Investigation of urinary steroid profiles as a diagnostic method in Cushing's syndrome.

Patients with Cushing's syndrome may be discriminated from normal subjects on the basis of their respective neutral urinary steroid profile. In the former group, evidence is presented that lowered levels of T3 secondary to hypercortisolism, decrease the liver enzymes associated with 5 alpha-reductase and 11 beta-hydroxy steroid dehydrogenase activity. As a result the metabolism of cortisol and androstenedione in Cushing's syndrome yields a unique pattern dominated by 5 beta and 11 beta-hydroxy steroid metabolites.