Endocrine Abstracts (2011) 26 P351

Evaluation of a method to measure long term cortisol levels in health and disease

L Manenschijn, J W Koper, E L T van den Akker, R A Feelders, S W J Lamberts & E F C van Rossum


Erasmus MC, Rotterdam, The Netherlands.


Introduction: Elevated levels of cortisol are known to induce a wide range of pathology, e.g. abdominal obesity, type 2 diabetes and cardiovascular disease. Measuring serum and saliva cortisol is limited to one time point. Measurement of cortisol in scalp hair is a recently developed method to measure long term cortisol levels and might reflect cortisol exposure in patients with hyper- or hypo-cortisolism and in healthy persons. Our aims were to explore this measurement of cortisol by determining factors influencing hair cortisol levels in healthy controls. We also studied whether hair cortisol levels correspond to features of cortisol exposure in healthy persons and clinical course in patients with hyper- or hypo-cortisolism.

Methods: Hair samples were collected from 192 healthy individuals, 10 patients with Cushing’s syndrome (CS) and two patients with Addison’s disease (AD). Cortisol was extracted using methanol and cortisol levels were measured using a salivary ELISA kit. Measurements of waist and hip circumference were performed in 46 healthy subjects. A questionnaire was used to collect data concerning hair features.

Results: Cortisol levels were slightly influenced by hair treatment, but not by other factors such as gender, hair color, frequency of hair wash or hair products. In long hair, cortisol levels showed variation over time, without an overall washout effect. In patients with AD and CS, cortisol levels in hair corresponded with clinical course. In healthy individuals hair cortisol correlated positively with WHR (r=0.506, P<0.001) and waist circumference (r=0.360, P=0.01).

Conclusions: Hair cortisol concentrations seem to be slightly influenced by hair treatment. No washout effect of cortisol in distal hair segments was observed and hair cortisol levels correspond with clinical course in patients with AD and CS. This suggests that cortisol in scalp hair reflects cortisol exposure, which is supported by the positive correlation between hair cortisol and abdominal fat.

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