SERUM CORTICOIDS IN LIVER DISEASE*

Abstract

IN ORDER to evaluate differences in blood corticoid responses to common stress, factors affecting the disappearance of corticoids from the blood as well as those affecting their appearance must be understood. This study was undertaken to consider the effect of liver disease upon serum corticoids. It was carried out by measuring both the free and the conjugated serum corticoids (acid hydrolyzable) in normal individuals and in patients with liver disease. The measurements were made in subjects studied before and after the ingestion of cortisone, before and after receiving ACTH intravenously and before and after undergoing surgical procedures. METHODS The free serum corticoids were measured by the method of Nelson and Samuels (1). The conjugated serum corticoids were measured by an adaptation of this method. The modification, which is essentially an acid hydrolysis of the residue after the Nelson- Samuels extraction, has recently been described from this laboratory (2). This procedure leads to a 50 per cent destruction of pure compound F carried through the hydrolysis and extraction procedure and then measured by the method of Nelson and Samuels. However, over 90 per cent of tetrahydrocortisone is recoverable by this method.