Effect of Starvation on Adrenal Cortical Function in Obese Subjects

Abstract
The effect of starvation on adrenal cortical function was studied in 12 obese female subjects. Measurements of plasma and urine 17-hydroxycorticoids (17-OHCS) as Porter-Silber chromogens, urine 17-ketosteroids (17-KS), and increase in plasma 17-OHCS after ACTH infusion, were made before and after a 13-day period of starvation. Before starvation mean levels for plasma 17-OHCS at 8:00 pm, 8:00 am, and after ACTH, and urinary excretion of 17-OHCS and 17-KS were within the normal range. After 13 days' starvation, during which the average weight loss was 23 lb, the mean 24-hr urinary excretion of 17-OHCS and 17-KS was reduced by 27 and 47%, respectively. Both the evening and morning levels of plasma 17-OHCS became elevated after starvation, reaching values as high as 150 μg/100 ml (mean values: 8:00 pm, 52.4 μg/100 ml; 8:00 am, 61.9 μg/100 ml). Comparisons of the differences between 8:00 pm and 8:00 am plasma 17-OHCS and increases after ACTH stimulation, before and after starvation, revealed that no significant change had occurred, although absolute levels of plasma 17-OHCS had increased after starvation. Measurement of plasma cortisol by a chromatographic isotope dilution method after starvation in 2 subjects yielded normal values (6.3 and 14.4 μg/100 ml) despite high values (68.0 and 150 μg/100 ml) measured as Porter-Silber chromogens. Blue tetrazolium staining of the chromatograms ruled out the presence of other alpha-ketolic steroids in the plasmas, giving the Porter-Silber reaction. These observations indicate that, although starvation was associated with a marked increase in plasma 17-OHCS measured as Porter-Silber chromogens, this was not a reflection of the actual level of cortisol in the plasma. The increased chromogens in the plasma are most likely nonsteroidal material produced during starvation.