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Non-conjugated versus total urinary cortisol in the diagnosis of Cushing's syndrome. 1998

M B Kohek, and W Nicolau, and B B Mendonca
Unit of Developmental Endocrinology, Hospital das Clínicas da FMUSP, São Paulo, Brazil.

The radioimmunoassay of, urinary cortisol extracted by organic solvent (non-conjugated cortisol) has been used in the diagnosis of hypercortisolism for a long time. With the development of more specific antisera it became possible to measure urinary cortisol without extraction (total urinary cortisol). We compared both methods in the hypercortisolism diagnosis. Basal 24-hour urinary cortisol levels from 43 normal subjects, 53 obese patients and 53 Cushing's syndrome patients were measured. Urinary cortisol levels were not statistically different in normal and obese group in either methods (p > 0.05). There was a significant difference for the Cushing's syndrome group in relation to the normal and obese groups in both methods (p < 0.05). Sensitivity was similar for both methods and a positive correlation was noticed in the three groups. We conclude that both methods are efficient for the diagnosis of hypercortisolism but we suggest that total urinary cortisol should be the first choice to diagnose Cushing's syndrome considering its advantages such as low cost and feasibility.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003480 Cushing Syndrome A condition caused by prolonged exposure to excess levels of cortisol (HYDROCORTISONE) or other GLUCOCORTICOIDS from endogenous or exogenous sources. It is characterized by upper body OBESITY; OSTEOPOROSIS; HYPERTENSION; DIABETES MELLITUS; HIRSUTISM; AMENORRHEA; and excess body fluid. Endogenous Cushing syndrome or spontaneous hypercortisolism is divided into two groups, those due to an excess of ADRENOCORTICOTROPIN and those that are ACTH-independent. Cushing's Syndrome,Hypercortisolism,Syndrome, Cushing,Syndrome, Cushing's
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006854 Hydrocortisone The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. Cortef,Cortisol,Pregn-4-ene-3,20-dione, 11,17,21-trihydroxy-, (11beta)-,11-Epicortisol,Cortifair,Cortril,Epicortisol,Hydrocortisone, (11 alpha)-Isomer,Hydrocortisone, (9 beta,10 alpha,11 alpha)-Isomer,11 Epicortisol
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity

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