PLASMA 3-ALPHA-ANDROSTANEDIOL GLUCURONIDE IN NORMAL-CHILDREN AND IN CONGENITAL ADRENAL-HYPERPLASIA DUE TO 21-HYDROXYLASE DEFICIENCY

Monitoring therapy for congenital adrenal hyperplasia (CAH) due to 21- hydroxylase is difficult, although plasma determinations of 17 alpha-h ydroxyprogesterone (17OHP), Delta 4-androstenedione (Delta 4A) and tes tosterone are helpful. We have studied the usefulness of monitoring pl asma 3 alpha-androstanediol glucuronide (3 alpha-AG) in a group of 24 CAH patients aged from birth to 18 years. For comparison, normal value s for age and pubertal stage were determined in a control group of 115 girls and 118 boys. Mean plasma levels were higher during the first y ear of life, decreased to a nadir between 1 and 4 years, and increased steadily thereafter; there was also a significant increase with puber tal stage. In 24 pairs of blood samples obtained at the time of venopu ncture and 2 h after, 3 alpha-AG levels did not change (p > 0.05) demo nstrating that 3 alpha-AC levels were not affected by stress. In the p atients with CAH, positive correlations between plasma 3 alpha-AG and Delta 4A (females, r = 0.73; males, r = 0.98), 170HP (females, r = 0.5 8; males, r = 0.84) and testosterone (females, r = 0.83; males, r = 0. 97) were observed. Concordance between 3 alpha-AG and Delta 4A was obs erved in 90% of all samples, and in 91% between 3 alpha-AG and testost erone. Our study demonstrates that 3 alpha-AG is a valid marker of con trol and its determination appears to be a reliable tool to monitor CA H.