Gomez-Sanchez C E, Gomez-Sanchez E P, Holland O B
Department of Internal Medicine, James A. Haley V. A. Hospital, University of South Florida College of Medicine, Tampa 33612.
J Steroid Biochem. 1987;27(4-6):971-5. doi: 10.1016/0022-4731(87)90176-2.
The isolation of 18-hydroxycortisol and 18-oxocortisol was recently described. These steroids have been shown to be excreted in exaggerated quantities in patients with primary aldosteronism, with adrenal adenomas and in glucocorticoid suppressible aldosteronism. We report the measurement of both steroids in the urine of patients with essential hypertension. 18-Oxocortisol excretion did not differ in patients with normal renin essential hypertension (0.7 +/- 0.7 micrograms/24 h), low renin essential hypertension (0.7 +/- 0.5 micrograms/24 h) and normal individuals (1.2 +/- 0.9 micrograms/24 h). Patients with normal renin hypertension excreted 54 +/- 43 micrograms/24 h of 18-hydroxycortisol, those with low renin essential hypertension excreted 58 +/- 54 micrograms/24 h, and normal individuals excreted 63 +/- 36 micrograms/24 h. Three of the low renin and one of the normal renin hypertensive subjects excreted greater quantities of 18-hydroxycortisol than the upper limit of normal, but all excreted normal quantities of 18-oxocortisol. As 18-hydroxycortisol is inactive, the meaning of this elevated excretion is unclear, but it may be a marker of an adrenal enzymatic abnormality which may be playing a more direct role in hypertension.
最近报道了18-羟皮质醇和18-氧代皮质醇的分离。这些类固醇已被证明在原发性醛固酮增多症、肾上腺腺瘤患者以及糖皮质激素可抑制性醛固酮增多症患者中排泄量过高。我们报告了对原发性高血压患者尿液中这两种类固醇的测量结果。正常肾素原发性高血压患者（0.7±0.7微克/24小时）、低肾素原发性高血压患者（0.7±0.5微克/24小时）和正常个体（1.2±0.9微克/24小时）的18-氧代皮质醇排泄量无差异。正常肾素高血压患者的18-羟皮质醇排泄量为54±43微克/24小时，低肾素原发性高血压患者为58±54微克/24小时，正常个体为63±36微克/24小时。低肾素高血压患者中有3例和正常肾素高血压患者中有1例排泄的18-羟皮质醇量高于正常上限，但所有患者的18-氧代皮质醇排泄量均正常。由于18-羟皮质醇无活性，这种排泄量升高的意义尚不清楚，但它可能是肾上腺酶异常的一个标志物，而肾上腺酶异常可能在高血压中发挥更直接的作用。
