Inactivation of hormones

The liver is the Deposit of certain hormones, as well as activation and inactivation of the latter. Hormones and their derivatives are excreted in the urine. The number and composition of both reflect the functional state not only endocrine organs and the liver.
For estimation of functional activity of the liver is the determination in urine estrogen, aldosterone, and 17-ketosteroids.
The composition of estrogen includes a large number of similar structure substances; the most studied 3 factions: estradiol, estrone and estriol. Formed estrogen in the sex glands and in small numbers in the adrenal glands (Engel, 1960; Henry, 1961). The liver is the Deposit of estrogen in the form of estrogen-globulin complex and changes in the activity of estrogen: the most biologically active estradiol becomes less active estrone (in this phase, the process is reversible), then of estrone is produced estriol is the least active fraction. Further inactivation of estrogen also is in the liver by education sulfa - and glycoconjugates.
The daily excretion of estrogen with urine * women varies in connection with the menstrual cycle and the age range is from 4 to 60 mcg. Men spontaneous excretion of estrogen much smaller, almost does not change with age, accounting for 8 to 12 mcg dominated the least active fraction - estriol (O. Savchenko and G. Stepanov, 1961; T. N. Zabelina, 1964, 1968; Pinkus, 1955).
When liver damage due to violation of the process of inactivation and destruction of estrogen last accumulate in the body; increased excretion of estrogen with urine, the ratio changes separate factions in favor of more active. So, cirrhosis of the liver in the phase of parenchymatous flash excretion of estrogen in men reaches 30-40 mcg per day with a predominance of active fractions - estrone and estradiol (I.e. Zabelina, 1964, 1968; Cameron, 1957; Miiller, 1958).
The 17-ketosteroids includes over 20 different substances, which are products of the adrenal cortex and their metabolites.
It is known that the liver plays an important role in the metabolism of corticosteroids (N. A. Yudaev, 1856; Cameron, 1957). The liver is the biological inactivation of steroid hormones produced metabolites are removed from urine. One of the products of transformation of adrenal cortex hormones are 17-ketosteroids, which are formed from androgenic fraction of testosterone and glucocorticoids. The content of 17-ketosteroids, urine, as a rule, reflects the functional state of adrenal cortex in various diseases. With the exception of liver disease as a synthesis of the 17-ketosteroidov with the defeat of its parenchyma is broken. This leads to the change of their content in the urine. When determining the excretion of 17-ketosteroids to study the functional state of the liver to determine the functional state of adrenal glands. Therefore, in addition to the definition of spontaneous excretion of 17-ketosteroids, you must define them in the urine after preliminary injection of ACTH.
Daily allocation of 17-ketosteroids in the urine is in healthy men 9-22,6 mg; in healthy women - 4,5 is 12.5 mg (E. C. Krutskikh, 1961; C. E. Baptist, 1960). After intramuscular injection 25-30 UNITS ACTH highlighting 17-ketosteroidov with urine increases, which testifies of a satisfactory functional state of adrenal cortex.
Parenchymal liver causes a decrease in spontaneous excretion with urine 17-ketosteroidov. Comparison of the clinical course and indicators of other liver samples with the level of spontaneous excretion with urine 17-ketosteroidov shows the dependence of the intensity of his reduce the severity of the lesion of the liver parenchyma.
Response to injection of ACTH shows that in most cases the decrease excretion with urine 17-ketosteroidov not related to the oppression of the crust napochechnikov (I.e. Century Krutskikh, 1961).
Aldosterone - mineralocorticoid - plays a leading role in regulating the metabolism of sodium and potassium increasing the reabsorption of Na in the renal tubules. At the same time increases the excretion in the distal renal tubules. The delay of sodium and increased excretion in turn can lead to water retention in the body.
Daily urine of healthy people, the content of aldosterone ranges from 1 to 10 mcg (N. E. Gerasimov and A. S. Loginov, 1963; R. G. Sprintsson, 1968). In patients with liver inactivation of aldosterone is broken. Last accumulates in the body and in the increased amount excreted in the urine. The secretion of aldosterone in patients with persistent form of Botkin's disease is 10 to 30 micrograms per day, cirrhosis of the liver increased aldosterone excretion even more significantly and reaches in some cases 40-50 mg / day (N. E. Gerasimov and A. S. Loginov, 1963; R. G. Sprintsson, 1968). The content of aldosterone in urine especially sharply increased in patients with liver cirrhosis with portal hypertension and ascites in the period of parenchymatous flash.
Modern methods for the determination of aldosterone ** time-consuming and therefore can not find wide practical application. Indirectly we can judge about the number of aldosterone by contents and Na in the blood. In the serum of healthy individuals using the method of flame photometry *** define the content"from 13,6 to 20.9 mg% (average of 16.5 mg%), and in the Na from 288 to 335 mg% (average 309 mg%).
For severe liver disease is characterized by the decrease in blood To, and the increase in Na (Schonberg, 1953; Kabusch, 1958). The imbalance of electrolytes due to many factors. A great role in this, apparently, plays a secondary aldosteronism.

* Methodology see: O. N. Savchenko and G. S. Stepanov. Problems of endocrinology and hormonal therapy, № 3, 1961.
** Methodology see: E. N. Gerasimov. Ter. arch., № 9, 1959.
*** See: N. C. Poluektov. Methods of analysis for flame photometry. M., 1959.