POMC and congenital adrenal hyperplasia: Notably, a German study involving individuals with bilateral adrenal hyperplasia found that while the contribution of cortisol to steroid levels in the adrenal vein remained comparable before and after ACTH stimulation, the contributions of 11-deoxycortisol, corticosterone, and 11-DOC increased by approximately 2.5-3.5-fold, which aligned with their respective changes in peripheral veins [25].