AN ENDOCRINE FINDING APPARENTLY CHARACTERISTIC OF GOUT: VERY LOW URINARY 17-KETOSTEROID EXCRETION WITH CLINICALLY NORMAL ANDROGENIC FUNCTION*

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Abstract
WE HAD speculated on the role of androgens (Table 1) and other hormones in gout but deferred study of the problem because most gout patients are free of obvious endocrine disease. One of our gout patients, a vigorous alert 59-year-old tavern keeper, who complained of impotence and hair loss on the forearms, was then found to have a urinary 17-ketosteroid excretion of only 0.7 mg./day. In current endocrine theory, this finding implies either failure of both gonadal and adrenal androgen production, or a more obscure disturbance in steroid production or metabolism. This observation led to the survey of a group of gout patients reported here. Unusually low values for 17-ketosteroid excretion were found in all patients studied. An attempt will be made to explain this finding by detailed consideration of the various known causes for very low 17-ketosteroid outputs. Material and Methods The data were chiefly obtained from study of the 11 patients listed in Table 2. Data from other patients seen during the past few years have been quoted in the discussion. Certain other investigators, whose aid is acknowledged elsewhere in the text, have provided important related data.

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