Endocrine Abstracts

Introduction: The stress response post-operatively increases glucocorticoid concentration and a higher cortisol response is associated with better recovery. The measurement of cortisol concentrations post-operatively can be unreliable due to altered binding protein concentrations. Free serum cortisol is felt to be the better marker of bio-active glucocorticoid concentrations but is difficult to measure. Salivary cortisol and cortisone have been shown to correlate well with ser...

Background & Aims: Observational studies implicate glucocorticoid excess, principally due to altered steroid metabolism in target tissues, in both the insulin resistance and liver fat accumulation that accompanies type 2 diabetes. To test the contribution of glucocorticoid signalling to metabolic dysfunction we blocked cortisol secretion (with metyrapone) and action (with the GR antagonist mifepristone) simultaneously in men with type 2 diabetes ± fatty liver.<p c...

Background: Testosterone deficiency is common in obesity and in type 2 diabetes mellitus. It is hypothesised that the expanded adipose pool, which is the major source of aromatase in men, depletes testosterone levels by excess conversion to estradiol. Individuals with either the GG rs2470152 polymorphism in intron 1 or a high number of TTTA repeats in intron 4 of CYP19 are known to have greater aromatase activity with demonstrable effects upon plasma estradiol and osteoporosis...

Inhibiting cortisol regeneration by 11β-HSD1 is a promising therapy for type two diabetes. In obesity, 11β-HSD1 activity is increased in adipose tissue but decreased in the liver, the latter putatively mediated by hyperinsulinaemia. We tested whether insulin sensitisation with metformin regulates 11β-HSD1 activity in whole body and in liver in obesity.Five obese men (age 48±5 years, BMI 39.8±3.6 kg/m2) participated in ...

The accurate measurement of cortisol by immunoassay is compromised by the potential for cross-reactivity of reagent antibodies with structurally-related steroid compounds present in patient serum. This susceptibility is potentiated when normal steroid metabolism is altered pharmacologically by anti-steroidogenic drugs. This class of drug is utilised in the management of Cushing’s syndrome to moderate cortisol production. To investigate the effect of the 11β-hydroxyla...

Objective: We aim to study whether a difference exists in cardiovascular risk and variability of IR within the hyperandrogenic group of women with PCOS who are ovulatory and anovulatory.Method: Fifty-three women with PCOS were recruited. All subjects were diagnosed to have PCOS by the ESHRE/ASRM Rotterdam criteria where all patients had evidence of biochemical hyperandrogenism and hirsutism, chronic anovulation and polycystic ovaries on transvaginal ultr...

Circulating estrogens decrease after the menopause from 60–400 to 5–30 pg/ml in postmenopausal women and in men are below 30 pg/ml. These low physiological concentrations present an analytical challenge. Analysis of steroids by tandem mass spectrometry is attractive due to its high specificity compared with immunoassays. However, estrogens do not ionise efficiently and therefore chemical modifications are necessary to achieve the sensitivity required.<p class="ab...

Objective: Androsterone glucuronide (ADTG) concentrations have been suggested as a more reliable marker of the effects of androgen at the target tissue level and is significantly elevated in hirsute compared to non-hirsute women with PCOS. As the mechanism for hyperandrogenemia in obese and nonobese PCOS may differ, this study compares the different precursors of testosterone, including DHEAS, ADTG and androstenedione in nonobese compared to obese women with PCOS and their imp...

The glucocorticoid hormone, cortisol, regulates fuel metabolism, inflammation and stress–responses. Its circulating concentrations are tightly controlled by the hypothalamic–pituitary–adrenal axis. However, 11β-hydroxysteroid dehydrogenase 1 (11βHSD1) generates additional cortisol in tissues, by reduction of inert cortisone. Using a tracer (9,11,12,12[2H]4-cortisol; d4-cortisol), the velocity of 11βHSD1 can be determined as t...

Primary aldosteronism is an important cause of secondary hypertension though its diagnosis can prove challenging. In normal individuals aldosterone release follows a diurnal pattern, with a morning peak and low levels in the evening. Aldosterone is present in saliva and due to its lipophilic nature it passes into saliva along a concentration gradient. Salivary steroid testing is well established for cortisol and testosterone, but not yet for aldosterone....