The relationship of serum hexuronic acid and monosaccharide levels to urinary free cortisol and cortisone excretion in healthy subjects and in patients with diabetes mellitus and atherosclerotic peripheral vascular disease.

The relationship of hexuronic acid and monosaccharide concentrations in serum to the excretion of urinary free cortisol and cortisone was studied in 14 healthy subjects, in 16 patients with diabetes mellitus, and in 14 patients with atherosclerotic peripheral vascular disease. In both groups of patients increased values of hexuronic acids, reducing monosaccharides and keto-sugars were registered. In diabetics the relative proportion of monosaccharides was increased, the proportion of hexuronic acids was lowered. In atherosclerotic peripheral vascular disease a significant preponderance of hexuronic acid and keto-sugar amounts in the composition of total sugar components was observed in comparison with healthy subjects. In healthy subjects there is a close correlation of urinary free cortisol and cortisone with reducing monosaccharides in blood, measured on the same day. In diabetes not any correlation of the increased values of free corticoids with the sugar components was registered. In atherosclerotic peripheral vascular disease a highly significant correlation between urinary free cortisol and cortisone and the hexuronic acid content in serum was observed. In patients with atherosclerotic peripheral vascular disease the results suggest an altered metabolism of glucose, which is shunted into insulin-insensitive glucuronate pathway in conditions of endogenous hypercortisolism.