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Endocrine Abstracts (2016) 41 GP30 | DOI: 10.1530/endoabs.41.GP30

1Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA; 2Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; 3Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health (NIH), Bethesda, Maryland, USA; 4Department of Psychology, University of Massachusetts, Amherst, Massachusetts, USA.

Context: Hair cortisol has been recently studied to determine evidence of hypercortisolemia in humans. This test may be valuable in estimating cortisol levels, particularly in patients with cyclical Cushing’s syndrome (CS).

Objective: To determine correlations with biochemical evidence of CS, and to compare hair cortisol measurements in patients with CS to normative data.

Methods: Hair samples from 49 study subjects were collected (30 with CS (mean age: 25.9±18.2 years) and 19 without CS (mean age: 39.0±19.4 years)). Three hair samples from each patient were processed and analyzed for cortisol according to the methods described by Meyer et al 2014. Diurnal serum cortisol and ACTH measurements, 24-h-urinary free cortisol corrected by body surface area (UFC/BSA) and 17-hydroxysteroids, corrected for creatinine (17OHS/Cr), were pre-operatively assessed. Average hair cortisol data were log-transformed for normality and compared to normal data of healthy adults as measured in the same laboratory.

Results: Average hair cortisol values in the groups with CS and without CS were 46.2±64.9 pg cortisol/mg hair (median: 24.6 pg/mg; range: 3.1–406.3 pg/mg) and 125.7±455.2 pg cortisol/mg hair (median: 18.0 pg/mg; range: 1.9–2745.6 pg/mg), respectively. In the CS group, hair cortisol was positively and moderately correlated with UFC/BSA (r=0.31, P<0.001). Mean hair cortisol levels in CS patients were significantly different from patients without CS (P=0.02) but not statistically significantly different from the mean level of 22.0±59.0 pg/mg in a cohort of healthy individuals (P=0.07 and P=0.12, respectively).

Discussion: We found that hair cortisol levels correlated with some biochemical tests for CS; in addition, there was a difference in hair cortisol levels between those with and those without CS among our cohort at the NIH, yet not among a separate normal control cohort. We speculate that hair cortisol can assist in the diagnostic workup for CS. More research is needed on the use of hair cortisol in patients with CS.

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