Endocrine Abstracts

How do we distinguish normal from abnormal? Are reference ranges the ‘gold standard’? Who do they identify? Where have they come from? For clinical practice that is increasingly dictated by guidelines and consensus statements accurate reference ranges are key to safe practice. Using examples of, amongst others, growth hormone, thyroid stimulating hormone and parathyroid hormone this talk will highlight the need for greater collaboration between laboratories, physicia...

One study examining the lipid profile of adults with partial GH deficiency (GH insufficiency, GHI) suggested they are dyslipidaemic. We defined GH status using two stimulation tests, the ITT and AST, in to patients with severe GHD (pGH < 3ng/ml, n = 30) or GHI (pGH 3 - 7ng/ml, n = 24). Thirty age and gender matched controls were studied.There were no differences in age between the GHD, GHI, and control subjects (30.9 vs 31.5 vs 34.2 yrs). IGF-I levels...

There is increasing reliance on published consensus criteria for clinical decision-making in states of GH excess and deficiency. NICE eligibility criteria for GH treatment include a peak GH response <9 mU/L during an ITT. To determine the adequacy of GH assay performance for diagnosing GH deficiency (GHD), we have assessed the variability in 101 UKNEQAS reported results from a single sample with a value close to 9.0 mU/L. For all laboratories (n=101) median GH was 11.1 mU/L...

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We have previously shown that adults with partial GHD have increased total body and truncal fat mass, an adverse lipid profile, and insulin resistance. In this study we have gone on to analyse suggogate markers of vascular risk and carotid IMT. We defined GH status using the combination of two stimulation tests, the ITT and arginine stimulation test, in to patients with severe GHD (pGH<3 ng/ml, n=30) or GH insufficiency (pGH 3–7 ng/ml, n=24). Thirty age ...

IGF-I is a marker of activity of the growth axis. It is accepted that the interpretation of IGF-I values requires age- and gender-specific reference ranges (RR).We have studied IGF-I assay performance by circulating 2 blood samples with different clinical scenarios to 23 centers [IDS-OCTEIA (n=2), DPC-Immulite (3), DPC-Immulite 2000 (4), in-house RIA (1), Nichols-Advantage (10) and Nichols-IRMA (3)] participating in the UK-NEQAS IGF-I scheme. Participant...

Growth hormone deficiency (GHD) is associated with adverse changes in lipid profile. There are no longitudinal studies of lipid abnormalities in childhood-onset GHD into adulthood. In order to more accurately define the metabolic consequences of GHD in childhood progressing through to adulthood we have examined lipid levels in a group of untreated severely GHD patients with a mutation in the GHRH receptor gene from a rural community in Northeast Brazil.1...

Metyrapone is a potent inhibitor of the conversion of 11-deoxycortisol (11-DOC) to cortisol and is used in the treatment of Cushing's syndrome. This study has assessed the clinical significance of 11-DOC cross-reaction in five serum cortisol assays provided on automated immunoassay analysers. Cross-reaction was determined from the linear regression of increase in measured cortisol against increasing levels of 11-DOC (0, 1590, 4310, 6490, 7040 nmol/L) added to a serum pool. In ...