Somatostatin-like immunoreactivity levels (SLI) in cerebrospinal fluid (CSF) were determined in twenty-three patients with untreated parkinsonian syndrome (15 with Idiopathic Parkinson's disease (IPD) and 8 with other forms of parkinsonism) at the moment of clinical diagnosis (mean duration of disease 1.1 +/- 0.2 years), and in 26 subjects without neurological symptoms. None of the IPD patients had a diagnosis of dementia at the moment of inclusion in the study. CSF-SLI content was found to be significantly higher in patients with parkinsonian syndrome (107.9 +/- 9.8 pg/ml) than in control subjects (73.5 +/- 8.4 pg/ml). The increase was also significant when controls were compared with IPD patients. In addition, a positive correlation between SLI and homovanillic acid was found in CSF of all patients. A test of learning memory was used to evaluate the mental state of patients and a significant increase in CSF-somatostatin levels was observed in patients with Idiopathic Parkinson's disease and severe affectation of memory. These results indicate that in the early steps of untreated parkinsonian syndrome, somatostatin concentration in cerebrospinal fluid may increase, probably due to the neurodegenerative depletion of somatostatin from striatal or cortical neurons.

We studied the growth hormone (GH) response to GH-releasing hormone (GHRH) and the thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) in four groups of patients with dementia and examined whether GH and TSH secretion is altered in patients with Alzheimer's disease. The four groups included those with Alzheimer's disease (n = 28), parkinsonism with dementia (n = 10), progressive supranuclear palsy with dementia (n = 10), and dementia of vascular origin (n = 28). The results showed no differences among the four groups in GH response to GHRH (12.2 +/- 2, 10.7 +/- 2, 8.9 +/- 1.1, and 9.9 +/- 1.9 micrograms/ml, respectively); there was no correlation between GH response to GHRH and sex, stage of the disease, or cerebral atrophy. The proportion of patients with exaggerated, normal, or lower GH response was similar in the four groups in terms of TSH response to TRH (9.2 +/- 0.9, 11.1 +/- 1, 11.1 +/- 1, and 10.3 +/- 1 mU/ml, respectively), nor was there a correlation between TSH response to TRH and sex, stage of the disease, cerebral atrophy, or GH response to GHRH. The proportion of those with exaggerated, normal, or lower TSH response was similar in the four groups. Cerebrospinal somatostatin levels were similar in Alzheimer's disease and vascular dementia patients. These findings indicate that neither GH response to GHRH nor TSH response to TRH provides a useful diagnostic adjunct in Alzheimer's disease patients.

Objective. To measure salivary testosterone in women with systemic lupus erythematosus (SLE).Methods. We investigated concentrations of salivary testosterone in 13 women with active SLE and 47 women with inactive SLE, and in 72 healthy female controls.Results. We found a significant decrease in salivary testosterone concentrations in glucocorticoidtreated SLE patients (mean 2 SD 0.06 f 0.04 nmoled liter) but no differences in concentrations in untreated patients (0.09 f 0.03 nmolesfiiter), compared with the healthy controls (0.11 f 0.04 nmoleshiter).Conclusion. Glucocorticoid treatment appears to cause a decrease in the salivary testosterone level. Measurement of salivary testosterone is a simple way of monitoring androgen metabolism in patients with SLE.It is well known that glucocorticoid treatment reduces serum testosterone levels in men and women (1,2). However, considerable doubts remain as to whether this effect is stronger on hormone that is bound to the transport protein or on non-proteinbound hormone, the latter being responsible for the biologic effects of the hormone. Androgen metabolism abnormalities, as well as decreased serum testosterone concentrations, have been described in women with systemic lupus erythematosus (SLE) (3-5). These effects have occurred in untreated women as well as in those undergoing treatment with glucocorticoids.Saliva is considered to be an appropriate medium for measuring concentrations of various hormones, testosterone being one of the most important (6-9). There are 2 advantages associated with the use of saliva, as opposed to serum, for hormone analysis. First, the sampling procedure is noninvasive, and second, the free hormone fraction not influenced by hormonal transport proteins can be obtained more easily. In the present investigation, we studied saliva levels of testosterone in a group of female SLE patients, some of whom were being treated with glucocorticoids. PATIENTS AND METHODSTestosterone concentrations were measured in saliva samples from 60 premenopausal women with SLE that met 4 or more of the American College of Rheumatology (formerly, the American Rheumatism Association) criteria (lo), and from 72 female controls not known to have any disease. Thirteen of the patients with SLE had active disease but had not begun treatment with glucocorticoids, and 47 had quiescent disease and were receiving glucocorticoids. The glucocorticoid dosage exceeded 25 mg of prednisone every other day in 24 of the treated patients.All saliva samples were obtained at -9:OO AM. Patients deposited their saliva into tubes prepared for this purpose. The samples were centrifuged and then frozen at -80°C until use. Testosterone concentrations were determined by radioimmunoassay according to the procedure

