Hair glucocorticoids as a biomarker for endogenous Cushing's syndrome: validation in two independent cohorts
Open accessAbstract
BACKGROUND/AIMS: The current diagnostic workup of Cushing's syndrome (CS) requires various tests which only capture short-term cortisol exposure, whereas patients with endogenous CS generally have elevated cortisol levels over longer periods of time. Scalp hair assessment has emerged as a convenient test in capturing glucocorticoid concentrations over long periods of time. The aim of this multicenter, multinational, prospective, case-control study was to evaluate the diagnostic efficacy of scalp hair glucocorticoids in screening of endogenous CS. METHODS: We assessed the diagnostic performances of hair cortisol (HairF), hair cortisone (HairE), and the sum of both (sumHairF+E), as measured by a state-of-the-art LC-MS/MS technique, in untreated patients with confirmed endogenous CS (n = 89) as well as in community controls (n = 295) from the population-based Lifelines cohort study. RESULTS: Both glucocorticoids were significantly elevated in CS patients when compared to controls. A high diagnostic efficacy was found for HairF (area under the curve 0.87 [95% CI: 0.83-0.92]), HairE (0.93 [0.89-0.96]), and sumHairF+E (0.92 [0.88-0.96]) (all p < 0.001). The participants were accurately classified at the optimal cutoff threshold in 86% of the cases (81% sensitivity, 88% specificity, and 94% negative predictive value [NPV]) by HairF, in 90% of the cases (87% sensitivity, 90% specificity, and 96% NPV) by HairE, and in 87% of the cases (86% sensitivity, 88% specificity, and 95% NPV) by the sumHairF+E. HairE was shown to be the most accurate in differentiating CS patients from controls. CONCLUSION: Scalp hair glucocorticoids, especially hair cortisone, can be seen as a promising biomarker in screening for CS. Its convenience in collection and workup additionally makes it feasible for first-line screening.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Studies evaluating hair cortisol and cortisone have reported diagnostic cutoffs ranging from approximately 5-31 pg/mg for hair cortisol and 14-28 pg/mg for hair cortisone, with sensitivities of ∼60-100% and specificities of ∼79-99%, depending on assay methodology, study population, and disease severity.
“Studies evaluating hair cortisol and cortisone have reported diagnostic cutoffs ranging from approximately 5-31 pg/mg for hair cortisol and 14-28 pg/mg for hair cortisone, with sensitivities of ∼60-100% and specificities of ∼79-99%, depending on assay methodology, study population, and disease severity (Table 3) (119-121).”
From Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement. (2026) · cites this paper as [121]
Hair cortisol and cortisone measurements can distinguish CS from controls.
“Overall, hair cortisol and cortisone measurements can distinguish CS from controls, but substantial variability in reported cutoffs and diagnostic performance underscores the lack of validated thresholds and the need for further standardization before routine clinical use.”
From Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement. (2026) · cites this paper as [121]
Substantial variability in reported cutoffs and diagnostic performance of hair cortisol and cortisone underscores the lack of validated thresholds.
“Overall, hair cortisol and cortisone measurements can distinguish CS from controls, but substantial variability in reported cutoffs and diagnostic performance underscores the lack of validated thresholds and the need for further standardization before routine clinical use.”
From Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement. (2026) · cites this paper as [121]
Hair steroid analysis has high diagnostic efficacy in screening of CS.
“We and others also showed high diagnostic efficacy in screening of CS with hair steroid analysis.”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [48]
Hair cortisone has a higher differentiating capacity (sensitivity 87%, specificity 90%) than hair cortisol (sensitivity 81%, specificity 88%).
“Interestingly, we found that hair cortisone has a higher differentiating capacity (sensitivity 87%, specificity 90%) than hair cortisol (sensitivity 81%, specificity 88%) (48).”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [48]
Scalp hair analysis is a patient-friendly noninvasive method yielding cortisol values representing long-term cortisol exposure of the past months.
“A relatively novel method of cortisol measurement in patients suspected of CS is scalp hair analysis, a patient-friendly noninvasive method yielding cortisol values representing long-term cortisol exposure of the past months (48, 59-62).”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [48]
Hair cortisol has been shown to differentiate between CS patients and healthy controls with high sensitivity and specificity.
