Spironolactone Effective Hypertension in the Elderly Due to 11β-hydroxysteroid Dehydrogenase Type 2 (11β-HSD2) Impairment: Contributory Role of Determining Serum Cortisol/Cortisone Ratio as a Marker of 11β-HSD2 Activity

被引:6
|
作者
Inada, Mitsuo [1 ]
Iwasaki, Keiko [1 ]
Imai, Chihiro [1 ]
Hashimoto, Satoshi [1 ]
机构
[1] Kizuyabashi Takeda Hosp, Dept Internal Med, Kyoto, Japan
关键词
mineralocorticoid excess; 11; beta-HSD2; impairment; urinary THF plus allo-THF/THE ratio; urinary cortisol/cortisone ratio; serum cortisol/cortisone ratio;
D O I
10.2169/internalmedicine.47.1165
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Two elderly patients with mineralocorticoid excess state due to 11 beta-hydroxysteroid dehydrogenase type 2 (11 beta-HSD2) impairment are described. Moreover, the role of the precursor-product ratios of the steroids reflecting 11 beta-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 11 beta-HSD2 impairment.
引用
收藏
页码:2157 / 2164
页数:8
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