[Usefulness of measurement of hormones in urine samples collected during the night period for the diagnosis of endocrine disorders].
It has been known that the measurement of adreno-cortical and medullary hormones in urine for 24 hours is the best way for diagnosis of the disease state. This is not only because hormone release shows circadian rhythm but also because the urinary excretion of hormones reflects the total amount of hormones produced for 24 hours. However, the civilized people, particularly the workers, are too busy to correct urine for 24 hours. Therefore, we aimed to evaluate whether the urine sample corrected for only 12 hours during night is useful for the diagnosis of adrenal diseases. Circadian rhythm of hormones in urine was evaluated by correcting urine every 4 hours in 18 normal adults. Diurnal variations of 17-ketosteroids (17-KS) and 17-hydroxycorticosteroids (17-OHCS) were evident; they showed the peak value during 8 AM and 12 AM, and the trough during 0 AM and 4 AM. Similarly, urinary noradrenaline and adrenaline showed the peak value at day time and the trough at night time. However, the rhythm was not observed in urinary dopamine and vanilyl mandelic acid (VMA). Under consideration of outpatient's convenience, urine sampled during night (between 8 PM and 8 AM) was evaluated. The amount of hormones during night was 35.9-46.9% of the total amount of the day, and the deviation was relatively small. The reference intervals (mean +/- 2SD) were as follows; 17-KS (n = 56, 2.8 +/- 2.4 mg/12 hours), 17-OHCS (n = 56, 2.0 +/- 2.0 mg/12 hours), 17-KGS (n = 52, 3.6 +/- 3.6 mg/12 hours), free cortisol (n = 43, 14.3 +/- 14.2 micrograms/12 hours), noradrenaline (n = 50, 12.9 +/- 9.8 micrograms/12 hours), adrenaline (n = 50, 2.1 +/- 4.0 micrograms/12 hours), dopamine (n = 50, 134 +/- 194 micrograms/12 hours), VMA (2.3 +/- 2.4 mg/12 hours). When the night periods urine in patients with adrenal disorders such as virilizing adrenocortical carcinoma, pituitary adenoma, adrenocortical hydroxylase deficiency, Addison's disease, hypopituitarism, Cushing's syndrome, pheochromocytoma was analyzed, the respective urinary hormone level corresponding to each disease was significantly changed from the reference interval. These results indicate that analysis of urine sample during night has advantage over the daily urine because the difference between normal and disease state is augmented when measured urinary during night.
Tanaka
K
K
Department of Laboratory Medicine, Kansai Medical University, Moriguchi.
Itsuji
Y
Y
Tanabe
T
T
Ogawa
N
N
Takahashi
H
H
D000236:Adenoma / Q000175:diagnosis; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000652:urine*; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis; D000328:Adult; D002395:Catecholamines / Q000652:urine*; D002940:Circadian Rhythm; D003480:Cushing Syndrome / Q000175:diagnosis; D004700:Endocrine System Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis
D000305:Adrenal Cortex Hormones; D002395:Catecholamines