“Hair cortisol has been shown to differentiate between CS patients and healthy controls with high sensitivity and specificity (48, 66).”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [48]
Cites
pROC: an open-source package for R and S+ to analyze and compare ROC curves
Robin, X., Turck, N., Hainard, A., Tiberti, N., Lisacek, F., Sanchez, J.-C., & Müller, M. (2011) · BMC Bioinformatics · doi:10.1186/1471-2105-12-77 · Cited by 13,697 · see citing works
The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline.
Nieman, L. K., Biller, B. M. K., Findling, J. W., Newell-Price, J., Savage, M. O., Stewart, P. M., & Montori, V. M. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0125 · Cited by 2,718 · see citing works
Newell-Price, J. D. C., BERTAGNA, X. Y., Grossman, A. B., & Nieman, L. K. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68699-6 · Cited by 1,220 · see citing works
The Diagnosis and Differential Diagnosis of Cushing’s Syndrome and Pseudo-Cushing’s States
Newell-Price, J., Trainer, P., Besser, M., & Grossman, A. (1998) · Endocrine Reviews · doi:10.1210/edrv.19.5.0346 · Cited by 833 · see citing works
Incidence and late prognosis of cushing's syndrome: a population-based study.
Lindholm, J., Juul, S., Jørgensen, J., Astrup, J., Bjerre, P., Feldt-Rasmussen, U., Hagen, C., Jørgensen, J., Kostel-janetz, M., Kristensen, L., et al. (2001) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jcem.86.1.7093 · Cited by 755 · see citing works
Stolk, R. P., Rosmalen, J. G. M., Postma, D. S., de Boer, R. A., Navis, G., Slaets, J. P. J., Ormel, J., & Wolffenbuttel, B. H. R. (2008) · European Journal of Epidemiology · doi:10.1007/s10654-007-9204-4 · Cited by 391 · see citing works
ROSS, E. (1982) · The Lancet · doi:10.1016/s0140-6736(82)92749-0 · Cited by 390 · see citing works
Evaluation of a method to measure long term cortisol levels
Manenschijn, L., Koper, J. W., Lamberts, S. W. J., & van Rossum, E. F. C. (2011) · Steroids · doi:10.1016/j.steroids.2011.04.005 · Cited by 322 · see citing works
Accuracy of Diagnostic Tests for Cushing’s Syndrome: A Systematic Review and Metaanalyses
Elamin, M. B., Murad, M. H., Mullan, R., Erickson, D., Harris, K., Nadeem, S., Ennis, R., Erwin, P. J., & Montori, V. M. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0139 · Cited by 222 · see citing works
Salivary cortisone is a potential biomarker for serum free cortisol
Perogamvros, I., Keevil, B. G., Ray, D. W., & Trainer, P. J. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1215 · Cited by 222 · see citing works
Hair analysis provides a historical record of cortisol levels in Cushing's syndrome
Thomson, S., Koren, G., Fraser, L.-A., Rieder, M., Friedman, T. C., & Van Uum, S. H. M. (2009) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0029-1220771 · Cited by 218 · see citing works
Clinical applications of cortisol measurements in hair
Wester, V. L., & van Rossum, E. F. C. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0313 · Cited by 210 · see citing works
Self-citationDeterminants of hair cortisol and hair cortisone concentrations in adults.
Staufenbiel, S. M., Penninx, B., de Rijke, Y. D., van den Akker, E. V. D., & van Rossum, E. V. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.06.011 · Cited by 169 · see citing works
Localization of 11 beta-hydroxysteroid dehydrogenase type II in human epithelial tissues.
