ArticleThe Journal of clinical endocrinology and metabolism2025
Steroid Profiling and Circadian Cortisol Secretion in Patients With Mild Autonomous Cortisol Secretion: A Cross-sectional Study.
Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07649317 (Ketoconazole Effects on Cortisol Circadian Rhythm in Mild Autonomous Cortisol Secretion), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Ketoconazole Effects on Cortisol Circadian Rhythm in Mild Autonomous Cortisol Secretion: A Pilot Study
Who cites it
11 citing papers in PubMed.
- Hypercortisolism: Causes, Consequences and Clinical Significance - A Review of Pathophysiology.Diabetes, obesity & metabolism · 2026Review
- Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement.The Journal of clinical endocrinology and metabolism · 2026Review
- Effects of short-term metyrapone treatment on glycaemic control in patients with mild autonomous cortisol secretion: a pilot study.Endocrine · 2026Article
- [Diagnostics and surgery of mild autonomous cortisol secretion (MACS)].Chirurgie (Heidelberg, Germany) · 2026Article
- Efficacy and Tolerability of Metyrapone in Mild Autonomous Cortisol Secretion: Real-World Findings From Clinical Practice.Clinical endocrinology · 2026Article
- Time-dependent Increase in Cortisol after 1-mg Overnight Dexamethasone Suppression Test in Adrenal Incidentalomas.Journal of the Endocrine Society · 2026Article
- Dynamic testing of cortisol in consecutive patients with suspected adrenal disorders: a comparison of Elecsys Cortisol II and LC-MS/MS.Endocrine connections · 2026Article
- Managing mild autonomous cortisol secretion (MACS): evaluating the role of medical treatment.Frontiers in endocrinology · 2026Article
- "Feeding the Rhythm"-Effects of Food and Nutrients on Daily Cortisol Secretion: From Molecular Mechanisms to Clinical Impact.International journal of molecular sciences · 2025Review
- Osilodrostat Treatment for Adrenal and Ectopic Cushing Syndrome: Integration of Clinical Studies With Case Presentations.Journal of the Endocrine Society · 2025Review
- Steroid Profiling and Circadian Cortisol Secretion in Patients With Mild Autonomous Cortisol Secretion: A Cross-sectional Study.The Journal of clinical endocrinology and metabolism · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
contextMild autonomous cortisol secretion (MACS) is diagnosed based on postdexamethasone cortisol >1.8 µg/dL. Scarce evidence exists on steroid circadian secretion and steroid metabolome in MACS.
objectiveTo characterize 24-hour (h) urine steroid metabolome in patients with MACS and determine circadian differences in urine steroid profiling and cortisol concentrations in patients with MACS vs referent subjects.
methodsCross-sectional study, 2018-2023, at a referral center. Patients with MACS and age-, sex-, body mass index-, and menopausal status-matched referent subjects were included. Urine was collected over a 24 hour period as separate daytime and nighttime collections. High-resolution mass spectrometry assay was used to measure 25 steroids. A subgroup of patients and referent subjects was admitted for serum measurements of free and total cortisol every 2 hours. Outcomes were steroids, steroid sums, and ratios.
resultsPatients with MACS (n = 72) had lower µg/24 hour median androgens (2084 vs 3283, P < .001), higher glucocorticoids (15 754 vs 12936, P < .001), and higher glucocorticoid/androgen ratio (8.7 vs 3.9, P < .001) than referent subjects. Patients also had lower steroid day/night ratios than referent subjects, reflecting a higher relative nocturnal steroid production in MACS. In a subgroup of 12 patients with MACS and 10 referent subjects, the 24-hour areas under the curve for total and free serum cortisol were similar. However, evening mean total (5.3 vs 4.0 µg/dL, P = .056) and free (0.2 vs 0.1 µg/dL, P = .035) cortisol was higher in patients vs referent subjects.
conclusionPatients with MACS demonstrate an abnormal urine steroid metabolome, with a high glucocorticoid to androgen ratio, and a higher nocturnal steroid production.
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