scholarly journals Plasma Steroid Profiles in Subclinical Compared With Overt Adrenal Cushing Syndrome

2019 ◽  
Vol 104 (10) ◽  
pp. 4331-4340 ◽  
Author(s):  
Jimmy Masjkur ◽  
Matthias Gruber ◽  
Mirko Peitzsch ◽  
Denise Kaden ◽  
Guido Di Dalmazi ◽  
...  
Keyword(s):  
Cushing Syndrome ◽  
Plasma Concentrations ◽  
Screening Method ◽  
Serum Cortisol ◽  
Dehydroepiandrosterone Sulfate ◽  
Cross Sectional Study ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
Steroid Profiles ◽  
Plasma Steroids

Abstract Context Diagnosis of subclinical adrenal hypercortisolism is based on several tests of the hypothalamic-pituitary-adrenal axis to establish mild alterations of cortisol secretion and dysregulated cortisol physiology. Objective We assessed whether plasma steroid profiles might assist diagnosis of subclinical Cushing syndrome (SC). Design Retrospective cross-sectional study. Setting Two tertiary medical centers. Patients Of 208 patients tested for hypercortisolism, disease was excluded in 152 and confirmed in 21 with overt adrenal Cushing syndrome (AC) compared to 35 with SC. Another 277 age- and sex-matched hypertensive and normotensive volunteers were included for reference. Main Outcome Measures A panel of 15 plasma steroids was measured by mass spectrometry, with classification by discriminant analysis. Results Patients with SC had lower plasma concentrations of dehydroepiandrosterone and dehydroepiandrosterone-sulfate than subjects without SC (P < 0.05). The largest increases (P < 0.001) in plasma steroids among patients with SC were observed for 11-deoxycortisol and 11-deoxycorticosterone. Nevertheless, concentrations of 11-deoxycorticosterone, 11-deoxycortisol, and pregnenolone in patients with AC were higher (P < 0.05) than in those with SC. Patients with SC or AC could be distinguished from subjects without disease using this combination of steroids as precisely as with use of measurements of serum cortisol after administration of dexamethasone. The steroid combination provided superior diagnostic performance compared with each of the other routine biochemical tests. Conclusion Distinct plasma steroid profiles in patients with SC may provide a simple and reliable screening method for establishing the diagnosis.

scholarly journals Plasma Steroid Metabolome Profiling for Diagnosis and Subtyping Patients with Cushing Syndrome

2018 ◽  
Vol 64 (3) ◽  
pp. 586-596 ◽  
Author(s):  
Graeme Eisenhofer ◽  
Jimmy Masjkur ◽  
Mirko Peitzsch ◽  
Guido Di Dalmazi ◽  
Martin Bidlingmaier ◽  
...  
Keyword(s):  
Cushing Syndrome ◽  
Urinary Free Cortisol ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Free Cortisol ◽  
Multistep Process ◽  
Steroid Profiles ◽  
Plasma Steroids ◽  
Metabolome Profiling ◽  
Adrenal Disease

Abstract BACKGROUND Diagnosis of Cushing syndrome requires a multistep process that includes verification of hypercortisolism followed by identification of the cause of adrenocortical hyperfunction. This study assessed whether pituitary, ectopic, and adrenal subtypes of Cushing syndrome were characterized by distinct plasma steroid profiles that might assist diagnosis. METHODS In this retrospective cross-sectional study, mass spectrometric measurements of a panel of 15 plasma steroids were applied to 222 patient samples tested for Cushing syndrome. Disease was excluded in 138 and confirmed in 51 patients with pituitary Cushing syndrome, 12 with ectopic adrenocorticotropin secretion, and 21 with adrenal disease. Another 277 age- and sex-matched hypertensive and normotensive volunteers were included for comparison. RESULTS Compared with patients without disease, the largest increases in plasma steroids among patients with Cushing syndrome were observed for 11-deoxycortisol (289%), 21-deoxycortisol (150%), 11-deoxycorticosterone (133%), corticosterone (124%), and cortisol (122%). Patients with ectopic disease showed the most prominent increases, but there was considerable variation for other steroids according to subtype. Patients with adrenal disease had the lowest concentrations of androgens, whereas those with ectopic and pituitary disease showed the lowest concentrations of aldosterone. Plasma 18-oxocortisol was particularly low in ectopic disease. With the use of 10 selected steroids, subjects with and without different Cushing syndrome subtypes could be discriminated nearly as closely as with the use of salivary and urinary free cortisol, dexamethasone-suppressed cortisol, and plasma adrenocorticotropin (9.5% vs 5.8% misclassification). CONCLUSIONS Patients with different subtypes of Cushing syndrome show distinctive plasma steroid profiles that may offer a supplementary single-test alternative for screening purposes.

