All Endocrinology

Fertility

Dysfunction of the reproductive axis can be due to inappropriate secretion of the related hormones. In males and females the proper functions can be investigated through the determination of the principal parameters for example LH and FSH.
These hormones are secreted by the pituitary gland wich stimulate the testis and ovary to produce additional hormones such as Testosteronefor production of spermatozoa, Estradiol and Progesterone to make the ovulum available for a possible fecundation and prepare the uterus for the implantation of the embryo. Monitoring of the correct implantation of the embryo and its growth can be performed during the first 3 months with hCG, which is an hormone secreted by the syncytium trophoblast in women (this tissue is not present in males). Increased levels of hCG in males can be due to the presence of germinoma, a very aggressive cancer of the testis.
Prolactin level icrease during pregnancy, peaking immediately after delivery and is needed to stimulate the milk production in the breast to feed the newborn.  In males its presence is related to abnormal sexual characteristics.

Diabetes

Diabetes is the sixth leading cause of death, and the fifth leading cause of death from disease in the world. US estimations indicate that diabetes costs many billion dollars annually in direct medical costs as well as in indirect costs (loss of work, disability, loss of life). Evaluation of the diabetic's status using major parameter such us Insulin and C-Peptide is critical to correctly diagnose and manage this condition.

Adrenal Function

Two important markers related to Adrenal Function are ACTH and Cortisol.
Adrenocorticotropic hormone (ACTH) is a hormone produced in the pituitary gland to stimulate secretion of the hormone cortisol by the adrenal glands. Cortisol is important for regulating glucose, protein and lipid metabolism; suppressing the immune response; and maintaining blood pressure. Normally, ACTH increases when cortisol is low and falls when cortisol is high. ACTH levels in the blood are tested to help diagnose Cushing's syndrome, Addison's disease and tumours of the pituitary and adrenal glands. Measuring both ACTH and cortisol can help sort out some of the causes of these conditions. Because the level of ACTH normally changes in the opposite direction to the level of cortisol, is important to identify an imbalance in this relationship and the direction in which the imbalance occurs. For example, if cortisol level is high and ACTH level is also increased, that would indicate that there is a pituitary disease that causes production of too much ACTH. Furthermore blood and urine tests for cortisol are used to help diagnose Cushing’s syndrome and Addison’s disease, two serious disorders affecting the production of cortisol by the adrenal gland. Cushing's syndrome is caused by too much cortisol, while Addison's disease is caused by damage to the adrenal gland and is associated with too little cortisol. If cortisol concentrations are abnormal, additional testing may be required to confirm the diagnosis and decide on treatment. These further tests may involve a test to suppress cortisol production with dexamethasone or a test to stimulate the adrenal gland to produce cortisol, using a synthetic form of ACTH.

Thyroid

Around 200 million people worlwide have some form of thyroid disease, with 1 billion people worldwide estimated to be at risk for developing a thyroid goiter. Women are 5 to 8 times more likely than men to develop some form of thyroid disease.
Along with the traditional and consolidated first line assays for assessing the thyroid function (fT4, TSH) DiaSorin offers the opportunity to further investigate thyroid diseases with fT3 and with tests for the measurement of autoantibodies to Thyroglobulin (Tg) and Thyroid Peroxidase (TPO). The classical assays for the measurement of total T3 and total T4 are available using either RIA technology or on LIAISON® systems.
Furthermore the Thyroglobulin, even if it is a fully recognized tumor marker, is included in the Thyroid panel. In spite of its physiological role transportation at Thyroid hormones via thyroid cells, from the thyroid hormones to be released in the blood, from the diagnosticaly point of view Tg helps in the characterization of the presence of the undifferentiated tumor of the thyroid and to monitor recurrences after therapy or surgery.

Growth

Together with the nervous system, the endocrine system regulates and integrates the body’s metabolic activities. The endocrine system meets the nervous system at the hypothalamus. The hypothalamus controls the function of the endocrine organs by neural and hormonal pathways. In response to the hypothalamus, the anterior pituitary secretes prolactin, which stimulates milk production and human Growth Hormone (hGH) which affects most body tissues.
hGH stimulates growth by increasing protein synthesis, fat mobilization and by decreasing carbohydrate utilization. Hypo secretion of hGH results in dwarfism; hyper secretion causes gigantism and acromegaly in adults.
IGF-I or Sometomedin-C is a peptide highly dependent on growth hormone and has a potent growth promoting activity. The IGF-I is transported in serum by several IGF-binding proteins. Measurements of IGF-I are useful adjunt to assessment of growth hormone secretion. A normal plasma or serum IGF-I concentration is strong evidence against GH deficiency, with the exception of GH deficient children with craniopharyngiomas and adults who have prolactin secreting tumor accompanied with GH deficiency and prolactin excess.
One of the most important binding proteins is the IGFBP-3. This protein is responsible for the maintenance of appropriate levels of IGF-I in serum, minimising concentration fluctuations. IGFBP-3 levels increase in GH deficient patient after GH administration and it is useful in assessing nutritional status, since it decreases during both caloric and protein restriction.