Endocrine Abstracts

A 34-year-old lady presented with a 3 year history of central weight gain, hypertension and secondary amenorrhoea. Initial 24-hour urinary free cortisol (UFC) was raised (536 nmol/24 hr) and subsequent overnight dexamethasone suppression test (DST) was elevated at 593 nmol/L. Low and high dose DST confirmed the diagnosis of Cushing’s syndrome with a slightly unusual trend of increasing cortisol levels compared with baseline. ACTH levels were undetectable while adrenal ima...

Diabetic Ketoacidosis (DKA) in patients with Type 2 Diabetes Mellitus (T2DM) is relatively rare and usually associated with intercurrent illness but can cause significant morbidity and mortality. SGLT2 inhibitor (SGLT2i) use has been implicated as a potential risk factor for developing euglycaemic DKA, particularly in sepsis, surgery and starvation. We aimed to investigate the common causes of DKA in T2DM in NHS Lothian to identify whether SGLT2i use was having a significant i...

Canrenone and mifepristone (RU486) are respectively mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) antagonists commonly used to block or displace steroid for clinical pharmacological or research purposes. The aim of this study was to develop and validate a sensitive, quantitative assay for the combined analysis of glucocorticoids (cortisol, cortisone, corticosterone, and 11-dehydrocorticosterone), mineralocorticoids (aldosterone), canrenoate, and mifepristone...

Congenital adrenal hyperplasia (CAH) is associated with poor health outcomes. This is, in part, because doses of glucocorticoid sufficient to suppress excess adrenal androgens are also associated with adverse metabolic effects such as insulin resistance. This toxicity occurs with efficacious doses of all commonly prescribed glucocorticoids (hydrocortisone, prednisolone and dexamethasone). However, the glucocorticoid corticosterone may have an improved therapeutic index because...

Human plasma contains both cortisol (F) and corticosterone (B). B has been largely neglected in humans as it is 10–20 times less abundant however previous studies suggest B and F have differential tissue-specific actions. Compared with F, B has an enhanced response to ACTH, relatively higher concentrations in brain and CSF and differential transmembrane trafficking by ATP-binding cassette (ABC) transporters. Plasma F is bound to corticosteroid-binding globulin (CBG) and a...