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Cortisol is the main glucocorticoid synthesized from cholesterol in adrenal zona fasciculata cells. Nonspecific stimuli such as physical or psychological stress results in hypothalamic-pituitatary-adrenal (HPA) axis activation and secretion of cortisol which has a wide spectrum of biological effects. Therefore, different diagnostic tests are used to evaluate HPA axis activity in routine clinical practice, e.g. dexamethasone suppression test, determination of adrecorticotropic hormone (ACTH) in blood serum and cortisol concentration measurement in both blood serum and 24-hour urine samples.
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