Endocrine Abstracts

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...

Background: Hormones oscillate in circadian and ultradian rhythms. Consequently, single time point measurements are very difficult to interpret. To address this, we developed an automated system of 24-hour ambulatory microdialysis. This allows measurement of free hormone concentrations in subcutaneous interstitial fluid collected while participants continue normal daily activities. To validate the technique for adrenal steroid hormones, we simultaneously sampled interstitial f...

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...

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...

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...

Background: Hormones oscillate in circadian and ultradian rhythms. Single time point samples are difficult to interpret and high frequency measurements are time consuming, expensive and invasive. We developed a minimally invasive technique of ambulatory, automated microdialysis. This allows frequent 24-hour sampling of interstitial fluid while participants continue normal daily activities.Methods: Healthy volunteers (age 18–68, no regular medication...

BackgroundNon-classical congenial adrenal hyperplasia (NCCAH) is an important differential diagnosis in women with acne, hirsutism, menstrual abnormalities and infertility. To diagnose NCCAH can be challenging, and currently used cutoff levels are based on unstandardized immunological assays, no longer in use.ObjectiveDefine LC-MS/MS based cut-off levels for steroid hormones, to improve diagnosis of NCCAH and...

Rhythms and change are fundamental properties of all living things, having evolved to allow adaptation to life on earth. Rhythmicity can be observed both in behaviour and internal biology of all mammals including humans. Hormonal secretion patterns that occur at circadian and or ultradian frequencies occur commonly in the endocrine system but for practical and pragmatic reasons clinicians tend to sample and attempt to interpret single time point measures. These results can oft...

Background: Establishing endocrine diagnoses including pituitary Cushing’s remains challenging with delayed or misdiagnosis being very costly for both patient and the health care system. A key issue is that standard diagnostic tests are typically single time point, single analyte samples, which do not consider dynamic variation intrinsic to endocrine systems. Having previously demonstrated that free tissue hormones correlate strongly with plasma concentrations, we present...

Patients on long term glucocorticoid replacement therapy have higher rates of morbidity and mortality. One causative factor may be non-physiological cortisol replacement. We have developed as part of the ULTRADIAN consortium (https://www.uib.no/en/ultradian) the U-RHYTHM, an ambulatory bio-sampling device that can collect clinical samples using in-vivo microdialysis every 20 minutes over the 24hour day whilst individuals continue with their normal everyday activities....