J.Jpn. Surg. Soc.. 81(11): 1476-1490, 1980

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Original article

SIMULTANEOUS ASSAY OF PLASMA 12 STEROIDS AND ITS CLINICAL APPLICATION

Twelve steroids were determined simultaneously by radioimmunoassay or competitive protein binding assay after fractionation with Sephadex LH-20 column chromatography in a small amount— 1.3 ml―of plasma in humans. These include all main steroids in each synthetic steps of four groups,― precursor group (pregnenolone, 17α-hydroxypregnenolone, progesterone, 17α-hydroxyprogesterone), mineralocorticoids (11-deoxycorticosterone, corticosterone, aldosterone), glucocorticoids (11-deoxycortisol, cortisol) and androgens (dehydroepiandrosterone, androstenedione, testosterone).
In Cushing's syndrome, various patterns were found in all four groups. In adenoma, mineralocorticoids particularly 11-deoxycorticosterone were increased, whereas androgens were decreased. In hyperplasia, corticosterone was slightly increased, and androgens were also increased in female cases. However, there was no distinct difference of the increases of cortisol levels in either the adenoma o hyperplasia. In primary aldosteronism, all mineralocorticoids were increased characteristically with a high ratio of aldosterone to 11-deoxycorticosterone and corticosterone, suggesting an accelerated conversion of corticosterone to aldosterone. In 21-hydroxylase deficiency syndrome, the lower levels of mineralocorticoids particularly aldosterone were found in the salt-losing type than in the simple type. These findings led us to suggest that the two types are principally originated from the defect of two different enzymes respectively. In 17-hydroxylase deficiency syndrome, mineralocorticoids were increased strikingly to be associated with the remarkable decreases of glucocorticoids and slight decreases of androgens.

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