(A) Schematic representation of steroidogenesis depicting the major products of adrenocortical steroid synthesis, the mineralocorticoid aldosterone (dark green), and its precursors (light green), glucocorticoid precursors (yellow), the active glucocorticoid cortisol (orange) and its metabolite cortisone, and the adrenal androgens and their precursors (light blue). Synthesis of active androgens (dark blue) mainly takes place in the gonads. (B0. The 24-hour urinary steroid metabolite excretion in healthy controls (n=88). Box plots represent median and interquartile ranges; the whiskers represent 5th and 95th percentile, respectively. Color coding of steroid metabolites mirrors that used for depicting the major adrenal corticosteroid classes in (A). CYP, cytochrome P450; HSD, hydroxysteroid dehydrogenase; DHT, 5 α -dihydrotestosterone (342). From Arlt W, Biehl M, Taylor AE, Hahner S, Libe R, Hughes BA, Schneider P, Smith DJ, Stiekema H, Krone N, Porfiri E, Opocher G, Bertherat J, Mantero F, Allolio B, Terzolo M, Nightingale P, Shackleton CH, Bertagna X, Fassnacht M, Stewart PM. Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors. J Clin Endocrinol Metab 2011; 96:3775-3784 (Under Open Access License).