Endocrinology and Metabolism

Original Articles

Clinical Study
Stimulated Salivary Cortisol as a Noninvasive Diagnostic Tool for Adrenal Insufficiency: Yoon Ji Kim, Jung Hee Kim, A Ram Hong, Kyeong Seon Park, Sang Wan Kim, Chan Soo Shin, Seong Yeon Kim; Endocrinol Metab. 2020;35(3):628-635. Published online September 22, 2020; DOI: https://doi.org/10.3803/EnM.2020.707

5,856 View
203 Download
12 Web of Science
12 Crossref

Background
Salivary cortisol is routinely used as a diagnostic test for Cushing syndrome. The diagnostic use of salivary cortisol for adrenal insufficiency (AI), however, is less established. We aimed to investigate the utility of morning basal and adrenocorticotropic hormone-stimulated salivary cortisol in diagnosing AI in Korean adults.
Methods
We prospectively included 120 subjects (female, n=70) from Seoul National University Hospital. AI was defined as a stimulated serum cortisol level of <496.8 nmol/L during the short Synacthen test (SST). Serum and saliva samples were drawn between 8:00 AM and 10:00 AM. Salivary cortisol levels were measured using an enzyme immunoassay kit.
Results
Thirty-four patients were diagnosed with AI according to the SST results. Age, sex, body mass index, serum albumin levels, and serum creatinine levels did not significantly differ between the normal and AI groups. Basal and stimulated salivary cortisol levels were positively correlated with basal (r=0.538) and stimulated serum cortisol levels (r=0.750), respectively (all P<0.001). Receiver operating characteristic curve analysis yielded a cutoff level of morning basal salivary cortisol of 3.2 nmol/L (sensitivity, 84.9%; specificity, 73.5%; area under the curve [AUC]=0.822). The optimal cutoff value of stimulated salivary cortisol was 13.2 nmol/L (sensitivity, 90.7%; specificity, 94.1%; AUC=0.959). Subjects with a stimulated salivary cortisol level above 13.2 nmol/L but a stimulated serum cortisol level below 496.8 nmol/L (n=2) had lower serum albumin levels than those showing a concordant response.
Conclusion
The diagnostic performance of stimulated salivary cortisol measurements after the SST was comparable to serum cortisol measurements for diagnosing AI.

Citations

Citations to this article as recorded by

Extensive expertise in endocrinology: adrenal crisis in assisted reproduction and pregnancy
Ulla Feldt-Rasmussen
European Journal of Endocrinology.2024; 190(1): R10. CrossRef
Turning Antibodies into Ratiometric Bioluminescent Sensors for Competition-Based Homogeneous Immunoassays
Eva A. van Aalen, Joep J. J. Lurvink, Leandra Vermeulen, Benice van Gerven, Yan Ni, Remco Arts, Maarten Merkx
ACS Sensors.2024; 9(3): 1401. CrossRef
A Contemporary Approach to the Diagnosis and Management of Adrenal Insufficiency
Suranut Charoensri, Richard J. Auchus
Endocrinology and Metabolism.2024; 39(1): 73. CrossRef
Diagnostic strategies in adrenal insufficiency
Vasiliki Siampanopoulou, Elisavet Tasouli, Anna Angelousi
Current Opinion in Endocrinology, Diabetes & Obesity.2023; 30(3): 141. CrossRef
The association between neuropeptide oxytocin and neuropsychiatric disorders after orthopedic surgery stress in older patients
Wanru Dong, Zengbo Ding, Xiao Wu, Ran Wan, Ying Liu, Liubao Pei, Weili Zhu
BMC Geriatrics.2023;[Epub] CrossRef
The Reliability of Salivary Cortisol Compared to Serum Cortisol for Diagnosing Adrenal Insufficiency with the Gold Standard ACTH Stimulation Test in Children
Silvia Ciancia, Sjoerd A. A. van den Berg, Erica L. T. van den Akker
Children.2023; 10(9): 1569. CrossRef
РІВЕНЬ СТРЕСУ В ДІТЕЙ ШКІЛЬНОГО ВІКУ З COVID-19
Г. А. Павлишин, О. І. Панченко
Здобутки клінічної і експериментальної медицини.2023; (4): 119. CrossRef
Secondary adrenal suppression related to high doses of inhaled corticosteroids in patients with severe asthma
Mariana Lobato, João Gaspar-Marques, Pedro Carreiro-Martins, Paula Leiria-Pinto
Annals of Allergy, Asthma & Immunology.2022; 128(4): 464. CrossRef
Clinical and Technical Aspects in Free Cortisol Measurement
Man Ho Choi
Endocrinology and Metabolism.2022; 37(4): 599. CrossRef
Continuous biomarker monitoring with single molecule resolution by measuring free particle motion
Alissa D. Buskermolen, Yu-Ting Lin, Laura van Smeden, Rik B. van Haaften, Junhong Yan, Khulan Sergelen, Arthur M. de Jong, Menno W. J. Prins
Nature Communications.2022;[Epub] CrossRef
Reversible Immunosensor for the Continuous Monitoring of Cortisol in Blood Plasma Sampled with Microdialysis
Laura van Smeden, Annet Saris, Khulan Sergelen, Arthur M. de Jong, Junhong Yan, Menno W. J. Prins
ACS Sensors.2022; 7(10): 3041. CrossRef
Adrenal insufficiency in HIV/AIDS: a review
Simon Mifsud, Zachary Gauci, Mark Gruppetta, Charles Mallia Azzopardi, Stephen Fava
Expert Review of Endocrinology & Metabolism.2021; 16(6): 351. CrossRef

