Increased urinary 6-sulfatoxymelatonin excretion in women with non-classical steroid 21-hydroxylase deficiency.
OBJECTIVE
To determine melatonin production in hyperandrogenic women.


METHODS
Seventeen women with late onset adrenal hyperplasia due to 21-hydroxylase deficiency (LOCAH) and 15 control women were studied in early follicular phase of the menstrual cycle. Fasting serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E(2)), testosterone, dihydroepiandrosterone sulfate (DHEA-S), 17-hydroxyprogesterone (17-OHP) as well as the peak 17-OHP response to ACTH (250 microg IV) and 24h urinary 6-sulfatoxymelatonin (aMT6s) were determined in all participants.


RESULTS
All 17 hyperandrogenic women were carrying mutations of the CYP21 gene. Women with LOCAH had significantly higher serum testosterone, DHEA-S, 17-OHP and ACTH stimulated 17-OHP values compared with controls. Their aMT6s values (44.6+/-20.3 microg/24h) were significantly higher than the values in control women (31.5+/-20.3) (p<0.03). The urinary aMT6s values were positively correlated with testosterone (p<0.04), DHEA-S (p<0.02) and peak 17-OHP (p<0.04).


CONCLUSIONS
Women with LOCAH have increased melatonin production. There is a relationship between adrenal androgens and melatonin in these women.
Luboshitzky
R
R
Endocrine Institute, Haemek Medical Center, Afula, Israel. luboshitzky_r@clalit.org.il
Qupti
G
G
Ishay
A
A
Shen-Orr
Z
Z
Herer
P
P
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital; D000324:Adrenocorticotropic Hormone; D000328:Adult; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005215:Fasting; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase; D006801:Humans; D017588:Hyperandrogenism / Q000201:enzymology / Q000235:genetics; D007986:Luteinizing Hormone / Q000097:blood; D008550:Melatonin / Q000031:analogs & derivatives* / Q000652:urine*; D009154:Mutation; D013255:Steroid 21-Hydroxylase / Q000235:genetics; D013739:Testosterone / Q000097:blood
C054513:6-sulfatoxymelatonin; D013739:Testosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013255:Steroid 21-Hydroxylase; D008550:Melatonin