Searchable abstracts of presentations at key conferences in endocrinology

ea0021p332 | Steroids | SFEBES2009

Steroid analysis in patients receiving metyrapone therapy

Owen Laura , Halsall David , Yates Alexandra , Keevil Brian

Clinical guidance recommends titrating the dose of metyrapone against serum cortisol concentrations. These serum samples are usually measured by immunoassays; however it has been well documented that there are interferences in these assays in patients with altered steroid metabolism due to a pathological process or drug treatment. The increasing availability of mass spectrometry (MS) assays for steroid hormones may circumvent this issue and assays that measure multiple steroid...

ea0021p333 | Steroids | SFEBES2009

Reference range data on androsterone glucuronide in healthy male and female volunteers and clinical uses of the assay

Adaway Joanne , Miller Adrian , Wu F C W , Keevil Brian

Androsterone glucuronide (ADG) is a major metabolite of the androgen dihydrotestosterone and has also been shown to arise from the intracrine conversion of other adrenal androgens such as androstenedione and androsterone. ADG has been shown to be raised in some women with clinical signs of hyperandrogenism such as acne and hirsutism, even when levels of androgens, e.g. testosterone or DHEA-S are normal. This indicates that raised ADG levels may be an early indication of hypera...

ea0021p337 | Steroids | SFEBES2009

Determination of tandem mass spectrometry specific reference ranges for testosterone, androstenedione and DHEAS

Macdonald Philip , Wu Frederick , Owen Laura , Keevil Brian

Testosterone, androstenedione and DHEAS are commonly measured by immunoassays. Variations in antibody specificity and calibration of assays results in non-commutability of measurements. Even more specific mass spectrometry (LC–MS/MS) assays still exhibit differences in calibration. As the use of mass spectrometry for measuring steroids is becoming more common in the clinical laboratory, the development of LC–MS/MS reference ranges for these analytes is essential to h...

ea0015p313 | Steroids | SFEBES2008

Measurement of salivary cortisol with LC-MS/MS in patients with suspected adrenal pathology

Perogamvros Ilias , Keevil Brian , Owen Laura , Trainer Peter , Brabant Georg

Salivary cortisol (SalC) potentially has advantages over serum cortisol (SerC) as it is easier to collect and possibly reflects unbound (free) cortisol. SalC levels are approximately 10 times lower than SerC and require high measurement precision best addressed by liquid chromatography–tandem mass spectrometry (LC-MS/MS), which in contrast to previously used radioimmunoassays eliminates cross-reactivity by other steroids. We describe the use of LC-MS/MS to evaluate the po...

ea0081p698 | Reproductive and Developmental Endocrinology | ECE2022

The biochemical investigation of PCOS: a UK wide survey of laboratory practice

M Hawley James , Marrington Rachel , MacKenzie Finlay , Adaway Jo , Taylor Angela , Arlt Wiebke , Keevil Brian

Background: Polycystic ovary syndrome (PCOS) is a heterogenous condition that affects approximately 12% of females. The diagnosis can be complex and biochemistry tests are routinely relied upon to help identify hyperandrogenaemia and to exclude other conditions. However, although national and international guidelines advocate the use biochemistry tests, little information is provided as to which tests should be used and which other endocrinopathies should be excluded.<p cl...

ea0081ep105 | Adrenal and Cardiovascular Endocrinology | ECE2022

Serum cortisol immunoassay performance in the overnight dexamethasone suppression test.

Atkins Jonathan , Owen Laura , Clayton Jonathan , Hawley James M , Scargill Jonathan , Keevil Brian

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended for the differential diagnosis of Cushing’s syndrome and the investigation of adrenal incidentalomas. However, diagnostic performance of the test relies on accurate methods to quantitate cortisol in serum. Although the variable performance of serum cortisol immunoassays has been well-documented, little has been published on their performance following the ONDST.Aims...

ea0050p187 | Clinical Biochemistry | SFEBES2017

How well can we measure SHBG?

Adaway Jo , Miller Ann Marie , Monaghan Phillip , Merrett Nicola , Keevil Brian , Owen Laura

Sex hormone binding globulin (SHBG) is a glycoprotein which binds hormones such as testosterone. Around 97% of circulating testosterone is bound to SHBG and is therefore biologically unavailable; approximately 2–3% of testosterone is free or loosely bound to proteins such as albumin, and is biologically active, or bioavailable. Free testosterone is very technically challenging to quantify; in order to circumvent this problem, equations are used...

ea0050p187 | Clinical Biochemistry | SFEBES2017

How well can we measure SHBG?

Adaway Jo , Miller Ann Marie , Monaghan Phillip , Merrett Nicola , Keevil Brian , Owen Laura

Sex hormone binding globulin (SHBG) is a glycoprotein which binds hormones such as testosterone. Around 97% of circulating testosterone is bound to SHBG and is therefore biologically unavailable; approximately 2–3% of testosterone is free or loosely bound to proteins such as albumin, and is biologically active, or bioavailable. Free testosterone is very technically challenging to quantify; in order to circumvent this problem, equations are used...

ea0085p47 | Adrenal 2 | BSPED2022

Salivary sampling in neonates, infants, and young children: glucocorticoid stability under different conditions and the introduction of a novel collection technique

Tonge Joseph , Keevil Brian , Craig Jessica , Whitaker Martin , Ross Richard , Elder Charlotte

Background: Measurement of salivary glucocorticoids is gaining popularity as it offers a non-invasive collection technique, enabling sampling in the community or home environment, allowing tailored capture of steroid circadian rhythm and improved patient experience. Current popular salivary collection methods cannot be used in very young children due to choking and the requirement for active participation. There is little data on saliva stability during home collection.<p ...

ea0065p6 | Adrenal and Cardiovascular | SFEBES2019

Monitoring metyrapone therapy for Cushing’s syndrome using salivary glucocorticoid measurement by liquid chromatography tandem mass spectrometry (LC–MS/MS)

Manson Megan , Adam Safwaan , Higham Claire , Keevil Brian , Trainer Peter , Monaghan Phillip

Introduction: Late-night salivary cortisol assessment is an important element when investigating suspected Cushing’s syndrome (CS). The goal of medical therapy is achieving a mean (of 5 samples during a single day) serum cortisol (serumF) of 150–300 nmol/l (Cushing Day Curve [CDC]). Metyrapone is an 11β-hydroxylase inhibitor elevating levels of 11-deoxycortisol causing conventional immunoassay (IA) to overestimate SerumF; a problem obviated by LC–MS/MS. We ...