title: 11beta-hydroxyandrostenedione and delta5-androstenediol as markers of adrenal androgen production in patients with 21-hydroxylase-deficient nonclassic adrenal hyperplasia.
abstract: OBJECTIVE
  To determine the sensitivity of 11beta-hydroxyandrostenedione (11-OHA4) and delta5-androstenediol (ADIOL) as markers of excessive adrenal androgen production.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic medical centers.
  
  
  METHODS
  Thirteen women with untreated 21-hydroxylase-deficient nonclassic adrenal hyperplasia (NCAH) and 18 healthy, eumenorrheic, nonhirsute controls matched for age and body mass index.
  
  
  METHODS
  All subjects were studied before and after acute adrenal stimulation with 0.25 mg of IV ACTH-(1-24).
  
  
  METHODS
  Basal levels of total testosterone, sex hormone-binding globulin, DHEAS, and free testosterone were measured. Levels of androstenedione (A4), DHEA, 11-OHA4, and ADIOL were determined before (Steroid0) and 60 minutes after (Steroid60) acute ACTH-(1-24) stimulation.
  
  
  RESULTS
  Patients with NCAH had higher median basal levels of DHEAS and total and free testosterone than controls. Patients with NCAH had higher median A4(0), A460, DHEA(0), DHEA60, 11-OHA4(0), ADIOL0, and ADIOL60 levels but similar 11-OHA4(60) levels compared with controls. Among patients with NCAH, 30%, 54%, 15%, and 85% had 11-OHA4(0), ADIOL0, 11-OHA4(60), and ADIOL(60) levels, respectively, above the 95th percentile of controls.
  
  
  CONCLUSIONS
  Overall, serum levels of 11-OHA4 did not appear to be a very sensitive marker of excessive adrenal androgen production, at least in patients with NCAH. Although ACTH-stimulated ADIOL levels were elevated in 85% of the patients studied, they did not appear to have any advantage over the measurement of A4 or DHEA levels.
authors.affiliation: Instituto de Investigaciones Medicas, Universidad de Guanajuato, Leon, Mexico.
authors.forename: R
authors.initials: R
authors.lastname: Huerta
authors.forename: D
authors.initials: D
authors.lastname: Dewailly
authors.forename: C
authors.initials: C
authors.lastname: Decanter
authors.forename: E S
authors.initials: ES
authors.lastname: Knochenhauer
authors.forename: L R
authors.initials: LR
authors.lastname: Boots
authors.forename: R
authors.initials: R
authors.lastname: Azziz
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000378:metabolism*; D000328:Adult; D000728:Androgens / Q000096:biosynthesis*; D000735:Androstenedione / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000728:Androgens; D015415:Biomarkers; D000735:Androstenedione; C003582:11-hydroxyandrostenedione