scholarly journals The Unique Role of 11-Oxygenated C19 Steroids in Both Premature Adrenarche and Premature Pubarche

2021 ◽  
pp. 1-10
Author(s):  
Brittany K. Wise-Oringer ◽  
Anne Claire Burghard ◽  
Patrick O’Day ◽  
Abeer Hassoun ◽  
Aviva B. Sopher ◽  
...  
Keyword(s):  
Dehydroepiandrosterone Sulfate ◽  
Early Morning ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Healthy Children ◽  
Cross Sectional ◽  
Metabolic Markers ◽  
Premature Adrenarche ◽  
Steroid Profiles ◽  
Premature Pubarche

<b><i>Introduction:</i></b> Recent studies have shown 11-oxygenated androgens (11oAs) are the dominant androgens in premature adrenarche (PA). Our objective was to compare 11oAs and conventional androgens in a well-defined cohort of children with PA or premature pubarche (PP) and correlate these androgens with metabolic markers. <b><i>Methods:</i></b> A prospective cross-sectional study was conducted at a university hospital. Fasting early morning serum steroids (including 11oAs) and metabolic biomarkers were compared and their correlations determined in children ages 3–8 years (F) or 3–9 years (M) with PA or PP (5 M and 15 F) and healthy controls (3 M and 8 F). <b><i>Results:</i></b> There were no differences between PA, PP, and controls or between PA and PP subgroups for sex, BMI z-score, or criteria for childhood metabolic syndrome. Dehydroepiandrosterone sulfate (DHEAS) was elevated only in the PA subgroup, as defined. 11oAs were elevated versus controls in PA and PP although no differences in 11oAs were noted between PA and PP. Within the case cohort, there was high correlation of T and A4 with 11-ketotestosterone and 11β-hydroxyandrostenedione. While lipids did not differ, median insulin and HOMA-IR were higher but not statistically different in PA and PP. <b><i>Conclusions:</i></b> PA and PP differ only by DHEAS and not by 11oAs or insulin sensitivity, consistent with 11oAs – rather than DHEAS – mediating the phenotypic changes of pubarche. Case correlations suggest association of 11oAs with T and A4. These data are the first to report the early morning steroid profiles including 11oAs in a well-defined group of PA, PP, and healthy children.

scholarly journals Novel GC-MS/MS Technique Reveals a Complex Steroid Fingerprint of Subclinical Hypercortisolism in Adrenal Incidentalomas

2019 ◽  
Vol 104 (8) ◽  
pp. 3545-3556 ◽  
Author(s):  
Václav Hána ◽  
Jana Ježková ◽  
Mikuláš Kosák ◽  
Michal Kršek ◽  
Václav Hána ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Serum Cortisol ◽  
Serum Levels ◽  
Dehydroepiandrosterone Sulfate ◽  
Urinary Free Cortisol ◽  
Cross Sectional Study ◽  
Adrenal Incidentalomas ◽  
Subclinical Hypercortisolism ◽  
Cross Sectional ◽  
Free Cortisol

AbstractContextImprovement of imaging methods has led to more incidental adrenal tumor findings, especially adenomas. Routine hormonal evaluation uses only a few steroids to evaluate possible hormonal hypersecretion of these adenomas, but a wide spectrum of serum steroid hormone changes has not been published.ObjectiveTo measure the serum levels of 83 steroids from patients with unilateral and bilateral adrenal incidentalomas to uncover full steroid profile changes in patients with subclinical hypercortisolism (SH).DesignCross-sectional study.SettingThe study was conducted at a tertiary inpatient clinic.PatientsFifty-two patients with adrenal incidentalomas (unilateral, n = 29; bilateral, n = 23), including nonfunctioning (n = 11) vs SH (n = 41), and 26 age- and sex-matched controls from the general population were included.Main Outcome MeasuresEighty-three serum steroids were measured by gas chromatography–tandem mass spectrometry (GC-MS/MS) before and after 1 mg dexamethasone, ACTH, midnight serum cortisol, and urinary free cortisol/24 hour.ResultsOf 83 measured steroids, 10 were significantly decreased in patients with SH, including dehydroepiandrosterone sulfate (DHEAS), androsterone sulfate, epiandrosterone sulfate, androstenediol sulfate, conjugated 5α-androstane-3β,17β-diol, and conjugated 5α-androstane-3α,17β-diol. This finding was observed even when unilateral, bilateral, male, and female subgroups were analyzed separately. When we compared routine clinical methods and GC-MS/MS‒measured steroids, the most discriminatory was DHEAS followed by midnight serum cortisol, epiandrosterone sulfate, androsterone sulfate, ACTH, and 16α-hydroxypregnenolone.ConclusionsSH was associated with decreased levels of adrenal androgens, their metabolites, and pregnenolone metabolite. GC-MS/MS is a powerful tool for measuring serum levels of these undescribed changes in steroid metabolism, which are characteristic of SH in adrenal incidentalomas.

