Levels of Mineralocorticoids in Whites and Blacks

Abstract

Abstract —Blacks appear, on average, to retain more Na than whites. A higher production rate of mineralocorticoids could explain the greater Na retention in blacks. Although production of aldosterone has been shown to be lower in blacks, the level of another mineralocorticoid may be increased. Plasma levels of deoxycorticosterone and cortisol were measured in young whites (n=23; age=16.4±3.1[SD] years) and young blacks (n=25; age=13.8±1.3 years). Blacks had lower plasma levels of renin activity and aldosterone and lower urinary aldosterone excretion rates; thus, they appeared to be representative of blacks that retain additional Na. Plasma deoxycorticosterone levels were lower in blacks than in whites both at baseline (247±161 versus 381±270 pmol/L, P =0.048) and after stimulation with adrenocorticotropic hormone (822±294 versus 1127±628 pmol/L at 30 minutes, P =0.047; 925±366 versus 1440±834 pmol/L at 60 minutes, P =0.013). Cortisol levels were also lower in blacks at baseline ( P =0.014) but were not significantly different from levels in whites after stimulation with adrenocorticotropic hormone. In a larger cohort of 407 whites (age=12.0±2.9 years) and 247 blacks (age=12.9±3.1 years), 18-hydroxycortisol excretion rates were also lower in blacks ( P =0.021). In conclusion, increased Na retention in blacks does not appear to be secondary to increased production of either aldosterone, deoxycorticosterone, cortisol, or 18-hydroxycortisol. A primary renal mechanism may mediate the increase in Na reabsorption in blacks.