Lewicka S, Winter J, Bige K, Bokkenheuser V, Vecsei P, Abdelhamid S, Heinrich U
J Clin Endocrinol Metab. 1987 Apr;64(4):771-7. doi: 10.1210/jcem-64-4-771.
21-Deoxyaldosterone appears in urine in free and conjugated forms. Total excretion is best determined after acid hydrolysis (pH 1) of urine, followed by extraction, repeated chromatographic purification, and quantitation of the steroid by RIA. 21-Deoxyaldosterone excretion was normal in 70% of patients with essential hypertension (n = 18), while 30% (n = 8) had more or less elevated values. In patients with primary aldosteronism (n = 21) elevated as well as normal values of urinary 21-deoxyaldosterone were found, indicating that in some patients aldosterone may be formed not only from corticosterone but also from the 21-deoxy compound. In patients with 21-hydroxylase deficiency (n = 21) urinary 21-deoxyaldosterone was invariably elevated, whether the patients had the virilizing or salt-losing form of the disease. Although the clinical manifestations of the salt-losing form seem unrelated to the inability to convert 21-deoxyaldosterone to aldosterone, the determination of 21-deoxyaldosterone adds insight into the biosynthesis of aldosterone in primary aldosteronism and 21-hydroxylase deficiency.
21-脱氧醛固酮以游离和结合形式出现在尿液中。尿液经酸水解（pH 1）后，通过萃取、反复色谱纯化以及放射免疫分析法对该类固醇进行定量，这样能最好地测定其总排泄量。在70%的原发性高血压患者（n = 18）中，21-脱氧醛固酮排泄正常，而30%（n = 8）的患者其值或多或少有所升高。在原发性醛固酮增多症患者（n = 21）中，发现尿21-脱氧醛固酮值有升高的情况，也有正常的情况，这表明在一些患者中，醛固酮可能不仅由皮质酮生成，还可由21-脱氧化合物生成。在21-羟化酶缺乏症患者（n = 21）中，无论患者患的是该疾病的男性化型还是失盐型，尿21-脱氧醛固酮总是升高的。虽然失盐型的临床表现似乎与无法将21-脱氧醛固酮转化为醛固酮无关，但对21-脱氧醛固酮的测定有助于深入了解原发性醛固酮增多症和21-羟化酶缺乏症中醛固酮的生物合成。
