Establecer el punto de corte entre la glucemia en ayunas normal y la alterada resulta de suma importancia a los efectos de considerar a un paciente en riesgo, tanto de progresar a estados más avanzados de la enfermedad como de sufrir complicaciones micro y macroangiopáticas. Desde 2006 la Sociedad Argentina de Diabetes (SAD), sobre la base de la evidencia considerada en ese momento, estableció el límite inferior de la glucemia alterada en ayunas (GAA) en 110 mg/dl; posteriormente, durante 2022, la Comisión Directiva de la SAD convocó a un grupo de expertos con el objeto de evaluar si esta recomendación debía mantenerse o, al igual que otras sociedades científicas de prestigio, adoptar a tal efecto 100 g/dl.En este documento de Opiniones y Recomendaciones se encuentran los fundamentos por los cuales la SAD adoptará, de ahora en más, 100 mg/dl como límite inferior de la GAA, en base a las nuevas evidencias científicas que muestran que desde este punto de corte se produce un aumento en progresión a la diabetes mellitus y de las complicaciones tanto macro como microangiopáticas.

La estandarización de la hemoglobina A1c (HbA1c) permitió en algunos países su uso para el diagnóstico de la diabetes mellitus (DM) y la prediabetes, además de su empleo en el seguimiento del paciente con DM. Es importante recordar que se trata de una medida indirecta del promedio glucémico durante el tiempo de vida media del eritrocito, pudiendo verse afectada por variables no glucémicas, como también por interferencias analíticas según la metodología empleada para su determinación.A continuación, se describen las recomendaciones y consideraciones a tener en cuenta para la determinación de la HbA1c cuando se emplea como criterio diagnóstico de la DM, teniendo en cuenta que al utilizarla para tal fin es necesario que la medida se realice con métodos certificados y estandarizados según el Diabetes Control and Complications Trial (DCCT).

Salivary cortisol (SC) is a measure of free cortisol and follows diurnal rhythm of serum or plasma cortisol, so it is convenient for collection noninvasively on an outpatient basis. The Endocrine Society recommends measuring MiSC concentrations as a first-line test in screening for Cushing's syndrome. To define its utility as a diagnostic test, it is important to know whether assay techniques or thresholds affect the rate of false-positive results. Revision of literature showed that there are marked differences in sensitivity and specificity, and cutoff values of SC assays. The aim of this study was to compare MiSC results obtained by available immunoassays with different analytical sensitivity (AS) in an Argentinian population, and compare by pairs of methods their Diagnostic Concordance (DC) using individual reported cutoffs (RCO). Material and methods: Salivary samples obtained at 11 PM, from 133 adults subjects (18-74 years), with no corticoid therapy (last 6 months), psychiatric medication, depression, thyroid diseases, statins administration, or smoking. MiSC (nmol/L) were measured by ECLIA Cobas Roche (RCO: 4.9; AS: 1.5); RIA Beckman Coulter (RCO: 0.8; AS: 0.8), CLIA Liaison DiaSorin (RCO: 8.0; AS: 4.4), CLIA Access Beckman Coulter (RCO: 8.3; AS: 0.3) and CLIA Immulite 1000 Siemens (modified methodic) (RCO: 5.0 own data not reported; AS: 1.0). Bland & Altman biases were calculated between methods. Results: Calculated median, range and p95 (nmoL/L) for each method were: ECLIA Cobas (n=131): 1.6 (1.5-14.5) 6.4; RIA (n=90): 1.33 (0.8-7.7) 3.6, CLIA Liaison (n=126): 4.4 (8.4-22.1) 8.2, CLIA Access (n= 125): 4.1 (0.3-28) 15.6, and CLIA Immulite1000 (n: 99): 2.5 (1.4-20) 7.6. Calculated p95 was higher than RCO in all methods, being RIA the highest. ANOVA analysis for paired samples measured by all methods showed significant (p<0.005) differences except for Access and Liaison (p=1,000). Biases (nmol/L) obtained were: Cobas vs Immulite = -1; Access vs Cobas = 3.2; Cobas vs Liaison = -2.8; Cobas vs RIA = 0.9; Access vs Immulite = 2.4; Immulite vs Liaison = -1.8; Access vs Liaison = 0.3; Access vs RIA = 4.1; Liaison vs RIA = 3.6; Immulite vs RIA = 1.9. Lowest bias found was between Access and Liaison, result coincident with ANOVA. %DC between pairs of methods using RCOs was: Cobas vs Immulite = 87%; Access vs Cobas= 84%; Cobas vs Liaison = 95%; Cobas vs RIA = 64%; Access vs Immulite = 85%; Immulite vs Liaison = 90%; Access vs Liaison = 84%; Access vs RIA= 72%; Liaison vs RIA = 63%; Immulite vs RIA = 70%. Lowest %DC was found when RIA was involved in the comparison, which could be due to its low AS and RCO that are the same. Conclusions: Differences in %DC observed could be due to not only differences between methods but differences in composition of the population studied. Validating MiSC cutoff values in individual laboratories is important for good clinical use of results in the diagnosis and follow-up of Cushing’s syndrome. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Por décadas, el significado clínico de la hormona antimülleriana (HAM) ha estado limitado a su papel crítico en el desarrollo sexual fetal. Sin embargo, en los últimos 20 años esta ha surgido también como marcador de función ovárica.

