MedicalResearch.com Interview with:
Mihail Zilbermint, M.D.
Endocrinologist, Office of the Scientific Director
Eunice Kennedy Shriver
National Institute of Child Health and Human Development
National Institutes of Health
MedicalResearch.com: What is the background for this study?
Response: Diagnosing Cushing Syndrome is often difficult and challenging. Diagnosing hypercortisolemia, could require the use of a combination of any of these tests: 24-hour free urine cortisol monitoring, an overnight dexamethasone suppression test, and measurement of late night salivary cortisol. Cortisol levels may change daily, requiring that testing be repeated. Undiagnosed and untreated Cushing Syndrome greatly increases morbidity and mortality risk.
Cortisol levels can be detected in hair samples. Much like hemoglobin A1C is a long-term indicator of blood glucose levels, efforts have been made to determine if hair cortisol could serve as a long-term measure of the body’s glucocorticoid levels. We sought to compare the results of cortisol levels for Cushing Syndrome patients with data from data on cortisol in hair segments, to gain further information on the role of sampling hair cortisol as an initial or supportive method for diagnosing Cushing Syndrome.
MedicalResearch.com: What are the main findings?
Response: Cortisol levels of hair samples within 1 cm of the scalp corresponded closely with levels of cortisol detected in standard tests of urinary cortisol and late night serum cortisol.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings support further investigations into the use of the most proximal 1 cm of hair as an initial or supportive diagnostic test for Cushing Syndrome.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Because Cushing syndrome is rare, our study was limited to 49 participants: 36 cases and 6 controls. Replicating our findings in a larger sample would be a good first step for future research. Similarly, many factors are known to degrade hair cortisol levels—among them shampoo and ultraviolet light. Future studies are needed to investigate how to consistently obtain accurate cortisol data from hair samples.
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Hodes A, et al “Hair cortisol in the evaluation of Cushing Syndrome” Endocrine Intl J Basic Clin Endocrinol 2017; DOI: 10.1007/s12020-017-1231-7.
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