Low adrenal androgenic-anabolic steroids in women with rheumatoid arthritis (RA): Gas-liquid chromatographic studies of RA patients and matched normal control women indicating decreased 11-deoxy-17-ketosteroid excretion

摘要: Using GLC, multiple adrenal corticosteroid urinary metabolites, including androgenic-anabolic, glucocorticoid, pregnanediol, and pregnanetriol, were measured in eight ambulatory female RA patients matched normal control subjects on baseline, ACTH-, metyrapone-stimulation days under carefully monitored clinical research center protocol. Neither group had been treated previously with any steroid hormones. The 11-deoxy-17-KS derived from androgenic-anabolic steroids, comprising androsterone, etiocholanolone, DHA, significantly lower baseline (P less than .001), ACTH .005)-, metyrapone .02)-stimulation days. To the contrary, 11-oxy-17-KS mainly glucocorticoids, showed some lowered excretion at .05), but none ACTH- or metyrapone-stimulation. tetrahydrocortisone .001) tetrahydro-11-deoxycortisol .01) not during metyrapone-stimulation, subjects. Pregnanetriol was .005) only ACTH-stimulation. No difference found between groups tetrahydrocortisol pregnanediol day studied. Under conditions of oral administration (750 mg every four hours for seven doses) each subject increased their DHA excretion, no patient an increase over .02). Except 11-deoxy-17-KS, other metabolites studied stimulation, ie, tetrahydro-11-deoxycortisol, tetrahydrocortisol. 24-hour test provided a greater stimulus to total eight-hour intravenous particularly even though decreased groups. Our findings metabolite various supportive androgenic hormone studies reviewed English reports suggest abnormality androgen synthesis metabolism RA, whether it be primary predisposing secondary factor disease. recognized sex preponderance age-specific patterns occurrence are consistent function adrenarche, adrenopause, later changes aging. Metabolite metyrapone- stimulation indicate greatest relative