URINARY EXCRETION OF Δ5-PREGNENETRIOL AND OTHER 3β-HYDROXY-Δ5STEROIDS BY SUBJECTS WITH AND WITHOUT ENDOCRINE DISEASE

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Abstract
5-Pregnene-3B, 17a, 20a-triol (5PT) was found in all urines analyzed, indicating that its presumptive adrenal precursor 3B,17a-dihydroxy- 5-preg-nen-20-one is regularly formed. After separation from other metabolites, 5-PT was quantitatively determined by oxidation to dehydroepiandrosterone (DHA), using periodic acid and then the Zimmermann reaction. The titers varied from 4 mg. to 53 mg per day in 5 patients with adrenal carcinoma, and from about 0.1 mg. to 0.4 mg. in 10 subjects without endocrine disorders. Elevated titers were not found in 2 patients with Cushing''s syndrome, nor in 2 with the Stein-Leventhal syndrome. Titers of 5-PT tended to vary inversely with those of DHA, suggesting the possibility that an inefficient conversion of 3B- 17a-dihydroxy- 5-pregnen-20-one to DHA may cause increased formation of 5-PT. Both 5-PT and DHA were sharply reduced when amphenone was given to a patient with adrenal carcinoma, whereas other C19O2 steroids showed little change. Thus, saturated 17-ketosteroids (e.g., eticholanolone) may arise from precursors other than DHA in adrenal cancer. A 5-Pregnen-3B- 20a-diol was detected for the first time in the urine of all subjects without endocrine disorders. It was present and elevated in the urine of 4 of the 5 adrenal cancer patients. In adrenal carcinoma, 5-androstenediol excretion was about one-tenth that of the DHA. This steroid was also found in the urine of 3 other subjects.