Clinical Study
Impaired Cortisol and Growth Hormone Counterregulatory Responses among Severe Hypoglycemic Patients with Type 2 Diabetes Mellitus: Young A Rhyu, Ju-Young Jang, Sooyoun Park, Jee Hyun An, Dong-Lim Kim, Suk Kyeong Kim, Kee-Ho Song; Endocrinol Metab. 2019;34(2):187-194. Published online June 24, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.187

5,028 View
75 Download
10 Web of Science
12 Crossref

Abstract PDF PubReader ePub

Background

Elevated levels of cortisol and growth hormone are critical counterregulatory responses to severe hypoglycemia. However, the proportion and clinical characteristics of patients with type 2 diabetes mellitus (DM) who fail to show appropriate cortisol and/or growth hormone secretion in response to severe hypoglycemia have not been investigated.

Methods

We measured plasma cortisol and growth hormone levels in type 2 DM patients with severe hypoglycemia who visited the emergency department between 2006 and 2015.

Results

Of 112 hypoglycemic patients, 23 (20.5%) had an impaired cortisol response (<18 µg/dL) and 82 patients (73.2%) had an impaired growth hormone response (<5 ng/mL). Nineteen patients (17.0%) had impaired responses to both cortisol and growth hormone. The patients with impaired responses of cortisol, growth hormone, and both hormones were significantly older and more likely to be female, and had higher admission rates, lower growth hormone levels, and lower adrenocorticotropic hormone levels than the patients with a normal hormonal response. Multivariate logistic regression analysis indicated that an impaired growth hormone response was significantly associated with advanced age, shorter DM duration, a higher admission rate, and a higher body mass index (BMI). An impaired cortisol response was significantly associated with growth hormone levels. Patients with an impaired growth hormone response had higher admission rates than patients with a normal response.

Conclusion

A considerable number of type 2 DM patients had impaired cortisol and/or growth hormone responses to severe hypoglycemia. Advanced age, shorter DM duration, and higher BMI were independently associated with an abnormal growth hormone response.

