Evening urinary free corticoids: a screening test in Cushing's syndrome and incidentally discovered adrenal tumours

Abstract

In this study, we investigated the usefulness of the determination of evening urinary free corticoids/ creatinine in samples collected from 20.00 to 24.00 h as a screening test in Cushing's syndrome. In controls (N = 61) the ratio values ranged from 1.1 to 9.4 \g=m\mol/mol,whereas in patients with Cushing's syndrome (N = 20), they ranged from 27.5 to 855.5 \g=m\mol/mol. However, in 28% of patients with major obesity (> 50% overweight) and no hypercortisolism, the ratio values were between 9.4 to 27.8 \g=m\mol/mol. A short (10 days) hypocaloric diet induced a decrease in the values in 75% of these patients; the normal range was reached in 50% of them. In addition, the evening urinary free corticoids/creatinine was slightly abnormal in 8 out of 10 patients with incidentally discovered 'silent' adrenal adenomas, whereas it was normal in all 6 with other adrenal masses. In conclusion, evening urinary free corticoids/creatinine is easy to obtain and it reaches a higher sensitivity (100%) and specificity (97%) than the 24 h urinary free corticoids. In the case of borderline values, the presence of overweight should be taken into account.

Overnight dexamethasone suppression test: comparison of plasma and salivary cortisol measurement for the screening of Cushing's syndrome

“…We suggest that a screening procedure for Cushing's syndrome could combine this simple and stress-tree test with the measurement of evening urinary cortisol level (19), because both saliva and evening urine collections can be obtained easily in outpatients.…”

Pre-Clinical Cushing’s Syndrome: Report of Three Cases and Literature Review

“…Copeland [23] sug gested in 1983 that prevalence of adrenocortical tumors appearing to have no secretory activity decreases as indices of steroid metabolism are more closely scruti nized. Also, Laudat et al [24] reported the utility of a timed 4-hour collection for UFC and creatinine between 8 p.m. and midnight compared with the 24-hour UFC in 10 patients with incidentaloma previously described as 'hormonally normal'. All 61 control patients had an eve ning UFC/Cr ratio less than lOpmol/mol, while 8/10 patients with incidentalomas had an evening UFC/Cr ratio greater than 10 pmol/mol.…”

Overnight urinary free cortisol determination: A screening test for the diagnosis of Cushing's syndrome

“…Previous studies have highlighted the possibility of diagnosing Cushing's syndrome by collecting urine for less than 24 h (Contreras et al, 1986;Laudat et al, 1988). However, the urine sampling is frequently inaccurate.…”