Abstract
This study was made to clarify the mechanism of steroid metabolism in human adrenal cortex by the estimation of total urinary 17-ketosteroids (17-KS), their fractions (by the microscale alumina-column elution chromatography), and urinary 17-hydroxycorticosteroids (17-OHCS). The subject for this study were healthy adults, patients receiving large doses of steroid hormone for a long time, and patients with pituitary-adrenocortical disorders. The influence of ACTH infusions and dexamethasone on urinary corticoid-excretions patterns of healthy adults were also studied.
The results are as follows :
1) In 21 healthy adults, 17-KS fraction patterns had individual variations to some extent, but little sex differences.
2) In healthy adults, there were no significant correlations between 17-OHCS and total 17-KS, III (Dehydroepiandrosterone), IV+ V (11-Desoxy-17-KS), VI + VII (11-Oxy-17-KS) fractions, respectively. But in patients with pituitary-adrenocortical disorders, there was a close correlation between them, except in III fraction.
3) In ACTH infusion of 1, healthy male and 1 healthy female, the rate of increase of urinary corticoids was high : 17-OHCS, VI +VII, IV + V fraction in descending order.
4) After 3 days of successive administration of dexamethasone to 9 healthy adults, the rate of decrease of urinary corticoids was high : 17-OHCS, VI + VII, IV+ V fraction in descending order. The quantitative change of III fraction was indefinite.
5) In 9 patients receiving large doses of steroid hormone for a long time, the urinary 17-OHCS, 17-KS and its fractions all decreased remarkably. Especially, the decrease of 17-OHCS was high.
6) From these data, it was concluded that the hydrocortisone-biosynthetic system is the most sensitive among all the adrenocortical steroid-biosynthetic systems under the pituitary-ACTH control, and that the adrenal androgens (C19 steroids) change, as Dorfman said, as a “by-product” accompanying this control. The evaluation of III fraction must be made with careful consideration because it is unstable in acid hydrolysis and it is an intermediate and not the end metabolite in steroid metabolism.
7) The corticoid excretion of 18 cases of pituitary-adrenocortical disorders showed various abnormal patterns. But 17-KS fractions, by this methods, have little specificity concerning diseases or disease types, and therefore I feel that their meaning is limited.
