ASSESSMENT OF THE FUNCTIONAL CAPACITY OF THE ADRENAL CORTEX. I. ESTABLISHMENT OF NORMAL VALUES*

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Abstract
The functional capacity of the human adrenal cortex was studied by estimating urinary 17-hydroxycorticosteroids, total 17-ketosteroids, dehydroepiandrosterone, androsterone+etiocholanolone, and 11-oxygenated 17-ketosteroids, before and after the intravenous infusion of 25 I.U. of ACTH. The number of circulating eosinophils was also followed. Data are presented on the overall reliability (in terms of precision, accuracy, sensitivity and specificity) of the methods employed. In all steroids or steroid groups studied, there was a highly significant correlation between the logarithms of resting and stimulation levels. Neglect of this correlation may result in an erroneous assessment of adrenocortical reserve. By far the most useful index of adrenocortical reserve capacity was found to be the estimation of urinary 17-hydroxycorticosteroids. Normal values obtained in 52 subjects and fiducial limits (within which 95 per cent of normal responses to intravenous ACTH can be expected to fall) are also presented. The use of this technique seems to provide a suitable means also for the laboratory diagnosis of latent adrenocortical hypofunction. The estimation of circulating eosinophils was of distinctly limited value.