title: Correlation between androstenedione and 17-hydroxyprogesterone levels in the saliva and plasma of patients with congenital adrenal hyperplasia.
abstract: BACKGROUND
  Congenital adrenal hyperplasia (CAH) or adrenogenital syndrome is the most common cause of female ambiguous genitalia. Management of such patients involves medical treatment using glucocorticoids such as hydrocortisone, prednisone or dexamethasone. Monitoring is done by measurement of 17-hydroxyprogesterone (17-OHP) or androstenedione in serum, plasma or saliva. The aim of this study was to develop a system of monitoring steroid treatment in CAH patients using only saliva.
  
  
  METHODS
  We studied the saliva of 24 CAH patients who received glucocorticoid replacement therapy. The patients were asked to collect saliva upon awakening, and in the afternoon and evening. The levels of 17-OHP and androstenedione in the saliva as well as in serum were then measured by immunoassay.
  
  
  RESULTS
  There was a significant positive correlation between 17-OHP in serum and in saliva (R equals 0.929, p-value less than 0.01). A significant positive correlation between androstenedione level in saliva and serum was also found (R equals 0.611, p-value less than 0.01). This study also revealed a significant positive correlation between androstenedione and 17-OHP in serum (R equals 0.647, p-value less than 0.01) and saliva (R equals 0.799, p-value less than 0.01). All patients showed increased level of 17-OHP and androstenedione in the sample collected upon awakening.
  
  
  CONCLUSIONS
  Determination of salivary androstenedione and 17-OHP in CAH patients could be a useful alternative to the measurement of these hormones in serum.
authors.affiliation: Department of Human Genetics, Centre for Biomedical Research, Faculty of Medicine, Diponegoro University, Jalan Dr No. 14 Sutomo, Semarang 50232, Indonesia.
authors.forename: A Z
authors.initials: AZ
authors.lastname: Juniarto
authors.forename: K
authors.initials: K
authors.lastname: Goossens
authors.forename: B A
authors.initials: BA
authors.lastname: Setyawati
authors.forename: S L
authors.initials: SL
authors.lastname: Drop
authors.forename: F H
authors.initials: FH
authors.lastname: de Jong
authors.forename: S M H
authors.initials: SM
authors.lastname: Faradz
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000378:metabolism*; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood* / Q000378:metabolism*; D000735:Androstenedione / Q000096:biosynthesis* / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D012734:Disorders of Sex Development / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007223:Infant; D010949:Plasma / Q000378:metabolism; D012463:Saliva / Q000378:metabolism; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D000735:Androstenedione; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone