尿中17-ketosteroids分劃と副腎皮質

抄録

Though the total amount of neutral 17-ketosteroids in urine cannot always be adopted as an indicator of adrenocortical activity on account of their multiple sources, urinary 17-ketosteroids pattern has a valuable suggestion for the metabolic fates of adrenocortical hormones. It is noted, clinically, that the excretion of total 17-hydroxycorticosteroids has a good correlation with adrenocortical glucocorticoids activity. However, the relationship between urinary 17-ketosteroids pattern and urinary total 17-hydroxycorticosteroids has not been well established with regard to adrenocortical function.
In this paper, the observation of total 17-ketosteroids amounts and their chromatographic patterns in urine were made comparing with urinary total 17-hydroxycorticosteroids in human subjects.
Microscale alumina column elution chromatography was used for the separation of urinary 17-ketosteroids, and Smith's modification of Reddy's procedure was employed for the estimation of urinary total 17-hydroxycorticosteroids.
Following results were obtained :
1) The total 24 hour excretion of urinary 17-ketosteroids (17-KS) was not correlated significantly with that of urinary total 17-hydroxycorticosteroids (17-OHCS) obtained from 12 days observation of 10 male healthy adults. However, in some cases of endocrine disorders a parallerism between total 17-OHCS and total 17-KS was noted.
2) A change in the urinary total 17-OHCS excretion was more sensitive indicator of adrenal activation following Gel-ACTH intramuscular administration and muscular exertion by means of bicycle ergometer than the alteration in the total amount of urinary 17-KS.
3) On the chromatographic pattern of urinary 17-KS in healthy adults, there was more significant individual variation than sexual difference.
4) In spite of the existence of diurnal rhythms in the excretion of total 17-OHCS and total 17-KS in healthy adults (3 males and 3 females), individual chromatographic patterns of urinary 17-KS were maintained almost constantly.
5) Effect of ACTH on diurnal rhythms in the excretion of urinary total 17-OHCS and 17-KS pattern was observed as follows :
i) In healthy subjects, there were observed either significant increased of Fraction III (dehydroisoandrosterone and its related compounds) prior to the marked increase of total 17-OHCS or gradual increases of Fraction VI and VII (11-oxygenated 17-KS) following administration of ACTH 25 units intravenously or Gel-ACTH 40 units (Armour) intramuscularly. The increase of Fraction IV and V (androsterone and etiocholanolone) were not always significant following ACTH administration, while the increases of Fraction VI and VII were lasted to the next day of ACTH administration.
ii) In an Addisonian, 30 years old male, there was no significant change in any fraction of urinary steroids following ACTH administration.
iii) In a patient with Cushing's syndrome due to unilateral adrenal adenoma, 10 years old girl, there were slight increase of total 17-OHCS and Fraction VI and VII following Gel-ACTH administration, but Fraction VI and VII were increased prior to the increase of total 17-OHCS.