Smith, R. E., Maguire, J. A., Stein-Oakley, A. N., Sasano, H., Takahashi, K., Fukushima, K., & Krozowski, Z. S. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.9.8784076 · Cited by 146 · see citing works
LC‐MS/MS‐based method for long‐term steroid profiling in human scalp hair
Noppe, G., de Rijke, Y. B., Dorst, K., van den Akker, E. L. T., & van Rossum, E. F. C. (2015) · Clinical Endocrinology · doi:10.1111/cen.12781 · Cited by 127 · see citing works
Self-citationTiganescu, A., Walker, E. A., Hardy, R. S., Mayes, A. E., & Stewart, P. M. (2011) · Journal of Investigative Dermatology · doi:10.1038/jid.2010.257 · Cited by 122 · see citing works
Manenschijn, L., Koper, J. W., van den Akker, E. L. T., de Heide, L. J. M., Geerdink, E. A. M., de Jong, F. H., Feelders, R. A., & van Rossum, E. F. C. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-1852 · Cited by 122 · see citing works
Self-citationAntonelli, G., Ceccato, F., Artusi, C., Marinova, M., & Plebani, M. (2015) · Clinica Chimica Acta · doi:10.1016/j.cca.2015.10.004 · Cited by 111 · see citing works
Hair cortisol and cortisone are decreased by natural sunlight
Wester, V. L., van der Wulp, N. R. P., Koper, J. W., de Rijke, Y. B., & van Rossum, E. F. C. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.06.016 · Cited by 93 · see citing works
Self-citationHennebert, O., Chalbot, S., Alran, S., & Morfin, R. (2007) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2007.03.026 · Cited by 79 · see citing works
Radiolabel validation of cortisol in the hair of rhesus monkeys
Kapoor, A., SCHULTZ‐DARKEN, N. J., & Ziegler, T. E. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.07.022 · Cited by 52 · see citing works
Hair cortisol in the evaluation of Cushing syndrome
Hodes, A. D., Lodish, M. B., Tirosh, A., Meyer, J. S., Belyavskaya, E., Lyssikatos, C., Rosenberg, K. L., Demidowich, A. P., Swan, J., Jonas, N., et al. (2017) · Endocrine · doi:10.1007/s12020-017-1231-7 · Cited by 46 · see citing works
Scalp hair cortisol for diagnosis of Cushing's syndrome
Wester, V. L., Reincke, M., Koper, J. W., van den Akker, E. L. T., Manenschijn, L., Berr, C. M., Fazel, J., de Rijke, Y. B., Feelders, R. A., & van Rossum, E. F. C. (2017) · European Journal of Endocrinology · doi:10.1530/eje-16-0873 · Cited by 39 · see citing works
Self-citationWester, V. L., Noppe, G., Savas, M., van den Akker, E. L. T., de Rijke, Y. B., & van Rossum, E. F. C. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.02.024 · Cited by 39 · see citing works
Self-citation
Flagged first, then by citations
2 of the 26 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Approach to the Patient: Diagnosis of Cushing Syndrome
Savas, M., Mehta, S., Agrawal, N., van Rossum, E. F. C., & Feelders, R. A. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac492 · Cited by 91 · see citing works
“In these studies, a 3-cm hair sample per patient was used (corresponding to mean glucocorticoid levels of roughly past 3 months) and hair analysis was performed with either immunoassay (59, 61) or liquid chromatographytandem mass spectrometry (48, 66).”
BackgroundMethodInfluentialSelf-citationTabarin, A., Assié, G., Barat, P., Bonnet, F., Bonneville, J. F., Borson-Chazot, F., Bouligand, J., Boulin, A., Brue, T., Caron, P., et al. (2022) · Annales d Endocrinologie · doi:10.1016/j.ando.2022.02.001 · Cited by 59 · see citing works
Diagnostic workup of Cushing’s syndrome
Balomenaki, M., Margaritopoulos, D., Vassiliadi, D. A., & Tsagarakis, S. (2022) · Journal of Neuroendocrinology · doi:10.1111/jne.13111 · Cited by 41 · see citing works
Variation in glucocorticoid sensitivity and the relation with obesity
Lengton, R., Iyer, A. M., van der Valk, E. S., Hoogeveen, E. K., Meijer, O. C., van der Voorn, B., & van Rossum, E. F. C. (2021) · Obesity Reviews · doi:10.1111/obr.13401 · Cited by 44 · see citing works
Determination of cortisone and cortisol in human scalp hair using an improved LC-MS/MS-based method
Mirzaian, M., van Zundert, S. K. M., Schilleman, W. F., Mohseni, M., Kuckuck, S., van Rossum, E. V., van Schaik, R. V., & van den Berg, S. V. D. (2023) · Clinical Chemistry and Laboratory Medicine · doi:10.1515/cclm-2023-0341 · Cited by 34 · see citing works
“lower limit of normal (LLN), upper limit of normal (ULN)) as much as possible [31].”
