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Adrenal steroidogenesis is essential for human survival and depends on the availability of the precursor cholesterol. Male subjects with low plasma levels of high density lipoprotein (HDL) cholesterol are characterized by decreased adrenal function. Whether this is also the case in female subjects with low plasma HDL-C levels is unresolved to date.    Findings  15 female ATP binding cassette transporter AI ( ABCAI ) and 14 female lecithin-cholesterol acyltransferase ( LCAT ) were included in the study. HDL-C levels were 38% and 41% lower in  ABCA1  and  LCAT  mutation carriers compared to controls, respectively. Urinary steroid excretion of 17-ketogenic steroids or 17-hydroxy corticosteroids did not differ between 15 female  ABCA1  mutation carriers (p = 0.27 vs 0.30 respectively) and 30 matched normolipidemic controls or between 14 female  LCAT  mutation carriers and 28 matched normolipidemic controls (p = 0.10 and 0.14, respectively). Cosyntropin testing in an unselected subgroup of 8  ABCA1  mutation carriers and 3  LCAT  mutation carriers did not reveal differences between carriers and controls.    Conclusion  Adrenal function in females with molecularly defined low HDL-C levels is not different from controls. The discrepancy with the finding of impaired steroidogenesis in males with molecularly defined low HDL-C levels underscores the importance of gender specific analyses in cholesterol-related research.

Adrenal Function in Females with Low Plasma HDL-C Due to Mutations in ABCA1 and LCAT