Endocrine Abstracts

Introduction: Current clinical practice guidelines recognise that a calculated free testosterone (T) level is the single most-useful, clinically sensitive marker of androgen excess in women, but there is no clear guidance as to the best way to measure free T. Several equations have been proposed to calculate clinically useful estimates of free T including the free androgen index (FAI) and calculated free T (cFT). The FAI is not used in men but it is...

Adipose exposure to glucocorticoids (GCs) results in visceral adiposity and insulin resistance. Only the unbound, free fraction of GC can diffuse into cells. Corticosteroid binding globulin (CBG) is the major GC carrier, binding 80–85% of circulating GCs with high affinity. Targeted proteolysis of CBG by neutrophil elastase (NE) significantly reduces CBG binding affinity. This suggests that neutrophil-mediated inflammation provides a regulatory mechanism for delivery of G...

Measuring circulating androgen and gestagen concentrations is essential for the diagnosis and treatment monitoring of pathological conditions caused by abnormal steroidogenesis, such as congenital adrenal hyperplasia (CAH) and polycystic ovary syndrome (PCOS). Saliva collection represents a simple and non-invasive technique advantageous for multi sample profiling. We therefore developed a liquid chromatography-tandem mass spectrometry assay for the s...

Introduction: Current clinical practice guidelines recognise that a calculated free testosterone (T) level is the single most-useful, clinically sensitive marker of androgen excess in women, but there is no clear guidance as to the best way to measure free T. Several equations have been proposed to calculate clinically useful estimates of free T including the free androgen index (FAI) and calculated free T (cFT). The FAI is not used in men but it is...

: We report on 4 patients who acutely presented to our unit and diagnosed with adrenal haemorrhage.Case 1: A 72 year old man presented with generalised abdominal pain, fever and raised CRP a week after hip replacement surgery. CT abdomen showed non-enhancing bilateral adrenal lesions consistent with adrenal haemorrhage. He was taking Apixaban for DVT following hip replacement. SST was performed which confirmed suboptimal cortisol response. Hence, Treated...

Introduction: Alternative biofluids such as sweat, which can be obtained non-invasively and present a simpler matrix composition than serum/plasma or urine, may be useful for monitoring biomarkers. The long-term sampling with patches either on the chest or back can be conveniently used under both rest and exercise conditions to provide an integrated response of free biomarkers over the course of a day. The smaller sample volumes generated by sweat collection can be convenientl...

: In community-dwelling men, salivary testosterone (Sal-T) concentrations are thought to represent tissue hormone levels and correlate strongly with serum free-T levels. Measurement of salivary glucocorticoid concentrations is a non-invasive and objective means of assessing cortisol exposure in users and non-users of hydrocortisone therapy. We assessed relationships of Sal-T with transdermal testosterone replacement therapy (TD-TRT) and with markers of testosterone exposure. I...

Background: Insulinoma in a pre existing patient of type diabetes is extremely rare presentation.Methods: We are presenting a a rare case of insulinoma in a pre existing case of type 2 diabetes. A 73 years old patient with type 2 diabetes for 35 years presented to endocrine clinic with hypoglycaemic symptoms ultimatley diagnosed with insulinoma and patient developed renal failure with diazoxide treatment.Result: A 73 years old chin...

Vitamin D-dependent rickets type-1 (VDDR1) is an autosomal recessive disorder characterised by onset of rickets by 2 years of age, accompanied by poor growth and hypotonia, muscle weakness, seizures, hypocalcaemia with secondary hyperparathyroidism, hypophosphataemia and normal plasma 25-hydroxyvitamin D (25(OH2)D) concentration that distinguishes VDDR1 from vitamin D deficient rickets. VDDR1 is caused by loss-of-function mutations of the 25-hydroxyvitamin D 1-alpha...

Background: Adrenal incidentalomas (AI) are being seen frequently in endocrine clinics due to increased cross-sectional imaging with a prevalence of 4% (7% in patients >70 years) of abdominal CT scans. The majority of these tumours are benign and non-functional, but identifying malignancy and functionality is important. Excess cortisol production is the commonest endocrinopathy associated with AI, with a reported prevalence of ~10%. The overnight 1 mg dexamethasone suppres...