Urinary free 18-hydroxy-11-desoxycorticosterone excretion in normal and hypertensive patients.
One hundred fourteen hypertensives and 20 normal controls were examined using a new clinical technique of measuring 24-h urinary free 18-hydroxy-11-desoxycorticosterone (18-OH-DOC) excretion in response to dietary salt manipulations and ACTH injections. The object was to avoid potential errors of random plasma sampling. Mean urinary free 18-OH-DOC in normals on 110 milliequivalent sodium diet was 1.84 +/- 0.69 microgram (mean +/- SD) and represented about 2% of the daily secretion rate of this steroid. Both in normals and hypertensives, urinary free 18-OH-DOC approximately doubled on low salt (P less than 0.01 for each) and rose about 10 times in response to ACTH injection (P less than 0.05 and P less than 0.01, respectively). Plasma and urinary free 18-OH-DOC showed good correlation in patients with essential hypertension on a low salt diet (r = 0.45, P less than 0.01). Suppressed renin patients showed no propensity toward excess 18-OH-DOC excretion and hypertensives with elevated 18-OH-DOC could not be distinguished by their aldosterone levels, cortisol levels, nor their responses to various stimuli. These data suggest 18-OH-DOC is predominantly secreted under ACTH control and, to a smaller extent, in response to salt changes. Hypertension characterized by chronic overproduction of 18-OH-DOC forms only a small percentage of the hypertensive population. It is proposed that measuring 24-h urinary free 18-OH-DOC excretion may be the best method of assessing its rate of secretion without resorting to injection of radiolabeled material.
D015070:18-Hydroxydesoxycorticosterone / Q000097:blood / Q000652:urine*; D000324:Adrenocorticotropic Hormone; D000450:Aldosterone / Q000097:blood; D003900:Desoxycorticosterone / Q000031:analogs & derivatives*; D004039:Diet, Sodium-Restricted; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006914:Hydroxysteroids / Q000652:urine; D006973:Hypertension / Q000378:metabolism*; D012083:Renin / Q000097:blood; D012965:Sodium Chloride
D015070:18-Hydroxydesoxycorticosterone; D006914:Hydroxysteroids; D003900:Desoxycorticosterone; D012965:Sodium Chloride; D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D012083:Renin; D006854:Hydrocortisone