Letter to the Editor: Including the Zona Reticularis in the Definition of Hypoadrenalism and Hyperadrenalism

摘要

Dennedy et al. (1) confirmed in their recent interesting publication in this journal prior reports that low dehydroepiandrosterone (DHEA) sulfate (DHEAS), with excellent sensitivity and specificity, permits detection of subclinical hypercortisolism from adrenocorticotropin (ACTH)-independent adrenal adenomas or nodular adrenal hyperplasia, in the literature often described as incidentalomas. The presumed mechanism for low DHEAS is subclinical hypercortisolism that depresses pituitary ACTH. Because DHEA/DHEAS production in the zona reticularis is under pituitary ACTH control (1), DHEAS is suppressed.