Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;23(1):113-120.
doi: 10.1007/s42000-023-00495-x. Epub 2023 Oct 4.

Hair cortisol and endocannabinoid measurement in patients with adrenal incidentalomas: a case-control study

Chrysoula Mytareli  1 , Fani Athanasouli  1 , Evangelia Andreadaki  1 , Foteini Thanasoula  1 , Anna Angelousi  2
Affiliations

Hair cortisol and endocannabinoid measurement in patients with adrenal incidentalomas: a case-control study

Chrysoula Mytareli et al. Hormones (Athens). 2024 Mar.

Abstract

Purpose: The role of endocannabinoids (ECs) in the regulation of the hypothalamic-pituitary-adrenocortical axis has already been studied; however, data are scarce in humans. The aim of our study was to analyze EC [anandamide (AEA) and 2-arachidonoylglycerol (2-AG)] and cortisol (F) levels in hair samples of patients with adrenal incidentalomas (AIs) in comparison with those found in controls and assess their association with the hormone profile.

Methods: Forty-four patients with AIs [32 with non-functioning AIs (NFAIs) and 12 with possible autonomous secretion (PACS)] and 44 controls were recruited. Basal and post-1 mg overnight dexamethasone suppression test (ODST) F, adrenocorticotropic hormone, dehydroepiandrosterone sulfate, and 24-h urinary free cortisol were analyzed. After hair collection, EC and F levels were measured by liquid chromatography tandem-mass spectrometry.

Results: There was no difference between the groups regarding age, sex, and metabolic status. Significantly decreased hair AEA and 2-AG levels were found in patients with AIs compared to controls (p < 0.001 and p = 0.002, respectively) as well as between NFAI or PACS and controls (p < 0.001 or p = 0.002 and p = 0.038 or p = 0.02, respectively). Among the AI patients, EC levels tended to be lower in the PACS group. AEA hair levels were negatively correlated with F levels post-1 mg ODST (rs = -0.257, p = 0.033). We found no significant difference comparing hair F between the groups.

Conclusion: Our findings suggest that hair EC measurement could be a potential biomarker in the evaluation of patients with AIs, whereas hair F analysis is not a useful diagnostic test for mild hypercortisolemia.

Keywords: Adrenal mass; Cortisol; Endocannabinoids; Hair biomarkers.

PubMed Disclaimer

References

    1. Fassnacht M, Arlt W, Bancos I et al (2016) Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 175(2):G1–G34. https://doi.org/10.1530/EJE-16-0467 - DOI - PubMed
    1. Aresta C, Favero V, Morelli V, et al. (2021) "Cardiovascular complications of mild autonomous cortisol secretion," 2021 Best Pract Res Clin Endocrinol Metab 35(2):101494. https://doi.org/10.1016/j.beem.2021.101494
    1. Chiodini I, Vainicher CE, Morelli V et al (2016) MECHANISMS IN ENDOCRINOLOGY: Endogenous subclinical hypercortisolism and bone: a clinical review. Eur J Endocrinol 175(6):R265-r282. https://doi.org/10.1530/EJE-16-0289 - DOI - PubMed
    1. Deutschbein T, Reimondo G, Di Dalmazi G et al (2022) Age-dependent and sex-dependent disparity in mortality in patients with adrenal incidentalomas and autonomous cortisol secretion: an international, retrospective, cohort study. Lancet Diabetes Endocrinol 10(7):499–508. https://doi.org/10.1016/S2213-8587(22)00100-0 - DOI - PubMed - PMC
    1. Hodes A, Meyer J, Lodish MB et al (2018) Mini-review of hair cortisol concentration for evaluation of Cushing syndrome. Expert Rev Endocrinol Metab 13(5):225–231. https://doi.org/10.1080/17446651.2018.1517043 - DOI - PubMed - PMC

Supplementary concepts

Grants and funding

LinkOut - more resources