Ueshiba H, Shimojo M, Miyachi Y
First Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
Scand J Clin Lab Invest. 1997 Aug;57(5):395-400. doi: 10.3109/00365519709084586.
In patients with primary aldosteronism due to an aldosterone-producing adenoma and glucocorticoid-suppressible aldosteronism, 18-hydroxycortisol and 18-oxocortisol excretions are elevated. Both steroids are synthesized in the transitional zone between the zona glomerulosa and zona fasciculata. There are no reports concerning production of these steroids in Cushing's syndrome due to adrenal adenoma or hyperplasia, as far as we know. We determined the urinary excretion and serum concentration of 18-hydroxycortisol and 18-oxocortisol in eight patients with Cushing's syndrome (four due to adrenal adenoma, and four due to adrenal hyperplasia). Two of the four patients with adrenal adenoma had high levels of urinary and serum 18-hydroxycortisol and 18-oxocortisol; on the other hand all the patients with adrenal hyperplasia had normal urinary and serum levels of both steroids. Patients with high concentrations of 18-hydroxycortisol and 18-oxocortisol, however, showed no differences in clinical features, routine laboratory findings and hormonal data compared to patients with normal concentrations of 18-hydroxycortisol and 18-oxocortisol. Our data suggest that some adrenal adenomas causing Cushing's syndrome originate from transitional cells.
在因醛固酮分泌性腺瘤和糖皮质激素可抑制性醛固酮增多症导致的原发性醛固酮增多症患者中，18-羟皮质醇和18-氧代皮质醇的排泄量会升高。这两种类固醇都是在球状带和束状带之间的过渡带合成的。据我们所知，目前尚无关于肾上腺腺瘤或增生所致库欣综合征中这些类固醇产生情况的报道。我们测定了8例库欣综合征患者（4例因肾上腺腺瘤，4例因肾上腺增生）的尿中18-羟皮质醇和18-氧代皮质醇排泄量以及血清浓度。4例肾上腺腺瘤患者中有2例尿和血清中的18-羟皮质醇和18-氧代皮质醇水平较高；另一方面，所有肾上腺增生患者的尿和血清中这两种类固醇水平均正常。然而，18-羟皮质醇和18-氧代皮质醇浓度高的患者与18-羟皮质醇和18-氧代皮质醇浓度正常的患者相比，临床特征、常规实验室检查结果和激素数据并无差异。我们的数据表明，一些导致库欣综合征的肾上腺腺瘤起源于过渡细胞。
