HETEROGENEITY IN ADRENAL STEROIDOGENESIS IN NORMAL MEN AND WOMEN

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Abstract
SUMMARY: Adrenal steroidogenesis has been studied in vivo in normal men and women. Serum levels of nine steroids on the biosynthetic pathway (the Δ5 3‐β‐hydroxy‐steroids, pregnenolone (Pe), 17α‐hydroxypregnenolone (17Pe), dehydroepian‐drosterone (DHEA), androstenediol (Adiol), and their Δ4 3‐keto counterparts, progesterone (Po), 17α‐hydroxyprogesterone (17Po), androstenedione (Adione), and testosterone (T)) as well as cortisol were measured during adrenal suppression and stimulation. This study demonstrates a marked heterogeneity in adrenal steroid responses between different subjects in the normal population. Thus, in three subjects ACTH stimulation from a dexamethasone‐sup‐pressed state resulted in a far greater increment of 17Po than in the other nineteen normal subjects. These three individuals (designated Type 2 res‐ponders) may have a partial deficiency of 21‐hydroxylase activity. In the remaining nineteen subjects (designated as Type 1 responders) the women had a greater increment of Adiol (P<0.05) and a lower increment of Po (P<0.01) than the men, suggesting that adrenal 3‐β‐hydroxysteroid dehydrogenase/isomerase activity may be slightly lower in women than men.