Excretion of individual adrenocortical steroids in obese children

The excretion of 13 individual adrenocortical metabolites in the urine of 21 obese children aged 7 months to 16 years is reported. Fractionation of the steroids was carried out on 24-hour samples of urine by paper chromatography using Bush systems and incorporating a radioactive steroid recovery technique. The excretion of the 17-hydroxycorticosteroids and of the α-ketolic metabolites of cortisol and corticosterone exceeded that of normal children studied in the same manner. These differences persisted when the results were corrected for surface area but were eliminated by correction for body weight. The raised corticosteroid excretion in obese children is therefore related to the increased weight. In addition the excessive calorie intake enhances the hepatic metabolism of cortisol leading to an increased corticosteroid excretion. The excretion of the 17-oxosteroids and 11-deoxygenated-17-oxosteroids exceeded that of normal children. Before puberty these steroids represent the adrenal androgens, and the raised excretion in the obese children was associated with an advanced bone age. The early onset of puberty in obesity may be related to the increased body weight, but it is suggested that the increased adrenal androgen secretion may stimulate early maturation of the hypothalamic centre controlling the onset of puberty.