Endocrine Abstracts

Salivary cortisol (SalC) potentially has advantages over serum cortisol (SerC) as it is easier to collect and possibly reflects unbound (free) cortisol. SalC levels are approximately 10 times lower than SerC and require high measurement precision best addressed by liquid chromatography–tandem mass spectrometry (LC-MS/MS), which in contrast to previously used radioimmunoassays eliminates cross-reactivity by other steroids. We describe the use of LC-MS/MS to evaluate the po...

Itraconazole increases glucocorticoid levels through inhibition of CYP3A4 in the liver. Recent case-reports have shown that the co-administration of itraconazole with inhaled glucocorticoids in asthmatics may result in suppression of their HPA axis and a Cushing’s phenotype. We have evaluated the impact of this interaction on the cortisol axis in a double-blind randomised placebo-controlled study.Twenty-seven patients with severe asthma (17 women; m...

Background: The use of salivary cortisol is well validated in the diagnosis of Cushing’s syndrome but routine use of salivary measurements during dynamic tests of HPA axis sufficiency is uncommon and reference ranges are not established. Salivary cortisol (SalF) and cortisone (SalE) measurements by LC–MS have several advantages including ease of collection and more accurate reflection of unbound serum cortisol levels in conditions of altered CBG levels (e.g. oestroge...

Aim: To measure interstitial cortisol obtained by adipose tissue microdialysis (MD) as well as serum total and free cortisol in 31 mechanically ventilated patients upon sepsis onset (days 1 and 2). MD tissue glucose, pyruvate, lactate, and glycerol were also measured (as markers of altered or disrupted local energy production).Methods: The Acute Physiology and Chronic Health Evaluation (APACHE II) on day 1 and the sequential organ failure assessment (SOF...