THE NEUTRAL STEROIDS OF HUMAN URINE: QUANTITATIVE STUDIES IN VARIOUS CLINICAL CONDITIONS

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Abstract
DATA on the levels of 17-ketosteroids in the urine of normal and diseased persons have been summarized by Dorfman (1). Isolation studies, chiefly in cases of adrenal cortical tumor and hyperplasia, have shown that urine may contain derivatives of the adrenal cortical hormones other than 17-ketosteroids. These may be classified as 20-ketosteroids or steroid alcohols. During the luteal phase of the menstrual cycle and in pregnancy, metabolites of progesterone such as pregnanediol and possibly pregnanolones (20-ketosteroids) are also found in urine. Tompsett and Oastler (2) have separated the extract containing the urinary neutral steroids into “ketonic” and “nonketonic” fractions with Girard's reagent T and have determined the quantity of each gravimetrically. During late pregnancy the 17-ketosteroids formed only a small part of an increase in the “ketone” fraction which is probably due to pregnanolones. In a wide variety of other conditions the 17-ketosteroids, as determined by the Zimmermann reaction, formed the major part of the “ketonic” fraction and there was little evidence for the excretion of 20-ketosteroids in any appreciable quantity. The “nonketonic” fraction contained measurable quantities of alcohols, i.e., substances capable of forming hemi-succinates with succinic anhydride. Cholesterol was only a minor constituent.