Exp Clin Endocrinol Diabetes 2013; 121 - P77
DOI: 10.1055/s-0033-1336755

Urinary steroid profile analysis using gas chromatography-mass spectrometry (GC-MS) and enzymatic activities in patients with major depression and controls

G Paslakis 1, M Deuschle 1, MF Hartmann 2, SA Wudy 2
  • 1Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Dpt. of Psychiatry and Psychotherapy, Mannheim, Germany
  • 2Center of Child and Adolescent Medicine, Justus Liebig University, Steroid Research and Mass Spectrometry Unit, Gießen, Germany

Introduction: Only few studies so far have examined the regulation of glucocorticoid catabolism and excretion in depressed patients and even less studies have dealt with intracellular modulators of steroid action in depression.

Methods: We assessed the concentrations of several main cortisol metabolites (among others tetrahydrocortisone, tetrahydrocortisol and allo-tetrahydrocortisol) in 24-h urine samples of 32 inpatients with major depression and 36 healthy controls. We also investigated patterns of steroidogenic enzyme activities for 21-hydroxylase, 3ß-hydroxysteroid dehydrogenase, 17ß-hydroxysteroid dehydrogenase, 5a-reductase and 11ß-hydroxysteroid dehydrogenase. The enzymatic activities were calculated using definite ratios of urinary steroid metabolites. Concentrations of urinary steroid metabolites were obtained by gas chromatography-mass spectrometry (GC-MS) urinary steroid profiling. Differences between patients and controls were investigated using t-tests and the univariate analysis of variance (ANOVA) to control for age, gender, BMI and severity of patients' depression (Hamilton Depression Rating Scale, HAMD) at baseline and after a 4-week antidepressant treatment.

Results: We found no difference in the excretion of tetrahydrocortisone, tetrahydrocortisol and allo-tetrahydrocortisol when comparing depressed patients and healthy controls. With regard to enzymatic activities we also found no differences between patients and the healthy cohort, although there were significant main effects for gender (3ß-hydroxysteroid dehydrogenase: p < 0.001, 21-hydroxylase: p = 0.048) and age (3ß-hydroxysteroid dehydrogenase: p = 0.001; 21-hydroxylase: p = 0.019; 17ß-hydroxysteroid dehydrogenase: p = 0.001) regardless of group affiliation (patients vs. controls).

Conclusion: In the present study cohort we found no differences in major pathways of cortisol metabolism and urinary steroidogenic enzyme activities between depressed patients and healthy controls.