| Abstract | Endokrinološki sustav građen je od hipofize, epifize, gušterače, spolnih žlijezda, štitnjače, paratiroidne žlijezde, dviju nadbubrežnih žlijezda, probavnog sustava, masnog tkiva. Reguliran je od strane hipotalamusa, koji djeluje na adenohipofizu šaljući joj ili stimulirajuće ili inhibirajuće hormona pomoću čega ona djeluje na organe koji zatim ili luče ili prestaju lučiti hormone, dok se hormoni neurohipofize (oksitocin,vazopresin) sintetiziraju u donjem dijelu diencefalona i odlažu u neurohipofizi sve dok se ne pokaže potreba da se luče. Adenohipofiza je građena od 3 skupine stanica koje luče hormon rasta, prolaktin, adrenokortikotropne hormone, folikulostimulirajuće, luteinizirajuće hormone, tirotropne hormone. Proces nastanka i lučenja hormona adenohipofize regulirano je mehanizmom povratne sprege.
Hormoni su signalne molekule, luče ih žlijezde s unutarnjim izlučivanjem (hipofiza, štitna, doštitna žlijezda, prsna žlijezda, gušterača, nadbubrežna žlijezda, muške, ženske spolne žlijezde) u krvotok.
U endokrinologiji koristimo dvije vrste dijagnostičkih testova; testove bazalne sekrecije i dinamičke testove. Pri određivanju deficita hormona rasta koristimo skrining test, test s argininom, L-dopa test i provokacijski test vježbanjem. Za detekciju hipertireoidizma koristimo supresijski test s T3, kod hipotireoidizma pomaže nam test stimulacije TRH kao i kod hiperprolaktinemije. U dijagnostici hipoparatireoidizma koristimo EDTA test, za dokaz feokromocitoma koristimo glukagonski test, za akromegaliju test supresije s glukozom. Kod sindroma policističnih jajnika ili preuranjenog puberteta koristimo gonadotropinski test spavanja ili GNRH odgovarajući test. Kako bismo potvrdili dijabetes insipidus koristimo test odsutsva vode, a za dijagnozu dijabetesa melitusa glukoza tolerancijski test. Kod sumnje na Cushingov sindrom primjenjujemo deksametazonski test, na Addisonovu bolest ili kongenitalnu adrenalnu hiperplaziju |
| Abstract (english) | The endocrine system is build out of pituitary gland, pineal gland, pancreas, gonads, thyroid gland, parathyroid glands, two adrenal glands, gastrointestinal system and fat tissue. The whole system is regulated by hypothalamus, whose stimulatory or inhibitory signals govern adenohypophysis,which governs other endocrine organs in a way that stimulates or depresses their hormone secretion.Neurohypophysis function is storage and timely release of oxytocin and vasopressin that are produced in lower parts of diencephalon.
Adenohypophysis is made of 3 types of cells that secrete growth hormone,prolactin, adrenocorticotropic hormone, follicle-stimulating,luteinizing hormone and thyroid-stimulating hormone.The whole process of hormone production and secretion is regulated by feedback mechanism.
Hormones are signal molecules which are secreted from glands with internal secretion such as pituitary, thyroid and parathyroid, thymus, pancreas, adrenal glands, and gonads in the bloodstream.
There are two types of diagnostic test; test of basal secretion and dynamic tests.
Tests to determinate the deficiency of GH are screening test, arginine and combined arginine-L-dopa test, L-dopa stimulation test and exercise induced GH secretion. In diagnostics of hyperthyroidism we use thyroid suppression test, hypothyroidism and hyperprolactinemia are determined by TRH test. EDTA infusion test is used in diagnostics of hypoparathyroidism. To confirm pheochromocytoma glucagon test is used, while for confirmation of acromegaly glucose test for suppresion of GH secretion is used. If there is suspicion for polycystic ovarian syndrome or precocious puberty ,GNRH response test or gonadotropin sleep study, are used. For confirmation of diabetes insipidus water deprivation test is used, for diagnosis of diabetes mellitus glucose tolerance test. Dexamethasone suppression test is used to determinate Cushing syndrome and if we want to confirm CAH or Addison disease the dexamethasone-suppressed ACTH stimulation test should be performed. Matyrapone test usage is in confirmation of adrenal insufficiency. |
