Endocrine Abstracts

For several years, steroid hormones including testosterone (T), androstenedione (A4) and 17-hydroxyprogesterone (17-OHP) have been utilised in the diagnosis of a range of conditions with clinical features of hyperandrogenaemia including polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia. In recent years a potential role for the 11-oxygenated androgens has emerged in the diagnosis and characterisation of androgenic disorders. Specifically, the 11-oxygenated and...

Introduction: Alternative biofluids such as sweat, which can be obtained non-invasively and present a simpler matrix composition than serum/plasma or urine, may be useful for monitoring biomarkers. The long-term sampling with patches either on the chest or back can be conveniently used under both rest and exercise conditions to provide an integrated response of free biomarkers over the course of a day. The smaller sample volumes generated by sweat collection can be convenientl...

Background: The overnight dexamethasone (DEX) suppression test is useful for the investigation of hypercortisolism, however several factors may influence its performance. Intestinal uptake of DEX, inactivation by conversion by CYP3A4 in the liver and renal clearance can all affect test variability. It is also known that several drugs can either reduce or accelerate CYP3A4 activity, thereby affecting blood DEX concentrations. Interpretation of the test would be greatly enhanced...

Steroid profiling of biological fluids has been used for clinical and diagnostic research since the 1950s. Most methods focus on blood and urine, however, more recently saliva analysis has been employed as a non-invasive, simple to collect sample for the diagnosis of conditions such as Cushing’s and androgen excess. Despite its ease of collection, saliva remains an underutilised biofluid. To investigate the use of salivary steroid profiling for endocrine research, we aimed to ...

Background: Polycystic ovary syndrome (PCOS) is a heterogenous condition that affects approximately 12% of females. The diagnosis can be complex and biochemistry tests are routinely relied upon to help identify hyperandrogenaemia and to exclude other conditions. However, although national and international guidelines advocate the use biochemistry tests, little information is provided as to which tests should be used and which other endocrinopathies should be excluded.<p cl...

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended for the differential diagnosis of Cushing’s syndrome and the investigation of adrenal incidentalomas. However, diagnostic performance of the test relies on accurate methods to quantitate cortisol in serum. Although the variable performance of serum cortisol immunoassays has been well-documented, little has been published on their performance following the ONDST.Aims...

Background: Accurate measurement of serum cortisol is essential in the investigation of the HPA axis. It has been documented that routine immunoassays are liable to both under- and over-recovery leading to inaccurate results and subsequent inappropriate investigations. This study seeks to provide an up-to-date assessment of the accuracy of the major immunoassay platforms and compares results to a liquid chromatography–tandem mass spectrometry (LC–MS/MS) candidate ref...

Comprehensive multi-steroid profiling offers a powerful tool for the investigation, diagnosis and management of steroidogenic disorders by simultaneously quantifying multiple steroids from several pathways of steroid biosynthesis and metabolism. Difficulties can arise when optimising chromatography and mass spectrometry conditions for many analytes in a single method. Low concentrations of ammonium fluoride have previously been shown to enhance the sensitivity of select analyt...

Background: Development of multi-steroid profiling allows comprehensive investigation into the different branches of steroid metabolism. Immunoassays only allow analysis of a single steroid per assay and suffer from problems with specificity due to cross reactivity of similar steroids. Liquid-chromatography mass spectrometry has the specificity to analyse multiple steroids in a single experiment and the dynamic range to quantify steroids at high concentrations such as those ob...

Background: Excess testosterone in PCOS is accompanied by increased levels of other ovarian and adrenal androgens and precursors. Recently, 11-oxygenated adrenal androgens have been postulated as major components of the circulating androgen pool in PCOS. Obesity is strictly connected with androgen excess and with the derangement of hormone circadian rhythmicity. To date, it has not been clarified whether hyperandrogenism in PCOS, either complicated by obesity or not, is accomp...