尿中17-ketosteroids分劃と副腎皮質
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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.<BR>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.<BR>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.<BR>Following results were obtained : <BR>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.<BR>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.<BR>3) On the chromatographic pattern of urinary 17-KS in healthy adults, there was more significant individual variation than sexual difference.<BR>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.<BR>5) Effect of ACTH on diurnal rhythms in the excretion of urinary total 17-OHCS and 17-KS pattern was observed as follows : <BR>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.<BR>ii) In an Addisonian, 30 years old male, there was no significant change in any fraction of urinary steroids following ACTH administration.<BR>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.
- 一般社団法人 日本内分泌学会の論文