The biological variation of several relative lipid quantities, calculated as the ratios between the concentrations of various serum lipids and apolipoproteins, has been estimated over a one-year period. The medians of the within-subject biological coefficient of variation, separated by sex when significant differences exist, were 15.4% for [apolipoprotein A-I]/[apolipoprotein B], 6.8% for [high-density lipoprotein (HDL)-cholesterol]/[cholesterol], 10.5% and 17.6% (women and men, respectively) for [HDL2-cholesterol]/[HDL-cholesterol], 13.6% for [HDL2-cholesterol]/[HDL3-cholesterol], 10.6% for [low-density lipoprotein (LDL)-cholesterol]/[apolipoprotein B], 10.6% and 8.7% (women and men, respectively) for [LDL-cholesterol]/[cholesterol], and 6.3% for [LDL-cholesterol]/[HDL-cholesterol]. From these data, we have calculated the critical difference for significant change detection, the index of individuality, and the goal for the between-day imprecision. Concerning within-subject biological variation, the best ratios for the detection of risk of coronary heart disease and the monitoring of intervention are [LDL-cholesterol]/[HDL-cholesterol] and [HDL-cholesterol]/[cholesterol]. The index of individuality obtained in this study indicates that the use of population-based reference values is inadequate for interpreting the ratios studied.

In systemic lupus erythematosus (SLE) androgen abnormalities in men and women have been described, 1,2 although these findings have occurred in untreated women as well as in those undergoing treatment with glucocorticoids.3 Salivary testosterone is a well-established marker for circulating free testosterone concentrations in different clinical disorders and there is a consistency among laboratories in their values;' likewise salivary testosterone levels did not increase in premenopausal women with active untreated SLE, but decreased in women treated with glucocorticoids.8We studied salivary testosterone concentrations in the three phases of menstrual cycle from 13 SLE women that met 4 or more of the American Rheumatism Association's criteria. All patients were premenopausal, (mean age = 31 y, from 21-44), had quiescent disease and were receiving less than 20 mg of prednisone every other day. The clinical activity of the patients according to the SLEDAI was 3.4 ~ 1.6. None of the patients was taking immunosuppressive therapy or any other drug, and they reported having menstrual cycles of 28 ±5 d of length not varying more than 3 f 1 d. None of the patients had symptoms of Sjogren's syndrome.The saliva samples were collected at approximately 9:00 am into tubes prepared for this purpose without external stimulation; testosterone concentrations were measured with extraction procedure (Orion Diagnostica, Oulunsalo, Finland) with modifications in the sample volume. For the evaluation of the menstrual cycle of patients, LH and FSH serum concentrations were measured by RIA (DPC, Los Angeles, USA). Estradiol concentrations were measured by enzymeimmunoassay (ES-700 Boehringer Mannheim, Germany).Non-parametrical and paired Wilconson t-tests were used for the statistical analysis of data. A significant increase (P < 0.05) in salivary testosterone concentrations in both ovulatory peak (0.06 f 0.04 nmol/L) and luteal phase (0.07 zL 0.03 nmol/L) was observed respect to pholicular phase (0.05 0 .03 nmol/L) but no differences were observed between the ovulatory peak and the luteal phase. These results were decreased compared with those obtained in 72 healthy subjects age matched with patients (0.11 ::!: 0.04 nmol/L) in which the menstrual cycle was not studied. The levels of LH, FSH and estradiol were similar respect to the menstrual cycle from normal women. No correlation was observed between the duration of disease and the salivary testosterone concentrations, and similarly respect to anti Ro levels. As far as we know, there are no studies of the behaviour of testosterone in saliva during the menstrual cycle in SLE women treated with glucocorticoids. In healthy women, serum testosterone concentrations show how this hormone fluctuates during the menstrual cycle with higher levels in midcycle9 and in saliva of women with normal menstruations, testosterone values varying significantly during menstrual cycle. 10 An important point in our study is that salivary testosterone concentrations maintain a similar profile as in normal sub...