Kraan G P, Drayer N M
Department of Pediatrics, University of Groningen, Netherlands.
Steroids. 1990 Apr;55(4):159-64. doi: 10.1016/0039-128x(90)90104-j.
A urinary method of determining the cortisol production rate (CPR) in children was studied under physiologic conditions by administration of low amounts of [1,2,3,4-13C]cortisol. The CPR in three patients with multiple pituitary deficiency ranged from 7 to 16 mumoles d-1 m-2, and the CPR in three patients with congenital adrenal hyperplasia (CAH) due to 11 beta-hydroxylase deficiency (11 beta OHD) and 17 alpha-hydroxylase deficiency (17 alpha OHD) from 0.1 to 2.11 mumoles d-1 m-2. Results showed that with this method, very low CPRs can be reliably measured. The metabolism of [13C4]cortisol or [9,12,12-2H]cortisol was compared with that of native cortisol in adrenalectomized piglets. For the urinary cortisol metabolites, small to substantial differences in isotope dilution were noted relative to that in the original cortisol mixture. With [13C4]cortisol, the so-called secondary isotope effects were approximately 2% to 3% for tetrahydrocortisone (THE) and tetrahydrocortisol (THF), and about 10% for the cortolones, relative to the cortisol mixture. When [2H3]cortisol was used, the cortisol metabolites THE and THF contained only two deuterium atoms. Together with this apparent loss of one deuterium atom, the secondary isotope effects in these steroids amounted to 5% to 10%. It was concluded that [13C4]cortisol was the better tracer to use for the measurement of urinary CPR.
通过给予少量的[1,2,3,4-¹³C]皮质醇，在生理条件下研究了一种测定儿童皮质醇生成率（CPR）的尿液方法。三名垂体功能减退患者的CPR范围为7至16微摩尔·d⁻¹·m⁻²，三名因11β-羟化酶缺乏（11βOHD）和17α-羟化酶缺乏（17αOHD）导致先天性肾上腺皮质增生（CAH）患者的CPR为0.1至2.11微摩尔·d⁻¹·m⁻²。结果表明，用这种方法可以可靠地测量非常低的CPR。将[¹³C₄]皮质醇或[9,12,12-²H]皮质醇的代谢与肾上腺切除仔猪体内天然皮质醇的代谢进行了比较。对于尿皮质醇代谢物，相对于原始皮质醇混合物，在同位素稀释方面观察到了小到显著的差异。使用[¹³C₄]皮质醇时，相对于皮质醇混合物，四氢可的松（THE）和四氢皮质醇（THF）的所谓二级同位素效应约为2%至3%，皮质酮类约为10%。当使用[²H₃]皮质醇时，皮质醇代谢物THE和THF仅含有两个氘原子。连同这一明显的一个氘原子损失，这些类固醇中的二级同位素效应为5%至10%。得出的结论是，[¹³C₄]皮质醇是用于测量尿CPR的更好示踪剂。
