{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:55:45Z","timestamp":1787504145216,"version":"build-2736575974"},"reference-count":39,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Novartis and HRA Pharma"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Cortisol-lowering drugs may not restore a normal cortisol secretion in Cushing disease (CD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This work aimed to assess the long-term cortisol exposure in medically treated CD patients using hair-cortisol (HF) and hair-cortisone (HE) measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter prospective study included 3 groups of female patients: CushMed = 16 treated with a stable cortisol-lowering drug dosage and normal urinary free cortisol (UFC); CushSurg = 13 cured by pituitary surgery; CushBla = 15 receiving stable recommended doses of hydrocortisone following bilateral adrenalectomy. Patients were evaluated for 3 months with their usual treatments. Two late-night saliva and 24-hour urine samples were collected monthly in CushMed, and at study end in CushSurg and CushBla patients. A 3-cm hair sample was collected at study end from all patients. Main outcome measures included clinical score and centralized measurement of UFC, late-night salivary cortisol (LNSF), late-night salivary cortisone (LNSE), HE, HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Despite having almost all UFCs normalized, CushMed patients exhibited increased HE as compared to CushSurg controls (P = .003). CushMed patients also had increased clinical score (P = .001), UFC (P = .03), LNSF, LNSE (P = .0001), and variability in the latter parameters (P = .004). CushBla patients had increased HF and HE, contrasting with LNSEs similar to CushSurg patients. Six of 15 CushMed patients exhibited increased HE concentrations and had increased antihypertensive drug dosage compared to CushMed patients with normal HE (P = .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite normalized UFCs, a subset of medically treated CD patients displays an altered circadian rhythm of serum cortisol. A single HE measurement identifies chronic mild persistent hypercortisolism and could replace multiple saliva analyzes to monitor medical treatments in CD patients once UFC is normalized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgad251","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T08:08:11Z","timestamp":1683274091000},"page":"e963-e970","source":"Crossref","is-referenced-by-count":21,"title":["Evidence of Persistent Mild Hypercortisolism in Patients Medically Treated for Cushing Disease: the Haircush Study"],"prefix":"10.1210","volume":"108","author":[{"given":"Kamel","family":"Mohammedi","sequence":"first","affiliation":[{"name":"Department of Endocrinology, French Reference Center for Adrenal Cancer, EURACAN European Expert Center on Rare Neuroendocrine Tumors, H\u00f4pital Haut-L\u00e9v\u00e8que, CHU and University of Bordeaux , F-33604 Pessac , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Bertherat","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, French Reference Center for Rare Adrenal Disorders, H\u00f4pital Cochin, Universit\u00e9 Paris Cit\u00e9, Institut Cochin, Inserm U1016, CNRS UMR8104 , F-75014, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9517-338X","authenticated-orcid":false,"given":"Gerald","family":"Raverot","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, French Reference Center for Rare Pituitary Diseases HYPO, Hospices Civils de Lyon and Inserm U1052, CNRS UMR5286, Claude Bernard Lyon 1 University, Cancer Research Center of Lyon , F-69001, Lyon , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Drui","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Institut du thorax, CHU de Nantes , F-44000 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Reznik","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, CHU C\u00f4te de Nacre , F-14033 Caen , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-8800","authenticated-orcid":false,"given":"Frederic","family":"Castinetti","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Assistance Publique-Hopitaux de Marseille, French Reference Center for Rare Pituitary Diseases, EURACAN European Expert Center on Rare Pituitary Tumors, La Conception Hospital, Aix Marseille University , F-13385, Marseille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5096-5722","authenticated-orcid":false,"given":"Philippe","family":"Chanson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Reference Center for Rare Pituitary Diseases HYPO, CHU Bic\u00eatre , F-94270 Le Kremlin-Bic\u00eatre , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Fafin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, French Reference Center for Adrenal Cancer, EURACAN European Expert Center on Rare Neuroendocrine Tumors, H\u00f4pital Haut-L\u00e9v\u00e8que, CHU and University of Bordeaux , F-33604 Pessac , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Brossaud","sequence":"additional","affiliation":[{"name":"Laboratory of Hormonology and Tumor Markers, Nutrition and Integrated Neurobiology Laboratory, UMR 1286, CHU de Bordeaux , F-33300, Bordeaux , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1231-3306","authenticated-orcid":false,"given":"Antoine","family":"Tabarin","sequence":"additional","affiliation":[{"name":"Department of 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