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Cited by 18Sexual Differentiation and DisordersAdrenal Hormones and DisordersOvarian function and disorders

Salivary morning androstenedione and 17α-OH progesterone levels in childhood and puberty in patients with classic congenital adrenal hyperplasia

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de Groot, Monique J.M., Pijnenburg-Kleizen, Karijn J., Thomas, Chris M.G., Sweep, Fred C.G.J., Stikkelbroeck, Nike M.M.L., Otten, Barto J., Claahsen-van der Grinten, Hedi L.·2015·Clinical Chemistry and Laboratory Medicine (CCLM)
DOI 10.1515/cclm-2014-0375
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Abstract

BACKGROUND: Treatment of congenital adrenal hyperplasia due to 21-hydroxylase deficiency can be monitored by salivary androstenedione (A-dione) and 17α-hydroxyprogesterone (17OHP) levels. There are no objective criteria for setting relevant target values or data on changes of 17OHP and A-dione during monitoring. METHODS: We evaluated A-dione and 17OHP levels in nearly 2000 salivary samples collected during long-term treatment of 84 paediatric patients with classic 21-hydroxylase deficiency. RESULTS: A-dione and 17OHP levels and its ratio 17OHP/A-dione remained constant from 4 to 11 years with no sex-related differences. During puberty, A-dione and 17OHP levels both increased, starting at earlier age in girls than in boys. The ratio 17OHP/A-dione declined. Normalised A-dione concomitant with elevated 17OHP [1.43 nmol/L (0.46-4.41) during prepuberty; 2.36 nmol/L (0.63-8.89) for boys and 1.99 nmol/L (0.32-6.98) for girls during puberty] could be obtained with overall median glucocorticoid doses of 11-15 mg/m2/day. A-dione levels above the upper reference limit (URL), suggesting undertreatment, coincided with 17OHP levels ≥10 times URL. The percentage of A-dione levels above URL was 16% at ages 4-8 years, but increased to 31% for girls at 16 years and 46% for boys at 17 years. CONCLUSIONS: Normalised A-dione consistent with 17OHP three times URL during prepuberty and normalised A-dione consistent with 4-6 times URL during puberty could be obtained by moderate glucocorticoid dosages. A constant 17OHP/A-dione ratio during prepuberty suggested absence of adrenarche. During puberty, a higher percentage of samples met the criteria for undertreatment, especially of boys.

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Authors
de Groot, M. J. M., Pijnenburg-Kleizen, K. J., Thomas, C. M. G., Sweep, F. C. G. J., Stikkelbroeck, N. M. M. L., Otten, B. J., & Claahsen-van der Grinten, H. L.
Affiliations
Radboud University Medical Center (NL)
ORCID
Venue
Clinical Chemistry and Laboratory Medicine (CCLM)
Publisher
Walter de Gruyter GmbH
Published
2015-01-01
Volume
53
Issue
3
Pages
461-8
ISSN
  • 1434-6621 (ISSN-L)
  • 1437-4331
DOI
10.1515/cclm-2014-0375
OpenAlex
W1995260983
Cited by
18
References
13
Citations by year
2026: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2019: 4 · 2018: 3 · 2017: 1
FWCI
0.14
Type
journal article
Language
en
Open access
Locations
  • Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Keywords
classic congenital adrenal hyperplasia, 21-hydroxylase deficiency, 17-hydroxyprogesterone, glucocorticoid dosing, treatment monitoring, puberty, adrenarche, childhood, reference values
MeSH terms
Adolescent, Adrenal Hyperplasia, Congenital, Androstenedione, Child, Child, Preschool, Female, Glucocorticoids, Humans, Male, Puberty, Retrospective Studies, Saliva, 17-alpha-Hydroxyprogesterone

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