Plasma cortisol and cortisone concentrations in normal subjects and patients with adrenocortical disorders

Morita, Hiroyuki; Isomura, Yukinori; Mune, Tomoatsu; Daido, Hisashi; Takami, Rieko; Yamakita, Noriyoshi; Ishizuka, Tatsuo; Takeda, Noriyuki; Gómez-Sánchez, Celso E.

doi:10.1016/j.metabol.2003.06.005

Cited by 28 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast with our findings, a previous study by Mune et al (25), which examined the expression of HSD11B2 in CPAs, found that expression was inversely correlated with cortisol secretion. Likewise, a more recent study that measured the plasma cortisol/cortisone ratio in adenomas vs. NA found that patients with CPA had lower HSD11B2 activity, whereas HSD11B2 activity in patients with APA was increased (26). However, our real-time RT-PCR for HSD11B2 detected elevated levels of this enzyme in CPA (P ϭ 0.002), but not in APA, compared with NA samples (n ϭ 12 for each sample group).…”

Section: Microarray Analysis Of Steroid-metabolizing Enzymessupporting

confidence: 42%

Expression Profiles for Steroidogenic Enzymes in Adrenocortical Disease

Bassett

Mayhew

Rehman

et al. 2005

The Journal of Clinical Endocrinology & Metabolism

105

View full text Add to dashboard Cite

Context: Excess production of aldosterone or cortisol has profound effects on cardiovascular function and impacts other major organ systems. The mechanisms leading to the autonomous hypersecretion of aldosterone or cortisol in aldosterone-producing adenoma (APA) or cortisol-producing adenoma (CPA) are unknown.Objective: The objective of this study was to compare the expression profiles of several steroid-metabolizing enzymes and transcription factors from normal adrenal (NA), APAs, and CPAs.Design: RNA from NAs, APAs, and CPAs were analyzed by microarray and real-time RT-PCR. Setting:This study was performed at academic research laboratories.Patients: At least nine normal controls and 12 patients with APA or CPA were studied.Intervention: There was no intervention procedure. Main Outcome Measure:The main outcome measure was the expression of steroidogenic enzymes in adrenocortical disease.Results: A microarray indicated a greater than 3-fold increase in the expression of CYP11B2 (aldosterone synthase) in APA, whereas 11␤-hydroxysteroid dehydrogenase type 2 (HSD11B2) and HSD17B1 had greater than 3-fold increases in expression in CPA compared with NA. Real-time RT-PCR showed that APAs produced higher levels of HSD3B2, CYP21 (21-hydroxylase), and CYP11B2 mRNA, whereas CPAs produced higher levels of CYP11A (cholesterol side-chain cleavage), CYP17 (17␣-hydroxylase/17-20 lyase), HSD3B2, and CYP11B1 (11␤-hydroxylase) mRNA compared with normal adrenal. Steroidogenic factor-1, DAX-1 (dosage-sensitive sex reversal, adrenal hypoplasia congenita, critical region on the X chromosome gene 1), and GATA-6 were expressed at higher levels in APAs and CPAs, whereas NURR1 was expressed at higher levels in APAs than in CPAs or NAs. Conclusion

show abstract

Section: Microarray Analysis Of Steroid-metabolizing Enzymessupporting

confidence: 42%

Expression Profiles for Steroidogenic Enzymes in Adrenocortical Disease

Bassett

Mayhew

Rehman

et al. 2005

The Journal of Clinical Endocrinology & Metabolism

105

View full text Add to dashboard Cite

show abstract

“…It is synthesized and released into blood from the zona fasciculata of the adrenal gland. Apart from cortisol, several of its metabolites like 6beta-hydroxycortisol, 20alpha-and 20beta-dihydroxycortisol, and cortisone are also directly secreted by the gland, but their concentrations in the adrenal vein are much lower than that of cortisol [1][2][3]. A very small fraction of the direct secretion products are even released from the *Address correspondence to this author at the Forschungsinstitut für Kinderernährung, Research Institute of Child Nutrition, Department of Nutrition and Health, Heinstück 11,44225 Dortmund, Gemany; Tel: +49 231-79221043; Fax: +49 231-711581; E-mail: remer@fke-do.de adrenals sulfated at position C20 of the glucocorticoid molecule [1].…”

Section: Glucocorticoid Secretionmentioning

confidence: 99%

Glucocorticoid Measurements in Health and Disease - Metabolic Implications and the Potential of 24-h Urine Analyses