Citations

Citations to this article as recorded by

The deleterious effects of sofosbuvir and ribavirin (antiviral drugs against hepatitis C virus) on different body systems in male albino rats regarding reproductive, hematological, biochemical, hepatic, and renal profiles and histopathological changes
Rana A. Ali, Eatemad A. Awadalla, Yahia A. Amin, Samer S. Fouad, Maha Abd-El Baki Ahmed, Mohammed H. Hassan, Emaad Abdel-Kahaar, Rehab H. Abdel-Aziz
Scientific Reports.2024;[Epub] CrossRef
Prediabetes and mild hepatosteatosis are associated with blunted cortisol response to glucagon but not to growth hormone
Ozlem Deveci, Zuleyha Karaca, Fatih Tanriverdi, Kamil Deveci, Aysa Hacioglu, Kursad Unluhizarci, Fahrettin Kelestimur
Annales d'Endocrinologie.2023; 84(2): 254. CrossRef
Evaluación del cortisol plasmático durante el test de ayuno en pacientes con síndrome hipoglucémico por hiperinsulinismo endógeno. Experiencia de 15 años
María Eugenia Gullace, María Victoria Ortuño, Teresa Mabel Canteros, Belén Bosco, Cintia Rodriguez, Javier Giunta, Lucas Costa, Andrea Kozak, Valeria de Miguel, Luis Grosembacher
Endocrinología, Diabetes y Nutrición.2023; 70(10): 634. CrossRef
Evaluation of plasma cortisol during fasting test in patients with endogenous hyperinsulinemic hypoglycemia. Fifteen years experience
María Eugenia Gullace, María Victoria Ortuño, Teresa Mabel Canteros, Belén Bosco, Cintia Rodriguez, Javier Giunta, Lucas Costa, Andrea Kozak, Valeria de Miguel, Luis Grosembacher
Endocrinología, Diabetes y Nutrición (English ed.).2023; 70(10): 634. CrossRef
Cerebrospinal fluid levels of hypothalamic-pituitary-adrenal axis hormones in MCI and dementia due to Alzheimer’s disease: a systematic review
Felipe Duarte-Zambrano, Jorge A. Barrero, Ismena Mockus
Dementia & Neuropsychologia.2023;[Epub] CrossRef
PTEN Deletion in Adult Mice Induces Hypoinsulinemia With Concomitant Low Glucose Levels
Maria Crespo-Masip, Aurora Pérez-Gómez, Carla Guzmán, Sandra Rayego, Nuria Doladé, Alicia García-Carrasco, Ramiro Jover, José Manuel Valdivielso
Frontiers in Endocrinology.2022;[Epub] CrossRef
Beta Blockers can Mask not only Hypoglycemia but also Hypotension
Goran Koracevic, Sladjana Micic, Milovan Stojanovic, Radmila Velickovic Radovanovic, Milan Pavlovic, Tomislav Kostic, Dragan Djordjevic, Nebojsa Antonijevic, Maja Koracevic, Vesna Atanaskovic, Sonja Dakic
Current Pharmaceutical Design.2022; 28(20): 1660. CrossRef
Atherosclerosis Risk Factors in Patients with Reactive Hypoglycemia
Małgorzata Landowska, Agata Żebrowska, Konrad Fajer, Patrycja Adamek, Aleksandra Kruk, Bernadetta Kałuża, Edward Franek
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 3133. CrossRef
Depression with Comorbid Diabetes: What Evidence Exists for Treatments Using Traditional Chinese Medicine and Natural Products?
Yanting Lu, Tao An, Hu Tian, Xueqin Gao, Furong Wang, Shijun Wang, Ke Ma
Frontiers in Pharmacology.2021;[Epub] CrossRef
Hepatocyte-specific glucose-6-phosphatase deficiency disturbs platelet aggregation and decreases blood monocytes upon fasting-induced hypoglycemia
Anouk M. La Rose, Venetia Bazioti, Joanne A. Hoogerland, Arthur F. Svendsen, Anouk G. Groenen, Martijn van Faassen, Martijn G.S. Rutten, Niels J. Kloosterhuis, Bertien Dethmers-Ausema, J. Hendrik Nijland, Gilles Mithieux, Fabienne Rajas, Folkert Kuipers,
Molecular Metabolism.2021; 53: 101265. CrossRef
Effects of tofogliflozin on adrenocorticotropic hormone, renin and aldosterone, and cortisol levels in elderly patients with diabetes mellitus
Toshihiro Higashikawa, Tomohiko Ito, Takurou Mizuno, Keiichirou Ishigami, Kengo Kuroki, Naoto Maekawa, Daisuke Usuda, Takuro Morita, Kazu Hamada, Susumu Takagi, Kento Takeshima, Shinya Yamada, Ryusho Sangen, Toshihide Izumida, Hideyuki Mori, Jun Kiyosawa,
Medicine.2021; 100(45): e27638. CrossRef
Stress, glucocorticoid signaling pathway, and metabolic disorders
Roldan M. de Guia
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2020; 14(5): 1273. CrossRef

Review Article

Adrenal gland
Recent Updates on the Diagnosis and Management of Cushing's Syndrome: Lynnette K. Nieman; Endocrinol Metab. 2018;33(2):139-146. Published online June 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.2.139

12,035 View
746 Download
50 Web of Science
48 Crossref

Abstract PDF PubReader ePub

Cushing's syndrome, a potentially lethal disorder characterized by endogenous hypercortisolism, may be difficult to recognize, especially when it is mild and the presenting features are common in the general population. However, there is a need to identify the condition at an early stage, as it tends to progress, accruing additional morbidity and increasing mortality rates. Once a clinical suspicion is raised, screening tests involve timed measurement of urine, serum or salivary cortisol at baseline or after administration of dexamethasone, 1 mg. Each test has caveats, so that the choice of tests must be individualized for each patient. Once the diagnosis is established, and the cause is determined, surgical resection of abnormal tumor/tissue is the optimal treatment. When this cannot be achieved, medical treatment (or bilateral adrenalectomy) must be used to normalize cortisol production. Recent updates in screening for and treating Cushing's syndrome are reviewed here.

