Rao A, Melby J C, Wilson T E
Department of Endocrinology, Boston University Medical Center Hospital, Massachusetts 02118, USA.
J Clin Endocrinol Metab. 1995 May;80(5):1677-80. doi: 10.1210/jcem.80.5.7745017.
Aldosterone-producing adenoma (APA) and idiopathic hyperplasia (IHA) are two main causes of primary hyperaldosteronism, which differ in the modes of treatment. Some of the prohormones, such as 18-hydroxycorticosterone, are elevated in adenomas. 19-Nor-deoxycorticosterone (19-nor-DOC), produced in the kidney, has been shown to be excreted in excess in patients with APA. Deoxycorticosterone is a known precursor of aldosterone and 19-nor-DOC. This study is designed to evaluate the levels of prohormones in adrenal venous effluent in eight patients, three with APA, of which two were confirmed by surgical pathology and four with IHA, and one patient with primary adrenal hyperplasia. 19-OH-DOC, a precursor of 19-nor-DOC, was found to be the main prohormone in adrenal venous effluent in patients with both APA and IHA. 19-Oic-deoxycorticosterone and 19-nor-DOC were also detected, but in smaller quantities. 19-OH-DOC appears to be the main prohormone in adrenal venous effluent for the biosynthesis of 19-nor-DOC.
醛固酮瘤（APA）和特发性增生（IHA）是原发性醛固酮增多症的两个主要病因，二者治疗方式不同。一些激素原，如18-羟皮质酮，在腺瘤中会升高。在肾脏中产生的19-去甲脱氧皮质酮（19-nor-DOC）已被证明在APA患者中排泄过量。脱氧皮质酮是已知的醛固酮和19-nor-DOC的前体。本研究旨在评估8例患者肾上腺静脉流出液中激素原的水平，其中3例为APA患者，2例经手术病理证实，4例为IHA患者，1例为原发性肾上腺增生患者。19-OH-DOC是19-nor-DOC的前体，被发现是APA和IHA患者肾上腺静脉流出液中的主要激素原。还检测到了19-氧代脱氧皮质酮和19-nor-DOC，但含量较少。19-OH-DOC似乎是肾上腺静脉流出液中用于19-nor-DOC生物合成的主要激素原。
