Endocrine Abstracts

Background: Soluble alpha klotho (sαKL) is a circulating protein that has been linked to the growth hormone (GH) axis. We previously showed its association to disease activity in patients with acromegaly, with considerable robustness towards biological confounders. However, there is scarce data in literature regarding the analytical performance of the assay, and pre-analytical stability of sαKL in blood samples. Objective: We aimed to evaluate ...

Introduction: Pasireotide is a potent somatostatin analogue (SSA) and used in therapy-refractory acromegaly, commonly after failure of treatment with first-generation SSA. However, it may induce severe hyperglycemia, which usually occurs rapidly after initiation of therapy and in general gradually improves over time. We here present two cases of young male patients who developed severe pasireotide-induced hyperglycemia after several years of treatment.Ca...

Context: Patients with primary bilateral macronodular adrenocortical hyperplasia (PBMAH) usually present with bilateral benign adrenocortical macronodules at imaging and variable levels of cortisol excess. There is anecdotal evidence that, besides cortisol, other adrenal steroids, like mineralocorticoids, can be oversecreted.Objective: To assess the prevalence, clinical, biochemical characteristics and imaging features of aldosterone excess leading to pr...

Background: We recently have shown a close association of high concentrations of soluble alpha klotho (sαKL) to disease activity in acromegaly. Small pilot studies suggested that sαKL concentrations might be reduced in GH deficiency (GHD) and increase after recombinant human GH (rhGH) therapy. Our aim was to evaluate the potential of sαKL as a biomarker in GHD.Methods: We evaluated sαKL in comparison to the classical biomarkers GH, IG...

Background: Recent studies reported high soluble α-klotho concentrations (α-klotho) in active acromegaly, with normalization after successful therapy. We showed that α-klotho correlates to GH and even better to IGF-I. So far, most studies employed an immunoassay from Immuno-Biological Laboratories (IBL) for measurement of α-klotho, but other assays are available. Agreement between assays remains questionable since α-klotho exists in several isoforms: K...

Background: Soluble alpha klotho (sαKL) is high in active acromegaly, normalizes after disease control, and therefore is suggested as a new biomarker for growth hormone (GH) excess. However, little is known about the impact of biological variables other than GH.Methods: Serum sαKL (pg/ml) was measured by ELISA (IBL, Hamburg, Germany). We first evaluated pre-analytical stability, defined a reference interval for sαKL in healthy subjects (A:...

Background: Serum soluble alpha klotho (sαKL) is a circulating protein which had been shown to be very high in active acromegaly, and significantly reduced after disease control. Therefore, sαKL has been suggested as a new biomarker for growth hormone (GH) excess. In this study, we aimed to evaluate the impact of short-term stimulation and suppression of GH and acute modulation of glucose metabolism on sαKL concentrations.Methods: Serum s&...

Background: Secondary hypogonadism (SH) is a common comorbidity of Cushing’s syndrome (CS) in men. There is a large overlap in associated symptoms and comorbidities between hypogonadism and hypercortisolism. To date, the influence of coexistent SH on clinical and biochemical parameters in CS is largely unknown and longitudinal data investigating its recovery during the remission phase are scarce.Hypothesis: We hypothesized that SH is a frequent and ...

Background: Alpha klotho is a transmembrane protein that regulates calcium metabolism. Its soluble portion has been linked to endocrine functions. We have recently shown high concentrations of serum soluble alpha klotho (sαKL) in active acromegaly. There is limited information about regulation of sαKL secretion. We aimed to gain insight about sαKL as a potential biomarker for H-related diseases.Methods: SαKL was measured by ELISA (IBL...

GH consists of various molecular isoforms. Most abundant is 22 kDa-GH (80–90% of total GH), followed by 20 kDa-GH (5–15% of total GH). The biological significance of 20 kDa-GH remains unclear, but its effects appear comparable to those of 22 kDa-GH. Acromegaly is characterized by chronic GH excess. Data on GH isoforms in acromegaly are scarce, but an increased 20 kDa-/22 kDa-GH-ratio (20k-ratio) has been described. Our aims were to compare the 20k-ratio in a larger c...