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A Comparative Study of Urinary 17-Hydroxycorticosteroids, Urinary Free Cortisol, and the Integrated Concentration of Plasma Cortisol^*

Harriet Lane Service, Childrens Medical and Surgical Center, Johns Hopkins University and Hospital Baltimore, Maryland 21205;the Department of Medicine, Veterans Administration Hospital, Baltimore, Maryland 21218
Institution de Endocrinologia Curitiba-PR, Brazil

The discriminatory power of three clinical tests for adrenal activity are compared bymeasuring the variability of the results obtained in 40 normal control subjects,35 patients with mild essential hypertension, and 13 patients with Cushing syndrome.

The variance of the 24-h integrated plasma concentration of cortisol was significantly(P < 0.0001) smaller than the variance of the 24-h urinary excretion of 17-hydroxycorticosteroids and freecortisol. While the 24-h urinary excretion of 17-hydroxycorticosteroids and free cortisol of the patients with Cushing syndrome overlapped with the corresponding values of the normal and hypertensive subjects, their integrated cortisol concentration did not exhibit any overlap.

^* This work was by Research Grants HD-06284 and AM-00180 and Traineeship Grant Tl-AM-5219 from the NIH, USPHS. The patients were studied at the Clinical Research Center of Pediatrics, supported by Grant 5-M01-RR3353 from the General Clinical Research Centers Program of the Division of Research Resources, NIH.

Received May 1, 1980.

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