The degree of urinary hypercortisolism is not correlated with the severity of cushing’s syndrome

Roberto Citarrella, Carla Giordano, Valentina Guarnotta, Marco Calogero Amato, Alessandro Ciresi, Annamaria Colao, Laura Trementino, Chiara Simeoli, Davide Iacuaniello, Giorgio Arnaldi, Grazia Michetti, Rosario Pivonello

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17 Citazioni (Scopus)

Abstract

Cushing syndrome (CS) is characterized byincreased morbidity and mortality compared to the generalpopulation. However, there are patients who have moreclinical aggressive forms than others. Aim of the study is toevaluate whether the degree of hypercortisolism, defined bythe number of times urinary free cortisol (UFC) levelsexceed the upper limit of the normal range (ULN), is relatedto the worsening of phenotypic features, as well as metabolicand cardiovascular parameters, in a cohort of CS patients. Across-sectional study was conducted on 192 patients withactive CS, consecutively presenting at the outpatients’ clinicof the University Hospitals of Ancona, Naples, and Palermo.Patients were grouped into mild (UFC not exceeding twicethe ULN), moderate (2–5 times the ULN), and severe (morethan 5 times the ULN) hypercortisolism. Thirty-sevenpatients (19.3 %) had mild, 115 (59.8 %) moderate, and 40(20.9 %) severe hypercortisolism. A significant trend ofincrease among the three groups was demonstrated for 8-,16-, and 24-h serum cortisol levels (p.001) and serumcortisol after low dose of dexamethasone suppression test(p = 0.001). No significant trend of increase was foundregarding phenotype and comorbidities. The degree ofhypercortisolism by itself does not appear to be a sufficientparameter to express the severity of CS. Therefore, estimatingthe severity of CS according to biochemical parametersremains a challenge, while the clinical phenotype andthe associated comorbidities might be more useful toassessing the severity of the CS.
Lingua originaleEnglish
pagine (da-a)564-572
Numero di pagine9
RivistaENDOCRINE
Volume55
Stato di pubblicazionePublished - 2017

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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    Citarrella, R., Giordano, C., Guarnotta, V., Amato, M. C., Ciresi, A., Colao, A., Trementino, L., Simeoli, C., Iacuaniello, D., Arnaldi, G., Michetti, G., & Pivonello, R. (2017). The degree of urinary hypercortisolism is not correlated with the severity of cushing’s syndrome. ENDOCRINE, 55, 564-572.