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PubMed1991

Steroid profile in serum: increased levels of sulphated pregnenolone and pregn-5-ene-3 beta,20 alpha-diol in patients with adrenocortical carcinoma.

A serum steroid profile was determined in 11 patients with adrenocortical carcinoma, 5 with adrenocortical adenoma and 10 healthy controls. Seven of the patients with carcinoma had different forms of endocrine symptoms, and of those with adenoma 3 had Cushing's syndrome and 2 primary hyperaldosteronism. Sulphated steroids dominated in serum from both patients and controls, whereas the levels of free and glucuronated steroids were low. All patients with adrenocortical carcinoma had increased levels of sulphated pregn-5-ene-3 beta-ol-20-one (pregnenolone) and pregn-5-ene-3 beta,20 alpha-diol compared with healthy controls and patients with adrenocortical adenoma. Serum levels of 11-deoxycortisol and/or its glucuronated metabolite tetrahydro-11-deoxycortisol were clearly elevated in 8 of the patients with carcinoma. The results are in agreement with those previously found for conjugated urinary steroids in patients with adrenocortical carcinoma. Thus, an impaired function or deficiency of 3 beta-hydroxysteroid dehydrogenase/delta isomerase and in some cases also of 11 beta-hydroxylase could explain the findings. The serum levels of sulphated pregnenolone and/or pregn-5-ene-3 beta,20 alpha-diol, possibly together with free 11-deoxycortisol seem to be useful for preoperative discrimination between malignant and benign adrenocortical tumours.

Adenoma↗

PubMed1989

Steroid profile for urine: reference values.

We describe a project, participated in by 24 institutions in The Netherlands and Belgium, to determine normal reference values for steroids in urine by capillary gas chromatography. Urine samples from 288 healthy volunteers were analyzed in triplicate. Reference values, expressed in mumol/24 h, were determined for androsterone, etiocholanolone, dehydroepiandrosterone, 11-keto-androsterone, 11-keto-etiocholanolone, 11-hydroxyandrosterone, 11-hydroxyetiocholanolone, pregnanediol, pregnanetriol, 11-desoxytetrahydrocortisol, tetrahydrocortisone, tetrahydrocortisol, allo-tetrahydrocortisol, and 17-keto- and 17-hydroxysteroids. We also determined reference ratios for etiocholanolone/androsterone, tetrahydrocortisone/tetrahydrocortisol, and tetrahydrocortisol/allo-tetrahydrocortisol; an upper limit of a discriminant function to establish polycystic ovarian disease; and reference values for 24-h urine volume and creatinine excretion. Reference values were determined separately for men and women, each in six age categories: 0-3 months, 4 months-12 years, 13-16 years, 17-50 years, 51-70 years, and older than 70 years. We conclude that these reference values are reliable and form a basis for quantitative interpretation of steroid profiles.

Adolescent↗

PubMed1982

Investigation of urinary steroid profiles as a diagnostic method in Cushing's syndrome.

Patients with Cushing's syndrome may be discriminated from normal subjects on the basis of their respective neutral urinary steroid profile. In the former group, evidence is presented that lowered levels of T3 secondary to hypercortisolism, decrease the liver enzymes associated with 5 alpha-reductase and 11 beta-hydroxy steroid dehydrogenase activity. As a result the metabolism of cortisol and androstenedione in Cushing's syndrome yields a unique pattern dominated by 5 beta and 11 beta-hydroxy steroid metabolites.

Adolescent↗

PubMed1983

Determination of steroid profiles in healthy and diseased states: identification and quantitation of a block of 17 alpha-hydroxylase.

The steroid metabolic profile on a patient with a suspected block in steroid biosynthesis was analyzed by gas chromatography and gas chromatography-mass spectrometry. The results of this work led to an interpretation of a block at the 17 alpha-hydroxylase step. Although the steroid metabolic profile was complex, we could not detect any steroids with a hydroxy moiety at position C-17. The use of gas chromatography-mass spectrometry, in this case, was the method of choice for a final diagnosis because of the confusion that resulted from other, more classical, forms of analysis. Data from our patient's sample are reported and compared to normals and to other cases where a block in 17 alpha-hydroxylase have been reported.

