TY - JOUR
T1 - Urinary 18-Hydroxy cortisol and its relationship to the excretion of other adrenal steroids
AU - Gomez-Sanchez, Celso E.
AU - Upcavage, Robert J.
AU - Zager, Philip G.
AU - Foecking, Mark F.
AU - Holland, O. Bryan
AU - Ganguly, Arunabha
PY - 1987/8
Y1 - 1987/8
N2 - The urinary excretion of 18-hydroxycortisol was recently reported to be increased in patients with primary aldosteronism who have an adrenal adenoma and in those with glucocorticoid-suppressible aldosteronism. A direct RIA for 18-hydroxycortisol in urine and plasma has been described, and we here report our experience using a similar direct RIA and a more elaborate RIA which includes a preliminary high pressure liquid chromatography (HPLC) purification step. The urinary excretion of 18-hydroxycortisol was compared with that of other adrencorticoids. The urinary excretion of 18-hydroxycortisol in 37 normal subjects using the direct RIA was 112 ± 49 (±SD) μg/24 h, and that with the HPLC-RIA method was 63 ± 36 μg/24 h. The accuracy and specificity of the HPLC-RIA assay method were confirmed by measuring the steroid after the HPLC step as the glycolic acid ester derivative. The urinary excretion of 18-hydroxycortisol correlated with that of cortisol (r = 0.36; P < 0.01), 18-oxocortisol (r = 0.42; P < 0.01), and 19-nordeoxycortisosterone (r = 0.71; P < 0.001), but did not correlate with the excretion of aldosterone 18-oxoglucuronide (r = 0.25; P = 0.15942). Dexamethasone administration to five normal subjects significantly decreased 18-hydroxycortisol excretion from 81 ± 47 to 23 ± 8 μg/24 h. ACTH infusion in these subjects receiving dexamethasone significantly raised 18-hydroxycortisol excretion to 147 ± 37 μg/24 h. Five days of a sodium-restricted diet (10 mmoles/day) resulted in a significant (P < 0.02) increase in 18-hydroxycortisol excretion, but two of eight subjects had decreased excretion, although urinary aldosterone excretion increased, as expected. These studies demonstrate that the direct RIA significantly overestimates urinary 18-hydroxycortisol excretion. These studies also demonstrate that the major factor resulating 18-hydroycortisol excretion is ACTH. However, since 18-hydroxycortisol excretion may increase during sodium depletion, angiotensin or other factors may also regulate its secretion.
AB - The urinary excretion of 18-hydroxycortisol was recently reported to be increased in patients with primary aldosteronism who have an adrenal adenoma and in those with glucocorticoid-suppressible aldosteronism. A direct RIA for 18-hydroxycortisol in urine and plasma has been described, and we here report our experience using a similar direct RIA and a more elaborate RIA which includes a preliminary high pressure liquid chromatography (HPLC) purification step. The urinary excretion of 18-hydroxycortisol was compared with that of other adrencorticoids. The urinary excretion of 18-hydroxycortisol in 37 normal subjects using the direct RIA was 112 ± 49 (±SD) μg/24 h, and that with the HPLC-RIA method was 63 ± 36 μg/24 h. The accuracy and specificity of the HPLC-RIA assay method were confirmed by measuring the steroid after the HPLC step as the glycolic acid ester derivative. The urinary excretion of 18-hydroxycortisol correlated with that of cortisol (r = 0.36; P < 0.01), 18-oxocortisol (r = 0.42; P < 0.01), and 19-nordeoxycortisosterone (r = 0.71; P < 0.001), but did not correlate with the excretion of aldosterone 18-oxoglucuronide (r = 0.25; P = 0.15942). Dexamethasone administration to five normal subjects significantly decreased 18-hydroxycortisol excretion from 81 ± 47 to 23 ± 8 μg/24 h. ACTH infusion in these subjects receiving dexamethasone significantly raised 18-hydroxycortisol excretion to 147 ± 37 μg/24 h. Five days of a sodium-restricted diet (10 mmoles/day) resulted in a significant (P < 0.02) increase in 18-hydroxycortisol excretion, but two of eight subjects had decreased excretion, although urinary aldosterone excretion increased, as expected. These studies demonstrate that the direct RIA significantly overestimates urinary 18-hydroxycortisol excretion. These studies also demonstrate that the major factor resulating 18-hydroycortisol excretion is ACTH. However, since 18-hydroxycortisol excretion may increase during sodium depletion, angiotensin or other factors may also regulate its secretion.
UR - http://www.scopus.com/inward/record.url?scp=0023184418&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0023184418&partnerID=8YFLogxK
U2 - 10.1210/jcem-65-2-310
DO - 10.1210/jcem-65-2-310
M3 - Article
C2 - 3036905
AN - SCOPUS:0023184418
SN - 0021-972X
VL - 65
SP - 310
EP - 314
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -