Prague Med. Rep. 2016, 117, 98-107

The Response of C19 Δ5-steroids to ACTH Stimulation and Hypoglycemia in Insulin Tolerance Test for Adrenal Insufficiency

Michaela Dušková1, Lucie Kolátorová Sosvorová1, Martin Hill1, Kateřina Šimůnková1,2, Hana Jandíková1, Hana Pospíšilová1, Monika Šrámková1, Mikuláš Kosák2, Michal Kršek2, Václav Hána2, Luboslav Stárka1

1Institute of Endocrinology, Prague, Czech Republic
23rd Department of Medicine – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic

Received April 7, 2016
Accepted September 2, 2016

Studies on the time course of ACTH- or insulin-induced hypoglycemia stimulating adrenal androgens are usually limited to dehydroepiandrosterone and/or its sulphate. Our data on dehydroepiandrosterone (DHEA) and its hydroxylated metabolites clearly show that measurements of DHEA and its sulphate (DHEAS) are valuable markers of the integrity of the HPA (hypothalamus-pituitary-adrenal) axis. Assessments of HPA function should rely on measurements of baseline and/or stimulated serum cortisol concentrations, and C19 Δ5-steroids may provide additional information. The art of stimulation of 7- and 16-hydroxylated metabolites of DHEA can help our understanding of the formation sequence of these compounds.


This study was supported by grant no. NT 11277-6 IGA of the Ministry of Health of the Czech Republic.


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