Urine 17-Ketosteroids (24 hours urine)

What sample is needed for Urine 17-ketosteroids?

1. A 24-hour urine sample was collected in a container containing 6 ml of HCL acid or one gram of boric acid.
2. When starting the collection, discard the first sample and collect all the samples, including the last sample, when 24 hours are completed.
3. A urine sample will be stable for 2 weeks at 4 °C.
4. For a longer period, keep at -20 °C.

What are the Indications for Urine 17-ketosteroids?

1. This is done to assess the following:
   1. The adrenal cortex function.
   2. To evaluate and monitor adrenal hyperplasia.
   3. To assess and monitor the adrenal tumors.
   4. To determine the hairs on the faces of females.

What are the Precautions for Urine 17-ketosteroids?

• Stop the medicines that interfere with the result like:

1. Diuretics
2. Aspirin
3. Antibiotics
4. Hormone therapy like Estrogen.
5. Stop birth control medication.

How will you define 17-Ketsteroids?

1. 17-Ketosteroids are a group of steroid hormones that are metabolic byproducts of adrenal and gonadal steroids.
2. They are excreted in urine and include compounds like androsterone, dehydroepiandrosterone (DHEA), and etiocholanolone.
3. 17-Ketosteroids are not metabolites of cortisone or hydrocortisone.

How will you discuss the pathophysiology of 17-ketosteroids?

1. Adrenal glands lie at the upper pole of the kidneys.
   1. It is pyramidal in shape.
   2. It measures approximately 2 to 3 cm in width, 4 to 6 cm long, and 1 cm thick.
   3. Its weight is 4 grams, irrespective of age, weight, and sex.
   4. Each gland consists of an outer yellow cortex and a grey inner medulla.

2. To understand the formation of 17-ketosteroids, we need to understand the functions of the adrenal gland, as shown in the following diagram.

3. Androgens and testosterone are metabolized to 17-ketosteroid, the overall measure of androgen production.
4. The main excretory metabolites of:
   1. Testosterone.
   2. Androstenedione.
   3. DHEA
5. They are collectively called 17-ketosteroids, which can be quantitated in the urine.
   1. 17-Ketosteroids are measured in urine only.

6. 17-ketosteroids are the metabolites of testosterone and another androgenic sex hormone.
7. 17- Ketosteroid is the end product, dehydroepiandrosterone secreted in the urine.

What are the Sources of 17-Ketosteroids?

1. In men:
   1. Roughly 1/3 is produced from the testosterone produced in the testes.
   2. Rest comes from other androgenic hormones produced in the adrenal cortex.
2. In women and children:
   1. Almost all 17-ketosteroids are non-testosterone produced by the androgens in females and males.
3. 17-Ketosteroids are not the metabolites of Cortisol, so they do not indicate cortisol production.

What is the presentation of increased 17-ketosteroid?

1. Masculinizing syndrome in females.
2. Precocious puberty in males.

What are the normal Urine 17-ketosteroids?

What are the causes of increased 17-ketosteroids?

1. Congenital adrenal hyperplasia.
2. Pregnancy.
3. Hyperpituitarism
4. Testosterone-secreting or androgen-secreting tumors of:
   1. Ovaries.
   2. Testes
   3. Ectopic ACTH-secreting tumors.
5. Administration of ACTH.
6. Stein-Leventhal syndrome.
7. Cushing’s syndrome.

What are the causes of decreased 17-ketosteroids?

1. Severe stress.
2. Severe infections.
3. Debilitating diseases.
4. Addison’s disease
5. Castration
6. Hypopituitarism
7. Myxedema
8. Nephrosis.
9. Klinefelter’s syndrome.
10. Chronic diseases.

What are the drugs that lead to a decrease in 17-ketosteroids?

1. Birth control pills
2. Estrogens
3. Probenecid
4. Reserpine
5. Salicylates (prolonged use)
6. Thiazide diuretics
7. Birth control pills
8. Estrogens
9. Probenecid
10. Reserpine
11. Salicylates (prolonged use)
12. Thiazide diuretics

Test value for the layman:

1. The 17-ketosteroid test is done to find any abnormality of the adrenal gland.
2. Advised if the female has hairs on the face.

Questions and answers: