Endocrine Abstracts

Objective: Determine inflammatory and cardiometabolic biomarkers in patients with autonomous cortisol secretion (ACS), compared with healthy controls and patients with overt Cushing syndrome (CS).Method: Serum from prospectively included patients with ACS (n=65), overt CS (n=8), and healthy subjects (n=120) were analysed for 92 different inflammatory biomarkers using proximity extension assay.Results: ACS...

Background: The Synachten test is used to diagnose for adrenal insufficiency (AI) and non-classical congenital adrenal hyperplasia (CAH). The cut-off levels for s-cortisol and s-17-hydroxyprogesterone are derived from immunoassays that were not well standardized and are no longer in use. Introduction of liquid chromatography tandem mass spectrometry (LCMSMS) could resolve the lack of standardization of steroid hormone assays and enable increased diagnostic accuracy.<p clas...

Background: 1-mg overnight dexamethasone-suppression test (DST) is commonly used to screen for hypercortisolism. Sensitivity is high (95%), but specificity is low (80%), leading to false positive results. Identifying individuals with abnormal dexamethasone absorption or metabolism could enhance diagnostic accuracy.Aim: Use serum dexamethasone (s-DXT) to increase diagnostic accuracy of DST.Methods: Prospective study of DST for clini...

BackgroundNon-classical congenial adrenal hyperplasia (NCCAH) is an important differential diagnosis in women with acne, hirsutism, menstrual abnormalities and infertility. To diagnose NCCAH can be challenging, and currently used cutoff levels are based on unstandardized immunological assays, no longer in use.ObjectiveDefine LC-MS/MS based cut-off levels for steroid hormones, to improve diagnosis of NCCAH and...

Background: Adrenal incidentalomas (AI) are found in approximately 5% of the adult population. Most AIs are benign; however, small-scale studies have indicated that 20–50% of patients harbouring a benign AI show biochemical evidence of mild autonomous cortisol excess (MACE), previously termed subclinical Cushing’s syndrome. MACE is differentiated into MACE-1 (serum cortisol after overnight suppression with 1 mg dexamethasone (1 mg-DST) 50–140 nmol/l) and MACE-2 ...

Background: Adrenal incidentalomas (AI) are found in approximately 5% of the adult population. Most AIs are benign; however, small-scale studies have indicated that 20–50% of patients harbouring a benign AI show biochemical evidence of mild autonomous cortisol excess (MACE), previously termed subclinical Cushing’s syndrome. MACE is differentiated into MACE-1 (serum cortisol after overnight suppression with 1 mg dexamethasone (1 mg-DST) 50–140 nmol/l) and MACE-2 ...

Background: Benign adrenal tumours (AT) can be non-functioning (NFAT) or associated with cortisol excess, as indicated by failure to suppress serum morning cortisol to <50 nmol/l in the 1mg-dexamethasone suppression test (1 mg-DST). The latter group divides into patients with clinically overt signs of cortisol excess (adrenal Cushing’s syndrome, CUSH) and patients lacking CUSH signs (mild autonomous cortisol excess, MACE). Smaller series and a recent meta-analysis rep...

BackgroundBenign adrenocortical tumours are found in 3–5% of adults and can be non-functioning (NFAT) or associated with cortisol excess. The latter group divides into patients with clinically overt signs (adrenal Cushing’s syndrome, CS) and patients lacking CS signs (mild autonomous cortisol excess, MACE). The 1 mg-overnight dexamethasone suppression test (DST) further differentiates MACE into MACE-1 (possible MACE; post-DST cortisol 50–1...

Background: The overwhelming majority of incidentally discovered adrenal tumours are benign adrenocortical adenomas. These can be non-functioning (NFAT) or associated with cortisol excess on a spectrum ranging from rare clinically overt adrenal Cushing’s syndrome (CS) to much more prevalent mild autonomous cortisol secretion (MACS) without signs of CS. The 1mg-overnight dexamethasone suppression test (DST) further differentiates MACS-1 (possible MACS; post-DST cortisol 50...

Background: Benign adrenal tumours are found in 3-10% of adults and can be non-functioning (NFAT) or associated with adrenal hormone excess. Analysing 1305 prospectively recruited patients with benign adrenal tumours, we recently demonstrated that 45% had mild autonomous cortisol secretion (MACS), i.e. biochemical cortisol excess without signs of Cushing’s syndrome (CS). MACS increases the prevalence and severity of hypertension and type 2 diabetes (Ann Int Med. 2022 Doi:...