Adrenal Hyperplasia, Congenital↗

PubMed1996

The relationship between the effects of metyrapone treatment on depressed mood and urinary steroid profiles.

In order to investigate mechanisms by which the adrenal 11 beta-hydroxylase inhibitor metyrapone might exert its antidepressant effect, we used gas chromatography to analyse the 24 h urinary steroid profiles from six females with major depression taking part in a trial of metyrapone (2-4 g/day) as an antidepressant. Due to concurrent administration of hydrocortisone (30 mg/day), plasma cortisol levels were not significantly reduced. Treatment with metyrapone resulted in greatly increased urinary excretion of 11-deoxy corticosteroids, including the GABA-modulatory steroid tetrahydro-11-deoxycorticosterone (from 68 +/- 34 to 219 +/- 75 micrograms/24 h, p < .05). Metyrapone also had multiple extra-adrenal effects on corticosteroid metabolism, including inhibition of the peripheral conversion of cortisone to cortisol as demonstrated by a significant decrease in the ratio of 11 beta-hydroxy/11-oxo metabolites of cortisol (from 0.81 +/- 0.08 to 0.46 +/- 0.04, p < .01). The decreased Montgomery-Asberg Depression Rating Scale scores seen during treatment with metyrapone did not correlate with changes in plasma cortisol, but did correlate significantly with total 11-deoxycortisol metabolites (r = 0.778, n = 12, p < .01). We conclude that, in addition to decreased cortisol synthesis, increased secretion of cortisol precursors and reduced local bioavailability of cortisol may play a role in the antidepressant effect of metyrapone.

Adult↗

PubMed1995

Urinary steroid profile of a newborn suffering from pseudohypoaldosteronism.

A case is described of a newborn, admitted to hospital because of severe salt loss at the age of 1 month. Subsequent analysis of urinary steroid excretion, by gas chromatography and gas chromatography-mass spectrometry, revealed that the patient suffered from pseudohypoaldosteronism. However, it was difficult to interpret the results unambiguously, since the first urinary analysis appeared to suggest 21-hydroxylase- or 18-hydroxylase deficiency. The final diagnosis was possible only after detecting high urinary levels of aldosterone and tetrahydroaldosterone. It is concluded that neonatal urinary steroid profiles should be interpreted cautiously in order to arrive at the correct diagnosis.

Aldosterone↗

PubMed1985

Steroid profiling--an update.

Extraction of steroids from urine with C18 solid-phase extraction cartridges results in an extract containing impurities. If, during the extraction of hydrolyzed urine, an amino (NH2) column is placed in series with the C18 column, then one obtains a sample that is sufficiently clean for gas-chromatographic analysis. Analytical recovery of dehydroepiandrosterone from urine is considerably decreased by the use of increasing amounts of Helix pomatia enzyme preparation. Extraction of the steroid conjugates from urine with C18 columns before the hydrolysis stage is essential for hydrolysis with an amount of enzyme preparation that suffices for complete splitting of the polar steroid conjugates but not so much as to cause insufficient analytical recovery of dehydroepiandrosterone.

Animals↗

PubMed1982

Effects of stimulation on the steroid profile formed by rat adrenal capsule tissue incubated in vitro.

A characteristic of the response of non-dispersed rat adrenal capsule tissue (mainly zona glomerulosa) to ACTH stimulation is that corticosterone and aldosterone production is increased whereas 18-hydroxy-deoxycorticosterone (18-OH-DOC) is not. The effects of potential second messengers on the steroid profile were compared with those of ACTH and K+ ions in adrenal capsule incubations. ACTH stimulated corticosterone, 18-hydroxycorticosterone and aldosterone, but not 18-OH-DOC. In contrast, K+ (5.9 mM) stimulated 18-OH-DOC as well as the other capsule products. Compared with controls incubated with EDTA, the addition of Ca2+ and Mg2+ ions invariably stimulated aldosterone and 18-hydroxycorticosterone, while the effects on corticosterone were variable, and 18-OH-DOC production was unaltered. Addition of dibutyryl cyclic AMP (1 mM and 0.3 mM) or cyclic GMP (1mM) stimulated all products. The results show that Ca2+ ions and dibutyryl cAMP may have slightly different effects in that the cyclic nucleotides can stimulate all products whereas Ca2+ and Mg2+ ions preferentially support aldosterone and 18-hydroxycorticosterone. However, none of the potential intracellular stimulants studied fully reproduce the characteristic response of non-dispersed tissue to ACTH in which the secretion of corticosterone and 18-hydroxy-DOC is disassociated.

