EFFECT OF CORTICOSTEROIDS ON URINARY 5β AND 5α C19 STEROIDS IN MAN

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Abstract
[long dash]A high proportion of urinary C19 5[beta] to 5[alpha] steroid metabolites has been found on administration of glucocorticoids in a number of instances. During long term treatment with prednisone or dexamethasone, 100 mg testosterone propionate was administered to 3 patients. The ratios of the resulting metabolites etiocholanolone (E, 5[beta]) to androsterone (A,5[alpha]) were 2.7, 3.3 and 2.1, compared to 1.3 and 0.9 after withdrawal of corticoids from the first 2 patients. In normal men, ratios of endogenously derived E and A while receiving corticoids, compared to control ratios were 2.3 to 1.0, 2.2 to 0.6 and 12 to 0.9. Ratios in normal women rose from 1.1 to 2.2 and 2.4 to 43 on receiving dexamethasone. Not all subjects gave the expected response. In 3 of these the dosage of corticoid was either low or given for a short time. The ratio of C19O3 metabolites of administered 11[beta]-hydroxy-androst-4-ene-3,17-dione was also changed in favor of the 5[beta] products during corticoid treatment. In a man with periodic fever the high E/A ratios observed were probably related to dexamethasone therapy rather than to the disease.