Laboratory monitoring of androgenic activity in benign prostate hypertrophy treated with a 5 alpha-reductase inhibitor.
Testosterone and androstenedione are metabolized by 5 alpha- and 5 beta-reductases to androsterone (A) and etiocholanolone (E), respectively. These are excreted in the urine as conjugates, and the A/E ratio in normal men is usually greater than or equal to 1.5 (as opposed to 1 in women) because of the high 5 alpha-reductase activity in the prostate. The A/E ratio can be determined simply by gas chromatography after acid hydrolysis of a urine sample, extraction of steroids, and formation of trimethylsilyl derivatives. A timed collection of urine is unnecessary because the ratio of A/E is used rather than absolute values. In men suffering from benign prostate hypertrophy who are treated with Finasteride (a 5 alpha-reductase inhibitor), the A/E ratio decreases to less than 0.5. The A/E ratio decrease can be detected long before there is clinical improvement.
Matzkin
H
H
Department of Urology, Ichilov Hospital, Tel-Aviv Sourasky Medical Center, Israel.
Chayen
R
R
Goldfarb
H
H
Gilad
S
S
Braf
Z
Z
D058891:5-alpha Reductase Inhibitors; D000368:Aged; D000369:Aged, 80 and over; D000736:Androstenes / Q000008:administration & dosage / Q000627:therapeutic use*; D000738:Androsterone / Q000652:urine*; D001378:Azasteroids / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005043:Etiocholanolone / Q000652:urine*; D018120:Finasteride; D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000188:drug therapy / Q000652:urine*
D058891:5-alpha Reductase Inhibitors; D000736:Androstenes; D001378:Azasteroids; D018120:Finasteride; D005043:Etiocholanolone; D000738:Androsterone