Citations

Citations to this article as recorded by

Steroid as a Saviour and Culprit in Pemphigus Vulgaris Therapy: A Rare Case Series
Deepthi Avvaru, Raushan Kumar Chaudhary, Bhavana Doshi, Ramesh Bhandari
Current Drug Therapy.2024; 19(3): 360. CrossRef
Considerations for cutaneous physiologic changes of pregnancy that fail to resolve postpartum
Madison J. Anzelc, Mark A. Bechtel
International Journal of Dermatology.2023; 62(2): 190. CrossRef
Hypertension in Turner syndrome: a review of proposed mechanisms, management and new directions
Lily Jones, Joanne Blair, Daniel B. Hawcutt, Gregory Y.H. Lip, Alena Shantsila
Journal of Hypertension.2023; 41(2): 203. CrossRef
Methyl-Prednisolone and Betamethasone Induced Iatrogenic Cushing Syndrome - A Rare Case Report
Faaiz Khan, Jumana Hakeem, Mitta Raghavendra, Sushanta Kumar Das, Vallala Venakata Rajesham, Tadikonda Rama Rao
International Journal of Pharmaceutical Research and Allied Sciences.2023; 12(2): 40. CrossRef
Toward Systems-Level Metabolic Analysis in Endocrine Disorders and Cancer
Aliya Lakhani, Da Hyun Kang, Yea Eun Kang, Junyoung O. Park
Endocrinology and Metabolism.2023; 38(6): 619. CrossRef
Metabolic profile differences in ACTH‐dependent and ACTH‐independent Cushing syndrome
Zhengyang Li, Chen Zhang, Chong Geng, Yongfeng Song
Chronic Diseases and Translational Medicine.2022; 8(1): 36. CrossRef
Stressing the need for validated measures of cortisol in HIV research: A scoping review
Shayda A. Swann, Elizabeth M. King, Hélène C. F. Côté, Melanie C. M. Murray
HIV Medicine.2022; 23(8): 880. CrossRef
Concomitant coexistence of ACTH‐dependent and independent Cushing syndrome
Ach Taieb, Saad Ghada, Gorchène Asma, Ben Abdelkrim Asma, Kacem Maha, Ach Koussay
Clinical Case Reports.2022;[Epub] CrossRef
Incretin Response to Mixed Meal Challenge in Active Cushing’s Disease and after Pasireotide Therapy
Mattia Barbot, Alessandro Mondin, Daniela Regazzo, Valentina Guarnotta, Daniela Basso, Carla Giordano, Carla Scaroni, Filippo Ceccato
International Journal of Molecular Sciences.2022; 23(9): 5217. CrossRef
Intermittent Blurry Vision: An Unexpected Presentation of Cushing’s Syndrome Due to Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH)
Christopher Fernandez, Smriti Bhatia, Ariana Rucker, Lee Celio
Cureus.2022;[Epub] CrossRef
Recurrent Metatarsal Fractures in a Patient With Cushing Disease: A Case Report
Jose Iturregui, Glenn Shi
Cureus.2022;[Epub] CrossRef
Recognising and diagnosing Cushing’s syndrome in primary care: challenging but not impossible
Kate Scoffings, Damian Morris, Andrew Pullen, Sharon Temple, Anna Trigell, Mark Gurnell
British Journal of General Practice.2022; 72(721): 399. CrossRef
Recurrent Cushing Syndrome From Metastatic Adrenocortical Carcinoma With Fumarate Hydratase Allelic Variant
Emily Silverman, Noor Addasi, Muaataz Azzawi, Ernesto Martinez Duarte, Dali Huang, Benjamin Swanson, Apar Kishor Ganti, Gwen Reiser, Abbey L. Fingeret, Anupam Kotwal
AACE Clinical Case Reports.2022; 8(6): 259. CrossRef
Multiple Bone Fractures in a Patient With Difficult-to-Treat Cushing’s Disease
Sara Correia, Diogo Ramalho, Gustavo Rocha, Maria J Oliveira
Cureus.2022;[Epub] CrossRef
Management of patients on systemic steroids: An oral surgery perspective
Vikash Patel, Shrina Nathwani, Naomi Rahman
Dental Update.2022; 49(9): 749. CrossRef
Importancia del cateterismo de senos petrosos inferiores en el diagnóstico de síndrome de Cushing, a propósito de un caso
Clara Jiménez García, Paula Sirera Sirera, María Eugenia Torregrosa Quesada, Victoria González Bueno, Rocío Alfayate Guerra
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio.2022; 3(4): 411. CrossRef
Cushing's Syndrome Behind Hypokalemia and Severe Infection: A Case Report
Catarina Elias, Diana Oliveira, Maria Manuel Silva, Patrícia Lourenço
Cureus.2022;[Epub] CrossRef
