Liquid chromatographytandem mass spectrometry analysis of human adrenal vein corticosteroids before and after adrenocorticotropic hormone stimulation

Clinical Endocrinology, 05/11/2012

Nakamura Y et al. – Using liquid chromatography–tandem mass spectrometry, (LC–MS/MS), they successfully measured 10 corticosteroids in peripheral and adrenal vein (AV) serum samples under pre– and post–ACTH stimulation. This study demonstrates the primary adrenal steroid products and their response to adrenocorticotropic hormone (ACTH).

Methods

  • Three men and six women with a diagnosis of an adrenal aldosterone-producing adenoma (APA) were included in the study.
  • Serum was collected from the iliac vein (IV) and the AV contralateral to the diseased adrenal.
  • Samples were collected, before and after administration of ACTH.
  • LC-MS/MS was then used to quantify serum concentrations of unconjugated corticosteroids and their precursors.

Results

  • Prior to ACTH stimulation, the four most abundant steroids in AV were cortisol (90%), cortisone (4%), corticosterone (3%) and 11-deoxycortisol (0•8%).
  • Post-ACTH administration, cortisol remained the major adrenal product (79%); however, corticosterone became the second most abundantly produced adrenal steroid (11%) followed by pregnenolone (2•5%) and 17-hydroxypregnenolone (2%).
  • ACTH significantly increased the absolute adrenal output of all ten corticosteroids measured.
  • The four largest post-ACTH increases were pregnenolone (300-fold), progesterone (199-fold), 17alpha-hydroxypregnenolone (187-fold) and deoxycorticosterone (82-fold).

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