Endocrine Abstracts

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...

Acromegaly causes impaired insulin sensitivity and reduced fat mass. Using acipimox to block lipolysis, the impact of free fatty acids (FFA) on insulin sensitivity in active acromegaly was investigated. 1H MRS was used to quantify triglyceride (TG) content of liver and muscle.Methods: 6 patients with active acromegaly (AA) (5M, age 59 (34–70), IGF-I (ng/ml) (median (range)) (452 (342–1002)) were studied on 2 visits; (i) baseline (BL)...

Background: The UK Acromegaly Register contains data for 2700 patients. IGF-1 and random growth hormone (GH) measurements are used for disease monitoring. The registry reference laboratory (RRL) uses the Immunodiagnostic systems (IDS)-iSYS immunoassay platform for GH and IGF-1. The RRL uses age- and sex-specific reference ranges for IGF-1. We compared IGF-1 and GH results fromlocal laboratories to those of the RRL (pre-defined as the Gold standard) to determine the extent of d...

Introduction: Chromogranin-A (CgA) is a 49 kDa protein of the granin/secretogranin family originating from dense-core secretory granules within cells of the diffuse endocrine system. CgA is currently the best available diagnostic biomarker for neuroendocrine tumours (NETs) with recent clinical guidelines advocating the measurement of CgA as part of the baseline biochemical profile in patients presenting with symptoms suspicious of a gastroenteropancreatic NET.<p class="abs...

UK National Acromegaly Register collects data on real-life clinical practice in 34 centres. We analysed all GH and IGF1 data to assess adequacy of control on medical treatment (Rx) with somatostatin analogs (SMS) and dopamine agonists (DA).Methods: All GH records (basal, profile or GTT) in database were correlated with IGF1, Rx, surgery (TSS) and radiotherapy (RT), then processed to derive summary data for each patient and each course of Rx. GH considere...

UK National Acromegaly Register collects data on routine clinical practice in 34 centres. We analysed all GH and IGF1 data to assess adequacy of control & responses to medical treatment (Rx) with somatostatin analogs (SMS) & dopamine agonists (DA). Methods: Under program control, GH records (basal, profile or GTT) were correlated with IGF1, tumour size, Rx, surgery (TSS) & radiotherapy (RT) in the database, then processed in Excel to derive summary data for each pa...

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...

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...

Multiple endocrine neoplasia 1 (MEN-1) is an inherited autosomal dominant tumour syndrome affecting mainly the parathyroid gland, pituitary and pancreas. Genetic defect appears to be deletion mutation of MEN1 gene coding for tumour suppression. We describe a case of MEN1 mosaic mutation never reported in the literature.The index case presented aged 52 in 1985 with headaches and dizziness when hypercalcemia of 3.2 mmol/l was noted. Past medical history in...

The ERCUSYN (European Registry on Cushing’s syndrome (CS)) study is a project funded by the European Commission Public Health Program (PHP 800200), of which the ESE is one of the 41 Partners from 25 countries. The aims include obtaining prospective and follow-up data at EU level on epidemiology, mortality, outcome of therapies, co-morbidities, assessment of diagnostic and therapeutic strategies, quality of life evaluation using a disease-generated questionnaire (CushingQo...