Endocrine Abstracts

Analysis of sweat is well-established for the diagnosis of cystic fibrosis and for testing for drug abuse. Cortisol, cortisone and aldosterone were identified in sweat in 1948, and the presence of 11 beta hydoxysteroid dehydrogenase type 2 in the epidermis was reported in 1990. At present there are no studies of the diagnostic value of sweat cortisol measurement. We have evaluated the use of a sweat patch comprising a small 47 by 32 mm rectangle of filter paper secured by a wa...

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Background: Diabetes increases the risk of developing coronary heart disease irrespective of glycaemic control. Cortisol and growth hormone (GH) abnormalities have been found in these patients and have been proposed as possible mechanisms for this increased risk.Regular exercise, through an unknown mechanism, can modify cardiovascular risk and so prevent or delay the progression of coronary heart disease. In this study we assessed whether an exercise program would a...

For investigation of mild glucocorticoid resistance, dexamethasone may be inappropriate because, unlike cortisol, it crosses the blood-brain barrier and suitably low doses are difficult to titrate. Prednisolone has been proposed as an alternative but assay of cortisol as an endpoint is subject to cross-reaction with prednisolone in most ligand assays. Using capillary gas chromatography, we can distinguish urinary cortisol and prednisolone metabolites. We have compared this app...

Acute cortisol increase in man, whether from endogenous or exogenous sources, is associated with changes in cortisol:cortisone equilibrium. We have examined these during normal daily circadian rhythms and following treatment with hydrocortisone. Following local ethical committee approval, four adult volunteers (2 male) collected urine samples over 3 hour periods starting from midnight and over hourly periods between 0600 & 0900 to define the morning cortisol peak. They pro...

Background: A hydrocortisone day curve can be used to assess a patient's steroid replacement. However the need for venous samples requires patients to be admitted to hospital either over-night or as a day case and tablet times may vary compared to the patients' usual practice.Objective: The aim of this study was to determine whether patients could collect capillary or salivary cortisol at home and whether these collections were reproducible.<p class=...

A South Asian woman aged 44 years presented with longstanding hirsutism. Her periods had always been regular and she had two children. She had been treated with spironolactone and Dianette without clinical benefit and the hirsutism was managed cosmetically. Investigations showed a high serum testosterone of 6.1 nmol/l ( 1-3nmol/l) and androstenedione 25nmol/l (2-10nmol/l). Serum sex hormone binding globulin was elevated at 96 nmol/l (23-85nmol/l), with normal DHEA sulphate, 4....

Primary hyperaldosteronism ('Conn's syndrome') may have a prevalence as high as 10% in hypertensive patients, and in some cases there may not be obvious hypokalaemia. Recently the use of a single aldosterone/ renin ('A/R') ratio has been advocated as a screening test for Conn's, and less influence by anti-hypertensive drug therapy has been claimed.We have established a cut-off for ambulant A/R ratios of 25 ng/mU using the DPC'Coat-a-Count' aldosterone method and the Nichols 'A...

In the ovary, 11βHSD enzymes inter-convert cortisol (F) with its inert metabolite, cortisone (E). Porcine follicular fluid from antral follicles and spontaneous ovarian cysts contains hydrophobic compounds that inhibit NADP(H)-dependent cortisol metabolism by 11βHSD1. The aim of this study was to measure intra-follicular F:E ratios in porcine antral follicles and ovarian cysts, and determine whether F:E ratios correlate with the inhibition of 11βHSD1 by porcine ...

A role for local corticosteroid metabolism by 11beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1) has been proposed in bone and adipose tissue physiology. In vivo, 11b-HSD1 predominantly converts inactive cortisone to active cortisol and enzyme activity is critically dependent on substrate concentration. To examine 11b-HSD1 activity in vivo we have analysed the relationship between serum cortisone and markers of bone turnover, BMD and adipose tissue mass in a c...