Additional value of measurement of urinary cortisone and unconjugated cortisol metabolites in assessing the activity of 11β‐hydroxysteroid dehydrogenase in vivo

It has been shown recently that 11β‐hydroxysteroid dehydrogenase (11β‐HSD) is expressed as at least 2 isozymes. In the liver, 11β‐HSD1 converts cortisone to cortisol; in the kidney, 11β‐HSD2 converts cortisol to cortisone. Conventional assessment of 11β‐HSD activity in vivo has relied on gas chromatographic measurement of the ratios of conjugated cortisol and cortisone metabolites. However, these do not permit distinction between the tissue‐specific activities of the enzymes and do not reflect all forms of 11β‐HSD deficiency. In this report, we have assessed the usefulness of measuring unconjugated cortisol metabolites and free cortisol and cortisone in urine as indices of renal 11β‐HSD activity in man.

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