Relevance of inferior petrosal sinus sampling in the diagnosis of Cushing’s syndrome: a case report
Clara Jiménez García, Paula Sirera Sirera, María Eugenia Torregrosa Quesada, Victoria González Bueno, Rocío Alfayate Guerra
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio.2022; 3(4): 407. CrossRef
Proximal muscle weakness as the sole manifestation of Cushing’s disease, misdiagnosed as dermatomyositis: a case report
Marjan Jeddi, Mesbah Shams
Journal of Medical Case Reports.2022;[Epub] CrossRef
Differences in outcomes of bilateral adrenalectomy in patients with ectopic ACTH producing tumor of known and unknown origin
Thomas Szabo Yamashita, Alaa Sada, Irina Bancos, William F. Young, Benzon M Dy, David R. Farley, Melanie L. Lyden, Geoffrey B. Thompson, Travis J. McKenzie
The American Journal of Surgery.2021; 221(2): 460. CrossRef
A key role for conservative treatment in the management of pituitary apoplexy
Claire Marx, Muriel Rabilloud, Françoise Borson Chazot, Caroline Tilikete, Emmanuel Jouanneau, Gerald Raverot
Endocrine.2021; 71(1): 168. CrossRef
7-T Magnetic Resonance Imaging in the Management of Brain Tumors
Melanie A. Morrison, Janine M. Lupo
Magnetic Resonance Imaging Clinics of North America.2021; 29(1): 83. CrossRef
Medical therapy in severe hypercortisolism
Júlia Vieira Oberger Marques, Cesar Luiz Boguszewski
Best Practice & Research Clinical Endocrinology & Metabolism.2021; 35(2): 101487. CrossRef
Metabolic changes in serum steroids for diagnosing and subtyping Cushing’s syndrome
Chang Ho Ahn, Chaelin Lee, Jaeyoon Shim, Sung Hye Kong, Su-jin Kim, Yong Hwy Kim, Kyu Eun Lee, Chan Soo Shin, Jung Hee Kim, Man Ho Choi
The Journal of Steroid Biochemistry and Molecular Biology.2021; 210: 105856. CrossRef
Method-Specific Cortisol and Dexamethasone Thresholds Increase Clinical Specificity of the Dexamethasone Suppression Test for Cushing Syndrome
Nora Vogg, Max Kurlbaum, Timo Deutschbein, Benedict Gräsl, Martin Fassnacht, Matthias Kroiss
Clinical Chemistry.2021; 67(7): 998. CrossRef
Untargeted Plasma Metabolomics Unravels a Metabolic Signature for Tissue Sensitivity to Glucocorticoids in Healthy Subjects: Its Implications in Dietary Planning for a Healthy Lifestyle
Nicolas C. Nicolaides, Maria-Konstantina Ioannidi, Eleni Koniari, Ifigeneia Papageorgiou, Anastasia Bartzeliotou, Amalia Sertedaki, Maria I. Klapa, Evangelia Charmandari
Nutrients.2021; 13(6): 2120. CrossRef
Endocrine hypertension secondary to adrenal tumors: clinical course and predictive factors of clinical remission
Uriel Clemente-Gutiérrez, Rafael H. Pérez-Soto, Juan D. Hernández-Acevedo, Nicole M. Iñiguez-Ariza, Enrique Casanueva-Pérez, Juan Pablo Pantoja-Millán, Mauricio Sierra-Salazar, Miguel F. Herrera, David Velázquez-Fernández
Langenbeck's Archives of Surgery.2021; 406(6): 2027. CrossRef
Development of 68Ga DOTA-CRH for PET/CT Imaging of ACTH-Dependent Cushing's Disease: Initial Study
Jaya Shukla, Rakhee Vatsa, Rama Walia, Anupriya Chhabra, Nivedita Rana, Harmandeep Singh, Rajender Kumar, Bhagwant Rai Mittal
Cancer Biotherapy and Radiopharmaceuticals.2021; 36(8): 642. CrossRef
Cushing Syndrome Associated Myopathy: It Is Time for a Change
Martin Reincke
Endocrinology and Metabolism.2021; 36(3): 564. CrossRef
Cushing’s disease presenting with psychosis
Ahmed Saeed Mubarak Mohamed, Ahmed Iqbal, Suveera Prasad, Nigel Hoggard, Daniel Blackburn
Practical Neurology.2021; 21(4): 351. CrossRef
ACTH-independent Cushing's syndrome due to bilateral adrenocortical adenoma: A case report
Majd Sharaf, Rama Al-Saqqa, Mouhammad Kourabi
Radiology Case Reports.2021; 16(11): 3168. CrossRef
A New Clinical Model to Estimate the Pre-Test Probability of Cushing’s Syndrome: The Cushing Score
Mirko Parasiliti-Caprino, Fabio Bioletto, Tommaso Frigerio, Valentina D’Angelo, Filippo Ceccato, Francesco Ferraù, Rosario Ferrigno, Marianna Minnetti, Carla Scaroni, Salvatore Cannavò, Rosario Pivonello, Andrea Isidori, Fabio Broglio, Roberta Giordano, M
