Although animal experiments show that diabetes mellitus increases susceptibility to toxic liver injury caused by certain compounds (., APAP), there is no evidence to show that diabetes mellitus increases the risk of all-cause DILI in humans. Liver injury due to selected compounds such as methotrexate and anti-tuberculosis medicines may be increased in individuals with diabetes. A preliminary report from the United States Drug-Induced Liver Injury Network (DILIN) showed that underlying diabetes mellitus was independently associated with the severity of DILI (odds ratio=; 95% CI=–) (16).
Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.