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Hair cortisol in the evaluation of Cushing syndrome.

ABSTRACT: PURPOSE:Hair cortisol evaluation has been used to help detect patients with suspected Cushing syndrome. Our goal was to correlate segmental hair cortisol with biochemical testing in patients with Cushing syndrome and controls. This study was a prospective analysis of hair cortisol in confirmed Cushing syndrome cases over 16 months. METHODS:Thirty-six subjects (26.5?±?18.9?years, 75% female, and 75% Caucasian) were analyzed by diurnal serum cortisol, 24?h urinary free cortisol corrected for body surface area (UFC/BSA), and 24?h urinary 17-hydroxysteroids corrected for creatinine (17OHS/Cr). Thirty patients were diagnosed with Cushing syndrome, and six were defined as controls. 3-cm hair samples nearest to the scalp, cut into 1-cm segments (proximal, medial, and distal), were analyzed for cortisol by enzyme immunoassay and measured as pmol cortisol/g dry hair. Hair cortisol levels were compared with laboratory testing done within previous 2 months of the evaluation. RESULTS:Proximal hair cortisol was higher in Cushing syndrome patients (266.6 ± 738.4?pmol/g) than control patients (38.9?±?25.3?pmol/g) (p?=?0.003). Proximal hair cortisol was highest of all segments in 25/36 (69%) patients. Among all subjects, proximal hair cortisol was strongly correlated with UFC/BSA (r?=?0.5, p?=?0.005), midnight serum cortisol (r?=?0.4, p?=?0.03), and 17OHS/Cr, which trended towards significance (r?=?0.3, p?=?0.06). CONCLUSIONS:Among the three examined hair segments, proximal hair contained the highest cortisol levels and correlated the most with the initial biochemical tests for Cushing syndrome in our study. Further studies are needed to validate proximal hair cortisol in the diagnostic workup for Cushing syndrome.

SUBMITTER: Hodes A

PROVIDER: S-EPMC5437744 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Hair cortisol in the evaluation of Cushing syndrome.

Hodes Aaron A Lodish Maya B MB Tirosh Amit A Meyer Jerrold J Belyavskaya Elena E Lyssikatos Charalampos C Rosenberg Kendra K Demidowich Andrew A Swan Jeremy J Jonas Nichole N Stratakis Constantine A CA Zilbermint Mihail M

Endocrine 20170213 1

<h4>Purpose</h4>Hair cortisol evaluation has been used to help detect patients with suspected Cushing syndrome. Our goal was to correlate segmental hair cortisol with biochemical testing in patients with Cushing syndrome and controls. This study was a prospective analysis of hair cortisol in confirmed Cushing syndrome cases over 16 months.<h4>Methods</h4>Thirty-six subjects (26.5 ± 18.9 years, 75% female, and 75% Caucasian) were analyzed by diurnal serum cortisol, 24 h urinary free cortisol corr ...[more]

PMID: 28194652

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Project description:Distal hair segments collected at delivery may allow for the assessment of maternal cortisol secretion in early pregnancy, an important time window for fetal development. Therefore, an investigation of the validity of distal hair cortisol concentrations is warranted. We examined the concordance between proximal and distal hair cortisol concentrations (HCC), both representing the first trimester of pregnancy. The study population was comprised of a random sample of 97 women participating in the Pregnancy Outcomes Maternal and Infant Study, a prospective cohort study of pregnant women attending prenatal clinics in Lima, Peru. Each participant provided two hair samples: once at enrollment [mean gestational age (GA) = 13.1 weeks] and again at full-term delivery (mean GA = 39.0 weeks). Hair segments reflecting the first trimester were: 3 cm hair segments closest to the scalp on the first hair sample (proximal) and 6-9 cm from the scalp on the second hair sample (distal). HCC was determined using Luminescence Immunoassay. A subset (N = 28) had both hair segments additionally analyzed using liquid chromatography tandem mass spectrometry (LC-MS/MS). HCC values were log-transformed (logHCC), and proximal-distal differences tested using paired sample t-tests. Concordance was evaluated within and across assay types. LogHCC, measured using immunoassay, in distal hair segments was lower compared to proximal hair segments (1.35 versus 1.64 respectively; p = .02). No difference was observed using LC-MS/MS (1.99 versus 1.83, respectively; p=.33). Proximal-distal concordance was low within assay (immunoassay: Pearson = 0.27 and κ = 0.10; LC-MS/MS: Pearson = 0.37 and κ = 0.07). High correlation was observed across assays for both distal (Pearson = 0.78, p < .001; κ = 0.64) and proximal segments (Pearson = 0.96, p < .001; κ = 0.75). In conclusion, distal first-trimester hair segments collected at delivery have lower absolute HCC compared to HCC in proximal first trimester hair segments collected in early pregnancy, and are poorly concordant with HCC in proximal segments. Findings may inform the design of future studies.

Dataset Information

Hair cortisol in the evaluation of Cushing syndrome.

Publications

Hair cortisol in the evaluation of Cushing syndrome.

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