Evening urinary free corticoids: a screening test in Cushing's syndrome and incidentally discovered adrenal tumours.
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 mumol/mol, whereas in patients with Cushing's syndrome (N = 20), they ranged from 27.5 to 855.5 mumol/mol. However, in 28% of patients with major obesity (greater than 50% overweight) and no hypercortisolism, the ratio values were between 9.4 to 27.8 mumol/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.
Laudat
M H
MH
Laboratoire d'Hormonologie, Hôpital Cochin, Paris, France.
Billaud
L
L
Thomopoulos
P
P
Vera
O
O
Yllia
A
A
Luton
J P
JP
D000305:Adrenal Cortex Hormones / Q000652:urine*; D000310:Adrenal Gland Neoplasms / Q000652:urine*; D000328:Adult; D002940:Circadian Rhythm; D003404:Creatinine / Q000652:urine; D003480:Cushing Syndrome / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000652:urine
D000305:Adrenal Cortex Hormones; D003404:Creatinine