Frontiers in Endocrinology.2021;[Epub] CrossRef
Bilateral Adrenalectomy: Differences between Cushing Disease and Ectopic ACTH-Producing Tumors
Thomas Szabo Yamashita, Alaa Sada, Irina Bancos, William F. Young, Benzon M. Dy, David R. Farley, Melanie L. Lyden, Geoffrey B. Thompson, Travis J. McKenzie
Annals of Surgical Oncology.2020; 27(10): 3851. CrossRef
Decision-Making in Artificial Intelligence: Is It Always Correct?
Hun-Sung Kim
Journal of Korean Medical Science.2020;[Epub] CrossRef
Cushing's syndrome: Overview of clinical presentation, diagnostic tools and complications
Mattia Barbot, Marialuisa Zilio, Carla Scaroni
Best Practice & Research Clinical Endocrinology & Metabolism.2020; 34(2): 101380. CrossRef
Cortisol Measurements in Cushing’s Syndrome: Immunoassay or Mass Spectrometry?
Gregori Casals, Felicia Alexandra Hanzu
Annals of Laboratory Medicine.2020; 40(4): 285. CrossRef
Cardiopatías de origen endocrino: una etiología frecuentemente olvidada
Laura Duque-González, Luis Miguel Ruiz-Velásquez, José Luis Torres-Grajales, Mauricio Duque-Ramírez
Medicina y Laboratorio.2020; 24(3): 207. CrossRef
Reference ranges of late-night salivary cortisol and cortisone measured by LC–MS/MS and accuracy for the diagnosis of Cushing’s syndrome
F. Ponzetto, F. Settanni, M. Parasiliti-Caprino, F. Rumbolo, A. Nonnato, M. Ricciardo, E. Amante, G. Priolo, S. Vitali, L. Anfossi, E. Arvat, E. Ghigo, R. Giordano, G. Mengozzi
Journal of Endocrinological Investigation.2020; 43(12): 1797. CrossRef
Assessment of 1 mg Dexamethasone Suppression Test in Patients with Obesity Before Bariatric Surgery
Dilek Gogas Yavuz, Tugce Apaydin, Hatice Gizem Gunhan, Meliha Melin Uygur
Obesity Surgery.2020; 30(12): 4981. CrossRef
Prospective Evaluation of Late-Night Salivary Cortisol and Cortisone by EIA and LC-MS/MS in Suspected Cushing Syndrome
Joshua Kannankeril, Ty Carroll, James W Findling, Bradley Javorsky, Ian L Gunsolus, Jonathan Phillips, Hershel Raff
Journal of the Endocrine Society.2020;[Epub] CrossRef
Infantile Iatrogenic Cushing Syndrome due to Topical Steroids
Lulwah Alkhuder, Horia Mawlawi
Case Reports in Pediatrics.2019; 2019: 1. CrossRef
Synchronous bilateral adrenalectomy in ACTH-dependent hypercortisolism: predictors, biomarkers and outcomes
S. Chiloiro, A. Giampietro, M. Raffaelli, G. D’Amato, C. Bima, L. Lauretti, C. Anile, C. P. Lombardi, G. Rindi, R. Bellantone, L. De Marinis, A. Pontecorvi, A. Bianchi
Endocrine.2019; 66(3): 642. CrossRef
Low-dose etomidate for the management of severe hypercortisolaemia in different clinical scenarios: a case series and review of the literature
Agnieszka Łebek-Szatańska, Karolina M. Nowak, Wojciech Zgliczyński, Elżbieta Baum, Agnieszka Żyłka, Lucyna Papierska
Therapeutic Advances in Endocrinology and Metabolism.2019; 10: 204201881982554. CrossRef
Drug design strategies for Cushing’s syndrome
S. A. Usanov, A. V. Kliuchenovich, N. V. Strushkevich
Expert Opinion on Drug Discovery.2019; 14(2): 143. CrossRef
Pharmacological and analytical interference in hormone assays for diagnosis of adrenal incidentaloma
Antoine-Guy Lopez, François Fraissinet, Herve Lefebvre, Valéry Brunel, Frédéric Ziegler
Annales d'Endocrinologie.2019; 80(4): 250. CrossRef
Emerging Role of USP8, HMGA, and Non-Coding RNAs in Pituitary Tumorigenesis
Daniela D’Angelo, Marco De Martino, Claudio Arra, Alfredo Fusco
Cancers.2019; 11(9): 1302. CrossRef
Glucocorticoid Receptor Antagonist Administration Prevents Adrenal Gland Atrophy in an ACTH-Independent Cushing’s Syndrome Rat Model
Atsushi Yasuda, Toshiro Seki, Yoshie Kametani, Masahiro Koizumi, Natsumi Kitajima, Masayuki Oki, Masami Seki, Takatoshi Kakuta, Masafumi Fukagawa
International Journal of Endocrinology.2019; 2019: 1. CrossRef
Cushing’s Disease
Nishioka, Yamada
Journal of Clinical Medicine.2019; 8(11): 1951. CrossRef

