Voccia E, Saenger P, Peterson R E, Rauh W, Gottesdiener K, Levine L S, New M I
J Clin Endocrinol Metab. 1979 Mar;48(3):467-71. doi: 10.1210/jcem-48-3-467.
Urinary 6beta-hydroxycortisol (6betaOHF) excretion was measured and compared with free cortisol and 17-hydroxycorticosteroid (17OH) excretion in normal children, patients with Cushing's syndrome or disease (CSD), and patients during cortisol therapy. Normal 6betaOHF excretion in children was 0.23 +/- 0.03 mg/m2/24 h (mean +/- SE). No sex difference was found. ACTH infusion (40 U/day for 5 days) and high dose cortisol altered the 6 betaOHF:17OH ratio so that it was indistinguishable from the ratio seen in CSD. The fact that both Cushing's disease and high dose cortisol therapy caused the same change in the 6 betaOHF:17OH ratio suggests that cortisol and not ACTH induced 6beta-hydroxylase in hypercortisolemic subjects. Since the 6betaOHF:17OH ratio in CSD patients was always well above the normal range, measurement of 6betaOHF excretion was a better and more rapid test for chronic hypercortisolemia than urinary 17OH or free cortisol. Thus, measurement of urinary 6betaOHF is suggested as a good diagnostic test for hypercortisolemic states.
对正常儿童、库欣综合征或疾病（CSD）患者以及接受皮质醇治疗的患者，测量了尿6β-羟基皮质醇（6βOHF）的排泄量，并将其与游离皮质醇和17-羟基皮质类固醇（17OH）的排泄量进行比较。儿童正常的6βOHF排泄量为0.23±0.03mg/m²/24小时（均值±标准误）。未发现性别差异。促肾上腺皮质激素（ACTH）输注（40U/天，共5天）和高剂量皮质醇改变了6βOHF:17OH的比值，使其与CSD患者的比值无法区分。库欣病和高剂量皮质醇治疗均导致6βOHF:17OH比值发生相同变化，这一事实表明，在高皮质醇血症患者中，是皮质醇而非ACTH诱导了6β-羟化酶。由于CSD患者的6βOHF:17OH比值始终远高于正常范围，因此，与尿17OH或游离皮质醇相比，测量6βOHF排泄量是检测慢性高皮质醇血症更好、更快速的方法。因此，建议将测量尿6βOHF作为高皮质醇血症状态的良好诊断试验。
