Serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, and pregnenolone sulfate concentrations in patients with hyperthyroidism and hypothyroidism

Background: Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfat e (DHEA-S) have been suggested to have protective effects against cardiovas cular disease, cancer, immune-modulated diseases, and aging. We examined se rum concentrations of DHEA, DHEA-S, and pregnenolone sulfate (PREG-S) in pa tients with thyroid dysfunction. Methods: Steroids extracted with methanol from serum sample were separated into an unconjugated fraction (DHEA) and a monosulfate fraction (DHEA-S and PREG-S), using a solid-phase extraction and am ion-exchange column. After separation of unconjugated steroids by HPLC, the DHEA concentration was mea sured by enzyme immunoassay. The monosulfate fraction was treated with aryl sulfatase, and the freed steroids were separated by HPLC. The DHEA and PREG fractions were determined by gas chromatography-mass spectrometry, and the concentrations were converted into those of DHEA-S and PREG-S. Results: Serum concentrations of DHEA, DHEA-S, and PREG-S were all signific antly lower in patients with hypothyroidism (n = 24) than in age- and sex-m atched healthy controls (n = 43). By contrast, in patients with hyperthyroi dism (n = 22), serum DHEA-S and PREG-S concentrations were significantly hi gher, but the serum DHEA concentration was within the reference interval. S erum concentrations of these three steroids correlated with serum concentra tions of thyroid hormones in these patients. Serum albumin and sex hormone- binding globulin concentrations were not related to these changes in the co ncentration of steroids. Conclusions: Serum concentrations of DHEA, DHEA-S, and PREG-S were decrease d in hypothyroidism, whereas serum DHEA-S and PREG-S concentrations were in creased but DHEA was normal in hyperthyroidism. Thyroid hormone may stimula te the synthesis of these steroids, and DHEA sulfotransferase might be incr eased in hyperthyroidism. (C) 2000 American Association for Clinical Chemis try.