Use of urine cortisol:creatinine in screening for Cushing’s syndrome
Research type
Research Study
Full title
Use of a liquid chromatography tandem mass spectroscopy method to assess the utility of an overnight urine cortisol: creatinine ratio as a first-line screening tool in the investigation of Cushing’s syndrome.
IRAS ID
150588
Contact name
Philip Padfield
Contact email
Sponsor organisation
The University of Manchester
Research summary
Cushing’s syndrome is associated with the excess production of a hormone called cortisol. When a patient exhibits symptoms commonly associated with Cushing’s syndrome their doctor will ask them to perform a 24 hour urine collection to test for cortisol. If cortisol levels in the urine are found to be high further investigations will be performed to confirm the diagnosis of Cushing’s Syndrome. The need for a 24 hour urine collection is an inconvenience for patients and requires very careful collection to ensure accurate results. This study aims to determine if the urine collection procedure can be simplified by using the first urine passed of the day (i.e. a first morning urine sample) instead of a 24 hour urine collection. The first urine passed on the day of collection is usually discarded.
In this study, patients who are seen by a doctor with a suspected diagnosis of Cushing’s Syndrome and will therefore be providing a 24 hour urine collection as part of their routine clinical care, will be asked to provide us with a sample of their first morning urine passed on the same day as the 24 hour collection. This sample would usually be discarded. The first morning urine sample will be analysed in the laboratory for creatinine (an indicator of how concentrated the urine is) and cortisol (a hormone). A creatinine: cortisol ratio is then calculated and this determines if the patient needs further investigation for Cushing’s syndrome.
In addition to patients providing their first morning urine sample, a group of healthy volunteers will also be asked to provide a sample of their first morning urine. The volunteers will be NHS staff. The sample from volunteers will be used to provide a reference range for the creatinine/ cortisol ratio.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
14/LO/1036
Date of REC Opinion
3 Jun 2014
REC opinion
Favourable Opinion