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Svjatoslavs Kistkins Pauls Stradiņš Clinical University Hospital, Riga, Latvia

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Othmar Moser Division of Exercise Physiology and Metabolism, Institute of Sport Science, University of Bayreuth, Bayreuth, Germany

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Vitālijs Ankudovičs Pauls Stradiņš Clinical University Hospital, Riga, Latvia

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Dmitrijs Blizņuks Institute of Smart Computing Technologies, Riga Technical University, Riga, Latvia

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Timurs Mihailovs Institute of Smart Computing Technologies, Riga Technical University, Riga, Latvia

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Sergejs Lobanovs Pauls Stradiņš Clinical University Hospital, Riga, Latvia

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Harald Sourij Trials Unit for Interdisciplinary Metabolic Medicine, Division of Endocrinology and Diabetolgoy, Medical University of Graz, Graz, Austria

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Andreas F H Pfeiffer Department of Endocrinology and Metabolic Medicine, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm, Berlin, Germany

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Valdis Pīrāgs Pauls Stradiņš Clinical University Hospital, Riga, Latvia
Faculty of Medicine, University of Latvia, Riga, Latvia

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changing lifestyles, which include unhealthy dietary habits, sedentary behaviour, and increasing stress levels, interplaying with genetic and epigenetic factors ( 5 ). The intertwining of these two conditions amplifies the risk of various health

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M von Wolff Division of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern University Hospital, University of Bern, Bern, Switzerland

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C T Nakas University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Laboratory of Biometry, University of Thessaly, Volos, Greece

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M Tobler Division of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern University Hospital, University of Bern, Bern, Switzerland
Division of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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T M Merz Division of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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M P Hilty Intensive Care Unit, University Hospital, Zurich, Switzerland

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J D Veldhuis Endocrine Research Unit, Department of Internal Medicine, Mayo School of Graduate Medical Education, Centre for Translational Science Activities, Mayo Clinic, Rochester, New York, USA

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A R Huber Centre for Laboratory Medicine, Cantonal Hospital, Aarau, Switzerland

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J Pichler Hefti Division of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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shown in Figs 1 and 2 for cortisol and fT4. Figure 1 Cortisol concentration (nmol/L), representing a stress axis. Effect of altitude at 550 m before the expedition (PR), during ascent at 4.844 m (BC1), 6.022 m (C2) and 7.050 m altitude (C3

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Marieke Stientje Velema Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands

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Aline de Nooijer Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands

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Ad R M M Hermus Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands

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Henri J L M Timmers Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands

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Jacques W M Lenders Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany

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Olga Husson Division of Clinical Studies, Institute of Cancer Research, London, UK

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Jaap Deinum Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany

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values ( 5 , 6 ) and improvement in HRQoL after ADX ( 5 ) and during MRA-based treatment ( 6 ). Furthermore, psychological symptoms impairing HRQoL in patients with PA have been reported: occurrence of anxiety disorders and stress is higher than in the

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Angela Köninger Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany

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Antonella Iannaccone Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany

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Ensar Hajder Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany

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Mirjam Frank Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, Essen, Germany

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Boerge Schmidt Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, Essen, Germany

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Ekkehard Schleussner Department of Obstetrics, Jena University Hospital, Jena, Germany

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Rainer Kimmig Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany

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Alexandra Gellhaus Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany

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Hans Dieplinger Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria

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( 23 ) and afamin seems to play a crucial role in oxidative stress-related anti-apoptotic cellular processes ( 24 ). Impaired glucose tolerance, hyperandrogenism and oxidative stress were shown to be strongly dependent on each other in PCOS patients

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Clara Odilia Sailer Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
Department of Clinical Research, University of Basel, Basel, Switzerland

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Sophia Julia Wiedemann Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
Department of Biomedicine, University of Basel, Basel, Switzerland

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Konrad Strauss Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Ingeborg Schnyder Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland

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Wiebke Kristin Fenske Leipzig University Medical Center, Integrated Center for Research and Treatment Adiposity Diseases, Leipzig, Germany
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig, Leipzig, Germany

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Mirjam Christ-Crain Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
Department of Clinical Research, University of Basel, Basel, Switzerland

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Takahashi H . Short-time exposure of hyperosmolarity triggers interleukin-6 expression in corneal epithelial cells . Cornea 2014 1342 – 1347 . ( https://doi.org/10.1097/ICO.0000000000000256 ) 9 Shapiro L Dinarello CA . Hyperosmotic stress as

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Emanuelle Nunes-Souza Pelé Pequeno Príncipe Research Institute, Água Verde, Curitiba, Parana, Brazil
Faculdades Pequeno Príncipe, Rebouças, Curitiba, Parana, Brazil
Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC) at Universidade Federal do Paraná, Agostinho Leão Jr., Glória, Curitiba, Parana, Brazil

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Mônica Evelise Silveira Laboratório Central de Análises Clínicas, Hospital de Clínicas, Universidade Federal do Paraná, Centro, Curitiba, Paraná, Brazil

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Monalisa Castilho Mendes Pelé Pequeno Príncipe Research Institute, Água Verde, Curitiba, Parana, Brazil
Faculdades Pequeno Príncipe, Rebouças, Curitiba, Parana, Brazil
Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC) at Universidade Federal do Paraná, Agostinho Leão Jr., Glória, Curitiba, Parana, Brazil

