Congenital lipoid adrenal hyperplasia is an autosomal recessive disord
er that is characterized by impaired synthesis of all adrenal and gona
dal steroid hormones. In three unrelated individuals with this disorde
r, steroidogenic acute regulatory protein, which enhances the mitochon
drial conversion of cholesterol into pregnenolone, was mutated and non
functional, providing genetic evidence that this protein is indispensa
ble for normal adrenal and gonadal steroidogenesis.