Endocrine Abstracts

Measurement of steroid metabolites in urine by gas chromatography-mass spectrometry remains the gold standard for biochemical diagnosis of steroidogenic disorders. In the UK, three laboratories offer steroid profiling for routine clinical testing, with the Supraregional Assay Service at King’s College Hospital being the largest and experiencing increased demand year-on-year for testing. In this study, we used our profiling database to audit 2021 workload. By direct compar...

Objective: Mitotane (o,p’DDD) is an effective adrenolytic agent for treatment of advanced adrenocortical carcinoma (ACC). Suppression of cortisol biosynthesis, including inhibition of 11β-hydroxylation, has been described. Decreased cortisol bioavailability is indicated by increased dose requirement for hydrocortisone replacement during mitotane treatment. Urinary excretion of common cortisol metabolites (CM) has been reported to be normal but with increase of 6&#946...

Mitotane (o,p’DDD) is an effective oral adrenolytic agent for treatment of advanced adrenocortical carcinoma (ACC). Inhibition of cortisol biosynthesis has been described. Cortisol metabolic clearance rate is unchanged, but decreased cortisol biovailability is indicated by increased dose requirement for hydrocortisone replacement during mitotane treatment. Urinary excretion of common cortisol metabolites (CM) has been reported to be normal but with increase of 6β-hyd...

Introduction: Pituitary and adrenal Cushing’s may be managed by pharmacological-inhibition of adrenal steroidogenesis, using metyrapone and/or ketoconazole. Assessment of biochemical control is challenging owing to cross-reactivity in immunoassays (e.g. cortisol and 11-deoxycortisol) leading to over/under-treatment. Off-target effects can also result, e.g. hyperandrogenism/mineralocorticoid hypertension (increased 11-deoxycorticosterone/DOC). LC-MS/MS analysis is free fro...

Background: Polycystic ovarian syndrome (PCOS) affects 5–10% of women of reproductive age. Hyperandrogenism and hyperinsulinaemia have been attributed to the pathophysiology of PCOS. The aim of this study is to evaluate the effect of fat distribution and insulin resistance on steroid metabolism in PCOS.Methods: The study recruited 20 PCOS and 20 matched controls. Fat distribution was assessed by waist circumference, skin fold measurements, and body ...

Cellular reprogramming describes the process where a fully differentiated, specialized cell type is induced to transform into a different cell. Cell reprogramming techniques can become powerful tools for modelling diseases, drug testing and for personalized cellular therapy. The adrenal cortex is the primary site of steroid synthesis. Adrenal insufficiency, which can be life threatening, is caused by a number of adrenal disorders, and lifelong management of these patients with...

Adrenocortical carcinoma (ACC) is a rare malignancy, but accounts for up to 11% of adrenal masses investigated in referral centres. Diagnosis remains a challenge. Up to two thirds are biochemically inactive, resulting from de facto enzyme deficiencies in the steroid hormone biosynthetic pathways, as shown by urine steroid profiling by gas chromatography-mass spectrometry. Increased metabolites of pathway intermediates in ACC discriminate it from benign adrenal lesions...