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Seigo Nagashima Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, General Carneiro, Alto da Glória, Curitiba, Parana, Brazil
Departamento de Medicina, PUC-PR, Prado Velho, Curitiba, Parana, Brazil

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Caroline Busatta Vaz de Paula Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, General Carneiro, Alto da Glória, Curitiba, Parana, Brazil
Departamento de Medicina, PUC-PR, Prado Velho, Curitiba, Parana, Brazil

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Guilherme Guilherme Vieira Cavalcante da Silva Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, General Carneiro, Alto da Glória, Curitiba, Parana, Brazil
Departamento de Medicina, PUC-PR, Prado Velho, Curitiba, Parana, Brazil

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Giovanna Silva Barbosa Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, General Carneiro, Alto da Glória, Curitiba, Parana, Brazil
Departamento de Medicina, PUC-PR, Prado Velho, Curitiba, Parana, Brazil

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Julia Belgrowicz Martins Pelé Pequeno Príncipe Research Institute, Água Verde, Curitiba, Parana, Brazil
Faculdades Pequeno Príncipe, Rebouças, Curitiba, Parana, Brazil

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Lúcia de Noronha Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, General Carneiro, Alto da Glória, Curitiba, Parana, Brazil
Departamento de Medicina, PUC-PR, Prado Velho, Curitiba, Parana, Brazil

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Luana Lenzi Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil

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José Renato Sales Barbosa Pelé Pequeno Príncipe Research Institute, Água Verde, Curitiba, Parana, Brazil
Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC) at Universidade Federal do Paraná, Agostinho Leão Jr., Glória, Curitiba, Parana, Brazil

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Rayssa Danilow Fachin Donin Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC) at Universidade Federal do Paraná, Agostinho Leão Jr., Glória, Curitiba, Parana, Brazil

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Juliana Ferreira de Moura Pós Graduação em Microbiologia, Parasitologia e Patologia, Departamento de Patologia Básica – UFPR, Curitiba, Brazil

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Gislaine Custódio Faculdades Pequeno Príncipe, Rebouças, Curitiba, Parana, Brazil
Laboratório Central de Análises Clínicas, Hospital de Clínicas, Universidade Federal do Paraná, Centro, Curitiba, Paraná, Brazil

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Cleber Machado-Souza Pelé Pequeno Príncipe Research Institute, Água Verde, Curitiba, Parana, Brazil
Faculdades Pequeno Príncipe, Rebouças, Curitiba, Parana, Brazil
Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC) at Universidade Federal do Paraná, Agostinho Leão Jr., Glória, Curitiba, Parana, Brazil

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Enzo Lalli Institut de Pharmacologie Moléculaire et Cellulaire CNRS, Sophia Antipolis, Valbonne, France

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Bonald Cavalcante de Figueiredo Pelé Pequeno Príncipe Research Institute, Água Verde, Curitiba, Parana, Brazil
Faculdades Pequeno Príncipe, Rebouças, Curitiba, Parana, Brazil
Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC) at Universidade Federal do Paraná, Agostinho Leão Jr., Glória, Curitiba, Parana, Brazil
Departamento de Saúde Coletiva, Universidade Federal do Paraná, Curitiba, Paraná, Brazil

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most abundant adrenocortical steroid in blood, measurement is widely available and is more frequently reported than DHEA. Adrenarche constitutes a period of adaptive response to stress from prepuberty to early puberty, associated with maturation of

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Jairo Arturo Pinzón-Cortés Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia
School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Angelina Perna-Chaux Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Nicolás Steven Rojas-Villamizar Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Angélica Díaz-Basabe Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Diana Carolina Polanía-Villanueva Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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María Fernanda Jácome Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Carlos Olimpo Mendivil School of Medicine, Universidad de los Andes, Bogotá, Colombia
Endocrinology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia

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Helena Groot Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia
School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Valeriano López-Segura Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia
School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Introduction Type 2 diabetes mellitus (T2DM) is a complex disease characterized by hyperglycemia secondary to inappropriate insulin secretion, resistance to its action, or both. Over time, these alterations and oxidative stress promote the

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Patricia Arroyo Tardio University Hospital Basel, Basel, Switzerland

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Gabriela Baldini University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland

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Eleonora Seelig University Hospital Basel, Basel, Switzerland
University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland

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were admitted to the Clinical Trials Unit, University Hospital Basel, at 08:00 h. After arrival, stress levels were assessed with the perceived stress questionnaire ( 11 ). Basal metabolic rate was measured with indirect calorimetry (Quark RMR, COSMED

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Legh Wilkinson Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

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Nicolette J D Verhoog Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

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Ann Louw Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

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Introduction Due to the interrelatedness of the stress and inflammatory responses, chronic persistent inflammation may be considered both a cause and a consequence of a prolonged disruption of the central HPA axis, a systemic signalling

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Margret J Einarsdottir Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Penelope Trimpou Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Gudmundur Johannsson Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Oskar Ragnarsson Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden

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(stress dose) during physical and/or psychological stress. Similarly, patients undergoing severe stress who have recently ceased GC treatment also require stress doses of GC ( 1 ). Common symptoms and signs of adrenal crisis include hypotension, abdominal

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