Hair cortisol and cortisone measurements for the diagnosis of overt and mild Cushing’s syndrome
| Autor: | Magalie Haissaguerre, Delia De Angeli, Antoine Tabarin, Marie Puerto, Amandine Ferriere, Julie Brossaud, Jean Benoît Corcuff, Léa Charret, Blandine Gatta-Cherifi |
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| Přispěvatelé: | Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) |
| Rok vydání: | 2021 |
| Předmět: |
Adenoma
Adult endocrine system medicine.medical_specialty Hydrocortisone Endocrinology Diabetes and Metabolism Adrenal Gland Neoplasms 030209 endocrinology & metabolism Sensitivity and Specificity Severity of Illness Index Diagnostic Techniques Endocrine 03 medical and health sciences 0302 clinical medicine Endocrinology Predictive Value of Tests Internal medicine medicine Humans In patient Cushing Syndrome Aged Retrospective Studies S syndrome business.industry Healthy subjects Retrospective cohort study General Medicine Adrenal tumours Middle Aged Cortisone ACTH Syndrome Ectopic Dexamethasone suppression Case-Control Studies 030220 oncology & carcinogenesis Female [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] business Serum cortisol Hair medicine.drug |
| Zdroj: | European Journal of Endocrinology European Journal of Endocrinology, BioScientifica, 2021, 184 (3), pp.445-454. ⟨10.1530/EJE-20-1127⟩ |
| ISSN: | 1479-683X 0804-4643 |
| Popis: | Objective Hair cortisol (HF) and cortisone (HE) measurements reflect tissular exposure to cortisol over months and are increased in overt Cushing’s syndrome (CS). No data is available in mild CS. We compared the diagnostic performance of HF and HE between patients with overt or mild CS. Design Single centre retrospective study. Methods HF&HE were measured by LC-MS/MS in 48 consecutive adult females with Cushing’s disease (CD), ectopic ACTH syndrome, secreting adenomas and carcinomas, and adrenal incidentalomas. All had impaired dexamethasone suppression tests. Overt CS (n = 25) was diagnosed in front of specific symptoms, a mean UFC (>1.5 ULN) and increased midnight serum cortisol or salivary cortisol. Mild CS (n = 23) was diagnosed in patients lacking specific symptoms and displaying at least one additional biological abnormality including mildly increased UFC (≤1.5 ULN), increased midnight serum cortisol or salivary cortisol and suppressed plasma ACTH in patients with adrenal tumours. In this study, 84 healthy subjects and obese patients served as controls. Results HF and HE showed roughly similar performance in overt CS (92 and 100% sensitivity, 91 and 99% specificity, respectively). HF and HE were lower in mild CS but higher than in controls (P < 0.01). HE was correlated with midnight serum cortisol (P < 0.02) and volume of adrenal incidentalomas (P < 0.04) but not with UFC. HF and HE had 59% and 68% sensitivity, and 79 and 94% specificity, respectively, for the diagnosis of mild CS. Contrary to UFC, both HF and HE were in the range of overt CS in 11/23 patients with mild CS. Patients with mild CS and increased HE required more antihypertensive treatments and showed worser lipid profiles than patients with normal HE. Conclusions HF and HE measurement performed better in overt than in mild CS but is a useful adjunct to diagnose mild CS and to identify adrenocortical incidentalomas responsible for excessive cortisol exposure. |
| Databáze: | OpenAIRE |
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