The ratio of urinary beta-to-alpha 17-ketosteroids can help distinguish adrenocortical hyperplasia from carcinoma.
Specimen: 24 hour urine
ratio of urinary beta-to-alpha 17-ketosteroids =
= (beta fraction in mg/day) / (alpha fraction in mg/day)
where:
• The beta fraction is mostly dehydroepiandrosterone (DHEA).
• The alpha fraction is largely androsterone and etiocholanolone.
• Fractions are expressed in mg/day.
Interpretation:
• normal ratio is usually < 0.2
• in adrenocortical hyperplasia, the ratio is often normal and rarely > 0.3
• in adrenal cortical carcinoma, the ratio is usually 0.28-0.4; ratios > 0.4 usually are seen in carcinoma
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Specialty: Endocrinology, Clinical Laboratory