抄録
In an attempt to determine whether dehydroepiandrosterone (DHEA) and its sulfate (DS) are secreted by human adrenal and testis, steroids in human adrenal and spermatic venous effluent collected in surgery are analyzed by utilizing gas-liquid chromatography. It was demonstrated that both DHEA and DS levels in adrenal venous blood are definitely higher than in peripheral plasma. In sharp contrast, testis secreted, if any, little DS, although various steroids including pregnenolone, progesterone, 17α-hydroxypregnenolone, 17α-hydroxyprogesterone, DHEA, androstenediol, androstenedione and testosterone were identified in human spermatic venous blood. Taken together with our previous finding that the circulating levels of DS show several folds increase in response to the administration of ACTH and are depressed to the undetectable level after the long-term treatment of patients with glucocorticoid, or in patients with Addison's disease, whereas gonadal stimulation with HCG does not affect the plasma levels of DS in healthy subjects, estimation of the circulating levels of DS could be a valuable indicator of adrenal secretion of Cs steroids.
Plasma DS was determined in 32 patients with Cushing's syndrome. In all of the 16 cases of benign adrenocortical adenoma, the plasma DS levels were significantly suppressed, however, the levels were elevated in 16 patients with bilateral adrenal hyperplasia with three exceptions who showed normal plasma DS values. These results indicate that the circulating DS could reflect the plasma levels of ACTH and determination of plasma DS would be of help in differential diagnosis of the pathological lesion responsible for Cushing's syndrome.
