Comparative study of plasma steroid and steroid glucuronide levels in normal men and in men with benign prostatic hyperplasia

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Abstract
Plasma steroids were analyzed in 16 normal men and in 10 men with prostatic benign hyperplasia (BPH). The steroids measured by radioimmunoassay include pregnenolone, 17‐OH‐pregnenolone, dehydroepiandrosterone, androst‐5‐ene‐3β, 17β‐diol, testosterone, dihydrotestosterone, androstane‐3α 17β‐diol, androstane‐3β, 17β‐diol, estrone, and estradiol as well as their glucuronide derivatives. In addition, cortisol and the sulphoconjugated form of dehydroepiandrosterone were determined. Whereas the levels of pregnenolone, pregnenolone glucuronide and 17‐OH‐pregnenolone glucuronide are not different in the two groups, the levels of 17‐OH‐pregnenolone in the BPH group (0.87 ± 0.07 ng/ml) exceed by two‐fold (p < 0.01) those observed in normal men. Plasma dehydroepiandrosterone and androst‐5‐ene‐3β, 17β‐diol concentrations are markedly elevated in the BPH group (1.49 ± 0.23 and 0.55 ± 0.08 ng/ml vs the control groups 0.43 ± 0.11 and 0.31 ± 0.05 ng/ml, respectively). Since the plasma cortisol and pregnenolone levels are comparable in these two groups, our data suggest that the elevation of plasma 17‐OH‐pregnenolone, dehydroepiandrosterone, and androst‐5‐ene‐3β, 17β‐diol reflects an increase of adrenal 17‐hydroxylase activity in patients with BPH. A slight increase of the plasma dihydrotestosterone and androsterone glucuronide concentration is also observed in men with BPH, indicating an increase of 5α‐reduced androgen formation. We have also observed, in the BPH group, a 50% decrease (p < 0.01) of plasma glucuronidated androst‐5‐ene‐3β,17β‐diol, estrone, and estradiol levels, suggesting that the transformation of unconjugated estrogenic steroids into glucuronide derivative is inhibited in BPH patients. In summary, our data indicate that adrenal C‐19 steroids might be involved in the process of BPH. Furthermore, whereas the estrogen glucuronide formation is diminished in men with BPH, the prostatic androgen metabolism as reflected by plasma dihydrotestosterone and androsterone glucuronide concentrations seems to be increased.