Original Articles

Clinical Study
The Eosinophil Count Tends to Be Negatively Associated with Levels of Serum Glucose in Patients with Adrenal Cushing Syndrome: Younghak Lee, Hyon-Seung Yi, Hae Ri Kim, Kyong Hye Joung, Yea Eun Kang, Ju Hee Lee, Koon Soon Kim, Hyun Jin Kim, Bon Jeong Ku, Minho Shong; Endocrinol Metab. 2017;32(3):353-359. Published online September 18, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.3.353

7,711 View
46 Download
6 Web of Science
6 Crossref

Abstract PDF PubReader

Background

Cushing syndrome is characterized by glucose intolerance, cardiovascular disease, and an enhanced systemic inflammatory response caused by chronic exposure to excess cortisol. Eosinopenia is frequently observed in patients with adrenal Cushing syndrome, but the relationship between the eosinophil count in peripheral blood and indicators of glucose level in patients with adrenal Cushing syndrome has not been determined.

Methods

A retrospective study was undertaken of the clinical and laboratory findings of 40 patients diagnosed with adrenal Cushing syndrome at Chungnam National University Hospital from January 2006 to December 2016. Clinical characteristics, complete blood cell counts with white blood cell differential, measures of their endocrine function, description of imaging studies, and pathologic findings were obtained from their medical records.

Results

Eosinophil composition and count were restored by surgical treatment of all of the patients with adrenal Cushing disease. The eosinophil count was inversely correlated with serum and urine cortisol, glycated hemoglobin, and inflammatory markers in the patients with adrenal Cushing syndrome.

Conclusion

Smaller eosinophil populations in patients with adrenal Cushing syndrome tend to be correlated with higher levels of blood sugar and glycated hemoglobin. This study suggests that peripheral blood eosinophil composition or count may be associated with serum glucose levels in patients with adrenal Cushing syndrome.

Citations

Citations to this article as recorded by

Association between Eosinophil Count and Cortisol Concentrations in Equids Admitted in the Emergency Unit with Abdominal Pain
María Villalba-Orero, María Dolores Contreras-Aguilar, Jose Joaquín Cerón, Beatriz Fuentes-Romero, Marta Valero-González, María Martín-Cuervo
Animals.2024; 14(1): 164. CrossRef
Inverse relationship between eosinophil profiles and serum glucose concentration in dogs with naturally occurring hypercortisolism
Jimin Oh, Dohee Lee, Taesik Yun, Yoonhoi Koo, Yeon Chae, Mhan-Pyo Yang, Byeong-Teck Kang, Hakhyun Kim
Domestic Animal Endocrinology.2022; 80: 106727. CrossRef
Serum Cortisol and Its Correlation with Leucocyte Profile and Circulating Lipids in Donkeys (Equus asinus)
Daniela Alberghina, Alessandra Statelli, Vincenzo Monteverde, Irene Vazzana, Giuseppe Cascone, Michele Panzera
Animals.2022; 12(7): 841. CrossRef
Changes in leukocytes and CRP in different stages of major depression
Deepti Singh, Paul C. Guest, Henrik Dobrowolny, Veronika Vasilevska, Gabriela Meyer-Lotz, Hans-Gert Bernstein, Katrin Borucki, Alexandra Neyazi, Bernhard Bogerts, Roland Jacobs, Johann Steiner
Journal of Neuroinflammation.2022;[Epub] CrossRef
HIF1α is a direct regulator of steroidogenesis in the adrenal gland
Deepika Watts, Johanna Stein, Ana Meneses, Nicole Bechmann, Ales Neuwirth, Denise Kaden, Anja Krüger, Anupam Sinha, Vasileia Ismini Alexaki, Luis Gustavo Perez-Rivas, Stefan Kircher, Antoine Martinez, Marily Theodoropoulou, Graeme Eisenhofer, Mirko Peitz
Cellular and Molecular Life Sciences.2021; 78(7): 3577. CrossRef
The Immune System in Cushing’s Syndrome
Valeria Hasenmajer, Emilia Sbardella, Francesca Sciarra, Marianna Minnetti, Andrea M. Isidori, Mary Anna Venneri
Trends in Endocrinology & Metabolism.2020; 31(9): 655. CrossRef

