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)



• The beta fraction is mostly dehydroepiandrosterone (DHEA).

• The alpha fraction is largely androsterone and etiocholanolone.

• Fractions are expressed in mg/day.



• 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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