Essential Endocrinology and Diabetes. Richard I. G. Holt
href="#u67dd75f5-888d-5eb1-872e-7c9e56ad6ee4">Chapter 1). For some hormones, such as GH, a clinical impression can be gained from a series of six to eight measurements during the course of a day. Alternatively, dynamic testing may be necessary where, based on understanding normal physiology, responses are measured following a stimulus. This might be metabolic, such as insulin‐induced hypoglycaemia to study the expected rise in serum GH and cortisol (Chapter 5), or the administration of glucose during a glucose tolerance test to diagnose diabetes (Chapter 11). Alternatively, the stimulus might be hormonal, such as injecting adrenocorticotrophic hormone (ACTH; the anterior pituitary hormone) to measure secretion of cortisol (the adrenocortical hormone). In this sense, fasting measurements, as required for serum lipids or commonly for glucose, could be viewed as dynamic, where fasting is the stimulus.
Table 4.1 Endocrine reference ranges
| Adult reference hormone | Range | Units | Range | Unit |
|---|---|---|---|---|
| 17‐Hydroxyprogesterone (male) | 0.18–9.1 | nmol/L | 5.9–300 | ng/dL |
| 17‐Hydroxyprogesterone (female) | 0.6–3.0 | nmol/L | 20–99 | ng/dL |
| Adrenocorticotrophic hormone (ACTH, 9 AM) | 0–8.8 | pmol/L | 0–40 | ng/L |
| Aldosterone (AM; out of bed for 2 h; seated 5–15 min)a | 100–500 | pmol/L | 3.6–18.1 | ng/dL |
| Androstenedione (adult male and female) | 2.1–9.4 | nmol/L | 60–270 | ng/dL |
| Anti‐Müllerian hormone (to indicate poor ovarian reserve)b | >7 | pmol/L | >1 | ng/mL |
| Chromogranin A (fasting) | 0–5.2 | nmol/L | 0–250 | ng/ml |
| Cortisol (9 AM)c | 140–700 | nmol/L | 5–25 | μg/dL |
| Cortisol (midnight) | 80–350 | nmol/L | 2.9–12.5 | μg/dL |
| Cortisol (post low dose dexamethsaone) | <50 | nmol/L | 1.8 | μg/dL |
| Cortisol (urinary free) | 0–280 | nmol/24 h | 0–10 | μg/24 h |
| Epinephrine (adrenaline) | 0–546 | pmol/L | 0–100 | pg/mL |
| Epinephrine (adrenaline; urine) | 0–1.0 | μmol/24 h | 0.5–20 | μg/24 h |
| Follicle‐stimulating hormone (FSH) | ||||
| Males (adult) | 1.0–8.0 | U/L | – | – |
| Females | ||||
| Early follicular phase | 1.0–11.0 | U/L | – | – |
| Post‐menopausal | >30 | U/L | – | – |
| Gastrin (fasting) | 0–40 | pmol/L | 0–154 | pg/mL |
| Glucagon (fasting) | 0–50 | pmol/L | 0–139 | pg/mL |
| Glucose | ||||
| Fasting (normal) | <6.1 | mmol/L | <110 | mg/dL |
| Fasting (impaired fasting glycaemia; ‘pre‐diabetes’) | 6.1–6.9 | mmol/L | 110–125 | mg/dL |
| Fasting (diabetes) | ≥7.0 | mmol/L | ≥126 | mg/dL |
| Post‐glucose tolerance test (normal) | <7.8 | mmol/L | <140 | mg/dL |
| Post‐glucose tolerance test (impaired glucose tolerance; ‘pre‐diabetes’) | 7.8–11.0 | mmol/L | 140–200 | mg/dL |
| Post‐glucose tolerance test (diabetes) | ≥11.1 | mmol/L | ≥200 | mg/dL |
| Growth hormone | ||||
| After a glucose load | <0.3d | ng/mL | <0.8 | mU/L |
| Stress‐induced [e.g. glucose <2.2 mmol/L (<40 mg/dL)] | >6.7 | ng/mL | ||