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Mineralocorticoid Response to Low Dose Adrenocorticotropin Infusion^*

UCLA San Fernando Valley Program, Veterans Administration Medical Center, Sepulveda, California 91343; and Endocrine Sciences Tarzana, California 91356

Address requests for reprints to: Michael L. Tuck, M.D., Veterans AdministrationHospital, 16111 Plummer Street, Sepulveda, California 91343.

The adrenocorticoid responses to low dose ACTH of plasma aldosterone (aldo), corticosterone (B), 11-deox-ycorticosterone (DOC), 18-hydroxycorticosterone (18-OHB), 18-hydroxydeoxycorticosterone (18-0H-D0C), and cortisol (F) were compared. ACTH (l–24) was infused beginning at 0800 h at increasing rates from 12.5–200 mIU/30 min in supine normal subjects under the following conditions: 1) regular Na (120 meq) diet, 2) lowNa (10 meq) diet, 3) dexamethasone preadministra-tion (0.5 mg every 6 h for 48 h), and 4)night study (2000 h; 120-meq Na intake). Plasma 18-OH-DOC and B demonstrated quantitatively the greatest responses to ACTH, while DOC and 18-OHB responses were intermediate. Increments in aldo and F were least after ACTH and were maximum at 50 mIU/30 min ACTH, whereas other corticosteroids demonstrated linear responses up to infusionrates of 200 mIU/30 min. All corticoste-roids, however, were similar in their threshold responses to ACTH which were at infusion rates of approximately 7–9 mlU/ 30min. Na restriction enhanced aldo and 18-OHB responses to ACTH 2- to 3-fold but did not alter the other corticosteroid responses. Dexamethasone pretreatment augmented aldo, 18-OHB, and F responses but did not change the responsivity of the other corticosteroids to ACTH. Adrenal corticosteroid responses to ACTH were not significantly different between 0800 and 2000 h in subjects on 120-meq Na intake. Thus, corticoste-roids show markedly different responses to physiological doses of ACTH, which may have more importance in their regulation than heretofore proposed. Dexamethasone pretreatment enhances aldo, 18-OHB, and F responses to ACTH but does notaffect the responses of other corticosteroids. Contrary to reports in experimental animals, corticosteroid responses to ACTH in man do not differ from day to night.

^* This work was supported by the U.S. V.A. Research and Education Program (MRIS 8545).

Received July 28, 1980.

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