Steroid Profiling and Circadian Cortisol Secretion in Patients With Mild Autonomous Cortisol Secretion: A Cross-sectional Study
Authors' conclusion
Patients with MACS demonstrate an abnormal urine steroid metabolome, with a high glucocorticoid to androgen ratio, and a higher nocturnal steroid production.
Study context
- Population
- Patients with mild autonomous cortisol secretion (MACS) and matched referent subjects at a referral center, 2018–2023
- Exposure
- Patients with MACS vs matched referent subjects
- MACSn = 72
- Outcome
- 24-h urine steroids, steroid sums and ratios (25 steroids by high-resolution mass spectrometry, separate daytime and nighttime collections)
Methodological detailssingle referral centre, matched referent subjects
- Single referral centre
- Matched referent subjects
Main finding
As reported in the abstract
24-h urine steroid metabolome (µg/24 h, median)
- Lower steroid day/night ratios in MACS vs referent subjects, reflecting higher relative nocturnal steroid production
- MACS vs Referent: P < 0.001
- MACS vs Referent: P < 0.001
- MACS vs Referent: P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Serum cortisol every 2 h (subgroup: 12 MACS, 10 referent subjects)MACS vs Referent · Evening mean total cortisol higher in MACS: 5.3 vs 4.0 | P = 0.056 |
| Serum cortisol every 2 h (subgroup: 12 MACS, 10 referent subjects)MACS vs Referent · Evening mean free cortisol higher in MACS: 0.2 vs 0.1 | P = 0.035 |
Serum cortisol every 2 h (subgroup: 12 MACS, 10 referent subjects)
- 24-h AUC for total and free serum cortisol similar
Original publication
Steroid Profiling and Circadian Cortisol Secretion in Patients With Mild Autonomous Cortisol Secretion: A Cross-sectional Study. J Clin Endocrinol Metab. Published 9 July 2024. doi:10.
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