Scalp hair cortisol for diagnosis of Cushing’s syndrome

Wester, Vincent L.; Reincke, Martín; Koper, Jan W.; Akker, Erica L T van den; Manenschijn, Laura; Berr, Christina M.; Fazel, Julia; Rijke, Yolanda B. de; Feelders, Richard A; Rossum, Elisabeth F.C. van

doi:10.1530/eje-16-0873

Cited by 34 publications

(31 citation statements)

References 26 publications

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“…salivary, blood, or urinary cortisol) due to its relatively long time integration, ease of storage, robustness to acute stressors, and minimally invasive collection [2]. Moreover, in adults, the validity of HCC as a measure of HPA axis activity has been somewhat supported by studies observing higher HCC in individuals with Cushing's disease [3,4], chronic pain [5], cardiovascular disease [6], childhood trauma [7], schizophrenia and bipolar disorder [8], and post-traumatic stress disorder [9][10][11], though HCC has been less reliably associated with various sociodemographic stressors [2].…”

Section: Introductionmentioning

confidence: 99%

Prenatal and childhood predictors of hair cortisol concentration in mid-childhood and early adolescence

et al. 2020

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Background Hair cortisol concentration (HCC) is an increasingly used measure of systemic cortisol concentration. However, determinants of HCC in children and adolescents are unclear because few prospective studies have been conducted to date. Study design We followed 725 children in Project Viva, a pre-birth cohort study of mothers and children, who provided hair samples at mid-childhood (median age: 7.7 years) or early adolescence (median age: 12.9 years). We examined associations of various factors measured from pregnancy to mid-childhood with HCC in mid-childhood and early adolescence, as well as change in HCC between these time points (ΔHCC). Results There were 426 children with HCC measurements in both mid-childhood and early adolescence, 173 children with measures only in mid-childhood, and 126 with measures only in early adolescence. HCC was lower in mid-childhood (median 1.0pg/mg [interquartile range, IQR: 0.5, 2.4]) than early adolescence (2.2pg/mg [1.1, 4.4]). In multivariable-adjusted regression models, female sex (β =-0.41, 95% CI:-0.67,-0.15) and birth weight-for-gestational age z-score (β =-0.19, 95% CI:-0.33,-0.04) were associated with lower mid-childhood HCC, while prenatal smoking was associated with higher mid-childhood HCC (β = 0.53, 95% CI: 0.04, 1.01). In early adolescence, child age (β = 0.34 per year, 95% CI: 0.21, 0.46) female sex (β = 0.33, 95% CI: 0.10, 0.57), and maternal pre-pregnancy body mass

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Section: Introductionmentioning

confidence: 99%

Prenatal and childhood predictors of hair cortisol concentration in mid-childhood and early adolescence

et al. 2020

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“…The hypothalamic-pituitary-adrenal (HPA) axis is a key regulator in many physiological processes such as physical or mental stress and fatigue. Dysfunction of steroid hormones in the HPA axis can lead to many different endocrinological diseases and syndromes, like Cushing's syndrome [2], Addison's disease [3] and metabolic syndrome [4]. Furthermore disruption of the HPA system has also been associated with mental, immunological and cardiovascular disease which underlines the importance of this system for the human body and accordingly to human and public health [5].…”

