Urinary steroid excretion rates in acromegaly

Area of Science:

• Endocrinology
• Metabolic Research
• Steroid Biochemistry

Background:

• Acromegaly is a hormonal disorder caused by excess growth hormone (GH).
• GH excess impacts various metabolic processes, including steroid hormone metabolism.
• Understanding these metabolic alterations is crucial for managing acromegaly complications.

Purpose of the Study:

• To investigate urinary excretion rates of cortisol, cortisone, and their metabolites in acromegalic patients.
• To assess the activity of key enzymes involved in steroid metabolism, such as 11beta-hydroxysteroid dehydrogenase type 1 and hepatic 5alpha-reductase.
• To correlate these metabolic changes with hormonal levels like GH and insulin-like growth factor 1 (IGF-1).

Main Methods:

• Gas chromatography/mass spectrometry (GC/MS) was used to quantify urinary steroid metabolites.
• 35 acromegalic patients and 45 age- and weight-matched controls were included.
• Steroid metabolite ratios were analyzed and correlated with GH and IGF-1 concentrations.

Main Results:

• Acromegalic patients exhibited a preponderance of cortisone metabolites over cortisol metabolites, suggesting decreased 11beta-hydroxysteroid dehydrogenase type 1 activity (p < 0.01).
• This finding correlated directly with postglucose GH concentrations (r = 0.508, p < 0.01).
• Male acromegalic patients showed a preponderance of etiocholanolone over androsterone (p < 0.01), indicating reduced hepatic 5alpha-reductase activity, which correlated negatively with serum IGF-1 (r = -0.406, p < 0.05).

Conclusions:

• Acromegaly is associated with reduced activity of 11beta-hydroxysteroid dehydrogenase type 1, impacting cortisol/cortisone balance.
• Reduced hepatic 5alpha-reductase activity is observed in male acromegalics, affecting androgen metabolism.
• These steroid metabolic alterations are linked to GH and IGF-1 dysregulation in acromegaly.