Yamakita N, Mune T, Morita H, Yasuda K, Miura K, Gomez-Sanchez C E
Institute of Clinical Medicine, University of Tsukuba, Japan.
Clin Endocrinol (Oxf). 1994 May;40(5):583-7. doi: 10.1111/j.1365-2265.1994.tb03008.x.
18-Oxocortisol (18oxoF) shares structural characteristics with cortisol and aldosterone and is secreted from the adrenal cortex. It has been reported that 18oxoF has weak gluco and mineralo-corticoid activities and increases blood pressure when administered to animals. We tried to clarify the characteristics of the production of 18oxoF in patients with adrenocortical disorders compared with the control subjects.
In patients with primary aldosteronism due to aldosterone producing adenoma (APA) (n = 21) and Cushing's disease or syndrome (Cushing's disease n = 13; adrenocortical adenoma n = 10), plasma 18oxoF level early in the morning following an overnight fast was evaluated as well as plasma cortisol and aldosterone levels.
The plasma 18oxoF levels were significantly higher in the patients with adrenocortical disorders than in control subjects. The ratios of 18oxoF/cortisol and 18oxoF/aldosterone were high in APA and in Cushing's disease and syndrome patients, respectively. In the control subjects and combined group of patients with Cushing's disease and syndrome, plasma 18oxoF level significantly correlated with plasma cortisol level but not with aldosterone level. However, in APA patients plasma 18oxoF level correlated significantly with both cortisol and aldosterone levels.
The production of 18oxoF was elevated as a result of the hyperactivity of 18-hydroxylase and excess cortisol production in APA patients and in patients with Cushing's disease and syndrome, respectively. An excess 18oxoF production could be playing a role in the pathogenesis of hypertension in these patients. The correlation of plasma 18oxoF levels with plasma cortisol and aldosterone levels suggests that the production of 18oxoF is more dependent on the supply of cortisol than on 18-hydroxylase activity in normal subjects and patients with Cushing's disease and syndrome.
18-氧代皮质醇（18oxoF）与皮质醇和醛固酮具有相同的结构特征，由肾上腺皮质分泌。据报道，18oxoF具有较弱的糖皮质激素和盐皮质激素活性，给动物注射时会使血压升高。我们试图阐明肾上腺皮质疾病患者与对照受试者相比，18oxoF的产生特征。
在因醛固酮分泌腺瘤（APA）导致的原发性醛固酮增多症患者（n = 21）以及库欣病或综合征患者（库欣病n = 13；肾上腺皮质腺瘤n = 10）中，评估了空腹过夜后清晨的血浆18oxoF水平以及血浆皮质醇和醛固酮水平。
肾上腺皮质疾病患者的血浆18oxoF水平显著高于对照受试者。18oxoF/皮质醇和18oxoF/醛固酮的比值在APA患者以及库欣病和综合征患者中分别较高。在对照受试者以及库欣病和综合征患者的合并组中，血浆18oxoF水平与血浆皮质醇水平显著相关，但与醛固酮水平无关。然而，在APA患者中，血浆18oxoF水平与皮质醇和醛固酮水平均显著相关。
在APA患者以及库欣病和综合征患者中，分别由于18-羟化酶活性亢进和皮质醇产生过多，导致18oxoF的产生增加。过量的18oxoF产生可能在这些患者的高血压发病机制中起作用。血浆18oxoF水平与血浆皮质醇和醛固酮水平的相关性表明，在正常受试者以及库欣病和综合征患者中，18oxoF的产生更多地依赖于皮质醇的供应而非18-羟化酶活性。
