Table 2.
Steroid profiling in adrenal venous sampling before and after cosyntropin stimulation
| Right Adrenal Vein (Tumor Side) | External Iliac Vein | Left Adrenal Vein (Nontumor Side) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline | Post-ACTH | Folda | Baseline | Post-ACTH | Folda | Baseline | Post-ACTH | Folda | |
| Aldosterone, ng/dL | 62.8 | 473.9 | 7.5 | 5.2 | 9.3 | 1.8 | 92.8 | 3041.6 | 32.8 |
| Cortisol, ng/dL | 10.0 | 106.4 | 10.6 | 9.4 | 12.8 | 1.4 | 21.4 | 382.9 | 17.9 |
| Estrone, pmol/L | 119088 | 107874 | 0.9 | 3382 | 3334 | 1.0 | 1240 | 1484 | 1.2 |
| Estradiol, pmol/L | 1439 | 1090 | 0.8 | 719 | 657 | 0.9 | 297 | 248 | 0.8 |
| DHEA, nmol/L | 307 | 546 | 1.8 | 10 | 11 | 1.1 | 28 | 1404 | 50.1 |
| Androstenedione, nmol/L | 1095 | 1391 | 1.3 | 16 | 20 | 1.3 | 15 | 441 | 29.4 |
| Δ5A-diol, nmol/L | 3.1 | 7.5 | 2.4 | 1.3 | 1.9 | 1.5 | 0.9 | 19 | 21.1 |
| Testosterone, nmol/L | 25 | 21 | 0.8 | 6.0 | 6.5 | 1.1 | 4.0 | 15 | 3.8 |
| DHT, pmol/L | 723 | 585 | 0.8 | 654 | 757 | 1.2 | 723 | 620 | 0.9 |
| 11-OHAD, nmol/L | 22 | 218 | 9.9 | 4.5 | 6.4 | 1.4 | 65 | 1323 | 20.4 |
| 11-ketoAD, nmol/L | 1.0 | 3.2 | 3.2 | 0.6 | 1.0 | 1.7 | 1.7 | 15 | 8.8 |
| 11-OHT, pmol/L | 394 | 1478 | 3.8 | 887 | 788 | 0.9 | 854 | 7621 | 8.9 |
| 11-ketoT, pmol/L | 496 | 661 | 1.3 | 728 | 595 | 0.8 | 728 | 926 | 1.3 |
Measurement of sex steroid profiles and aldosterone-to-cortisol ratios was performed using blood samples collected from right and left adrenal veins (RAV, LAV) and the external iliac vein, at baseline and under stimulation with cosyntropin. Plasma estrone and estradiol levels in RAV were markedly higher than those in LAV, regardless of cosyntropin stimulation. In addition, androgen levels were higher in RAV than in LAV, but the androgens in LAV responded much more markedly to cosyntropin stimulation than those in RAV. However, the left adrenal gland produced more 11-oxygenated androgens than the right side. In terms of the laterality of hyperaldosteronism, aldosterone-to-cortisol ratios under cosyntropin stimulation were not significantly different between RAV and LAV (4.45 vs 7.94).
Abbreviations: Δ5A-diol, 5-androstene-3β,17β-diol; ACTH, adrenocorticotropin; DHEA, dehydroepiandrosterone; DHT, dihydrotestosterone; 11-ketoAD, 11-ketoandrostenedione; 11-ketoT, 11-ketotestosterone; 11-OHAD, 11-β-hydroxy-androstenedione; 11-OHT, 11-hydroxytestosterone.
aIncrease fold is calculated as a steroid concentration under cosyntropin stimulation divided by that concentration at baseline.