Urinary steroid metabolites and 11β-hydroxysteroid dehyrogenase activity in patients with unipolar recurrent major depression

Background: The aim of the present study was to obtain comprehensive information on steroid metabolism in depressed patients. Methods: 24-h urinary steroids were measured by gas chromatography in patients with unipolar recurrent major depression (URMD) compared to controls, and an index of relative activity of the 11β-hydroxysteroid dehydrogenase (11β-HSD) enzyme was calculated. Results: The levels of etiocholanolone (E) (p<0.05), β-cortolone (β-CL) (p<0.01) were significantly decreased, while levels of allo-tetrahydrocorticosterone (aTHB) (p<0.05) and cortisol (F) (p<0.01) were elevated in depressed women. The levels of dehydroepiandrosterone (DHEA) (p<0.01), tetrahydrocorticosterone (THB) (p<0.01), β-CL (p<0.01), and aTHB (p<0.05) were found significantly decreased in depressed men. The index of 11β-HSD activity (p<0.01) was significantly decreased in patients in both sexes. Limitations: The sample is limited to only urine samples of patient with URMD; the correlation between the severity of depression and F and DHEA was not analyzed. Conclusion: Our investigations confirmed that URMD associated with altered steroid metabolism, which shows gender differences, pointing to the different stress sensibility of women. These differences may be the cause as well as the consequence of the major depression (MD).