Adrenal Cortex↗

PubMed1989

Intratesticular feedback mechanisms in the regulation of steroid profiles in the frog, Rana esculenta.

Testosterone (T), 5 alpha-dihydrotestosterone (DHT), estradiol-17 beta (E), and progesterone (P) were measured in the plasma of the frog, Rana esculenta, during the annual cycle. Moreover, in vitro experiments were carried out in order to investigate the local regulation of steroidogenesis. Testosterone and DHT showed high values during autumn and early spring and had a T/DHT ratio which increased during summer, while E peaked in midspring, remaining at detectable values thereafter. Progesterone increased in autumn, winter, and spring. In vitro incubations of minced testes showed that E, stimulated by pituitary factors, inhibited androgen synthesis while T did not. Our results indicate that paracrine and/or autocrine mechanisms operate in the frog testis to regulate annual steroid profiles.

Animals↗

PubMed1990

Steroidogenesis in an estrogen-producing adrenal tumor in a young woman: comparison with steroid profiles associated with cortisol- and androgen-producing tumors.

There is only one previous report of an estrogen-secreting adrenal tumor occurring in a woman during reproductive years. Our patient presented with mild hirsutism associated with menstrual bleeding every 3-6 weeks. The occurrence of apparently intermenstrual bleeding prompted an evaluation of estrogen levels. Markedly elevated plasma estrone levels were found (860-2305 pmol/L; normal, 50-340). Lesser relative elevations in 11-deoxycortisol and androstenedione were noted. Computed tomographic scanning of the adrenal glands identified a large tumor, which was subsequently resected. Estrone levels fell to 120 pmol/L, and all other abnormalities were corrected. Eighteen months after adrenalectomy, ovulation occurred regularly, and steroid levels were entirely normal. Steroid production in a cell suspension made from tissue obtained from the 190-g tumor was compared with that occurring in normal human adrenal cells. The production of estrone by the tumor cells was 40-fold greater than that by normal adrenal cells. There was also a mild excess of 11-deoxycortisol produced by tumor cells, but the tumor cells were less than 50% as efficient as normal cells in producing cortisol, dehydroepiandrosterone, androstenedione, testosterone, and dehydroepiandrosterone sulfate. Examination of the steroid profile in plasma occurring in three other patients with adrenal tumors reveals that while elevations in estrone occur frequently, this is usually due to the peripheral conversion of very high levels of androstenedione. Estrone, androstenedione, and 11-deoxycortisol plasma levels were elevated in all four patients; dehydroepiandrosterone sulfate was elevated in only two of four patients. After resection of one of these tumors, all steroid levels remained normal despite the occurrence of extensive metastases. These observations confirm the difficulty of making a diagnosis of estrogen excess in a woman during reproductive years because of the paucity of physical signs. The acquisition of aromatase activity was clearly demonstrated by tumor cells from our patient in vitro. Elevated plasma concentrations of estrone, androstenedione, and 11-deoxycortisol provide useful markers for adrenal tumors, but no one steroid can be relied upon in all tumors, and metastases may lack the steroidogenic capabilities of the primary tumor.

Adrenal Gland Neoplasms↗

PubMed1995

Detection of dihydrotestosterone (DHT) doping: alterations in the steroid profile and reference ranges for DHT and its 5 alpha-metabolites.

