Spironolactone Effective Hypertension in the Elderly Due to 11 -hydroxysteroid Dehydrogenase Type 2 (11 -HSD2) Impairment: Contributory Role of Determining Serum Cortisol/Cortisone Ratio as a Marker of 11 -HSD2 Activity
نویسندگان
چکیده
Two elderly patients with mineralocorticoid excess state due to 11 β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) impairment are described. Moreover, the role of the precursor-product ratios of the steroids reflecting 11β-HSD2 activity was estimated in 5 patients, including 3 patients reported previously by us. Significant elevations of urinary cortisol/cortisone ratios were observed, whereas urinary tetrahydrocortisol (THF)+allo-THF/tetrahydrocortisone (THE) ratios were not elevated significantly. Furthermore, an even more distinct elevation of serum cortisol/cortisone ratio was evident in all instances of 5 patients, suggesting a significant clinical role of the serum cortisol/cortisone ratio in the diagnosis of 11β-HSD2 impairment.
منابع مشابه
11beta-hydroxysteroid dehydrogenase in cultured human vascular cells. Possible role in the development of hypertension.
11beta-Hydroxysteroid dehydrogenases (11beta-HSD) interconvert cortisol, the physiological glucocorticoid, and its inactive metabolite cortisone in humans. The diminished dehydrogenase activity (cortisol to cortisone) has been demonstrated in patients with essential hypertension and in resistance vessels of genetically hypertensive rats. 11beta-Hydroxysteroid dehydrogenase type 2 (11beta-HSD2) ...
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