Abstract
A sequential radioimmunoassay procedure for free and conjugated estrone (f-E1, c-E1), estradiol (f-E2, c-E2) and estriol (f-E3, c-E3) in male human plasma was developed. Plasma free and conjugated estrogen (f-E, c-E), testosterone (T), 5α-dihydrotestosterone (5α-DHT), luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels were determined on normal adult men, castrated men and patients with liver cirrhosis and renal insufficiencyThe results were as follows:1) Both f-E and c-E, especially f-E2 and c-E3 remarkably decreased after castration and this suggests that f-E2 was mainly secreted from the testis.2) In diurnal variations for f-E and c-E in normal adult men, the highest levels of f-E2 appeared near 8:00hr. and the highest levels of c-E1 and c-E2 appeared 24:00hr., but clear diurnal rhythms for f-E1 and c-E2 were noted in both normal and castrated men.3) In cases of liver cirrhosis, both f-E and c-E increased, which was probably due to an overproduction of estrogen and not to the decrease of conjugation potency. Also the f-E2/T-ratio in a group with gynecomastia was higher than in a group without gynecomastia. It is considered that changes in the balance between f-E and T may play some part in the pathogenesis of gynecomastia in liver cirrhosis.4) In cases of acute and chronic renal insufficiency, c-E, especially c-E3 increased remarkably but returned to normal levels after treatment in cases of acute renal insufficiency. Therefore, it is considered that the human kidney metabolizes estrogen and that c-E3 is a major urinary metabolite in human males. Plasma f-E, T and 5α-DHT levels in patients with chronic renal insufficiency were lower than in normal men and patients with acute renal insufficiency. These data suggest that persistent uremia or hemodialysis may be responsible for suppression of testicular function.The patients after renal transplantation showed lower f-E, T and 5α-DHT levels, which was probably due to a suppression of testicular function by glucocorticoids administered as immunosuppressive agents.
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