Endocrine Abstracts

Metabolic syndrome and its hepatic manifestation, non-alcoholic fatty liver disease (NAFLD), are increasing in prevalence. Steroid hormones are established regulators of metabolic phenotype. 5β-reductase (AKR1D1) is highly expressed in human liver, inactivating steroid hormones, including glucocorticoids and androgens. The human AKR1D1 gene contains 9 exons; six splice variants have been identified and three lead to functional protein isoforms (AKR1D1-001, -0...

Objective: Androsterone glucuronide (ADTG) concentrations have been suggested as a more reliable marker of the effects of androgens at the target tissue level and they are significantly elevated in hirsute compared to non-hirsute women with PCOS. This study compared the different precursors of testosterone, including dehydroepiandrosterone sulphate (DHEAS), ADTG and androstenedione in non-obese compared to obese women with PCOS, and in normal subjects and their implications on...

Background: The aim of this study was to evaluate salivary androgen measurements via liquid chromatography-mass spectrometry as a non-invasive tool for the diagnosis of polycystic ovary syndrome (PCOS) and the assessment of metabolic health.Methods: Saliva and serum samples of 274 patients with PCOS fulfilling Rotterdam criteria and 51 BMI-matched, premenopausal, healthy controls were analysed for steroid hormones using liquid chromatography/mass spectro...

Background: Accurate measurement of serum cortisol is essential in the investigation of the HPA axis. It has been documented that routine immunoassays are liable to both under- and over-recovery leading to inaccurate results and subsequent inappropriate investigations. This study seeks to provide an up-to-date assessment of the accuracy of the major immunoassay platforms and compares results to a liquid chromatography–tandem mass spectrometry (LC–MS/MS) candidate ref...

Vitamin D-deficiency during pregnancy has been associated with increased complications of pregnancy including a high risk of pre-eclampsia (PET). Current analysis of vitamin D ‘status’ is based exclusively on analysis of maternal serum 25-hydroxyvitamin D3 (25(OH)D3), the circulating precursor form of vitamin D. We hypothesised that comprehensive profiling of vitamin D metabolites may provide a more accurate determination of vitamin D function i...

Although a complex metabolic pathway for vitamin D exists, serum measurement of inactive 25-hydroxyvitamin D3 (25OHD3) continues to be the most common determinant of vitamin D ‘status’. However, several other metabolites contribute to the physiological role of vitamin D, notably the active form 1α,25-dihydroxyvitamin D (1α,25(OH)2D3), inactive 3-epi-25OHD3 and chiral 23R and 24R,25(OH)2D3 metabolites. Quantification of these additional metabolites could pro...

Introduction: Measuring serum cortisol to evaluate the normal circadian rhythm and adequacy of hydrocortisone replacement levels requires multiple readings; an expensive, cumbersome process. Conversely, salivary cortisone, a surrogate marker for free cortisol levels is non-invasive and well suited for out-patient settings. We hypothesised that salivary cortisone predicts circulating cortisol levels and can be used as an alternative marker of serum cortisol in a physiological s...

Background: Excess glucocorticoids are well recognised as a cause of osteoporosis; they inhibit osteoblast function and increase osteoblast and osteocyte apoptosis resulting in thinning of the trabeculae. The circadian rhythm of bone turnover, which is linked to cortisol rhythm, is abnormal in osteoporosis. Furthermore, some studies show abnormal cortisol metabolism in osteoporosis. The aim of our study was to evaluate the day–night rhythm of cortisol and to relate cortis...

Background: 5-hydroxyindole acetic acid (5-HIAA) (a metabolite of serotonin) is used as a marker for patients with serotonin-secreting neuroendocrine tumours. Currently, most laboratories measure 24 h 5-HIAA excretion in urine samples. Urine collections are cumbersome for the patient and impact on their daily activities; they are consequently often poorly performed, leading to over- or under-collection of urine and inaccurate 5-HIAA excretion results. Furthermore, large volume...

Background: The use of salivary cortisol is well validated in the diagnosis of Cushing’s syndrome but routine use of salivary measurements during dynamic tests of HPA axis sufficiency is uncommon and reference ranges are not established. Salivary cortisol (SalF) and cortisone (SalE) measurements by LC–MS have several advantages including ease of collection and more accurate reflection of unbound serum cortisol levels in conditions of altered CBG levels (e.g. oestroge...