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KMID : 0948320040040010021
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Konyang Medical Journal
2004 Volume.4 No. 1 p.21 ~ p.23
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Effect of Stress on 24 hour Urine Free Cortisol Excretion in Patients with Diabetes
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Park Keun-Young
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Abstract
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Background : 24 hour urine free cortisol (UFC) is a useful outpatient screening test for Cushing’s syndrome. Physical stresses and acute psychological stress increase cortisol secretion. Admission is a stress itself to patients and may increase urinary free cortisol level. But the influences of the admission stress on urine free cortisol level has not been well estimated. So we compared the influences of the stress according to the reasons for admission on 24 hour UFC excretion in patients with diabetes.
Methods : Total 73 admitted diabetic patients were assigned non-stress group (complication evaluation, glycemic control) or stress group (infection, operation, acute complication). Clinical characteristics and 24 hour UFC and urine creatinine (UC) were evaluated. False positive Cushing’s syndrome was defined as 24 hour UFC level greater than 100 μg/day. Statistical analysis was done using independent sampled T test.
Results : Compared with the non stress group, 24 hour UFC level and UFC/UC ratio in the stress group was greater (p=0.09, p=0.04). Compared with the non stress group (6.5%), false positive rate of Cushing’s syndrome in the stress group was significantly greater (22.2%).
Conclusion : Stress according to the reasons for admission may increase 24 hour UFC level and false positive ate of Cushing’s syndrome in patients with diabetes.
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KEYWORD
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urine free cortisol, admission, stress, Cushing’s syndrome, diabetes
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