DELTA-5-ANDROSTENEDIOL AND ITS SULFATE IN SERUM AND URINE OF NORMAL ADULTS AND PATIENTS WITH ENDOCRINE DISEASES

OBJECTIVES We evaluated the role of delta-5-androstenediol (adiol) and its sulphates in health and endocrine diseases. DESIGN Serum and urin e samples from healthy adult men and pre and post-menopausal women wer e analysed by gas chromatography-mass spectrometry to establish refere nce values. In patients who were either evaluated or treated for endoc rine diseases, sequential serum samples were collected and analysed. P ATIENTS Reference values were obtained from 24 healthy male, 23 premen opausal and 30 post-menopausal female volunteers. Adiol and delta-5-an drostenediol-3-sulphate (adiol-3S) concentrations were determined in c ombination with other relevant steroids in patients with either pituit ary (n = 5), adrenal (n = 2) or gonadal dysfunction (n = 1), or testic ular carcinoma (n = 19). MEASUREMENTS After addition of deuterated adi ol as internal standard, serum and urine samples were extracted. Stero id sulphates were hydrolysed. The extracts and hydrolysates were purif ied on HPLC, adiol was derivatized and finally quantified by gas chrom atography-mass spectrometry. RESULTS The calculated reference ranges f or adiol and adiol-3S concentrations in serum are respectively: in men 1.78-7.24 and 123-579 nmol/l, in premenopausal women 0.65-6.93 and 21 .2-298 nmol/l and in post-menopausal women 0.29-2.90 and 6-1-184 nmol/ l. Urinary values varied considerably. In the population with endocrin e abnormalities serum adiol and adiol-3S concentrations were compared with other relevant steroids. CONCLUSIONS The wide concentration range of adiol and adiol-3S in urine makes analysis of these steroids in ur ine of little clinical value. Serum concentrations of adiol and adiol- 3S are higher in men than in women. Premenopausal values are higher th an post-menopausal. Adiol and adiol-3S in serum are significantly corr elated in pre and post-menopausal women, r = 0.51 and r = 0.69 respect ively, but not in men. In endocrine patients the serum concentrations of adiol show an ACTH or LH dependency in women; adiol correlates with cortisol, dehydroepiandrosterone or androstenedione and, in males, ad ditionally with testosterone. However, in several situations adiol cor relates with none of these steroids. Although adiol secretion can be s timulated by ACTH and LH, the level of serum adiol is also determined by other factors. Finally, in adrenal carcinoma serum adiol and adiol- 3S may be used as tumour markers.