Urinary Excretion of 17-Ketogenic Steroids in Normal Subjects Before and After Stimulation With Intramuscular Zinc-Acth*†

The estimation of 17-ketogenic steroids in human urine has proved a useful means of indirectly measuring the adrenocortical production of cortisone and hydrocortisone. Studies of precision and accuracy indicate that this procedure is practical for routine clinical purposes. The excretion of 17-ketogenic steroids in day and night 12-hour urine samples was determined in a group of 31 normal subjects. The basal 24-hour excretion was 13.1 mg. (S.D.±5.0) for males and 10.8 mg. (S.D.±2.9) for females. A diurnal variation was noted. The output of 17-ketogenic steroids was also studied during two consecutive 12-hour periods following single intramuscular injections of Cortrophin-Zinc. The mean response was approximately proportional to the basal output. A maximal response in terms of both magnitude and duration was obtained with doses of 30 to 40 (USP) units. Larger doses produced no significant increase in steroid output nor prolongation of action. Repeated responses of 17-KGS to intramuscular ACTH may vary considerably. Individual differences between subjects or within the same subject on different occasions largely account for these variations, which appear to be correlated with variations in basal excretion from day to day.