Searchable abstracts of presentations at key conferences in endocrinology

ea0026mte20 | (1) | ECE2011

Glucocorticoid replacement therapy

Lovas Kristian

The glucocorticoid replacement therapy has been virtually unchanged since the invention of cortisone 60 years ago. Studies in patients with primary adrenal insufficiency have indicated increased mortality and unfavourable metabolic effects such as reduced bone mineral density, and evidence has accumulated that these patients suffer from reduced health-related quality of life (HRQoL). Although these endpoints possibly relate to inappropriate glucocorticoid therapy, the impact o...

ea0081p14 | Adrenal and Cardiovascular Endocrinology | ECE2022

Profound changes of inflammatory and cardiovascular biomarkers in patients with autonomous cortisol secretion and Cushing syndrome

Astrom Ueland Grethe , Methlie Paal , Lovas Kristian , Saevik Ase Bjorvatn , Heie Anette , Sverre Husebye Eystein

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...

ea0063p436 | Adrenal and Neuroendocrine Tumours 2 | ECE2019

Measuring steroids hormones by liquid chromatography–tandem mass spectrometry in 21-hydroxylase deficiency (21OHD) reveal large interindividual differences in hormone levels amongst patient with the same genetic mutation

Thorsby Per Medboe , Dahl Sandra R. , Bronstad Ingeborg , Lovas Kristian , Nermoen Ingrid

Background: We have previously shown that LC-MS/MS analyses of steroid hormones are superior to immunoassays monitoring 21OHD, due to better specificity and the possibility to multiplexing several steroid hormones in the same assay. This may lead to better understanding of the individual steroid hormone profile in patients with CAH. Here we present four patients cases with the same genotype in the CYP21A2 gene, and evaluate their steroid profile by LC-MS/MS analyses.<...

ea0049ep33 | Adrenal cortex (to include Cushing's) | ECE2017

Rapid reduction in left ventricular mass in primary aldosteronism after treatment; a prospective cardiac MRI study

Grytaas Marianne Aardal , Sellevag Kjersti , Thordarson Hrafnkell Baldur , Husebye Eystein Sverre , Lovas Kristian , Larsen Terje Hjalmar

Background: Primary aldosteronism (PA) patients have increased left ventricular mass (LVM) and increased cardiovascular morbidity compared with those with essential hypertension. Echocardiographic studies have demonstrated that adrenalectomy or spironolactone decreases LVM. The aim of the present study was to use MRI to assess both LVM and cardiac function before and during stress testing, at baseline and after treatment with adrenalectomy or spironolactone, compared with heal...

ea0049ep49 | Adrenal cortex (to include Cushing's) | ECE2017

The short Synacthen test revisited – reevaluation of the normal reference range using LCMSMS

Ueland Grethe AEstrom , Methlie Paal , Oksnes Marianne , Lovas Kristian , Thordarson Hrafnkell , Husebye Eystein

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...

ea0049ep59 | Adrenal cortex (to include Cushing's) | ECE2017

Assay of steroids with Liquid chromatography tandem mass spectrometry is superior to immunoassays in monitoring patients with 21-hydroxylase deficiency

Nermoen Ingrid , Dahl Sandra Rinne , Brondstad Ingeborg , Husebye Eystein S , Thorsby Per M , Lovas Kristian

Objective: Immunoassays of steroids are still used in the diagnosis and biochemical monitoring of patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21 OHD). However, high levels of steroid intermediates can promote cross-reactivity between steroids giving rise to falsely elevated levels.Design: Fifty-nine patients with classic 21OHD (38 women) were studied. Blood samples were collected in the morning after overnight medicatio...

ea0044p159 | Neuroendocrinology and pituitary | SFEBES2016

Dynamic hormonal diagnostics of acromegaly and Cushing’s disease

Simunkova Katerina , Russel Georgina , Upton Thomas , Husebye Eystein , Methlie Paal , Lovas Kristian , Lightman Stafford

Pituitary and adrenal gland assessment, is one of the most important aspects of the management of a pituitary and adrenal adenoma.Clinical practice varies widely with regard to assessment of pituitary and adrenal status pre- and post-operative. Pre-operative testing includes dynamic testing to assess function which is not practical in the immediate post-operative period. Instead a single morning serum total hormones are measured while a more definitive a...

ea0041gp24 | Adrenal (2) | ECE2016

Does measurement of serum dexamethasone increase diagnostic accuracy of the overnight dexamethasone-suppression test?

Ueland Grethe AEstrom , Methlie Paal , Thordasron Hrafnkell Baldur , Lovas Kristian , Kelp Oskar , Mellgren Gunnar , Husebye Eystein

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...

ea0037ep41 | Adrenal cortex | ECE2015

Effect of stress-dosed hydrocortisone on physical capacity in patients with Addison's disease

Simunkova Katerina , Jovanovic Nevena , Oksnes Marianne , Lovas Kristian , Husebye Eystein Sverre

The current conventional glucocorticoid (GC) replacement therapy in primary adrenal insufficiency (Addison’s disease) and congenital adrenal hyperplasia (CAH) renders the cortisol levels unphysiological, resulting in very high levels alternating with almost undetectable levels of cortisol over the day. This reduces not merely the patient’s quality of life but increases the patient’s morbidity and mortality. The HPA axis is characterised by a dynamic circadian va...

ea0032p9 | Adrenal cortex | ECE2013

Insulin sensitivity in patients with Addison's disease: a randomised cross-over trial comparing conventional glucocorticoid replacement therapy with continuous subcutaneous hydrocortisone infusion therapy.

Bjornsdottir Sigridur , Nystrom Thomas , Isaksson Magnus , Oksnes Marianne , Husebye Eystein , Lovas Kristian , Kampe Olle , Hulting Anna Lena , Bensing Sophie

Background: Conventional glucocorticoid replacement therapies result in unphysiological variation in plasma cortisol levels; concern has been raised regarding long-term metabolic consequences. Glucocorticoid replacement is technically feasible by continuous subcutaneous hydrocortisone infusion (CSHI), which can mimic the normal diurnal cortisol rhythm. The aim of this study was to compare insulin sensitivity in patients with Addison’s disease (AD) on CSHI vs three daily d...