Section: Introductionmentioning

confidence: 99%

Steroid profiling in nails using liquid chromatography-tandem mass spectrometry

et al. 2018

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The retrospective analysis of endogenous steroid hormones in nails can be used to elucidate endocrine diseases and thus help with their diagnosis and treatment. A liquid chromatographytandem mass spectrometry (LC-MS/MS) based method was developed for the simultaneous identification and quantification of 12 steroid hormones (aldosterone, cortisone, cortisol, corticosterone, 11deoxycortisol, androstenedione, testosterone, dehydroepiandrosterone (DHEA), 17-hydroxyprogesterone (17-OHP), dihydrotestosterone (DHT) and progesterone) in human fingernails. Steroid hormones were extracted from 0.5 mg -10 mg pulverized nail clippings by methanolic extraction, followed by a liquid-liquid extraction. The analysis was conducted with LC-MS/MS in electrospray ionization positive mode. The method was validated in terms of linearity, limit of detection (LOD), limit of quantification (LOQ), precision, accuracy, matrix effect, recovery and robustness. It was successfully applied for steroid profiling in nails of mothers and their infants where cortisol, cortisone, testosterone, progesterone, androstenedione and 11-deoxycorticosterone could be detected. Furthermore, it could be shown that there is no significant difference in concentrations between left and right hand for cortisol, cortisone and progesterone. A positive linear correlation between cortisol and cortisone in nails was found. In conclusion, it could be shown that nails are a suitable matrix for the retrospective monitoring of cumulative steroid hormone levels.Abstract: The retrospective analysis of endogenous steroid hormones in nails can be used to elucidate endocrine diseases and thus help with their diagnosis and treatment. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) based method was developed for the simultaneous identification and quantification of 12 steroid hormones (aldosterone, cortisone, cortisol, corticosterone, 11-deoxycortisol, androstenedione, 11-deoxycorticosterone, testosterone, dehydroepiandrosterone (DHEA), 17α-hydroxyprogesterone (17-OHP), dihydrotestosterone (DHT) and progesterone) in human fingernails. Steroid hormones were extracted from 0.5 mg -10 mg pulverized nail clippings by methanolic extraction, followed by a liquid-liquid extraction. The analysis was conducted with LC-MS/MS in electrospray ionization positive mode. The method was validated in terms of linearity, limit of detection (LOD), limit of quantification (LOQ), precision, accuracy, matrix effect, recovery and robustness. It was successfully applied for steroid profiling in nails of mothers and their infants where cortisol, cortisone, testosterone, progesterone, androstenedione and 11-deoxycorticosterone could be detected. Furthermore, it could be shown that there is no significant difference in concentrations between left and right hand for cortisol, cortisone and progesterone. A positive linear correlation between cortisol and cortisone in nails was found. In conclusion, it could be shown that nails are a suitable matrix for the retrospective monitoring of cumula...

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“…[4][5][6][7][8][9][10][11][12] Among the most relevant endocrine disorders in the context of HCC assays are Cushing's syndrome, Cushing's subclinical syndrome, Addison's disease, secondary adrenal insufficiency, and cortisol/hydrocortisone substitution. [13][14][15][16][17][18][19][20] Measurement of HCC seems to be a good alternative to the laboratory tests used thus far in diagnosing endocrine disorders, primarily due to its independence from the circadian rhythm of cortisol. Given the average hair growth of 1 cm per month, the results are related to average blood cortisol levels over the past weeks, months or years, depending on the length of the hair sample.…”

Section: Introductionmentioning

confidence: 99%

Hair cortisol concentration in a population without hypothalamic–pituitary–adrenal axis disorders

et al. 2018

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Background. Measuring hair cortisol seems to be a good alternative to laboratory tests used thus far in routine endocrine diagnostics, primarily because it is independent of the circadian rhythm of cortisol. Due to the average hair growth of 1 cm per month, the results are related to the average blood cortisol levels over the previous weeks, months or years (depending on the length of the hair sample). Objectives. The aim of this study is an attempt to apply hair cortisol concentration (HCC) measurements to clinical endocrine diagnostics, based on reference cortisol concentrations in the blood in a population without disorders of the hypothalamic-pituitary-adrenal axis (HPA). Material and methods. In the final selection process, 44 patients were enrolled in the study, all with negative interviews regarding disorders of the HPA and with reference levels of cortisol concentration obtained in routine laboratory tests. In the pre-analytic phase, we used 1 cm proximal hair strands cut from the posterior vertex area of the head, followed by the incubation of a 20 mg hair sample in methanol. The final cortisol measurement was done using an enzyme-linked immunosorbent assay (ELISA). Results. The results of HCC ranged from 2 pg/mg up to 51.63 pg/mg. The diurnal decrease in cortisol levels was significantly lower in females than in males (p = 0.031), but we do not consider that difference to be clinically significant. The difference in the HCC between males and females was not statistically significant (p = 0.767). The linear regression coefficient for age was not statistically significant (p = 0.847). Neither the regression coefficients for gender nor the gender and age interactions were statistically significant (p = 0.815). Conclusions. Hair cortisol concentration measurement, unlike other endocrinological tests, gives information about the cortisol concentration in the long-term perspective. The results obtained in this study may be used as a reference for further research aimed at determining normal values of HCC.

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Scalp hair cortisol for diagnosis of Cushing’s syndrome

Abstract: Analysis of cortisol in a single scalp hair sample offers diagnostic accuracy for CS similar to currently used first-line tests, and can be used to investigate cortisol exposure in CS patients months to years back in time, enabling the estimation of disease onset.

Cited by 34 publications

References 26 publications

Prenatal and childhood predictors of hair cortisol concentration in mid-childhood and early adolescence

Prenatal and childhood predictors of hair cortisol concentration in mid-childhood and early adolescence

Steroid profiling in nails using liquid chromatography-tandem mass spectrometry

Hair cortisol concentration in a population without hypothalamic–pituitary–adrenal axis disorders

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