THE EXCRETION PATTERN OF 17-KETOSTEROIDS AND CORTICOSTEROIDS IN SURGICAL STRESS

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Abstract
In a series of 18 patients before and after major surgical procedures, 17-ketosteroids (17-KS) were identified by chromatography and infrared spectroscopy. The total excretion of reducing corticoids after hydrolysis with beta-glucuronidase was also determined. Dehydroepiandrosterone (DHA) excretion showed a mean postoperative rise of 210%. Androsterone (A) and etiocholanolone (E) rose by 20%, while total excretion of 17-KS increased by only 45%. The 11-oxy-17-KS did not increase. Reducing corticoids showed a mean rise of 130%. Five patients with pathologically low 17-KS excretion prior to operation were unresponsive. Excretion of A and E returned to normal within 3 days and of DHA in 7-9 days. There was no correlation between the rise of total 17-KS and that of DHA or the corticoids. In most cases, increased values of DHA was a good indicator of increased adrenal activity in acute stress.