Abstract
Cushing’s syndrome (CS) is a disease which results from excessive levels of cortisol in the human body. The disorder is associated with various signs and symptoms which are also common for the general population not suffering from compound hypersecretion. Thus, more sensitive and selective methods are required for the diagnosis of CS. This follow-up study was conducted to determine which steroid metabolites could serve as potential indicators of CS and possible subclinical hypercortisolism in patients diagnosed with so called non-functioning adrenal incidentalomas (AIs). Urine samples from negative controls (n = 37), patients with CS characterized by hypercortisolism and excluding iatrogenic CS (n = 16), and patients with non-functioning AIs with possible subclinical Cushing’s syndrome (n = 25) were analyzed using gas chromatography-mass spectrometry (GC/MS) and gas chromatograph equipped with flame ionization detector (GC/FID). Statistical and multivariate methods were applied to investigate the profile differences between examined individuals. The analyses revealed hormonal differences between patients with CS and the rest of examined individuals. The concentrations of selected metabolites of cortisol, androgens, and pregnenetriol were elevated whereas the levels of tetrahydrocortisone were decreased for CS when opposed to the rest of the study population. Moreover, after analysis of potential confounding factors, it was also possible to distinguish six steroid hormones which discriminated CS patients from other study subjects. The obtained discriminant functions enabled classification of CS patients and AI group characterized by mild hypersecretion of cortisol metabolites. It can be concluded that steroid hormones selected by applying urinary profiling may serve the role of potential biomarkers of CS and can aid in its early diagnosis.
Highlights
Cushing’s syndrome (CS) is a result of body exposure to prolonged pathologic high levels of cortisol which is produced excessively by adrenal glands
In our previous paper [23] we have shown that steroid metabolomics can be applied to detect slight steroid hormone overproduction in adrenal incidentalomas (AIs) which may be responsible for generating subtle hypercortisolism in patients
Due to the fact that the diagnosis of the disease is often difficult, it is frequently aided by dexamethasone suppression test and ACTH serum levels [27]
Summary
Cushing’s syndrome (CS) is a result of body exposure to prolonged pathologic high levels of cortisol (hypercortisolism) which is produced excessively by adrenal glands. More reliable, specific, and selective methods which concentrate on the assessment of other biomarkers than solely cortisol are required to carry out early diagnosis of Cushing’s syndrome and subclinical hypercortisolism in patients. The bioanalytical data obtained after the application of metabolomic profiling is usually subjected to multivariate interpretation which enables researchers to identify possible biomarkers of a disease [11]. Steroid hormones might be the compounds of choice in the case of novel biomarkers selected for Cushing’s syndrome due to the fact that the disease is connected with elevated levels of cortisol, its altered pathway, and, possibly, altered concentrations of its metabolites [19]. The aim of this follow-up study was to undertake the targeted profiling approach and to measure the levels of major urinary steroid hormones in samples from patients diagnosed with Cushing’s syndrome, compare. The apppaliteiedntps rwoictehdnuorne-faulnloctwioendinfgoardtrheenaidl iennctiidfiecnatatilonmaosf tsoixvesrtiefyroiifdAhIsoarrme onnoet srewalhlyichhypdeirfsfecrreentotirayt.ed CS patiTehnetsapfrpolimedhperaolctehdyuirnedaillvoiwduedalfsor(ntheegaidtievnetifciocanttiroonlso)f asinxdstneroonid-fhuonrcmtioonneisnwg hAicIhadnidffecroeunltdiatseedrvCeSas potentipaal tbieionmts afrrokmershoeafltthhye CinSdiavniddusaulsbc(nliengiactailvhe ycponertrcoolrst)isaonldismno.n-functioning AI and could serve as potential biomarkers of the CS and subclinical hypercortisolism
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