Dihydrotestosterone (DHT), a biologically active metabolite of testosterone, may be misused in sports to benefit from its anabolic and psychotropic effects. After DHT application, a significant increase of the glucuronides of DHT and its metabolites can be expected for a certain time period depending upon dose, formulation, route of administration, and in case of percutaneous administration the chainlength of the ester. DHT and its metabolites can be monitored by gas-chromatography/mass spectrometry (GC/MS) after enzymatic hydrolysis and trimethylsilylation. To investigate the extent of the alteration of the urinary steroid profile after DHT application, timely controlled experiments have been performed with: a) oral application of [16,16,17-2H3]-DHT, and b) sublingual application of a 25 mg dose of DHT. In the experiment with [16,16,17-2H3]-DHT within 24 hours about 44% of the applied dose was recovered after hydrolysis with beta-glucuronidase from E. coli as di- or tri-deuterated 5 alpha-androstane glucuronides: androsterone (33.2%), 5 alpha-androsta-ne-3 alpha,17 beta-diol (2.5%), 5 alpha-androstane-3 beta, 17 beta-diol (0.9%), DHT (7.2%). Hydrolysis with beta-glucuronidase/arylsulfatase from Helix Pomatia resulted in a about 10% higher yield except for DHT. In the study with sublingual application of 25 mg of DHT the extent of the recovery of DHT and its metabolites was in the same range as for the deuterated DHT. The urinary glucuronide concentrations of DHT, androsterone (AND), 5 alpha-androstane-3 alpha, 17 beta-diol (5 alpha A3 alpha D) and 5 alpha-androstane-3 beta,17 beta-diol (5 alpha A3 beta D) and their ratios to etiocholanolone (ETIO), 5 beta-androstane-3 alpha, 17 beta-diol (5 beta A3 alpha D) and epitestosterone (EPIT) were increased for up to 48 hours after application. For doping control purposes concentrations of DHT, 5 alpha A3 alpha D, 5 alpha A3 beta D and ratios of 5 alpha-metabolites to non 5 alpha-metabolites such as DHT/ETIO, DHT/EPIT, 5 alpha A3 alpha D/5 beta A3 alpha D, 5 alpha A3 beta D/5 beta A3 alpha D, and AND/ETIO outside the reference ranges are a proof for DHT application. Reference ranges for Asian and Caucasian male and female athletes are calculated from data bases of the Asian Games 1994, the previous Asian Games 1990 and the routine doping control samples of Caucasian athletes measured in Cologne 1994. At the occasion of the 1994 Asian Games in Hiroshima alterations in the concentrations and ratios of the DHT depending parameters for outside there reference ranges have been found and have been sanctioned on this basis by the Medical Commission of the Organisation of Olympic Council of Asia (OCA).

Adult↗

PubMed2004

Steroid profiling by tandem mass spectrometry improves the positive predictive value of newborn screening for congenital adrenal hyperplasia.

Congenital adrenal hyperplasia (CAH) is primarily caused by 21-hydroxylase deficiency and leads to an accumulation of 17-hydroxyprogesterone and reduced cortisol levels. Newborn screening for CAH is traditionally based on measuring 17-hydroxyprogesterone by different immunoassays. Despite attempts to adjust cutoff levels for birth weight, gestational age, and stress factors, the positive predictive value for CAH screening remains less than 1%. To improve this situation, we developed a method using liquid chromatography-tandem mass spectrometry to measure 17-hydroxyprogesterone, androstenedione, and cortisol simultaneously in blood spots. A total of 1222 leftover blood spots from six different screening programs using different immunoassays (fluorescent immunoassay and ELISA) were reanalyzed in a blinded fashion by liquid chromatography-tandem mass spectrometry. Thirty-one samples were from babies with CAH, 190 had yielded false-positive results by immunoassay, and the remaining 1001 samples were from babies with normal screening results. Steroid profiling allowed for an elimination of 169 (89%) of the false-positive results and for an improvement of the positive predictive value from the reported 0.5 to 4.7%. Although this method is not suitable for mass screening due to the length of the analysis (12 min), it can be used as a second-tier test of blood spots with positive results for CAH by the conventional methods. This would prevent unnecessary blood draws, medical evaluations, and stress to families.

17-alpha-Hydroxyprogesterone↗

PubMed1990

Sex steroid profiles of coho salmon (Oncorhynchus kisutch) during early development and sexual differentiation.

