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[A critical analysis of cortisol measurements: an update].
[cushing syndrome]
Serum
cortisol
measurement
is
a
very
useful
tool
in
the
biochemical
evaluation
of
adrenocortical
function
.
Since
this
hormone
circulates
in
blood
mainly
linked
to
binding
globulins
but
is
also
partially
free
,
it
can
be
measured
not
only
in
the
blood
but
also
in
urine
,
saliva
and
other
biological
fluids
and
tissues
.
Basal
determinations
as
well
as
dynamic
testing
may
be
performed
to
evaluate
the
circadian
variations
,
to
estimate
the
diurnal
cortisol
secretion
and
to
analyze
its
relations
with
other
components
of
the
hypothalamic
-
pituitary
-
adrenal
axis
.
Measurements
of
cortisol
in
blood
,
saliva
and
urine
may
reflect
the
cortisol
secretion
at
the
time
of
sample
collection
or
during
a
24
h
span
.
Recently
,
it
has
been
proposed
the
determination
of
cortisol
in
tissues
such
as
hair
and
nails
like
a
means
of
evaluating
the
hormonal
status
during
prolonged
periods
.
The
aim
of
this
paper
is
to
update
the
methodology
for
measuring
cortisol
and
its
usefulness
for
the
clinical
diagnosis
of
troubles
of
the
hypothalamic
-
pituitary
-
adrenal
axis
.
