The utility of a baseline morning cortisol measurement, in the screening for adrenal insufficiency amongst non-critically ill hospital inpatients

Background: Serum cortisol levels vary according to the daily circadian cycle, with peak levels seen in the morning. There is evidence in ambulatory patients that a morning cortisol level can predict an adequate cortisol response to Synacthen (tetracosactide) stimulation. Aim: The aim of this study...

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Bibliographic Details
Published in:Endocrine and metabolic science 2023-12, Vol.13, p.100151, Article 100151
Main Authors: Langford, Rachel, Lee, Hye Jin, Depczynski, Barbara
Format: Article
Language:English
Subjects:
Cortisol
Hospital
Inpatients
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Summary:Background: Serum cortisol levels vary according to the daily circadian cycle, with peak levels seen in the morning. There is evidence in ambulatory patients that a morning cortisol level can predict an adequate cortisol response to Synacthen (tetracosactide) stimulation. Aim: The aim of this study is to determine the utility of baseline analysis of the serum cortisol levels in the morning “baseline morning cortisol”, determined using a newer immunoassay, in the screening for adrenal insufficiency amongst non-critically ill hospital inpatients. Methods: This is a retrospective cross-sectional cohort study. Results: 64 adult inpatients had undergone a short Synacthen test (SST) (measurement of serum cortisol levels 30 and 60 min after administration of tetracosactide) during the study period. 17 patients returned an abnormal SST result. The measured level of cortisol in the morning correlated to both the 30 min and 60 min stimulated cortisol values (r = 0.612, p 
ISSN:2666-3961
2666-3961
DOI:10.1016/j.endmts.2023.100151