Remer¹,

Maser-Gluth²,

Wudy³

2008

MRMC

View full text Add to dashboard Cite

For examination of glucocorticoid metabolism and identification of hyper and hypocortisolism, various measurements and diagnostic tools are available. After a brief overview of the physiology of glucocorticoid secretion and glucocorticoid actions, the currently used measurements for blood, saliva, and urine samples and the corresponding physiological and metabolic implications are critically reviewed. A special emphasis is placed on the potential of 24-h urine analyses to assess not only glucocorticoid secretion, but also functional glucocorticoid activity.

show abstract

“…In the literature, increase in cortisol/cortisone ratio has been reported in blood [13,14] or urine metabolites [15] after ACTH stimulation test, which also suggested the activity of key enzyme, type 2 11β-hydroxysteroid dehydrogenase, cannot be adjusted to increased cortisol. Moreover, Morita et al reported increased plasma cortisol/cortisone ratio in Cushing disease [16]. This means that chronically oversynthesized cortisol were also not metabolized to cortisone efficiently.…”

Section: Discussionmentioning

confidence: 99%

Free cortisol/cortisone ratio in pooled urine was increased after rapid-ACTH stimulation test under dexamethasone suppression

et al. 2011

View full text Add to dashboard Cite

To assess the adrenal function, rapid-ACTH stimulation test has been widely used, which involves measurement of serum cortisol after intravenous injection of 250 µg α 1-24 corticotropin acetate [1,2]. In our institute, we routinely perform rapid-ACTH stimulation test with low and high dose dexamethasone (DEX) suppression to assess the response to exogenous ACTH [3,4]. However, we have little knowledge about the changes of urinary free cortisol (FF) and cortisone (FE) concentration under this setting.The purposes of this study was to established reli- abstract. We employ rapid-ACTH stimulation test under dexamethasone (DEX) suppression to assess the adrenal function in daily clinic. However, we have little knowledge about the excretion of urinary free cortisol (FF) and cortisone (FE) in pooled urine in this setting. The purpose was to examine the changes of FF and FE as well as FF/FE ratio in pooled urine after rapid-ACTH stimulation test under DEX suppression using stable isotope dilution -gas chromatography/mass spectrometry (SID-GC/MS). Pooled urine samples were collected from 8 patients (age 33-71 years) who were suspected to have primary aldsteronism. They all were finally diagnosed as having normal glucocorticoid secretion. We performed rapid-ACTH stimulation test with DEX suppression for consecutive 4 days as follows. (1) 24 hour urine samples were serially collected from 2300h on day 1 for 72 hours (Basal, DEX1mg, and DEX8mg-ACTH). (2) 1 and 8 mg DEX was given at 2300h on day 2 and 3, respectively. (3) 250µg of ACTH was given at 0900h on day 4. Urine free steroids were delivered with bismethylenedioxy-heptafluorobutyric anhydride and analyzed by SID-GC/MS (µg/day). From DEX1mg to DXE8mg-ACTH, 1) FF and FE were significantly increased (3.9±1.3 to 21.3±14.6 and 12.4±4.8 to 26.1±11.0 µg/day, respectively), but 2) FF/FE ratio significantly increased (0.32±0.05 to 0.77±0.23). These data suggested that newly synthesized cortisol by ACTH stimulation was not efficiently metabolized to cortisone.Key words: Urinary free cortisol, Urinary free cortisone, Cortisol/cortisone ratio, ACTH stimulation test, SID-GC/MS able methods to measure urinary free glucocorticoids, and give insight into the response of FF and FE to exogenous ACTH under suppression of endogenous ACTH by examining the changes of FF and FE as well as FF/FE ratio in pooled urine after rapid-ACTH stimulation test under DEX suppression using stable isotope dilution -gas chromatography mass spectrometry (SID-GC/MS). First, we validated the method to measure free glucocorticoid in urine using double derivatization of bismethylenedioxy-heptafluorobutylate and SID-GC/MS [5,6]. Second, we measured FF and FE in pooled urine after rapid-ACTH stimulation test under DEX suppression and calculated FF/ FE ratio.

show abstract

Plasma cortisol and cortisone concentrations in normal subjects and patients with adrenocortical disorders

Cited by 28 publications

References 28 publications

Expression Profiles for Steroidogenic Enzymes in Adrenocortical Disease

Expression Profiles for Steroidogenic Enzymes in Adrenocortical Disease

Glucocorticoid Measurements in Health and Disease - Metabolic Implications and the Potential of 24-h Urine Analyses

Free cortisol/cortisone ratio in pooled urine was increased after rapid-ACTH stimulation test under dexamethasone suppression

Contact Info

Product

Resources

About