Sex steroids were measured by radioimmunoassay in whole-body extracts of coho salmon, Oncorhynchus kisutch, during early development and sexual differentiation. Profiles were developed for fish from the time of fertilization until 87 days postfertilization (dpf) for six steroids: testosterone (T), 11-ketotestosterone (KT), androstenedione (A), progesterone (P4), 17 alpha-hydroxy-20 beta-dihydroprogesterone (DHP), and 17 beta-estradiol (E2). Ovarian fluid was also examined for steroid content. Steroid profiles of unfertilized eggs essentially paralleled those of ovarian fluid. In one experiment, steroids in developing embryos declined precipitously after fertilization until 30 dpf; at hatching, all steroids increased slightly and then declined during yolk sac absorption. Results from a second experiment basically supported those of the first except that only testosterone increased at the time of hatching. Bimodality was evident in the data on steroid levels for fish collected between 42 and 56 dpf and again after 87 dpf. The hormone levels generally decreased or remained constant after the onset of exogenous feeding. Histological analyses during the first experiment showed the presence of undifferentiated gonads between hatching and 70 dpf, but by 77 dpf ovarian development was evident. In the second experiment, in which fish were more frequently sampled for histological analysis, undifferentiated gonads were present from hatching to 59 dpf. Development of oogonia was observed between 66 and 73 dpf and by 75 dpf ovarian development could be easily discerned. The sex of fish sampled at 101 dpf was determined by examining gonadal morphology, and steroid levels of those fish were determined. A sexual dimorphism was apparent in levels of T, KT, and A, but not of DHP or E2. The dynamics of steroid content of developing coho salmon at hatch, coupled with their bimodal distributions during yolk sac absorption, may suggest a role of sex steroids in the process of sexual differentiation apparent later in development. Changes in whole-body steroid levels at hatch may also be indicative of the onset of sexual differentiation even though no signs of gondal differentiation were histologically discernible at that time.

Androstenedione↗

PubMed1993

Sex change and steroid profiles in the protandrous anemonefish Amphiprion melanopus (Pomacentridae, Teleostei).

Plasma profiles of several gonadal steroids and cortisol were examined in a field population of the protandrous, sex-changing anemonefish Amphiprion melanopus to elucidate potential roles of these hormones in gonadal sex change. Sex change was experimentally induced in males by removal of their dominant female pair mates. These sex-changing males were captured and sampled at 5, 10, or 20 days after female removal. Unmanipulated males and females were also sampled. Males had higher plasma levels of 11-ketotestosterone (11-KT) than did females, but had lower levels of androstenedione (Ad), testosterone (T), and estradiol-17 beta (E2). The three androgens showed decreases from male levels at 10 days, then an increasing trend at 20 days after female removal. E2 levels exhibited no changes from male levels until 20 days, when a significant increase over male levels was observed. Mature females had higher levels of Ad, T, and E2 than the 20-day treatment group, indicating that these steroids continue to rise after Day 20. The results support hypothesized roles for androgens in male function and E2 in female function in A. melanopus. However, E2 increases lagged behind oogonial proliferation, arguing against an influence of this steroid in the initiation of female function. Cortisol levels did not differ between males and females, but exhibited an increase during sex change, peaking at 20 days.

Androstenedione↗

PubMed1986

Steroid profiles and optimization of high-performance liquid chromatographic analytic procedure.

This paper presents a short review of the results obtained to date in our laboratory, with respect to the studies of steroid excretion profiles in both breast and endometrial cancer patients, by using gas-liquid chromatographic analysis. These data demonstrate the importance of minor estrogens, including catechol estrogens, and of their ratios with the classical ones, in studies of steroid metabolism in both breast and endometrial cancer. New data concerning postmenopausal endometrial cancer are consistent with our previous observations and demonstrate the necessity of measuring these steroids directly in tumors and examining patterns of metabolism in vitro. In order to analyze steroid metabolic patterns in vitro, however, high-performance liquid chromatography rather than gas-liquid chromatography methods are preferable on account of their selectivity, specificity, sensitivity and capacity to handle labile materials. With the aim of providing methods suitable for the complete resolution and analysis of these complex natural mixtures a method of computer-aided optimization of HPLC has been developed and its practical utility has been tested.

Adrenal Cortex Hormones↗

PubMed1986

A one-step enzymatic assay for the measurement of 17 beta-hydroxy- and 17-oxo-steroid profiles in biological samples.

