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Basic principles in the laboratory evaluation of adrenocortical function

Lynnette K Nieman, MD
Section Editor
André Lacroix, MD
Deputy Editor
Kathryn A Martin, MD


The adrenal cortex consists of three functional zones [1,2]:

The zona glomerulosa, which secretes aldosterone and is primarily under the control of the renin-angiotensin system

The zona fasciculata, which secretes cortisol and is regulated by the corticotropin-releasing hormone (CRH)-corticotropin (ACTH) system

The zona reticularis, which secretes dehydroepiandrosterone (DHEA), DHEA sulfate, and smaller amounts of androstenedione, testosterone, and other 19-carbon steroids and is under the control of ACTH and perhaps other proopiomelanocortin (POMC)-derived peptides

Consequently, evaluation of adrenal function requires measurement of the relevant adrenal hormones and their metabolites and sometimes of the secretagogues (ACTH levels for cortisol or renin activity or concentration for aldosterone) that regulate their secretion.

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Literature review current through: Oct 2017. | This topic last updated: Nov 15, 2016.
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