title: The urinary steroid profile in patients diagnosed with adrenal incidentaloma.
abstract: OBJECTIVE
  The aim of this study was to investigate the possible urinary markers of hormonal activity in patients with non-functioning adrenal incidentalomas. In order to evaluate the endocrine activity of aforementioned tumours, urinary steroid metabolite levels were analyzed in samples from patients and controls. Possible blocks in metabolic pathways of the examined hormones were determined by comparing selected urinary steroid metabolite sums and ratios in both groups of interest.
  
  
  METHODS
  Urine samples were collected from 20 patients with non-functioning adrenal incidentalomas and from 25 controls matched in terms of age, sex and BMI. Excretion of 19 major urinary steroid metabolites was analyzed by gas chromatography. The results were subjected to statistical analysis.
  
  
  RESULTS
  In patients with adrenal incidentalomas sum of total urinary cortisol metabolites was significantly increased in respect to the control group. We also observed a shift towards tetrahydrocorticosterone, cortisol and etiocholanolone production in patients. No significant differences in production of other urinary steroid metabolites were noted in patients with adrenal incidentalomas in respect to control group.
  
  
  CONCLUSIONS
  Our data suggests that not only urinary free cortisol but also its metabolite such as tetrahydrocortisol and other steroids including etiocholanolone and corticosterone tetrahydrometabolite might be urinary markers for the endocrine activity of adrenal incidentalomas. Enhanced levels of these urinary steroid metabolites indicate an impairment of 11beta-hydroxysteroid dehydrogenase activity and slightly increased activity of 5beta-reductase in patients with adrenal incidentalomas.
authors.affiliation: Department of Environmental Analysis, Faculty of Chemistry, University of Gdańsk, Sobieskiego 18, Gdańsk, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Kotłowska
authors.forename: Edmund
authors.initials: E
authors.lastname: Maliński
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Sworczak
authors.forename: Jolanta
authors.initials: J
authors.lastname: Kumirska
authors.forename: Piotr
authors.initials: P
authors.lastname: Stepnowski
mesh_terms: D042842:11-beta-Hydroxysteroid Dehydrogenases / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000201:enzymology / Q000652:urine*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000652:urine; D002849:Chromatography, Gas; D003345:Corticosterone / Q000031:analogs & derivatives / Q000652:urine; D005043:Etiocholanolone / Q000652:urine; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008297:Male; D008875:Middle Aged; D010088:Oxidoreductases / Q000378:metabolism; D010673:Pheochromocytoma / Q000201:enzymology / Q000652:urine*; D013256:Steroids / Q000652:urine*; D013760:Tetrahydrocortisol / Q000652:urine
chemical_list: D014408:Biomarkers, Tumor; D013256:Steroids; C003676:tetrahydrocorticosterone; D013760:Tetrahydrocortisol; D005043:Etiocholanolone; D010088:Oxidoreductases; D042842:11-beta-Hydroxysteroid Dehydrogenases; C051860:cholestenone 5 beta-reductase; D003345:Corticosterone; D006854:Hydrocortisone