AldosteroneおよびCortisolの分泌と代謝に関する臨床的研究:第1篇 正常人および各種内分泌疾患々者におけるAldosteroneおよびCortisolの分泌と代謝に関する研究
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The studies on the secretion and metabolism of cortisol and aldosterone in humans were made by the use of radioactive steroid hormones. One to 3.0 μc of 7-H<SUP>3</SUP>- aldosterone, 7-H<SUP>3</SUP>-cortisol or 4-C<SUP>3</SUP>-cortisol were injected intravenously into normal subjects and patients with various endocrine disorders. Urine was collected for 24 hours after the injection of radioactive hormones. The daily secretion rate of cortisol and aldosterone was calculated from the injected radioactivities and specific activities of these urinary metabolites. To determine the specific activity of urinay metabolite of aldosterone, urinary aldosterone released by acid hydrolysis was purified by the use of column chromatography (florisil) and paper chromatographies (chloroform formamide system, butylacetate formamide water system and benzene methanol water system). In the case of cortisol, tetrahydrocortisol hydrolyzed by bacterial β-glucuronidase was isolated by the same paper chromatographic systems as for aldosterone.<BR>Heparinized blood samples were withdrawn at 10 to 30 minute intervals after the injection of radioactive hormones. The disappearance curves of labeled hormones were analysed mathematically and volumes of distribution space, metabolic clearance rate and speed of metabolism were calculated using two compartmental models of the human body as discribed by Tait et al.<BR>The mean values of secretion and metabolism for cortisol in three cases of normal subjects were as follow : <BR>The secretion rate of cortisol ; 20.9±3.7 mg/day, mean plasma concentration ; 5.02 ±0.62 mg/100 ml, speed of metabolism (K<SUB>2</SUB>) ; 39.1±1.6 units/day, volume of distribution space (V<SUB>1</SUB> + V<SUB>2</SUB>); 14.0±0.6 L, metabolic clearance rate (M<SUB>2</SUB>) ; 415±39.5 L/day, and miscible pool ; 701.2±98.6μg.<BR>The mean values of secretion and metabolism for aldosterone in normal men under sodium unrestricted diets were as follow : secretion rate ; 128±22 pg/day, mean plasma concentration ; 0.0085±0004 μg/100 ml, speed of metabolism ; 57.6±3.8 units/day, volume of distribution space ; 34.5±6.7 L, metabolic clearance rate ; 1385±158 L/day, and miscible pool ; 2.94±0.58 μg.<BR>In patients with Cushing's syndrome, daily secretion rate, mean plasma concentration and miscible pool of cortisol were markedly increased, especially higher valueswere obtained in the cases due to adrenal hyperplasia than those due to adrenal adenoma. The speed of metabolism and metabolic clearance rate of cortisol was lower than normal controls. Daily secretion rate of aldosterone was slightly increased in some cases of Cushing's syndrome.<BR>In patients with Addison's disease, daily secretion rate, mean plasma concentration, and miscible pool of cortisol and aldosterone were markedly decreased or not detectable, while the speed of metabolism of these hormones was within normal range.<BR>A patient with primary aldosteronism showed high values of daily secretion rate and mean plasma concentration of aldosterone. These values were reduced to normal range after the extirpation of adrenocortical adenoma, while the speed of metabolism of aldosterone in this case did not change by operation.
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