Metabolomic biomarkers in urine of Cushing's syndrome patients

Alicja Kotłowska , Tomasz Puzyn , Krzysztof Sworczak , Piotr Stepnowski , Piotr Szefer

Abstract

Cushing’s syndrome (CS) is a disease which results from excessive levels of cortisol in the human body. The disorder is associated with various signs and symptoms which are also common for the general population not suffering from compound hypersecretion. Thus, more sensitive and selective methods are required for the diagnosis of CS. This follow-up study was conducted to determine which steroid metabolites could serve as potential indicators of CS and possible subclinical hypercortisolism in patients diagnosed with so called non-functioning adrenal incidentalomas (AIs). Urine samples from negative controls (n = 37), patients with CS characterized by hypercortisolism and excluding iatrogenic CS (n = 16), and patients with non-functioning AIs with possible subclinical Cushing’s syndrome (n = 25) were analyzed using gas chromatography-mass spectrometry (GC/MS) and gas chromatograph equipped with flame ionization detector (GC/FID). Statistical and multivariate methods were applied to investigate the profile differences between examined individuals. The analyses revealed hormonal differences between patients with CS and the rest of examined individuals. The concentrations of selected metabolites of cortisol, androgens, and pregnenetriol were elevated whereas the levels of tetrahydrocortisone were decreased for CS when opposed to the rest of the study population. Moreover, after analysis of potential confounding factors, it was also possible to distinguish six steroid hormones which discriminated CS patients from other study subjects. The obtained discriminant functions enabled classification of CS patients and AI group characterized by mild hypersecretion of cortisol metabolites. It can be concluded that steroid hormones selected by applying urinary profiling may serve the role of potential biomarkers of CS and can aid in its early diagnosis.
Author Alicja Kotłowska
Alicja Kotłowska,,
-
, Tomasz Puzyn (FCh / DEChR / LECh)
Tomasz Puzyn,,
- Laboratory of Environmental Chemometrics
, Krzysztof Sworczak
Krzysztof Sworczak,,
-
, Piotr Stepnowski (FCh / DEA / LChER)
Piotr Stepnowski,,
- Laboratory of Chemical Environmental Risks
, Piotr Szefer
Piotr Szefer,,
-
Journal seriesInternational Journal of Molecular Sciences, ISSN 1661-6596, e-ISSN 1422-0067, (A 30 pkt)
Issue year2017
Vol18
No2
Pages1-15
Publication size in sheets0.7
Keywords in EnglishCushing’s syndrome, metabolomics, multivariate analysis, biomarkers, steroid hormones, urinary profiling, gas chromatography, linear discriminant analysis
DOIDOI:10.3390/ijms18020294
URL http://www.mdpi.com/1422-0067/18/2/294/pdf
Languageen angielski
LicenseJournal (articles only); author's original; Uznanie Autorstwa (CC-BY); with publication
Score (nominal)30
ScoreMinisterial score = 30.0, 20-12-2017, ArticleFromJournal
Ministerial score (2013-2016) = 30.0, 20-12-2017, ArticleFromJournal
Publication indicators WoS Impact Factor: 2016 = 3.226 (2) - 2016=3.482 (5)
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