Plasma Dehydroepiandrosterone Sulfate in Normal and Pathological Conditions

Abstract

Dehydroepiandrosterone sulfate (DS) in human peiipheral plasma was estimated under various experimental conditions. In both sexes base-line plasma levels of DS were found to be low before puberty, to reach their maximum between the late stage of the second decade and the early period of the third decade, and to decline with advancing age. The values were higher in young male than those in young female subjects. ACTH administration caused a definite increase in plasma DS as compared to the control values, and there was no difference between young and aged groups in per cent increase in plasma DS values after ACTH stimulation. Plasma DS levels were suppressed up to 21% of the control values after administration of dexamethasone, 2 mg daily for 3 days, and chronic treatment with prednisolone lowered plasma DS levels to near zero values. HCG produced no significant effect on plasma DS levels. Concentrations of plasma DS in 20 patients with hypoadrenocorticism were distinctly low in all cases. In 9 of 12 patients with Cushing's syndrome due to bilateral adrenal hyperplasia, elevated plasma DS levels were exhibited; in the remaining 3 patients, including one case of multinodular hyperplasia of the adrenal cortex, plasma DS values were within the normal range. In sharp contrast, the plasma DS levels were significantly low in all cases of 12 patients with Cushing's syndrome due to benign adrenal cortical adenoma. The marked differences in DS concentrations in adrenal and peripheral vein plasma collected at surgical operation or by catheterization were observed in 3 patients with bilateral adrenal hyperplasia, while the differences were only minimal or absent in 4 patients with adrenal cortical adenoma. These results suggest that the estimation of peripheral plasma DS would be a valuable indicator of the adrenal secretion of C19 steroids and could be of help in determining the etiology of Cushing's syndrome.