QUANTITATIVE ESTIMATION OF ADRENOCORTICAL HORMONES AND THEIR Α-Ketolic METABOLITES IN URINE

Cost, W. S.; Vegter, J. J. M.; Pol, J.A. Fernandez

doi:10.1530/acta.0.0410571

Cited by 26 publications

(8 citation statements)

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“…Two consistent abnormalities were observed in Cushing's syndrome: decreased 1 1 8-OHSD activity (increased ratio of (THF + allo-THF)/THE) (Cost, 1963b;Phillipou, 1982); and decreased A-ring reduction by 5a-reductase (increased ratio of aetiocholanolone/androstenedione (Jailer et a/., 1959;Moolenaar & Van Seters, 1971;Phillipou, 1982) and of THF/allo-THF (Cost, 1963b;Phillipou, 1982)). The same pattern was found in patients with chronic stress (Gold et al, 1958;Ichikawa, 1966), and in volunteers and patients receiving exogenous ACTH (Jailer et al, 1959;Cost, 1963a). The 5a-reductase defect correlated with ACTH activity, since it was most obvious in ectopic ACTH, less so in pituitary-dependent disease and least in adrenal adenomas (Moolenaar & Van Seter, 1971).…”

Section: Ll/i-ohsd Is Impaired In Patients With Ectopic Acth Syndromementioning

confidence: 75%

Mineralocorticoid excess and inhibition of 11 β‐hydroxysteroid dehydrogenase in patients with ectopic ACTH syndrome

Walker

Campbell

Fraser

et al. 1992

Clinical Endocrinology

181

126

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Section: Ll/i-ohsd Is Impaired In Patients With Ectopic Acth Syndromementioning

confidence: 75%

Mineralocorticoid excess and inhibition of 11 β‐hydroxysteroid dehydrogenase in patients with ectopic ACTH syndrome

Walker

Campbell

Fraser

et al. 1992

Clinical Endocrinology

181

126

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“…Physiological changes in adrenocortical function during childhood have previously been docu¬ mented on the basis of 17-oxosteroid and 17-hydroxycorticosteroid (17-oxogenic steroid) excre¬ tion rates (10,11). The Porter-Silber and blue tetrazolium reactions used in earlier studies are non¬ specific methods that measure not only metabolites of cortisol but certain precursors as well as material unrelated to steroids.…”

Section: Discussionmentioning

confidence: 99%

Urine steroid excretion rates in childhood reflect growth and activity of the adrenal cortex

Honour¹,

Kelnar²,

Brook³

1991

Acta Endocrinologica

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Normal ranges for daily urine steroid excretion rates in childhood are reported for the first time by gas chromatographic analysis using capillary columns and flame ionisation detector. Longitudinal data came from a study over 3 years of 127 normal boys (aged 7.5-15.6 years) studied on 5 occasions and 14 pubertal girls studied over 2 years. Cross-sectional data were collected from 115 hospitalized patients (58 males, 57 females) aged 2.9 to 14 years with normal adrenal function. The excretion rate of cortisol metabolites was constant for body size, whereas androgen metabolite excretion rates rose sharply in childhood to approach adult levels at the end of puberty. The new data will enable better interpretation of pediatric patient data.During childhood the adrenal cortex changes in size, cell distribution and function. At birth dehydroepiandrosterone sulphate (DHA-S) is the prin¬ cipal secretory product of the adrenal cortex. By six months of age DHA-S secretion declines to a low level which is sustained for the next 3-7 years. The adrenal weight at birth is regained when the child is 8-10 years old and between the ages of 3-7 years there is a rise in adrenal androgen which precedes the onset of puberty. There is a ten-fold rise in production rate and circulating levels of DH A and DHA-S. The adrenal androgens are secreted epi¬ sodically and concurrently with cortisol (1).Throughout childhood cortisol concentrations in serum have a circadian pattern similar to that in adults. The constant rate of cortisol synthesis for body size has been considered only in a few pub¬ lished papers (2-5). In the present study we have determined the excretion rates of steroid metabolites by capillary column gas chromatography in a large number of children so as to establish normal ranges. This was necessary because previous use of this technology has been limited to displaying gross abnormalities of steroid production, e.g. the inborn errors of metabolism (6).The clinical signs of endocrine abnormalities in childhood can be different to the presentation of the same disease in an adult. The growth of chil¬ dren is often affected by adrenal disease so that to interpret urinary steroid data from pédiatrie pa¬ tients we wished to test the relationship between steroid excretion rates with age and body size. Subjects and MethodsOne hundred and twenty-seven boys in 3 age groups were studied at intervals of six months over periods up to three years (Table 1). Fourteen normal girls (aged 11.7-14.5 years) were studied at six monthly intervals for two years. Twenty-four hour urine samples were collected by chil¬ dren at home during weekends. Merthiolate (0.2 ml) was added to each container as preservative. Aliquots were kept frozen until analysed for steroid content. The chil¬ dren were assessed at intervals for height, weight and pubertal ratings. Body surface areas were calculated from nomograms of height and weight.One hundred and fifteen hospitalized children (58 male, 57 female) aged 2.9-14.0 years were studied on one occasion. They we...