scholarly journals Influence ofABCC2andABCC4Polymorphisms on Tenofovir Plasma Concentrations in Thai HIV-Infected Patients

2015 ◽  
Vol 59 (6) ◽  
pp. 3240-3245 ◽  
Author(s):  
Kanokrat Rungtivasuwan ◽  
Anchalee Avihingsanon ◽  
Narukjaporn Thammajaruk ◽  
Siwaporn Mitruk ◽  
David M. Burger ◽  
...  
Keyword(s):  
Body Weight ◽  
Multivariate Analysis ◽  
Plasma Concentration ◽  
Protease Inhibitors ◽  
Demographic Data ◽  
Plasma Concentrations ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Mean

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)

scholarly journals Increased hypothalamic–pituitary–adrenal drive is associated with decreased appetite and hypoactivation of food-motivation neurocircuitry in anorexia nervosa

2013 ◽  
Vol 169 (5) ◽  
pp. 639-647 ◽  
Author(s):  
Elizabeth A Lawson ◽  
Laura M Holsen ◽  
Rebecca DeSanti ◽  
McKale Santin ◽  
Erinne Meenaghan ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Visual Processing ◽  
Serum Cortisol ◽  
Brain Regions ◽  
Cross Sectional Study ◽  
Food Motivation ◽  
Cross Sectional ◽  
Hypothalamic Pituitary Adrenal ◽  
Cortisol Levels ◽  
The Relationship

ObjectiveCorticotrophin-releasing hormone (CRH)-mediated hypercortisolemia has been demonstrated in anorexia nervosa (AN), a psychiatric disorder characterized by food restriction despite low body weight. While CRH is anorexigenic, downstream cortisol stimulates hunger. Using a food-related functional magnetic resonance imaging (fMRI) paradigm, we have demonstrated hypoactivation of brain regions involved in food motivation in women with AN, even after weight recovery. The relationship between hypothalamic–pituitary–adrenal (HPA) axis dysregulation and appetite and the association with food-motivation neurocircuitry hypoactivation are unknown in AN. We investigated the relationship between HPA activity, appetite, and food-motivation neurocircuitry hypoactivation in AN.DesignCross-sectional study of 36 women (13 AN, ten weight-recovered AN (ANWR), and 13 healthy controls (HC)).MethodsPeripheral cortisol and ACTH levels were measured in a fasting state and 30, 60, and 120 min after a standardized mixed meal. The visual analog scale was used to assess homeostatic and hedonic appetite. fMRI was performed during visual processing of food and non-food stimuli to measure the brain activation pre- and post-meal.ResultsIn each group, serum cortisol levels decreased following the meal. Mean fasting, 120 min post-meal, and nadir cortisol levels were high in AN vs HC. Mean postprandial ACTH levels were high in ANWR compared with HC and AN subjects. Cortisol levels were associated with lower fasting homeostatic and hedonic appetite, independent of BMI and depressive symptoms. Cortisol levels were also associated with between-group variance in activation in the food-motivation brain regions (e.g. hypothalamus, amygdala, hippocampus, orbitofrontal cortex, and insula).ConclusionsHPA activation may contribute to the maintenance of AN by the suppression of appetitive drive.

scholarly journals Spirometric evaluation of pulmonary function in Yazd’s dental laboratory workers in 1398

2020 ◽  
Author(s):  
M Hatami ◽  
AH Mehrpaevar ◽  
A Kouchak zadeh
Keyword(s):  
Pulmonary Function ◽  
Work Experience ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Influential Factor ◽  
Chi Square ◽  
Cross Sectional ◽  
Dental Staff ◽  
Laboratory Workers ◽  
Student’S T

Introduction: Spirometry is used as a screening method for occupational lung diseases. Dental laboratory workers are exposed to solvent vapors, toxic gases, and dust from metal alloys, acrylics, and gypsum. This study aimed to investigate the spirometric function of lung function in dental staff in Yazd. Materials and Methods: This descriptive cross-sectional study was performed on 37 technicians of dental laboratories in Yazd in the three months of spring 2017. To evaluate respiratory problems and their pulmonary function, standard respiratory and spirometry questionnaires according to ATS / ESR guidelines were used, respectively. Data were analyzed by SPSS software version 18 using Mann-Whitney U, Chi-square, and Student's T-test. Results: Mean age of participants was 35.59±1.13. 54% of participants had no respiratory symptoms. The most common respiratory complain were dry and exudative cough. The work field was the only influential factor in FVC%. Age and work experience, and exercise no significant effect on respiratory parameters. Overall spirometry parameters were in the normal pattern range, and only 5% of participants showed a mild restrictive pattern. Conclusion: Spirometric pulmonary function of Yazd'dental laboratory technicians was in the normal range, and possibly working in the dental laboratory did not have a significant effect on the pulmonary Function of technicians based on spirometric indices.

