Endocrine Abstracts

Objective: Quantify classic and 11-oxygenated androgens in serum and saliva and determine variations across age, sex, body mass index (BMI), menstruation and hormonal contraception use.Methods: Morning serum samples were collected from 292 healthy volunteers (125 men, 22-95 years; 167 women, 21-91 years). Morning saliva was collected from 83 healthy volunteers (51 women, 32 men). 25 individuals (12 women, 13 men) also collected a 7-timepoint diurnal sali...

Adrenocortical carcinoma (ACC) is a rare and aggressive endocrine neoplasia with heterogeneous molecular background and clinical outcome. Previous studies identified hypermethylation in specific genes to be associated with poor prognosis. Here, we aimed to investigate the role of methylation pattern for prognostic stratification of patients with ACC as compared to clinical parameters, using methods easily applicable in clinical routine. We investigated a total of 237 ACCs (96 ...

Background: The gonads are the major source of classic androgens during reproductive years. Additionally, the adrenal gland produces precursors for both classic and 11-oxygenated androgen biosynthesis, with androgen activation predominantly occurring in peripheral target tissues of androgen action. We used liquid chromatography-tandem mass spectrometry to profile classic and 11-oxygenated androgens in serum and saliva across the adult age range and assessed diurnal as well as ...

Introduction: Gas chromatography mass spectrometry (GC-MS) is the gold standard method for urinary steroid profiling. However, GC-MS requires chemical derivatisation, long run times, is labour intensive, expensive, and unsuitable for rapid multi-sample analysis, limiting its use in routine clinical practice. GC-MS urinary steroid metabolomics, the combination of steroid profiling and machine learning (Generalized Matrix Learning Vector Quantization) was shown to have superior ...

Background: Adrenal incidentalomas (AI) are found in approximately 5% of the adult population. Most AIs are benign; however, small-scale studies have indicated that 20–50% of patients harbouring a benign AI show biochemical evidence of mild autonomous cortisol excess (MACE), previously termed subclinical Cushing’s syndrome. MACE is differentiated into MACE-1 (serum cortisol after overnight suppression with 1 mg dexamethasone (1 mg-DST) 50–140 nmol/l) and MACE-2 ...

Background: Adrenal incidentalomas (AI) are found in approximately 5% of the adult population. Most AIs are benign; however, small-scale studies have indicated that 20–50% of patients harbouring a benign AI show biochemical evidence of mild autonomous cortisol excess (MACE), previously termed subclinical Cushing’s syndrome. MACE is differentiated into MACE-1 (serum cortisol after overnight suppression with 1 mg dexamethasone (1 mg-DST) 50–140 nmol/l) and MACE-2 ...

Background: Benign adrenal tumours (AT) can be non-functioning (NFAT) or associated with cortisol excess, as indicated by failure to suppress serum morning cortisol to <50 nmol/l in the 1mg-dexamethasone suppression test (1 mg-DST). The latter group divides into patients with clinically overt signs of cortisol excess (adrenal Cushing’s syndrome, CUSH) and patients lacking CUSH signs (mild autonomous cortisol excess, MACE). Smaller series and a recent meta-analysis rep...

Context: Adrenocortical carcinoma (ACC) is an aggressive malignancy with high recurrence rates. Regular post-operative follow-up imaging is essential, but associated with high radiation exposure and frequent diagnostic ambiguity. Urine steroid metabolomics has been described as a novel diagnostic tool for the detection of adrenocortical malignancy. Here we present the first clinical study assessing the performance of this innovative approach in the follow-up of patients with c...

BackgroundBenign adrenocortical tumours are found in 3–5% of adults and can be non-functioning (NFAT) or associated with cortisol excess. The latter group divides into patients with clinically overt signs (adrenal Cushing’s syndrome, CS) and patients lacking CS signs (mild autonomous cortisol excess, MACE). The 1 mg-overnight dexamethasone suppression test (DST) further differentiates MACE into MACE-1 (possible MACE; post-DST cortisol 50–1...

Introduction: Polycystic ovary syndrome affects 10% of women and comes with a 2-3fold increased risk of type 2 diabetes, hypertension, and fatty liver disease. Androgen excess, a cardinal feature of PCOS, has been implicated as a major contributor to metabolic risk. Adrenal-derived 11-oxygenated androgens represent an important component of PCOS-related androgen excess and are preferentially activated in adipose tissue. We aimed to identify PCOS sub-types with distinct androge...