Original ArticleHigh-density lipoproteins and adrenal steroidogenesis: A population-based study

•Prior studies suggest attenuated adrenal function in men with low high-density lipoprotein (HDL) cholesterol.•The relation of glucocorticoid production with HDL cholesterol was examined.•A total of 240 subjects (50% women) without relevant comorbidities were evaluated.•Urinary glucocorticoid metabolite excretion was inversely associated with HDL cholesterol.•Low HDL cholesterol does not predict attenuated glucocorticoid production.

BackgroundCholesterol trafficked within plasma lipoproteins, in particular high-density lipoproteins (HDL), may represent an important source of cholesterol that is required for adrenal steroidogenesis. Based on a urinary gas chromatography method, compromised adrenal function has been suggested in men but not in women with (genetically determined) low plasma HDL-cholesterol (HDL-C).ObjectiveThe objective of the article was to examine the extent to which glucocorticoid production relates to HDL-C in a population-based cohort.MethodsA total of 240 subjects (120 men and 120 women, aged 20-79 years) without relevant comorbidities were recruited from the general population. Glucocorticoid metabolites were measured by gas chromatography with tandem mass spectrometric detection in 24-hour urine collections to estimate total glucocorticoid production (TGP). Fasting plasma (apo)lipoproteins were assayed by routine methods.ResultsTGP was not decreased but tended to be increased in subjects with low HDL-C (NCEP-ATPIII criteria; P = .094). In univariate analysis, TPG was correlated inversely with HDL-C (r = −0.353, P < .001) and apoA-I (r = −0.263, P = .01). Multivariable linear regression analysis demonstrated that TGP was still inversely related to HDL-C (β = −0.145, P = .019) or alternatively to low HDL-C (β = −0.129, P = .013) taking age, sex, current smoking, and other metabolic syndrome components into account.ConclusionIn this population-based study, urinary glucocorticoid metabolite excretion was inversely associated with HDL-C. We found no evidence for an attenuated adrenal function in men and women with low HDL-C.