scholarly journals Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joanitah Nalunjogi ◽  
Frank Mugabe ◽  
Irene Najjingo ◽  
Pastan Lusiba ◽  
Francis Olweny ◽  
...  
Keyword(s):  
Screening Tool ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Case Detection ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Number Needed To Screen ◽  
Screening Algorithm ◽  
Chest X Ray

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.

scholarly journals An observational study to compare adenosine deaminase level among diabetes patients

2019 ◽  
Vol 7 (2) ◽  
pp. 473
Author(s):  
Vivek Sharma ◽  
Sangeeta Bhattacharya ◽  
Poornima Dey Sarkar ◽  
Gini Garima ◽  
Neeraj Gour ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Adipose Tissue Inflammation ◽  
Sectional Study ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
Metabolic Derangement ◽  
Prognostic Predictor ◽  
Medical College ◽  
Complex Disorder ◽  
Diabetes Patients

Background: Obesity is a complex disorder that involves some degree of over-consumption1 coupled with a metabolic derangement. As ADA has been putatively associated with inflammation, and adipose tissue inflammation is the hallmark of insulin resistance in obese T2DM patients. This study attempted to compare serum ADA in T2DM subjects.Methods: This observational cross-sectional study was conducted in the Department of Biochemistry at MGM Medical College and MY Hospital. All the patients and controls were clinically examined, and routine biochemical tests were analyzed for all subjects. ANOVA has been applied to assess the variance between groups.Results: Mean age of controls was 56.91 years where as mean age in the group of a subject with Obesity with diabetes was 40.91 years and with Obesity without diabetes was 48.10 years. ADA level was more among diabetes patients having obesity than diabetes patients having no obesity and controls.Conclusions: This is very much evident through this study that ADA may be treated as prognostic predictor of diabetes either linked to obesity or not, though more studies are warranted in same direction to make this finding conclusive and acceptable biochemical evidence.

scholarly journals Identification through Culture and Molecular Methods of Campylobacter jejuni, Campylobacter coli and Campylobacter fetus in Surface Waters in Rasht

2019 ◽  
pp. 1-7
Author(s):  
Keyvan Roshanjo ◽  
Nematallah Jonaidi Jafari ◽  
Leila Asadpour ◽  
Reza Ranjbar ◽  
Davoud Afshar ◽  
...  
Keyword(s):  
Multiplex Pcr ◽  
Campylobacter Jejuni ◽  
Surface Waters ◽  
Disease Transmission ◽  
Cross Sectional Study ◽  
Campylobacter Coli ◽  
Infectious Agents ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
Campylobacter Fetus

Backgrounds: As zoonotic infectious agents, Campylobacter spp. are important factors causing gastroenteritis in humans. Surveys show that the three strains; Campylobacter jejuni, Campylobacter coli and Campylobacter fetus play a major role in human infections. Identification of these infectious agents is valuable for sanitary control of disease transmission through water resources. Objectives: The aim of this study was identification and molecular diagnosis of Campylobacter jejuni, Campylobacter coli and Campylobacter fetus in surface waters in Rasht. Materials and Methods: This cross-sectional study was conducted on 45 samples of surface water in Rasht collected according to water health guidelines. After culture and biochemical tests on collected samples, detection and identification of Campylobacter jejuni, Campylobacter coli and Campylobacter fetus was done using sequence-specific amplification by Multiplex PCR. The results were subjected to statistical analysis using SPSS software. Results: Out of 45 samples tested, 6 were positive in culture, four of which were identified as Campylobacter jejuni after biochemical tests. Using Multiplex PCR, 8 samples were positive, from which 3 were Campylobacter jejuni, 1 Campylobacter coli and 4 were positive for both Campylobacter jejuni and Campylobacter coli. All the samples did not yield C. fetus. Conclusions: Multiplex PCR is regarded a diagnostic method with higher sensitivity and specificity than compared to methods for Campylobacter. The prevalence of Campylobacter jejuni and Campylobacter coli in surface waters in Rasht is considerable. Therefore, public health measures for the control of these organisms are recommended.

Sign in / Sign up

Export Citation Format

Share Document