We describe a simple enzymatic method for the sensitive and specific detection and quantitation of families of hydroxy- and oxo-steroids in biological mixtures. Analysis of the profiles of individual steroids may be achieved following their chromatographic separation. The objectives of this analytical system are, therefore, different from conventional methods which are designed to measure single steroids with a high degree of specificity. The method employs highly purified and active bacterial hydroxysteroid dehydrogenases (HSD) which promote stereospecific, nicotinamide nucleotide-dependent oxidations and reductions at specified positions of steroids. In the presence of catalytic quantities of steroids these enzymes promote the transfer of hydrogen (transhydrogenation) between NADH and NAD analogues. A recently purified 17 beta-HSD from an Alcaligenes species (D. W. Payne and P. Talalay, J. biol. Chem., 260, 13468-13655, 1985) shows almost complete specificity for the 17 beta-hydroxy- and 17-oxo-groups of both C18 and C19 steroids. This enzyme catalyzes steroid-dependent transhydrogenation between NADH and the thionicotinamide analogue of NAD (S-NAD). When these components are incubated at pH 8.5 in the presence of minute quantities of steroid substrates, S-NADH (measured at 398 nm where NADH does not absorb) accumulates at a constant rate which is proportional to the concentrations of steroid and enzyme. The linear increase in absorbance with time is a measure of the total concentration of 17 beta-hydroxy- and 17-oxo-steroids, and can be used to detect subpicomol quantities of steroids. The method is illustrated by the detection and identification of free and conjugated androgens in human serum following their separation by high pressure liquid chromatography. The specificity of the transhydrogenase assay is completely dependent on the specificity of the enzyme and is thus applicable to the detection of other hydroxy- and oxo-steroids by making use of HSDs with appropriate specificities (e.g. 3 alpha-HSD for the measurement of 3 alpha-hydroxy- and 3-oxo-steroids). The simple one-step reaction lends itself to automation, needs no auxiliary detection systems, and requires only an inexpensive colorimeter.

17-Ketosteroids↗

PubMed1984

The use of steroid profiling in the resolution of pregnenolone metabolites from porcine testicular preparations.

The behaviour of 22 steroids has been examined by capillary gas chromatographic profiling, and the identities of the steroids confirmed by mass spectrometry and their relative retention times. Five pairs of steroids have been separated: 5 alpha-androstane-3 alpha,17 beta- and -3 beta,17 beta-diols; 5-androstene-3 beta,17 alpha- and -3 beta,17 beta-diols; pregnenolone and 3 beta-hydroxy-5,16-pregnadien-20-one; progesterone and 4,16-pregnadiene-3,20-dione; 17-hydroxypregnenolone and 5-pregnene-3 beta,20 beta-diol. 5 alpha-Androst-16-en-3 beta-ol and 5,16-androstadien-3 beta-ol (as trimethylsilyl-, tert.-butyl-dimethylsilyl- and chloromethyldimethylsilyl ethers) were only partially resolved but could be well separated on thin-layer plates of Kieselgel that had previously been dipped in AgNO3 solution. The profiling method was successfully applied to the separation of pregnenolone and its metabolites in porcine testicular incubation extracts.

Animals↗

PubMed2000

Steroid sulfatase inhibitor alters blood pressure and steroid profiles in hypertensive rats.

Our hypothesis is that the steroid sulfatase gene (Sts) may indirectly contribute to the modulation of blood pressure (BP) in rats with genetic hypertension. The steroid sulfatase enzyme (STS) catalyzes the conversion of estrone sulfate, dehydroepiandrosterone sulfate, cholesterol sulfate and glucocorticoid sulfates to their active nonconjugated forms. This causes the elevation of biologically active steroids, such as glucocorticoids, mineralcorticoids as well as testosterone, which may lead to increased BP. The main objective was to examine the effects of a steroid sulfatase inhibitor on blood pressure and steroid levels in rats with hypertensive genetic backgrounds. Three treatment groups, 5-15 weeks of age were used: controls, estrone and STS inhibitor (estrone-3-O-sulfamate), (n=8 per group). BP was taken weekly by tail cuff, and serum testosterone (T), estrogens (E), and plasma corticosterone (C) levels were measured by radioimmunoassay. BP was significantly reduced by the STS inhibitor in the strains with genetically elevated BP. Also the inhibitor alone significantly reduced plasma corticosterone in all strains compared to estrone treatment with a concomitant as well as significant rise in estrogens and reduction in testosterone and body weight.

Animals↗