Impaired Steroidogenesis in Patients with Clinically Inactive Adrenal Adenomas, Revealed by Analysis of Steroid Precursors
Issue: 2/2011
Author: Vladimir, Vasilev, Georgi Kirilov, Sabina Zacharieva
Abstract:
Introduction: Up to 20% of patients with adrenal incidentalomas may experience some type of hormonal disorders either caused by hypersecretion of the adrenal cortex or medulla or by precursor molecules. Accumulating evidence suggests that even clinically inactive adrenal tumours harbour different derangements of steroidogenesis.
Aim of the study: To evaluate levels of cortisol, 11-deoxycortisol, 17-OH progesterone and DHEAS in patients with clinically non-functioning adrenal adenomas. Patients and methods: 88 patients with adrenal incidentalomas and 60 healthy subjects were included in the study. Cortisol, 11-deoxycortisol, 17-OH progesterone and DHEAS were assayed in blood serum using radioimmunologic method.
Results: Statistically significant elevation of cortisol levels was found in adrenal incidentaloma patients compared to healthy subjects – 601 ± 308 nmol/l vs. 456 ± 212 nmol/l respectively (p=0,009) but no difference was detected for the steroid precursors and their ratios. Correlation analysis revealed no significant relationship between the consecutive steroid precursors in patients with adrenal tumours in contrast to the control group.
Conclusions: The subtle enzyme disorders in patients with apparently inactive adrenal adenomas may cause cardiovascular and metabolic complications and should be considered by physicians when managing these patients.
Keywords:.adrenal incidentalomas, steroid precursors, 11-deoxycortisol, 17-OH progesterone, DHEAS
