ECE2015 Guided Posters Adrenal (1) (8 abstracts)
Steroid profiling by liquid chromatography–tandem mass spectrometry in patients with non-secreting adrenocortical adenomas and subclinical hypercortisolism
Guido Di Dalmazi 1, , Flaminia Fanelli 1, , Marco Mezzullo 1, , Elena Casadio 1 , Eleonora Rinaldi 1 , Silvia Garelli 1 , Valentina Vicennati 1 , Uberto Pagotto 1 & Renato Pasquali 1
1Endocrinology Unit, Department of Medical and Surgical Sciences, Alma Mater University of Bologna, Bologna, Italy; 2Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany; 3Centro di Ricerca Biomedica Applicata (CRBA), Alma Mater University of Bologna, Bologna, Italy.
Steroid profiling by liquid chromatography–tandem mass spectrometry (LC–MS/MS) offers an accurate and simultaneous detection of a panel of steroids with several advantages over traditional assays. However, only a few studies have investigated the steroid profiling in sporadic adrenocortical adenomas. Our aim was therefore to investigate steroid secretion by LC–MS/MS in patients with non-secreting adrenocortical adenomas (NSA) and subclinical hypercortisolism (SH), by analysing cortisol, 21-deoxycortisol (21-DF), 11-deoxycortisol, 17-hydroxyprogesterone (17-OHP), androstenedione, DHEA, testosterone, progesterone, 21-deoxycorticosterone (DOC), and corticosterone. Steroids were evaluated in basal condition and 60 min after stimulation with 250 μg of 1,24 ACTH. patients (n=94) were analysed at baseline and compared to 190 sex- and age-matched controls. DHEA levels were progressively decreased in NSA and SH, respect to controls. Androstenedione and testosterone levels were also reduced in females. A significant positive correlation between basal DHEA and ACTH was found (correlation coefficient 0.403, P<0.001), supporting the hypothesis that decreased stimulation of contralateral cortex by reduced ACTH levels is the likely cause of DHEA reduction. Considering the known anti-glucocorticoid effects of DHEA in adipocytes, we tested the potential effects of reduced DHEA on metabolic alterations. Increased BMI (correlation coefficient 2.01, P<0.001) and cortisol after dexamethasone test (correlation coefficient 0.14, P<0.001), and reduced DHEA (correlation coefficient −5.70, P=0.034), were all factors independently associated with the increase of waist circumference. Stimulation study was performed on 56 patients and revealed that subjects with SH had higher levels of cortisol, 21-DF, DOC, corticosterone, and lower levels of DHEA and androstenedione respect to NSA. Steroid profiling with LC–MS/MS highlighted important clues into the secreting pattern of adrenocortical adenomas. Further studies are needed to address the clinical implication of the increased levels of gluco- and mineralocorticoid precursors in the pathogenesis of cardiovascular and metabolic correlates in SH.
Volume 37
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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