5-ALPHA-ANDROSTANE-3-ALPHA, 17-BETA-DIOL AND 5-ALPHA-ANDROSTANE-3-ALPHA, 17-BETA-DIOL-GLUCURONIDE IN PLASMA OF NORMAL-CHILDREN, ADULTS AND PATIENTS WITH IDIOPATHIC HIRSUTISM - A MASS-SPECTROMETRIC STUDY

We investigated the developmental patterns of 5 alpha-androstane-3 alp ha, 17 beta-diol (AD) and 5 alpha-androstane-3 alpha, 17 beta-diol-glu curonide (ADG) in plasma of normal children and adults of both sexes a nd in patients with idiopathic hirsutism using a physicochemical metho d: high-resolution gas chromatography/ mass spectrometry (HRGC/MS). In children below the age of 11 years, AD and ADG increased with age sho wing no differences between sexes (mean +/- SD, nmol/l): normal subjec ts 3-6 years: AD in females 0.08 +/- 0.03, in males 0.07 +/- 0.03; ADG in females 0.15 +/- 0.05, in males 0.14 +/- 0.04; normal subjects 7-1 0 years: AD in females 0.17 +/- 0.03, in males 0.17 +/- 0.07; ADG in f emales 0.59 +/- 0.12, in males 0.47 +/- 0.14, Thereafter, AD and ADG s howed a greater increase in males (normal subjects 11-15 years: AD in females 0.24 +/- 0.06, in males 0.41 +/- 0.14; ADG in females 1.47 +/- 0.36, in males 3.36 +/- 1.22). In adults, plasma levels did not overl ap between females and males (AD in females 0.24 +/- 0.07, in males 0. 99 +/- 0.31; ADG in females 2.32 +/- 0.68, in males 13.01 +/- 3.05). 5 alpha-Androstane-3 alpha, 17 beta-diol-glucuronide discriminated bett er between sexes than AD. In idiopathic hirsutism, mean plasma concent rations of AD and ADG were higher than those of healthy females (ages 11-15 years: AD 0.31 +/- 0.10, ADG 3.48 +/- 2.00; ages > 16 years: AD 0.44 +/- 0.27, ADG 6.46 +/- 3.11), but 54% of patients had normal plas ma concentrations of AD and 29% had normal ADG values. Thus, ADG refle cted androgenicity better than AD. However, both metabolites were impe rfect markers of androgenicity in idiopathic hirsutism. Therefore, our findings do not support the concept of increased 5 alpha-reductase ac tivity in all patients with idiopathic hirsutism.