Clinical Study
The Recovery of Hypothalamic-Pituitary-Adrenal Axis Is Rapid in Subclinical Cushing Syndrome: Hee Kyung Kim, Jee Hee Yoon, Yun Ah Jeong, Ho-Cheol Kang; Endocrinol Metab. 2016;31(4):592-597. Published online December 20, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.592

3,678 View
45 Download
8 Web of Science
8 Crossref

Abstract PDF PubReader

Background

In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown.

Methods

Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively. Patients were treated with glucocorticoid after adrenalectomy and were reevaluated every 1 to 6 months using a rapid adrenocorticotropic hormone (ACTH) stimulation test.

Results

Levels of basal 24-hour urine free cortisol (UFC), serum cortisol after an overnight dexamethasone suppression test (DST), and serum cortisol and 24-hour UFC after low-dose DST and high-dose DST were all significantly lower in patients with SC compared with OC. Basal ACTH levels showed significantly higher in patients with SC compared with OC. The probability of recovering adrenal function during follow-up differed significantly between patients with OC and SC (P=0.001), with significant correlations with the degree of preoperative cortisol excess. Patients with OC required a longer duration of glucocorticoid replacement to recover a normal ACTH stimulation test compared with patients with SC (median 17.0 months vs. 4.0 months, P<0.001).

Conclusion

The HPA axis recovery time after adrenalectomy in patients with SC is rapid and is dependent on the degree of cortisol excess. More precise definition of SC is necessary to achieve a better management of patients and to avoid the risk of under- or over-treatment of SC patients.

Citations

Citations to this article as recorded by

Hypothalamic–pituitary–adrenal axis recovery after treatment of Cushing's syndrome
Annemarie Balasko, Karin Zibar Tomsic, Darko Kastelan, Tina Dusek
Journal of Neuroendocrinology.2022;[Epub] CrossRef
Early assessment of postoperative adrenal function is necessary after adrenalectomy for mild autonomous cortisol secretion
Trenton Foster, Irina Bancos, Travis McKenzie, Benzon Dy, Geoffrey Thompson, Melanie Lyden
Surgery.2021; 169(1): 150. CrossRef
Is Prophylactic Steroid Treatment Mandatory for Subclinical Cushing Syndrome After Unilateral Laparoscopic Adrenalectomy?
Dong Wang, Han-zhong Li, Yu-shi Zhang, Liang Wang, Zhi-gang Ji
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2019; 29(1): 31. CrossRef
When to Intervene for Subclinical Cushing's Syndrome
Lily B. Hsieh, Erin Mackinney, Tracy S. Wang
Surgical Clinics of North America.2019; 99(4): 747. CrossRef
Serum Cortisol Levels via Radioimmunoassay vs Liquid Chromatography Mass Spectrophotometry in Healthy Control Subjects and Patients With Adrenal Incidentalomas
Martha K P Huayllas, Brian C Netzel, Ravinder J Singh, Claudio E Kater
Laboratory Medicine.2018;[Epub] CrossRef
Contralateral adrenal width predicts the duration of prolonged post‐surgical steroid replacement for subclinical Cushing syndrome
Masahiro Sugiura, Yusuke Imamura, Koji Kawamura, Satoshi Yamamoto, Tomokazu Sazuka, Kazuyoshi Nakamura, Shinichi Sakamoto, Hidekazu Nagano, Hisashi Koide, Tomoaki Tanaka, Takashi Imamoto, Akira Komiya, Tomohiko Ichikawa
International Journal of Urology.2018; 25(6): 583. CrossRef
Predictability of hypoadrenalism occurrence and duration after adrenalectomy for ACTH-independent hypercortisolism
V. Morelli, L. Minelli, C. Eller-Vainicher, S. Palmieri, E. Cairoli, A. Spada, M. Arosio, I. Chiodini
Journal of Endocrinological Investigation.2018; 41(4): 485. CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef

First
Prev
Page of 1
Next
Last

Search