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“…Urinary H4S was assayed according to Cost & Vegter (1962). Plasma S was extracted according to Spark (1971) and assayed by competitive protein binding (Murphy 1967) using dog serum as binder, [3H]corticosterone as tracer and Florisil® for separation.…”

Section: Methodsmentioning

confidence: 99%

Plasma 11-deoxycortisol, androstenedione, testosterone and ACTH in comparison with the urinary excretion of tetrahydro-11-deoxycortisol as indices of the pituitary-adrenal response to oral metyrapone

Lange

Sluiter

Pratt

et al. 1980

Acta Endocrinologica

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Plasma levels of ACTH, 11-deoxycortisol, androstenedione and testosterone and urinary tetrahydro-11-deoxycortisol were determined during a two day oral metyrapone test using doses of 1.5 g every 6 h. The level of 11-deoxycortisol 48 h after the start was distinctive regarding the assessment of pituitary ACTH secretory capacity. The rise of androstenedione concentration after 48 h is distinctive in a similar way, whereas ACTH determination is of little diagnostic value in this respect.Further, an increase in testosterone level can be observed in cases of low basal testosterone production. This increase is probably the result of peripheral conversion of androstenedione to testosterone. Where the basal testosterone concentration was high, no change could be measured.Metyrapone, a compound structurally related to DDT, has been frequently used in the assessment of the secretory capacity of adrenocorticotrophic hormone (ACTH) since 1958 (Liddle et al. 1959).Metyrapone inhibits adrenal corticosteroid 11-hydroxylase, resulting in a decrease in cortisol synthe¬ sis followed by an increase in ACTH secretion and a rise of the plasma 1 l-deoxycortisol (S) level. The increase of S in plasma is accompanied by an augmented urinary excretion of tetrahydro-11-deoxycortisol (H4S). Short metyrapone tests (usually consisting of one dose of metyrapone) have been described (Jubiz et al. 1970b;Zachmann et al. 1974;Blichert-Toft 1975;Leisti 1977), but the conventional oral mety¬ rapone test is still widely used.Oral administration of metyrapone for three consecutive days results in a 95% inhibition of the 11-ß-hydroxylase, at a daily dose of 4.5 g (Cope et al. 1966).The relative increase of urinary H4S after mety¬ rapone administration exceeds the relative rise in plasma S considerably (Zachmann et al. 1974).However, in order to eliminate the troublesome collection of urine that can be a source of error, we investigated the diagnostic value of several plasma hormone assays in the assessment of ACTH secre¬ tory capacity. For this purpose we measured plasma ACTH, 11-deoxycortisol, androstenedione and testosterone in combination with urinary H4S. Androstenedione and testosterone measurementswere included because of the data of Nilsson & Hökfelt (1971) and of Schaison et al. (1977), indi¬ cating a five-fold rise of androstenedione during metyrapone administration in normal persons. Materials and MethodsThe metyrapone test was performed in the following groups of individuals : a. normal women (n = 6) and normal men (n = 8, in¬ cluding 5 cases of delayed puberty) ranging in age from 18 to 77 years (normal controls).b. Twenty-two men and 17 women with a pituitary tumour or a suspected process in the region of the sella turcica; of these 8 men and 4 women had undergone pituitary surgery.

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QUANTITATIVE ESTIMATION OF ADRENOCORTICAL HORMONES AND THEIR Α-Ketolic METABOLITES IN URINE

Cited by 26 publications

References 0 publications

Mineralocorticoid excess and inhibition of 11 β‐hydroxysteroid dehydrogenase in patients with ectopic ACTH syndrome

Mineralocorticoid excess and inhibition of 11 β‐hydroxysteroid dehydrogenase in patients with ectopic ACTH syndrome

Urine steroid excretion rates in childhood reflect growth and activity of the adrenal cortex

Plasma 11-deoxycortisol, androstenedione, testosterone and ACTH in comparison with the urinary excretion of tetrahydro-11-deoxycortisol as indices of the pituitary-adrenal response to oral metyrapone

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