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17-Ketosteroids in urine
Medical expert of the article
Last reviewed: 04.07.2025
Reference values (norm) for 17-Ketosteroids in urine:
- children under 5 years old - 0-2 mg/day, 15-16 years old - 3-13 mg/day;
- women 20-40 years old - 6-14 mg/day.
- men 20-40 years old - 10-25 mg/day.
After 40 years, there is a constant decrease in the excretion of 17-Ketosteroids.
Urine ketosteroids are metabolites of androgens secreted by the zona reticularis of the adrenal cortex and the sex glands. Only a small portion of urinary 17-Ketosteroids originates from glucocorticosteroid precursors (approximately 10-15%). Determination of 17-Ketosteroids in urine is necessary to assess the overall functional activity of the adrenal cortex.
A decrease in the excretion of 17-ketosteroids in urine is often (but not always) observed in chronic adrenal cortex insufficiency; an increase in the content of 17-ketosteroids in daily urine is observed in androsteroma, Itsenko-Cushing's disease and syndrome, and congenital adrenal cortex hyperplasia.
For diagnostics of congenital adrenal cortex hyperplasia it is important to identify a combination of increased excretion of 17-Ketosteroids and ACTH concentration in the blood with low or lower limit concentration of cortisol in the blood and 17-OCS in daily urine. The role of 17-Ketosteroids in diagnostics is small, since the criteria for assessing dexamethasone tests have been developed only for 17-OCS in daily urine and blood cortisol. Dynamic study of 17-Ketosteroids cannot be recommended for assessing the effectiveness of drug treatment of Itsenko-Cushing's disease, since many drugs used for this purpose selectively suppress the synthesis of glucocorticosteroids without affecting the amount of androgen secretion.
Corticoestromas - tumors of the adrenal cortex that produce large amounts of estrogens - cause feminization syndrome. These very rare tumors are mostly represented by carcinomas, less often by adenomas. The blood plasma and urine contain a sharply increased content of estrogens (estradiol), and a large amount of 17-ketosteroids are excreted in the urine.
Diseases and conditions in which the concentration of 17-Ketosteroids in urine changes
Increased concentration |
Decreased concentration |
Itsenko-Cushing syndrome Androgen-producing tumors of the adrenal cortex Virilizing tumors of the adrenal cortex Testicular tumors Stein-Leventhal syndrome Adenoma and cancer of the adrenal glands Ectopic ACTH production syndrome Use of anabolic steroids, phenothiazine derivatives, penicillin, digitalis derivatives, spironolactone, corticotropin, gonadotropins, cephalosporins, testosterone |
Hypofunction of the pituitary gland Liver parenchyma injury Use of reserpine, benzodiazepines, dexamethasone, estrogens, oral contraceptives, glucocorticosteroids |
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