Screening for Cushing's Syndrome using Early Morning Urine Samples

Abstract

SUMMARY Urinary free Il-hydroxycorticosteroid/creatinine ratios (UFCfCr) were determined in early morning urine samples from 138 obese subjects attending endocrine clinics in the Glasgow area. The majority of patients (128) had UFC/Cr ratios within the normal range for non-obese subjects (5-55 p.moI/mol). Of those with elevated UFCfCr ratios, further investigations of the hypothalamic-pituitary-adrenal axis confirmed a diagnosis of Cushing's syndrome due to bilateral adrenal hyperplasia in six of the cases and adrenal tumours in a further two patients. In the remaining two patients there was evidence of intermittent adrenal hyperactivity with inconsistent responses to insulin-induced hypoglycaemia tests.