculitis (27.3% patients), and chronic glomerulonephritis (40.6% patients) were included. 98 patients received GC pulse-therapy (GCPT) (first group), which included i.v. infusion of prednisolone 10–15 mg/kg per d...