BackgroundMethodvan der Valk, E. S., Abawi, O., Mohseni, M., Abdelmoumen, A., Wester, V. L., van der Voorn, B., Iyer, A. M., van den Akker, E. L. T., Hoeks, S. E., van den Berg, S. A. A., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13376 · Cited by 33 · see citing works
Self-citationLC-MS/MS-based reference intervals for hair cortisol in healthy children
de Kruijff, I., Noppe, G., Kieviet, N., Choenni, V., den Berg, M. P. L., Begijn, D. G. A., Tromp, E., Dorst, K. Y., van Rossum, E. F. C., de Rijke, Y. B., et al. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104539 · Cited by 32 · see citing works
Self-citationMechanism, diagnosis, and treatment of cyclic Cushing’s syndrome: A review
Cai, Y., Ren, L., Tan, S.-W., Liu, X., Li, C., Gang, X., & Wang, G. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.113301 · Cited by 31 · see citing works
Stressed-Out Oral Immunity: A Gateway From Socioeconomic Adversity to Periodontal Disease
Gomaa, N., Glogauer, M., Nicolau, B., Tenenbaum, H., Siddiqi, A., Fine, N., & Quiñonez, C. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000774 · Cited by 25 · see citing works
Emerging diagnostic methods and imaging modalities in cushing’s syndrome
Wright, K. E., van Rossum, E. F. C., Zan, E., Werner, N. L., Harris, A. G., Feelders, R. A., & Agrawal, N. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1230447 · Cited by 25 · see citing works
“In recent years, both hair cortisol and the inactive form, hair cortisone, have been shown to be useful measures to accurately diagnose overt CS (18, 35).”
BackgroundMethodResultInfluentialSelf-citationHair cortisol, obesity and the immune system: Results from a 3 year longitudinal study
van der Valk, E. S., van der Voorn, B., Iyer, A. M., Mohseni, M., Leenen, P. J. M., Dik, W. A., van den Berg, S. A. A., de Rijke, Y. B., van den Akker, E. L. T., Penninx, B. W. J. H., et al. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105422 · Cited by 31 · see citing works
Hair glucocorticoid levels in Parkinson's disease.
van den Heuvel, L. L., du Plessis, S., Stalder, T., Acker, D., Kirschbaum, C., Carr, J., & Seedat, S. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104704 · Cited by 22 · see citing works
Diurnal rhythmicity in breast-milk glucocorticoids, and infant behavior and sleep at age 3 months
Toorop, A. A., van der Voorn, B., Hollanders, J. J., Dijkstra, L. R., Dolman, K. M., Heijboer, A. C., Rotteveel, J., Honig, A., & Finken, M. J. J. (2020) · Endocrine · doi:10.1007/s12020-020-02273-w · Cited by 17 · see citing works
Cyclic Cushing’s Syndrome – A Diagnostic Challenge
Świątkowska−Stodulska, R., Berlińska, A., Stefanska, K. A., Kłosowski, P., & Sworczak, K. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.658429 · Cited by 28 · see citing works
Coping with stress before and after mild traumatic brain injury: a pilot hair cortisol study
Spikman, J., van der Horn, H. J., Scheenen, M., de Koning, M. D., Savas, M., Langerak, T., van Rossum, E. V., & van der Naalt, J. (2021) · Brain Injury · doi:10.1080/02699052.2021.1901143 · Cited by 13 · see citing works
“Further processing of the hair segments was performed as described in (17).”
MethodSelf-citationBiphasic Glucocorticoid Rhythm in One-Month-Old Infants: Reflection of a Developing HPA-Axis?
Hollanders, J. J., van der Voorn, B., de Goede, P., Toorop, A. A., Dijkstra, L. R., Honig, A., Rotteveel, J., Dolman, K. M., Kalsbeek, A., & Finken, M. J. J. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgz089 · Cited by 17 · see citing works
“Moreover, cortisone seems to be a more reliable 102 biomarker compared to cortisol, at least in saliva and hair.(31,32) GCs in breastmilk, season at time 103”
BackgroundPuglisi, S., Leporati, M., Amante, E., Parisi, A., Pia, A. R., Berchialla, P., Terzolo, M., Vincenti, M., & Reimondo, G. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.833514 · Cited by 10 · see citing works
Diurnal salivary cortisol profiles in patients with Cushing's syndrome
Braun, L. T., Vogel, F., Zopp, S., Rubinstein, G., Schilbach, K., Künzel, H., Beuschlein, F., & Reincke, M. (2022) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/a-1719-5381 · Cited by 8 · see citing works
“Different approaches have been tested in the past to improve diagnostic accuracy, such as face classification [15], diagnostic scores [16, 17], plasma steroid profiling [18], and measuring hair cortisol [19].”
