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摘要
Urine volume should be considered as a confounder when using urinary free cortisol (UFF) and cortisone (UFE) to assess glucocorticoid (GC) status. We aimed to examine whether adrenal androgen (AA) metabolites may be also affected by urine volume in healthy children. To compare the flow dependence of GC and AA metabolites, specific GC metabolites were examined. In 24-h urine samples of 120 (60 boys) healthy children (4-10 yr), steroid profiles were determined by GC-MS analysis, UFF and UFE by radioimmunoassay. To assess daily AA and GC secretion rates. 7 quantitatively most important AA (Sigma C19) and GC (Sigma C21) metabolites were summed. Sum of DHEA and its 16 alpha-hydroxylated metabolites were denoted as DHEA&M. Association of urine volume with AA (Sigma C19, DHEA&M, DHEA, 16 alpha-hydroxy-DHEA, 3 beta,16 alpha,17 beta-androstenetriol) and GC (Sigma C21, UFF, UFE, 6 beta-hydroxycortisol, 20 alpha-dihydrocortisol) were examined in linear regression models. Among the examined AA metabolites, 16 alpha-hydroxy-DHEA (beta = 0.56, p < 0.0001) and DHEA (beta = 0.43, p = 0.05) showed relatively strong association with urine volume. A trend was seen for Sigma C19 (beta = 0.23, p = 0.08), but not for DHEA&M (p > 0.1). Regarding GC metabolites, urine volume showed a stronger association with cortisol's direct metabolites, i.e., cortisone. 6 beta-hydroxycortisol and 20 alpha-dihydrocortisol (beta = 0.4-0.6. p < 0.01) than with cortisol itself (beta = 0.28, p < 0.05). Sigma C21 was not associated with urine volume. In conclusion, like UFF and UFE, renal excretion of DHEA, 16 alpha-hydroxy-DHEA, 6 beta-hydroxycortisol, and 20 alpha-dihydrocortisol may also depend on urine volume. The intrarenal production of the latter three and cortisone might explain their relative strong water-flow-dependency. Total AA or GC secretion marker appears not to be relevantly confounded by urine volume.
- 出版日期2011-1
