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Quebec Heart and Lung Institute, Laval University, Quebec, Canada
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Barts and the London School of Medicine, Centre for Endocrinology, William Harvey Institute, London, UK
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Obesity, Type 2 Diabetes and Immunometabolism Research Group, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Course Sciences, King’s College London, London, UK
Division of Reproductive Health, Warwick Medical School, University of Warwick, Coventry, UK
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), adrenocorticotrophic hormone (ACTH), cortisol-binding globulin (CBG), thyroxine-binding globulin (TBG), gonadotrophins, DHEAS, testosterone and plasma EDTA ACTH were collected using BD Vacutainer during the same venepuncture. Samples were stored at −80°C until analysis
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laboratories measure serum total cortisol concentrations and do not differentiate between the bound and free forms. Cortisol in blood exists in two forms: cortisol that is bound to carrier molecules (cortisol-binding globulin and albumin) and cortisol that is
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-linked immunosorbent assay (MyBioSource Inc., San Diego, CA, USA) and plasma cortisol (Immunotech, Beckman Coulter) and cortisol-binding globulin (CBG) (Riazen, ZenTech s.a., Liège, Belgium) by competitive radioimmunoassay. Plasma albumin was quantified by the
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
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differences between groups. Cortisol-binding globulin (CBG) was not measured; however, some studies have shown strong correlations between free (active) and total cortisol, implying no need to correct for CBG (32) . CBG is not affected by age, or the
Division of Endocrinology, Mid and South Essex NHS Trust, Broomfield, UK
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pre-existing pituitary or adrenal disease were excluded from the study. Those who were using medications affecting cortisol-binding globulin (estrogens) were also excluded from the study. Three hundred and two patients (median age 54 years
Department of Clinical Chemistry and Haematology, Zuyderland Medical Centre, Heerlen, The Netherlands
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cortisol concentrations ( 8 , 9 ). LC–MS/MS analyses are not influenced by changes in e.g. concentrations of cortisol-binding globulin or cross-reactivity with other corticosteroid substances. In addition, LC–MS/MS analysis enables the analysis of cortisol
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there has been any change in the use of diagnostic tests for CS across Europe over the past 5 years. LNSC is not affected by BMI or cortisol binding globulin and therefore accurately reflects serum cortisol concentrations. There is conflicting evidence
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5 Purnell JQ Brandon DD Isabelle LM Loriaux DL Samuels MH. Association of 24-hour cortisol production rates, cortisol-binding globulin, and plasma-free cortisol levels with body composition, leptin levels, and aging in adult men
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nmol/L) post-APST for patients with co-existing hypoalbuminemia. Since, the laboratory measures total cortisol levels and not free cortisol levels this would mean patients with low albumin and those with changes in cortisol binding globulin levels (e
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Departments of, Clinical Biochemistry, Medicine, Department of Endocrinology and Internal Medicine, King's College Hospital, London SE5 9RS, UK
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replacement during mitotane treatment is well established in clinical practice. Cortisol monitoring by standard methods is unhelpful due to mitotane-induced cortisol binding globulin increase and ACTH is more useful, with addition of free cortisol assay when