MethodSelf-citationHollanders, J. J., Dijkstra, L. R., van der Voorn, B., Kouwenhoven, S., Toorop, A. A., van Goudoever, J. V., Rotteveel, J., & Finken, M. (2019) · Nutrients · doi:10.3390/nu11102351 · Cited by 7 · see citing works
“Cortisone concentrations have been shown to be more reliable than cortisol measurements, at least in saliva and hair [25,26].”
BackgroundLong-Term Cortisol Exposure and Associations With Height and Comorbidities in Turner Syndrome
Savas, M., Wester, V. L., Dykgraaf, R., van den Akker, E. L. T., Roos‐Hesselink, J. W., Dessens, A. B., de Graaff, L. C. G., de Rijke, Y. B., & van Rossum, E. F. C. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2019-00148 · Cited by 8 · see citing works
Self-citationAssociation between hair cortisol, hair cortisone, and fatigue in people living with HIV
Zhang, Q., Li, X.-M., Qiao, S., Liu, S.-F., Shen, Z.-Y., & Zhou, Y.-J. (2021) · Stress · doi:10.1080/10253890.2021.1919616 · Cited by 6 · see citing works
“…cortisone levels and variables studied than hair cortisol levels did, including Parkinson’s disease (van den Heuvel et al., 2020), Cushing’s syndrome (Savas et al., 2019), cardiometabolic variables (Feeney et al., 2018; Stalder et al., 2013), and stress-related variables (Davison et al., 2019; van…”
BackgroundHair and Nail-On-Chip for Bioinspired Microfluidic Device Fabrication and Biomarker Detection
Ray, R., Rakesh, A., Singh, S., Madhyastha, H., & Mani, N. K. (2023) · Critical reviews in analytical chemistry · doi:10.1080/10408347.2023.2291825 · Cited by 5
van der Valk, E. S., van der Voorn, B., Iyer, A. M., van den Berg, S. V. D., Savas, M., de Rijke, Y. D., van den Akker, E. V. D., Melander, O., & van Rossum, E. V. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0077 · Cited by 5 · see citing works
Self-citationHeyns, B., Pieters, R., Stander, M. A., Atkin, S. L., & Swart, A. C. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1448013 · Cited by 4 · see citing works
The Determination of Endogenous Steroids in Hair and Fur: A Systematic Review of Methodologies.
Maher, P., Healy, M., Laird, E., Karšaj, J. M., Gao, W., & Zgaga, L. (2024) · Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2024.106649 · Cited by 4 · see citing works
Zhang, Q., Li, X.-M., Qiao, S., Liu, S.-F., Zhou, Y.-J., & Shen, Z.-Y. (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07257-x · Cited by 4 · see citing works
“Interestingly, we found stronger associations between hair cortisone levels and CD4 count than hair cortisol levels did, which was in line with some previous studies that also reported stronger associations between hair cortisone levels and variables studied than hair cortisol levels did, including Parkinson’s disease…”
ResultVital Role of Visceral Adipose Tissue in Maintaining Cognitive Functions
Shirafuji, R., Amagase, Y., Goto, A., & Takei, Y. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26146597 · Cited by 5 · see citing works
Zhang, Q., Li, X., Qiao, S., Liu, S., Shen, Z., & Zhou, Y. (2021) · Journal of Pain Research · doi:10.2147/jpr.s301651 · Cited by 4 · see citing works
Hamidi, O., St-Jean, M., Lacroix, A., & Bancos, I. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag095 · Cited by 5 · see citing works
Hair cortisol as a marker of stress in mild traumatic brain injury: a challenging measure
Ciubotariu, D., Visser, K., de Koning, M. D., Spikman, J., van Faassen, M., Krijnen, J., Storteboom, T., Kema, I., van der Naalt, J., & van der Horn, H. J. (2025) · Scientific Reports · doi:10.1038/s41598-025-93055-9 · Cited by 2 · see citing works
Current challenges in Cushing's syndrome testing: blood, saliva, urine, or hair?
