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Shuhui Ma Laboratory of Anatomy of Domestic Animals, College of Animal Medicine, China Agricultural University, Haidian, Beijing, China

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Zixu Wang Laboratory of Anatomy of Domestic Animals, College of Animal Medicine, China Agricultural University, Haidian, Beijing, China

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Jing Cao Laboratory of Anatomy of Domestic Animals, College of Animal Medicine, China Agricultural University, Haidian, Beijing, China

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Yulan Dong Laboratory of Anatomy of Domestic Animals, College of Animal Medicine, China Agricultural University, Haidian, Beijing, China

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Yaoxing Chen Laboratory of Anatomy of Domestic Animals, College of Animal Medicine, China Agricultural University, Haidian, Beijing, China

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the biological clock oscillators, the pineal gland secretes melatonin into the blood with high level during the subjective night and low level during the subjective day ( 2 ) and is a typical model system for the study of circadian rhythm. Melatonin

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Hershel Raff Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine
Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine
Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine
Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine

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Hariprasad Trivedi Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine

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are significant similarities between the morbidity of Cushing's syndrome and renal failure (8, 9) . Thus, it is important to be able to properly assess the HPA axis in ESRD subjects. The current study was designed to evaluate the circadian rhythm of

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Takuhiro Sonoyama Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Masakatsu Sone Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Naohisa Tamura Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Kyoko Honda Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Daisuke Taura Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Katsutoshi Kojima Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Yorihide Fukuda Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Naotetsu Kanamoto Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Masako Miura Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Akihiro Yasoda Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Hiroshi Arai Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Hiroshi Itoh Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Kazuwa Nakao Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

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Metabolism 1968 28 1014 – 1022 . ( doi:10.1210/jcem-28-7-1014 ). 15 Kem DC Weinberger MH Gomez-Sanchez C Kramer NJ Lerman R Furuyama S Nugent CA . Circadian rhythm of plasma aldosterone concentration in patients with primary aldosteronism

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Julie Smith Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Jan Fahrenkrug Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Henrik L Jørgensen Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Christina Christoffersen Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark
Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Jens P Goetze Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark
Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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regulation of energy metabolism . Nature Reviews. Endocrinology 2014 10 157 – 163 . ( doi:10.1038/nrendo.2013.234 ). 8 Bray MS Young ME . Circadian rhythms in the development of obesity: potential role for the circadian

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Rajae Talbi Department of Medicine, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

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Victor M Navarro Department of Medicine, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

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observed in control mice ( 57 ). This change in the circadian rhythm of feeding correlated with similar changes in physical activity and energy expenditure. These results suggested a critical role for Kiss1 ARC neurons in the regulation of circadian

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Sirazum Choudhury Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Karim Meeran Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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innervation of the adrenals and a local circadian clock within the adrenal glands. Apart from measurable rhythms in cortisol, GR activity is influenced by its own rhythm. CLOCK influences acetyl-transferase activity, which is directly capable of acetylating

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Filippo Ceccato Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Elisa Selmin Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Chiara Sabbadin Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Miriam Dalla Costa Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Giorgia Antonelli Laboratory Medicine, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Mario Plebani Laboratory Medicine, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Mattia Barbot Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Corrado Betterle Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Marco Boscaro Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Carla Scaroni Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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administered in two or three divided doses (the higher in the morning), as suggested in recent Consensus and Guidelines ( 2 , 6 ). Nevertheless, none of the proposed regimen is currently able to replicate the physiological cortisol circadian rhythm

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David J F Smith Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

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Karim Meeran Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

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profile with oral medication is a significant challenge because normal cortisol production is pulsatile and consists of a circadian rhythm and an ultradian rhythm ( 3 , 4 , 5 ). Under-replacement may cause lethargy and an increased risk of Addisonian

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Angelica Sharma Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Deborah Papadopoulou Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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Karim Meeran Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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patients take prednisolone as early as possible upon wakening. Other studies are trialling glucocorticoid pump replacement therapy to mimic circadian rhythms; however, there is limited evidence for their use so far ( 24 , 25 ). The importance of pulsatile

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L M Mongioì Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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R A Condorelli Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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S La Vignera Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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A E Calogero Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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 months ( 11 ). At the end of the 3 months, dual-release hydrocortisone mimicked the physiological circadian rhythm of cortisol secretion, confirming the results these authors had previously published in a phase 1 study ( 9 ). Moreover, the authors also

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