Urinary Free 11-Hydroxycorticosteroid/Creatinine Ratios in Early Morning Urine Samples as an Index of Adrenal Function

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Abstract
Urinary free 11-hydroxycorticosteroid/creatinine ratios were determined in early morning urine samples from 113 females (age range 20–45 years) and 65 males (age range 22–45 years). Basal values in normal subjects fluctuated between 5 and 55 μmol/mol creatinine. In four patients in whom Cushing's syndrome was diagnosed, urinary free 11-hydroxycorticosteroid/creatinine ratios were greater than 85 μmol/mol creatinine. Administration of dexamethasone (0.5 mg/q.i.d.) to nine normal laboratory staff for two days resulted in a suppression of the urinary free 11-hydroxycorticosteroid/creatinine ratio to less than 50% of the mean basal value in all cases. This degree of suppression did not occur in two cases of Cushing's syndrome due to adrenal tumours.