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Patricia Arroyo Tardio University Hospital Basel, Basel, Switzerland

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Gabriela Baldini University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland

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Eleonora Seelig University Hospital Basel, Basel, Switzerland
University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland

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Introduction The hypothalamopituitary–adrenal (HPA) axis tightly regulates cortisol secretion ( 1 ). Cortisol is secreted in a circadian rhythm with a brisk increase upon awakening and a nadir around midnight ( 1 ). Food is an external factor

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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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Introduction The measurement of salivary cortisol has emerged as a first-line test in the evaluation of the hypothalamic–pituitary–adrenal (HPA) axis in humans and, in particular, for the diagnosis of endogenous hypercortisolism (Cushing

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

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Paul N Hopkins Cardiovascular Genetics, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

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Nancy J Brown Vanderbilt University Medical Center, Nashville, Tennessee, USA

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

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

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

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

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role of both overt and non-overt hypercortisolism in the pathogenesis of cardiovascular disease (CVD). However, much less is known about the CV effects of cortisol concentrations within the physiological range. While some studies have shown a link

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Bjørn O Åsvold Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway
Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway

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Valdemar Grill Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway
Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway

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Ketil Thorstensen Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway

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Marit R Bjørgaas Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway
Department of Endocrinology, Department of Public Health, Department of Cancer Research and Molecular Medicine, Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, P O Box 3250 Sluppen, N-7006 Trondheim, Norway

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Introduction The 1 mg overnight dexamethasone suppression test (DST) is a common initial test for endogenous Cushing's syndrome (1) . The principle of the test is that dexamethasone will suppress ACTH and cortisol secretion in healthy individuals

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I Azzam Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel

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S Gilad Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel

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R Limor Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel

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N Stern Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Y Greenman Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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, prolactin and cortisol ( 15 , 16 , 17 ). The stimulation of the HPA axis by ghrelin is exerted predominantly at the hypothalamic level ( 18 ) through vasopressin stimulation ( 19 ) and indirect activation of CRH neurons ( 20 , 21 ). Direct effects of

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Ferdinand Roelfsema Department of Internal Medicine, Section Endocrinology, Leiden University Medical Center, Leiden, The Netherlands

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Peter Y Liu Department of Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California, USA

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Rebecca Yang Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota, USA

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Paul Takahashi Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

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Johannes D Veldhuis Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota, USA

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that it may be useful as an immuno-neuroendocrine probe of adrenal function ( 5 ). Nonetheless, virtually all studies were uncontrolled and performed in patients with advanced cancer, in whom cortisol responses differ from those of healthy men ( 5 ). In

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Arno Téblick Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Ilse Vanhorebeek Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Inge Derese Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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An Jacobs Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Renata Haghedooren Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Sofie Maebe Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Gerdien A Zeilmaker-Roest Department of Neonatal & Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands

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Enno D Wildschut Department of Neonatal & Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands

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Lies Langouche Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Greet Van den Berghe Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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thereafter, while free cortisol is only elevated upon PICU admission and normal thereafter ( 4 ). Plasma POMC has not been quantified in critically ill children. In addition, the dynamics of plasma ACTH and free cortisol before PICU admission are unknown. In

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Ferdinand Roelfsema Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Diana van Heemst Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands

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Ali Iranmanesh Endocrine Section, Medical Service, Salem Veterans Affairs Medical Center, Salem, Virginia, USA

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Paul Takahashi Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

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Rebecca Yang Endocrine Research Unit, Mayo Medical and Graduate Schools, Clinical Translational Research Center, Mayo Clinic, Rochester, Minnesota, USA

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Johannes D Veldhuis Endocrine Research Unit, Mayo Medical and Graduate Schools, Clinical Translational Research Center, Mayo Clinic, Rochester, Minnesota, USA

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inferences. Nonetheless, multivariate analysis also is unreliable in small cohorts ( 19 , 20 ). In addition, given the large concentration difference across the 24-h cycle and the marked pulsatility of cortisol, studies using a single sample, or a few blood

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Eva Olga Melin Diabetes Research Laboratory, Lund University, Lund, Sweden
Department of Research and Development, Region Kronoberg, Växjö, Sweden

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Magnus Hillman Diabetes Research Laboratory, Lund University, Lund, Sweden

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Mona Landin-Olsson Diabetes Research Laboratory, Lund University, Lund, Sweden
Department of Endocrinology, Skane University Hospital, Lund, Sweden

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with T1D was 35%, almost twice as high as in the non-diabetic population ( 2 ). Several factors might contribute to the development of hypertension, such as increased cortisol secretion ( 4 , 5 , 6 , 7 , 8 , 9 ), obesity ( 8 , 9 ), physical

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L Ghataore Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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I Chakraborti Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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S J Aylwin Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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K-M Schulte Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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D Dworakowska Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK
Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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P Coskeran Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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N F Taylor Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK

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patients treated with mitotane (9) . Patients with Cushing's syndrome receiving mitotane have shown decrease in the adrenal cortisol secretion rate over time but a faster clinical benefit, suggesting that cortisol bioavailability is also diminished (10

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