Ferrière, A., & Tabarin, A. (2025) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000923 · Cited by 2 · see citing works
MACS: mild by definition, challenging by nature
Bluszcz, G., Roszkowska, Z., Domański, J., Sharabi, A., Rapiejko, J., Malek, J., Ambroziak, U., & Bobrowicz, M. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1957127
Yilmaz, M. K., Tek, S., Pekmezci, A., Niyazoğlu, M., & Hatipoglu, E. (2026) · BMC Endocrine Disorders · doi:10.1186/s12902-026-02607-1
“In overt Cushing’s syndrome, higher hair cortisol thresholds have been reported, although cut-off values vary substantially across studies, likely reflecting differences in analytical techniques, assay platforms, and study populations [13, 14].”
Hair cortisol as a marker of glucocorticoid replacement adequacy in adrenal insufficiency
Yilmaz, M. K., Tek, S., Kiliccioglu, G. K., Ozkahraman, A. U., Niyazoğlu, M., & Şuheda, H. E. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1765179
“In endogenous hypercortisolism, multiple studies have reported markedly elevated HCC levels in patients with Cushing ’ s syndrome, with strong correlations with disease activity and normalization upon remission (9 – 11).”
Frolov, A., Zavyalov, O., & Galieva, Z. (2025) · Veterinary World · doi:10.14202/vetworld.2025.3761-3778
“Hair is an informative biosubstrate for assessing long-term changes in the hormonal status of animals and humans [30].”
Intervenções Farmacológicas no Tratamento da Síndrome de Cushing: Terapia e Resultados
Gonzaga, I. M., Melo, L. M. D. E., Vital, D. D. S. M., Matos, E. D. S. V., Santos, P. L., Kodama, F. B. D. O., Silva, S. M., de Oliveira, W. S., Senedese, M. S. D. V., Lemos, S. C., et al. (2024) · Brazilian Journal of Implantology and Health Sciences · doi:10.36557/2674-8169.2024v6n9p178-190
“Assim, esse procedimento pode ser feito de duas maneiras: pacientes portadores da síndrome endógena, adquiriram a melhora no perfil lipídico, normalização os níveis de cortisol, amenização do quadro depressivo e aperfeiçoamento da qualidade de vida 5,10 .”
BackgroundInfluentialTabarin, A., & Nunès, M. (2022) · EMC - Endocrinologie - Nutrition · doi:10.1016/s1155-1941(22)44261-2
Recent developments in the management of Cushing's syndrome.
Galiana, P. A. (2021) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endien.2021.01.001
Recent developments in the management of Cushing's syndrome.
Galiana, P. A. (2021) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2021.01.002
Research Progress in Diagnostic Methods of Cushing’s Syndrome
郭, 林. (2026) · Advances in Clinical Medicine · doi:10.12677/acm.2026.1662449
Holzer, K. (2021) · Springer Reference Medizin · doi:10.1007/978-3-662-61724-3_32-1
Neuroendocrinology: Front & Back Matter
Peri, A., Thompson, C., & Verbalis, J. (2019) · Neuroendocrinology · doi:10.1159/000502809
- Authors
- Savas, M., Wester, V. L., de Rijke, Y. B., Rubinstein, G., Zopp, S., Dorst, K., van den Berg, S. A. A., Beuschlein, F., Feelders, R. A., Reincke, M., & van Rossum, E. F. C.
- Affiliations
- Erasmus MC (NL)
- Ludwig-Maximilians-Universität München (DE)
- University of Zurich (CH)
- ORCID
- Venue
- Neuroendocrinology
- Publisher
- S. Karger AG
- Published
- 2019
- Volume
- 109
- Issue
- 2
- Pages
- 171-178
- ISSN
- 0028-3835 (ISSN-L)
- 1423-0194
- OpenAlex
- W2911707353
- Cited by
- 41
- References
- 26
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 8 · 2021: 10 · 2020: 2 · 2019: 4
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neuroendocrinology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion, cc-by-nc-nd)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc-nd)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- European Commission (HORIZON2020, 694913)
- Deutsche Forschungsgemeinschaft (CRC/TRR 205, 2012_A103, 2015_A228)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (91716453)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- Cushing's syndrome, endogenous Cushing's syndrome, hair cortisol, hair cortisone, biomarkers, screening, diagnostic accuracy
- MeSH terms
- Adult, Aged, Chromatography, Liquid, Cushing Syndrome, Female, Germany, Glucocorticoids, Hair, Humans, Male, Middle Aged, Netherlands, Predictive Value of Tests, Prospective Studies, Sensitivity and Specificity, Cohort Studies, Biomarkers, Case-Control Studies, Tandem Mass Spectrometry
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
