尿17-ketogenic steroid分画の臨床的研究

第1編健康人並びに各種内分泌疾患における測定成績について

抄録

The author made some modification in Morris' method for urinary 17-KGS determination. It was found that the use of NaBiO₃ 2.5 gm per 5cc of urine for two huors of oxidation was better than the original Morris' method where NaBiO₃ 1.0 gm per 8cc of urines was used for the determination of 17-hydroxycorticosteroids. By this modification, the fractions of 17-KGS, i.e. 11-deoxy 17-KGS and 11-oxygenated 17-KGS (11-oxy 17-KGS), were successfully determined.
The values of 17-KGS and its fractions in normal adults by this method were as follows : urinary 17-KGS : 8.2±2.7 mg/day, 11-deoxy 17-KGS : 0.9±0.8 mg/day, 11-oxy 17-KGS : 7.3±2.2 mg/day, the ratio of 11-deoxy 17-KGS to 11-oxy 17-KGS (11-deoxy/11-oxy) : 0.12±0.10. There was found no sex difference in normal adults. In elderly subjects, a lower value of each fraction was observed. Increased 11-deoxy 17-KGS and elevation of 11-deoxy/11-oxy due to placental pregnanetriol were observed in pregnant women, and this tendency became definitely apparent in the last trimester of pregnancy.
Among the cases with adrenogenital syndrome, 10 cases with simple virilizing form revealed a marked increase of urinary 17-KGS, which was due to the remarkable increase of 11-deoxy 17-KGS fraction and a mild increase of 11-oxy 17-KGS fraction and high 11-deoxy/11-oxy (2.41±0.61). In 3 other cases with hypertensive form, an equally higher 11-deoxy/11-oxy (6.76±1.71) was observed, but this was due to a relative decrease of 11-oxy 17-KGS fraction. In 9 cases with Cushing's syndrome, an increase of 17-KGS with normal 11-deoxy/11-oxy was observed in all cases. Since various cases with endocrine disorders such as Addison's disease, acromegaly, thyroidal disease or others, all revealed normal 11-deoxy/11-oxy, the elevation of 11-deoxy/11-oxy of urinary 17-KGS is though to be specific for adrenogenital syndrome due to congenital adrenal hyperplasia, besides pregnancy. Thus, determination of urinary 17-KGS fraction is very important for confirming the diagnosis of adrenogenital syndrome.