皮质醇尿试验

定义

The cortisol urine test measures the level of cortisol in the urine. Cortisol is a glucocorticoid (steroid) hormone produced by the 肾上腺.

Cortisol can also be measured using a 血 或者唾液测试.

选择的名字

24-hour urinary free cortisol (UFC)

How the Test is Performed

A 24-hour urine sample is needed. 你需要 collect your urine over 24 hours in a container provided by the laboratory. Your health care provider will tell you how to do this. Follow instructions exactly.

Because cortisol production by the 肾上腺 can vary, the test may need to be done three or more separate times over a few weeks to months to get a more accurate picture of average cortisol production.

How to Prepare for the Test

You may be asked not to do any vigorous exercise the day before the test.

You may also be told to temporarily stop taking medicines that can affect the test, including:

• 抗癫痫药物
• 雌激素
• Human-made (synthetic) glucocorticoids, such as hydrocortisone, prednisone, 和 prednisolone
• 雄激素

How the Test will Feel

The test involves only normal urination. 没有不适.

Why the Test is Performed

The test is done to check for increased or decreased cortisol production. Cortisol is a glucocorticoid (steroid) hormone released from the 肾上腺 in response to adrenocorticotropic hormone (ACTH). This is a hormone released from the pituitary gl和 in the brain. Cortisol affects many different body systems. 它在以下方面发挥作用:

• 骨骼生长
• 控制血压
• 免疫系统功能
• Metabolism of fats, carbohydrates, 和 protein
• Nervous system function
• 应激反应

Different diseases, such as 库欣综合症 和 艾迪生疾病, can lead to either too much or too little production of cortisol. Measuring urine cortisol levels can help diagnose these conditions.

正常的结果

Normal range is less than 45 mcg/24 hours (124 nmol/24 hours) for women 和 less than 60 mcg/24 hours (165 nmol/24 hours).

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

A higher than normal level may indicate:

• 库欣病, in which the pituitary gl和 makes too much ACTH because of excess growth of the pituitary gl和 or a tumor in the pituitary gl和
• Ectopic 库欣综合症, in which a tumor outside the pituitary or 肾上腺s makes too much ACTH
• 严重的抑郁症
• Tumor of the 肾上腺 that is producing too much cortisol
• 严重的压力
• Rare genetic disorders

A lower than normal level may indicate:

• 艾迪生疾病 in which the 肾上腺s do not produce enough cortisol
• 垂体机能减退 in which the pituitary gl和 does not signal the 肾上腺 to produce enough cortisol
• Suppression of normal pituitary or adrenal function by glucocorticoid medicines including pills, 护肤霜, 眼药水, 吸入器, 联合注射, 化疗

风险

There are no risks with this test.

参考文献

Guber HA, Oprea M, Russell YX. Evaluation of endocrine function. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis 和 Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 25.

Newell-Price JDC, Auchus RJ. 肾上腺皮质. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14日艾德. Philadelphia, PA: Elsevier; 2020:chap 15.