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- Title
Steroid reference intervals in women: influence of menopause, age and metabolism.
- Authors
Mezzullo, Marco; Gambineri, Alessandra; Di Dalmazi, Guido; Fazzini, Alessia; Magagnoli, Matteo; Baccini, Margherita; Vicennati, Valentina; Pelusi, Carla; Pagotto, Uberto; Fanelli, Flaminia
- Abstract
Objective: To investigate the impact of age, obesity and metabolic parameters on 13 circulating steroids in reproductive and menopausal age. To define reference intervals (RIs). Design: Cross-sectional. Methods: Three hundred and twenty five drug-free, healthy and eumenorrheic women were selected from the general population. Independent relationships of LC-MS/MS-determined steroid levels with age, BMI and metabolic parameters were estimated. Reference sub-cohorts were defined fo r calculating upper and lower limits in reproductive age, menstrual phases and menopause, and these were compared with limits in dysmetabolic sub-cohorts. Results: Lower androgens, pro-androgens and estrogens, but higher cortisol and metabolites were found in menopausal compared to reproductive age women. Androgens and precursors decreased during reproductive age (P < 0.001-P = 0.002) but not after menopause. 17OH-progesterone decreased with BMI (P = 0.006) and glucocorticoids with waist circumference (P < 0.001-P = 0.002) in reproductive age, but increased with triglycerides (P = 0.011-P = 0.038) after menopause. Inverse associations of dihydrotestosterone with BMI (P = 0.004) and HDL-cholesterol (P = 0.010), estrone with total cholesterol (P = 0.033) and estradiol with triglycerides (P = 0.011) were found in reproductive age. After menopause, estrone increased with waist circumferenc e (P < 0.001) and decreased with insulin resistance (P = 0.012). Ovarian steroid RIs were estimated in menstrual phases and menopause. Age- and reproductive status-specific RIs were generated for androgens, precursors and cortic osteroids. Lower limits for reproductive age cortisol (P = 0.020) and menopausal 11-deoxycortisol (P = 0.003) in dysmetabolic sub-cohorts were reduced and increased, respectively, compared to reference limits. Conclusions: Obesity and dysmetabolism differently influence circulating steroids in reproductive and menopausal status. Age, menstrual and menopausal status-specific RIs were provided by LC-MS/MS for a broad steroid panel.
- Subjects
CHILDBEARING age; STEROIDS; MENOPAUSE; WAIST circumference; METABOLISM
- Publication
European Journal of Endocrinology, 2021, Vol 184, Issue 3, p389
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-20-1147