Free urinary cortisol radioimmunoassay |
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Authors: | Marco Boscaro Isabella Karbowiak Franco Mantero |
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Institution: | (1) Istituto di Semeiotica Medica dell'Università degli Studi di Padova, Via Ospedale Civile-105, 35100 Padova, Italy |
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Abstract: | Summary The availability of a specific antiserum has made it possible to develop in our laboratory a radioimmunoassay for free urinary
cortisol which is quite simple and rapid to perform. No preliminary procedures of chromatographic purification are necessary,
and no correction for losses is required. Precision and accuracy tests are satisfactory. Seventeen normal subjects, 10 obese
subjects, 18 patients with Cushing's syndrome, 4 hypopituitaric patients and 4 with Addison's disease were studied. The values
of free urinary cortisol were compared with those of urinary 17-OHCS, plasma cortisol and, in some cases, the cortisol secretion
rate. In normal subjects, the mean free urinary cortisol was 77.22±7.74 μg/24 h, in obese subjects it was 112.05±13.64 μg/24
h, and in patients with Cushing's syndrome it was at significantly higher levels, with a mean value of 488.06±64.39 μg/24
h. There was no overlap between the values obtained in the first two groups and those of subjects with adrenal hyperfunction,
and the tesults were similar to those shown by the cortisol secretion rate. The same was not true for urinary 17-OHCS and
plasma cortisol. Thus, the assay of free urinary cortisol, that is the free biologically active circulating fraction, may
provide a relatively simple alternative to measurement of the cortisol secretion rate, as a single differential test for the
diagnosis of conditions with adrenal hyperfunction. Less satisfactory were the results obtained in patients with primary and
secondary adrenal hypofunction. Another limitation of the method is its relative non-specificity, since the results of 16
urinary samples measured without preliminary chromatography were 29.6% higher than those after previous chromatographic purification.
However, in our experience, this overestimation does not affect the value of the method as a screening test for the diagnosis
of Cushing's syndrome. |
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Keywords: | Cushing's syndrome Free urinary cortisol Obesity Radioimmunoassay Tests of adrenal function |
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