EXCRETION OF STEROIDAL SUBSTANCES BY THE ADRENAL CORTEX IN VARIOUS DISEASES*

Abstract

FOR many years it has been suspected that the adrenal glands play an important role in the pathogenesis of diseases not etiologically related to these glands. Further, it has been suggested with increasing frequency that the adrenal cortex plays a vital role in known and unknown homeostatic mechanisms which have sufficient lability to maintain physiologic function but which, when deranged, may ameliorate, complicate or actually cause disease itself. Since it was not possible in this study to evaluate the adrenal glands completely by all of the known tests, we selected the determination of urinary phosphomolybdate-reducing substances, which have at times been designated as “neutral reducing lipids,” and 17-ketosteroids as having significance indicative of the physiologic state of the adrenal cortex. These phosphomolybdate-reducing substances will be referred to in the remainder of the paper as Ph.S. Other groups have studied several aspects of this problem using different methods for cortical steroid determination (1–5). This is a preliminary report on the activity of the adrenal cortex in disease. We are in the process of examining some of the diseases in more detail, and these results will be set forth in future publications. The inadequate tests, the complexity of the responses of the adreno-endocrine system, and the myriad of poorly understood or unrecognized labile physiologic mechanisms render any report at this time only a series of observations which may serve as a springboard for more fruitful, orderly, and specific investigation concerning the pathogenesis of various diseases as related to the adrenals.