Glucocorticoids and mineralocorticoids in blood plasma as markers of early diagnostic adrenal cortical tumors

Authors

DOI:

https://doi.org/10.15587/2519-4798.2022.262441

Keywords:

adrenocortical adenoma, adrenal glands, cortisol, aldosterone, adrenocorticotropic hormone, renin

Abstract

Adrenocortical tumours of the adrenal glands are formed when the cells of the cortical layer grow. The morphological and histological structure of benign adrenal tumours is variable, which complicates their early diagnosis. The study of the levels of hormones in the adrenal cortex along with the analysis of the symptoms of the disease will allow not only to differentiate hormone-producing tumours, but also to predict the direction of metabolic processes, which will make it possible to choose the right treatment regimen and prevent complications from other organs.

The aim of the study is to determine the level of cortisol and aldosterone and assess the state of the pituitary-adrenal and renin-aldosterone systems in patients with various types of adrenocortical adenomas.

Materials and methods. The state of the hormonal status of the adrenal cortex was assessed by determining the level of glucocorticoids - cortisol and mineralocorticoids - aldosterone using a direct quantitative enzyme immunoassay. The level of adrenocorticotropic hormone (ACTH) and renin was determined by immunochemical methods using monoclonal antibodies specific for ACTH and renin.

Research results. An increase in the level of cortisol was detected against the background of a decrease in the level of ACTH in patients with cortisol-producing adrenocortical adenomas. It is shown that the aldosteronism we discovered in patients with aldosterone-producing adenomas develops against the background of an unchanged renin level and an increase in the aldosterone/renin ratio.

Conclusions. The development of hormone-dependent adenomas of the adrenal cortex is accompanied by an imbalance in the work of the pituitary-adrenal and renin-aldosterone systems, the direction of changes of which can serve as a criterion for early diagnosis of adrenocortical adrenal adenomas

Author Biography

Yurii Roienko, Shupyk National Healthcare University of Ukraine

Postgraduate Student

Department of Surgery and Transplantology

References

  1. Sherlock, M., Scarsbrook, A., Abbas, A., Fraser, S., Limumpornpetch, P., Dineen, R. Stewart P. M. et. al. (2020). Adrenal incidentaloma. Endocrine Reviews, 41 (6), 775–820. doi: http://doi.org/10.1210/endrev/bnaa008
  2. Almeida, M., Bezerra-Neto, J., Mendonça, B., Latronico, A., Fragoso, M. (2018). Primary malignant tumors of the adrenal glands. Clinics, 73, e756s. doi: http://doi.org/10.6061/clinics/2018/e756s
  3. Dong, R., Yang, R., Zhan, Y., Lai, H., Ye, C., Yao, X. et. al. (2018). Single-cell characterization of malignant phenotypes and developmental trajectories of adrenal neuroblastoma. Cancer Cell, 38 (5), 716–733.e6. doi: http://doi.org/10.1016/j.ccell.2020.08.014
  4. Ross, I., Louw, G. (2015). Embryological and molecular development of the adrenal glands. Clin Anat, 28 (2), 235–242. doi: http://doi.org/10.1002/ca.22422
  5. Hodgson, A., Pakbaz, S., Mete, O. (2019). A diagnostic approach to adrenocortical tumors, Surg Pathol Clin, 12 (4), 967–995. doi: http://doi.org/10.1016/j.path.2019.08.005
  6. Fassnacht, M., Arlt, W., Bancos, I., Dralle, H., Newell-Price, J., Sahdev, A. et. al. (2016.) Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of adrenal tumors. European Journal of Endocrinology, 175 (2), G1–G34. doi: http://doi.org/10.1530/eje-16-0467
  7. Ishiwata, K., Suzuki, S., Igarashi, K., Ruike, Y., Naito, K., Ishida, A. (2021). Characteristics of benign adrenocortical adenomas with 18F-FDG PET accumulation. European Journal of Endocrinology, 185 (1), 155–165. doi: http://doi.org/10.1530/eje-20-1459
  8. Reincke, M., Bancos, I., Mulatero, P., Scholl, U., Stowasser, M., Williams, T. (2021). Diagnosis and treatment of primary aldosteronism. Lancet Diabetes Endocrinol, 9 (12), 876–892. doi: http://doi.org/10.1016/s2213-8587(21)00210-2
  9. Hu, D., Li, J., Zhuang, Y., Mao, X. (2021). Adrenocorticotropic hormone: An expansion of our current understanding of the treatment for nephrotic syndrome. Steroids, 176, 108930. doi: http://doi.org/10.1016/j.steroids.2021.108930
  10. Lightman, S., Birnie, M., Conway-Campbell, B. (2020). Dynamics of ACTH and cortisol secretion and implications for disease. Endocrine Reviews, 41 (3). doi: http://doi.org/10.1210/endrev/bnaa002
  11. Reincke, M., Bancos, I., Mulatero, P., Scholl, U., Stowasser, M., Williams, T. (2021). Diagnosis and treatment of primary aldosteronism. Lancet Diabetes Endocrinol, 9 (12), 876–892. doi: http://doi.org/10.1016/s2213-8587(21)00210-2
  12. Hodgson, A., Pakbaz, S., Mete, O. (2019) A diagnostic approach to adrenocortical tumors. Surgical Pathology Clinics, 12 (4), 967–995. doi: http://doi.org/10.1016/j.path.2019.08.005
  13. Fukuoka, H., Shichi, H., Yamamoto, M., Takahashi, Y. (2020). The mechanisms underlying autonomous adrenocorticotropic hormone secretion in Cushing's disease. International Journal of Molecular Sciences, 21 (23), 9132. doi: http://doi.org/10.3390/ijms21239132
  14. Seccia, T., Caroccia, B., Maiolino, G., Cesari, M., Rossi, G. (2019) Arterial hypertension, aldosterone, and atrial fibrillation. Curr Hypertens Rep, 21 (12), 94. doi: http://doi.org/10.1007/s11906-019-1001-4
  15. Schilbach, K., Junnila, R., Bidlingmaier, M. (2019) Aldosterone to renin ratio as screening tool in primary aldosteronism. Exp Clin Endocrinol Diabetes, 127 (2-03), 84–92. doi: http://doi.org/10.1055/a-0672-0836

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Published

2022-07-29

How to Cite

Roienko, Y. (2022). Glucocorticoids and mineralocorticoids in blood plasma as markers of early diagnostic adrenal cortical tumors. ScienceRise: Medical Science, (4(49), 38–43. https://doi.org/10.15587/2519-4798.2022.262441

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Medical Science