help button home button Endocrine Society JCEM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

Journal of Clinical Endocrinology & Metabolism Vol. 62, No. 5 965-969
doi:10.1210/jcem-62-5-965
Copyright © 1986 by the Endocrine Society.
This Article
Right arrow Full Text (PDF)
Right arrow Submit a related Letter to the Editor
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by CONTRERAS, L. N.
Right arrow Articles by TYRRELL, J. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by CONTRERAS, L. N.
Right arrow Articles by TYRRELL, J. B.

Urinary Cortisol in the Assessment of Pituitary-Adrenal Function: Utility of 24-Hour and Spot Determinations

LILIANA N. CONTRERAS, SATOSHI HANE and J. BLAKE TYRRELL

Metabolic Research Unit and the Department of Medicine, University of California San Francisco, California 94143

Address all correspondence and requests for reprints to: J. Blake Tyrrell, M.D., Metabolic Research Unit, 1141-HSW, University of California, San Francisco, California 94143.

To more conveniently assess dynamic changes in the biologically active fraction of cortisol, we measured cortisol in 1-h urine samples obtained from 0700–0800 and from 2200–2300 h. In 20 normal subjects, morning 1-h urinary cortisol levels were 78 ± 36 ng/mg creatinine (mean ± SD), whereas levels from 2200-2300 h were 22 ± 12 ng/mg creatinine, demonstrating diurnal variability. In 14 patients with Cushing's syndrome, mean morning urinary cortisol was elevated (207 ± 176 ng/mg creatinine), but there was overlap with values in normal subjects. In contrast, evening values in Cushing's syndrome (248 ± 208 ng/mg creatinine) were elevated in each patient; there was no diurnal variation and no overlap with normal subjects. Similarly, the morning urinary cortisol response to dexamethasone (1 mg, orally, at 2300 h) clearly separated normal subjects from those with Cushing's syndrome (5 ± 6 vs. 169 ± 149 ng/mg creatinine, respectively). In 10 patients with secondary hypoadrenalism, urinary cortisol levels were less than 2 ng/mg creatinine in both morning and evening 1-h samples. Thus, the determination of cortisol in 1-h samples is a practical and simple method of assessing cortisol secretion and allows multiple sampling without hospitalization. It is effective in assessing dynamic cortisol responses, such as diurnal variation and responsiveness to suppression, and it is an effective screening test for Cushing's syndrome and hypoadrenalism.

Received September 17, 1985.




This article has been cited by other articles:


Home page
J. Clin. Endocrinol. Metab.Home page
A. W. Meikle, J. Findling, M. M. Kushnir, A. L. Rockwood, G. J. Nelson, and A. H. Terry
Pseudo-Cushing Syndrome Caused by Fenofibrate Interference with Urinary Cortisol Assayed by High-Performance Liquid Chromatography
J. Clin. Endocrinol. Metab., August 1, 2003; 88(8): 3521 - 3524.
[Abstract] [Full Text] [PDF]


Home page
J. Clin. Endocrinol. Metab.Home page
M. Castro, P. C. L. Elias, A. R. P. Quidute, F. P. B. Halah, and A. C. Moreira
Out-Patient Screening for Cushing's Syndrome: The Sensitivity of the Combination of Circadian Rhythm and Overnight Dexamethasone Suppression Salivary Cortisol Tests
J. Clin. Endocrinol. Metab., March 1, 1999; 84(3): 878 - 882.
[Abstract] [Full Text]


Home page
Endocr. Rev.Home page
J. Newell-Price, P. Trainer, M. Besser, and A. Grossman
The Diagnosis and Differential Diagnosis of Cushing's Syndrome and Pseudo-Cushing's States
Endocr. Rev., October 1, 1998; 19(5): 647 - 672.
[Abstract] [Full Text]


Home page
J. Clin. Endocrinol. Metab.Home page
H. Raff, J. L. Raff, and J. W. Findling
Late-Night Salivary Cortisol as a Screening Test for Cushing's Syndrome
J. Clin. Endocrinol. Metab., August 1, 1998; 83(8): 2681 - 2686.
[Abstract] [Full Text]


Home page
ANN INTERN MEDHome page
T. B. Kaye and L. Crapo
The Cushing Syndrome: An Update on Diagnostic Tests
Ann Intern Med, March 15, 1990; 112(6): 434 - 444.
[Abstract] [PDF]


Home page
Arch Gen PsychiatryHome page
A. P. Zis, R. A. Remick, B. E. K. Grant, M. Bernstein, and A. Grant
The Evening Urine Cortisol Excretion Test in Depression
Arch Gen Psychiatry, October 1, 1987; 44(10): 919 - 920.
[Abstract] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 1986 by The Endocrine Society