Análisis bibliográfico de las limitaciones y dificultades técnicas en el dosaje de testosterona total (TT). Revisión de trabajos publicados en diferentes bases de datos desde 2003 hasta el 2014 (PubMed, Biblioteca Virtual de Salud, Cochrane). Evaluación y comparación del dosaje de TT sérica utilizando métodos disponibles en nuestro país, validados por LC-MS/MS y no validados por LC-MS/MS. Elaboración de una monografía en la que se evalúan los problemas técnicos en el dosaje de TT en la actualidad. Bibliographic analysis of the constraints and technical difficulties in the total testosterone (TT) assay. Review of articles published in various databases from 2003 to 2014. (PubMed, Health Library, Cochrane). Evaluation and comparison of serum TT assays using the different methods available in our country, validated or not validated by LC-MS/MS. Development of a monograph in which technical problems are evaluated in current TT assays.

Background: Glycosylated prolactin (G-PRL) is considered as the major post-translational modification of prolactin (PRL) showing reduced lactotropic and mitogenic activities compared to non-glycosylated prolactin (NG-PRL). Aim: To evaluate the evolution of G-PRL in normoprolactinemic children and adolescents and to analyze possible variations in glycosylated/total prolactin (T-PRL) ratios. Methods: T-PRL, G-PRL and NG-PRL were evaluated in 111 healthy female and male children and adolescents (4.1–18 years), classified as group 1 (Tanner I), group 2 (Tanner II–III) and group 3 (Tanner IV–V). G-PRL and NG-PRL were identified by chromatography on concanavalin-A-Sepharose. Results: G-PRL/T-PRL (median-range): females, group 1: 0.59 (0.17–0.77), group 2: 0.56 (0.31–0.78), group 3: 0.60 (0.38–0.79); males, group 1: 0.64 (0.39–0.80), group 2: 0.61 (0.24–0.79), group 3: 0.62 (0.35–0.90); the p value is not significant among the different groups in both genders. G-PRL/T-PRL ratios do not change when comparing low (first quartile) versus high (third quartile) T-PRL levels in the different groups. Conclusion: Our study would appear to support cosecretion of G-PRL and NG-PRL from childhood to the end of puberty. Such cosecretion would not be dependent on sex steroid levels. It is important to point out that puberty does not change the proportions of G-PRL and NG-PRL.

Fil: Pardes, E.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Ramos Mejia; Argentina

Fil: Pardes, Ester. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Ramos Mejia; Argentina