학술논문
Salivary Profiles of 11-oxygenated Androgens Follow a Diurnal Rhythm in Patients With Congenital Adrenal Hyperplasia
Clinical Research Article
Clinical Research Article
Document Type
Academic Journal
Author
Source
Journal of Clinical Endocrinology & Metabolism. November 2021, Vol. 106 Issue 11, pe4509, 11 p.
Subject
Language
English
ISSN
0021-972X
Abstract
Classic congenital adrenal hyperplasia (CAH) secondary to 21-hydroxylase defciency (21OHD) is characterized by insuffcient cortisol synthesis; and, in approximately two-thirds of patients, aldosterone production is also affected. Patients affected by [...]
Context: Several studies have highlighted the importance of the 11-oxygenated 19-carbon (11oxC19) adrenal-derived steroids as potential biomarkers for monitoring patients with 21-hydroxylase deficiency (210HD). Objective: To analyze circadian rhythmicity of 11oxC19 steroids in saliva profiles and evaluate their relevance as potential monitoring parameters in 21OHD. Design, Setting, and Participants: Cross-sectional single-center study including 59 patients with classic 21 OHD (men = 30; women = 29) and 49 body mass index- and agematched controls (men = 19; women = 30). Outcome Measures: Salivary concentrations of the following steroids were analyzed by liquid chromatography-tandem mass spectrometry: 17-hydroxyprogesterone (170HP), androstenedione (A4), testosterone (T), 11(3-hydroxyandrostenedione (110HA4), and 11-ketotestosterone (11KT). Results: Similar to the previously described rhythmicity of 170HP, 110HA4 and 11 KT concentrations followed a distinct diurnal rhythm in both patients and controls with highest concentrations in the early morning and declining throughout the day (11-OHA4: mean reduction of hormone concentrations between timepoint 1 and 5 ([[DELTA].sub.mean]) in male patients = 66%; male controls [[DELTA].sub.mean] = 83%; female patients [[DELTA].sub.mean] = 47%; female controls [[DELTA].sub.mean] = 86%; 11KT: male patients [[DELTA].sub.mean] = 57%; male controls [[DELTA].sub.mean] = 63%; female patients [[DELTA].sub.mean] = 50%; female controls [[DELTA].sub.mean] = 76%). Signifcant correlations between the area under the curve for 17OHP and 11KT ([r.sup.p.sub.male] = [0.773.sup. Conclusions: Adrenal 11oxC19 androgens are secreted following a diurnal pattern. This should be considered when evaluating their utility for monitoring treatment control. Key Words: congenital adrenal hyperplasia, saliva, diurnal rhythm, 11-ketotestosterone, 11-oxygenated androgens
Context: Several studies have highlighted the importance of the 11-oxygenated 19-carbon (11oxC19) adrenal-derived steroids as potential biomarkers for monitoring patients with 21-hydroxylase deficiency (210HD). Objective: To analyze circadian rhythmicity of 11oxC19 steroids in saliva profiles and evaluate their relevance as potential monitoring parameters in 21OHD. Design, Setting, and Participants: Cross-sectional single-center study including 59 patients with classic 21 OHD (men = 30; women = 29) and 49 body mass index- and agematched controls (men = 19; women = 30). Outcome Measures: Salivary concentrations of the following steroids were analyzed by liquid chromatography-tandem mass spectrometry: 17-hydroxyprogesterone (170HP), androstenedione (A4), testosterone (T), 11(3-hydroxyandrostenedione (110HA4), and 11-ketotestosterone (11KT). Results: Similar to the previously described rhythmicity of 170HP, 110HA4 and 11 KT concentrations followed a distinct diurnal rhythm in both patients and controls with highest concentrations in the early morning and declining throughout the day (11-OHA4: mean reduction of hormone concentrations between timepoint 1 and 5 ([[DELTA].sub.mean]) in male patients = 66%; male controls [[DELTA].sub.mean] = 83%; female patients [[DELTA].sub.mean] = 47%; female controls [[DELTA].sub.mean] = 86%; 11KT: male patients [[DELTA].sub.mean] = 57%; male controls [[DELTA].sub.mean] = 63%; female patients [[DELTA].sub.mean] = 50%; female controls [[DELTA].sub.mean] = 76%). Signifcant correlations between the area under the curve for 17OHP and 11KT ([r.sup.p.sub.male] = [0.773.sup. Conclusions: Adrenal 11oxC19 androgens are secreted following a diurnal pattern. This should be considered when evaluating their utility for monitoring treatment control. Key Words: congenital adrenal hyperplasia, saliva, diurnal rhythm, 11-ketotestosterone, 11-oxygenated androgens