Mini-review of hair cortisol concentration for evaluation of Cushing syndrome

Expert Review of Endocrinology & Metabolism
Aaron HodesMihail Zilbermint

Abstract

The diagnosis of endogenous Cushing syndrome is often challenging and requires multiple repeated blood, urine, and saliva tests to detect elevated cortisol levels. Hair cortisol concentration has been described as a marker of long-term exposure to systemic cortisol in patients with Cushing syndrome. Like hemoglobin A1c is used to detect serum glucose exposure over months, segmental hair cortisol can help identify patients with milder forms of and/or periodic or cyclical Cushing syndrome, which may reduce time and costs associated with collection of urine, salivary, and serum cortisol. Success of hair cortisol in detection of Cushing syndrome will be discussed in context of current literature, including differences between total or segmental hair cortisol in accurately determining timeline of cortisol exposure. Optimal methods of hair collection, storage, processing, and analysis and efforts toward standardization will be a major focus. Recent evidence suggests increased sensitivity and specificity of hair cortisol in detecting Cushing syndrome. Future guidelines should consider this test as a routine part of the repertoire of screening tests for Cushing syndrome. Possible confounders to explain discrepant results in the literat...Continue Reading

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Citations

Jul 23, 2019·The Journal of Clinical Endocrinology and Metabolism·Mesut SavasElisabeth F C van Rossum
Nov 16, 2019·Journal of Clinical Medicine·Hiroshi Nishioka, Shozo Yamada
Aug 13, 2020·Developmental Psychobiology·Jerrold S Meyer, Melinda A Novak
Feb 19, 2020·Annals of Laboratory Medicine·Gregori Casals, Felicia Alexandra Hanzu
May 11, 2021·Frontiers in Endocrinology·Renata Świątkowska-StodulskaKrzysztof Sworczak
Jun 8, 2021·European Journal of Clinical Investigation·Maria G FilippaMaria P Yavropoulou

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