title: Sex hormone-binding globulin in congenital adrenal hyperplasia.
abstract: BACKGROUND
  Sex hormone-binding globulin biosynthesis is influenced by three hormonal systems: gonadal, insular and thyroid. Congenital adrenal hyperplasia is characterized by overproduction of adrenal androgens associated with impaired insulin sensitivity, hyperinsulinemia and often also with hypothyroidism. Only scarce data are available concerning congenital adrenal hyperplasia. The objective of this study was to determine the distribution of sex hormone-binding globulin and free testosterone levels in these patients and to what extent these values correlate with actual 17-hydroxyprogesterone and androstenedione levels, which are commonly used for monitoring of treatment effectiveness.
  
  
  METHODS
  A total of 300 retrospective laboratory records of 78 males and boys and 456 records of 162 girls and premenopausal women with diagnosis of congenital adrenal hyperplasia under common substitution treatment were evaluated statistically. The data were divided artificially into groups of low, normal and high levels, with respect to physiological concentrations for each sex and age. The percentages of the total in each group were calculated.
  
  
  RESULTS
  Whereas an almost Gaussian distribution occurred for males, the data for females displayed a considerable shift to low sex hormone-binding globulin and accordingly high free testosterone levels. Sex hormone-binding globulin levels did not correlate with 17-hydroxyprogesterone.
  
  
  CONCLUSIONS
  Low sex hormone-binding globulin levels in congenital adrenal hyperplasia, at least in females, reflect their involvement in insular and eventually thyroid axes, rather than the effectiveness of substitution.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Zamrazilová
authors.forename: Marcela
authors.initials: M
authors.lastname: Dvořáková
authors.forename: Lidka
authors.initials: L
authors.lastname: Lisá
authors.forename: Luboslav
authors.initials: L
authors.lastname: Stárka
authors.forename: Richard
authors.initials: R
authors.lastname: Hampl