Chapter XI 



THE BLOOD CHEMISTRY IN ADRENAL CORTICAL 

 INSUFFICIENCY 



The composition of the blood is characteristically altered in 

 adrenal cortical insufficiency as experimentally produced in 

 animals or as it occurs in Addison's disease. The chief altera- 

 tions occur in the water, sodium, potassium, magnesium, 

 glucose, chloride, non-protein nitrogen, and cholesterol con- 

 tent. There is thus a profound upset in the normal com- 

 position of the blood which will be reflected in the tissues and 

 will produce marked physiological effects in the organism. A 

 consideration of the changes in the glucose concentration of 

 the blood will be deferred to the next chapter. 



CHOLESTEROL 



The normally high cholesterol content of the adrenals and 

 the fact that changes in the cholesterol content of the adrenals 

 are often associated with corresponding changes in the blood 

 led earlier observers to consider the adrenals as regulators of 

 the cholesterol metabolism. Feeding cholesterol results in an 

 enlargement of the adrenals with an increase in their cholesterol 

 content. Adrenalectomy, as Grigaut, Rothschild, Chauffard, 

 and Landau 376 first demonstrated, is followed by an increase 

 in the cholesterol content of the blood. Abnormal conditions 

 not involving the adrenals primarily are however, also, at- 

 tended by changes in the level of the blood cholesterol. For 

 example, in infections, uremia, hypothyroidism, and cachexia, 

 the blood cholesterol is reduced while in biliary obstruction, 

 diabetes, nephrosis, and hyperthyroidism it is elevated. 



The disturbances in cholesterol metabolism which occur in 

 adrenal insufficiency are not caused by the absence of the 



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