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lüll Spironolactone effective hypertension in the elderly due to 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) impairment: contributory role of determining serum cortisol/cortisone ratio as a marker of 11beta-HSD2 activity Inada M; Iwasaki K; Imai C; Hashimoto SIntern Med 2008[]; 47 (24): 2157-64Two elderly patients with mineralocorticoid excess state due to 11 beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) impairment are described. Moreover, the role of the precursor-product ratios of the steroids reflecting 11beta-HSD2 activity was estimated in 5 patients, including 3 patients reported previously by us. Significant elevations of urinary cortisol/cortisone ratios were observed, whereas urinary tetrahydrocortisol (THF)+allo-THF/tetrahydrocortisone (THE) ratios were not elevated significantly. Furthermore, an even more distinct elevation of serum cortisol/cortisone ratio was evident in all instances of 5 patients, suggesting a significant clinical role of the serum cortisol/cortisone ratio in the diagnosis of 11beta-HSD2 impairment.|11-beta-Hydroxysteroid Dehydrogenase Type 2/*blood/urine[MESH]|Aged[MESH]|Biomarkers/blood/urine[MESH]|Cortisone/*blood/urine[MESH]|Diabetes Mellitus, Type 2/blood/urine[MESH]|Female[MESH]|Humans[MESH]|Hydrocortisone/*blood/urine[MESH]|Hypertension/*blood/drug therapy/urine[MESH]|Male[MESH]|Spironolactone/*therapeutic use[MESH] |