Adrenal cortex, tumor, and peripheral production of deoxycorticosterone

Steroids. 1992 Jan;57(1):7-12. doi: 10.1016/0039-128x(92)90089-r.

Abstract

A method is reported for the measurement of the urine excretion rates of tetrahydro-11-deoxycorticosterone (3 alpha,5 beta-THDOC), an important metabolite of 11-deoxycorticosterone (DOC). Quantification using gas chromatography/mass spectrometry (GC/MS) was achieved by comparing the ion fragment response for the molecular ion (m/z 507) of the analyte (as methyloxime trimethylsilyl ether derivative) to that of a fixed amount of an isomer of THDOC added to urine as internal standard. To improve the specificity of measuring THDOC in clinical samples, an additional Sephadex LH-20 chromatography step was introduced to separate 11-deoxycortisol and some progesterone metabolites. In the luteal phase of the menstrual cycle, THDOC excretion was higher than in the follicular phase; it was also higher than in women taking oral contraceptives. The correlation of THDOC with progesterone production, independent of a constant cortisol output, supports an ovarian or peripheral conversion of progesterone to DOC. The assay proved useful (1) in monitoring for the recurrence of a mineralocorticoid-secreting tumor and (2) when adrenal production of DOC was not fully suppressed in congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency. Under the latter circumstances, the renin-angiotensin system seemed to be an important regulator of DOC production.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex / metabolism*
  • Adrenal Gland Neoplasms / metabolism*
  • Adrenal Hyperplasia, Congenital / metabolism*
  • Adrenocorticotropic Hormone / blood
  • Adult
  • Carcinoma / metabolism*
  • Child
  • Contraceptives, Oral / pharmacology
  • Desoxycorticosterone / analogs & derivatives*
  • Desoxycorticosterone / biosynthesis*
  • Desoxycorticosterone / urine
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / secondary
  • Luteal Phase / physiology
  • Male
  • Middle Aged
  • Mineralocorticoids / metabolism
  • Progesterone / biosynthesis

Substances

  • Contraceptives, Oral
  • Mineralocorticoids
  • Desoxycorticosterone
  • tetrahydrodeoxycorticosterone
  • Progesterone
  • Adrenocorticotropic Hormone