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- Title
Scalp hair 17-hydroxyprogesterone and androstenedione as a long-term therapy monitoring tool in congenital adrenal hyperplasia.
- Authors
Noppe, Gerard; Rijke, Yolanda B.; Koper, Jan W.; Rossum, Elisabeth F.C.; Akker, Erica L.T.
- Abstract
Background Glucocorticoid replacement therapy in congenital adrenal hyperplasia ( CAH) is challenging, especially in children, because both over- and under-dosing may have profound and long-lasting adverse effects. Clinical follow-up parameters are largely nonspecific and slow to develop. Steroid concentrations in scalp hair may be a useful monitoring tool, as it provides information on both long-term steroid precursor and glucocorticoid exposure. Aim We aimed to evaluate scalp hair steroid precursor concentrations as a monitoring tool for treatment follow-up in children with CAH. Methods Scalp hair 17-hydroxyprogesterone (17- OHP) and androstenedione concentrations, measured by LC- MS/ MS, of children with CAH ( N = 26) were correlated with concentrations in serum and saliva, and compared to scalp hair concentrations in patient controls with adrenal insufficiency ( AI) ( N = 12) and healthy controls ( N = 293). Results Hair cortisol concentrations were higher in children with CAH, compared to both healthy controls ( P < 0·001) and patient controls ( P = 0·05), and did not differ significantly between patient controls with AI and healthy controls. Concentrations of androstenedione in scalp hair were strongly correlated with concentrations in serum (ρ = 0·72, P < 0·001) and saliva (ρ = 0·82, P = 0·002). This was also seen for 17- OHP in hair with serum (ρ = 0·94, P < 0·001) and saliva (ρ = 0·69, P = 0·009). Both hair 17- OHP and androstenedione were higher in CAH patients (mean concentration 17- OHP 2·9 pg/mg; androstenedione 1·3 pg/mg), when compared to healthy controls (17- OHP 0·44 pg/mg; androstenedione 0·65 pg/mg) and when compared to patients with AI (17- OHP 0·12 pg/mg; androstenedione 0·32 pg/mg). Conclusion This study shows that scalp hair 17-hydroxyprogesterone and androstenedione concentrations seem to be a promising parameter for treatment monitoring in patients with CAH.
- Subjects
ANDROSTENEDIONE; HYDROXYPROGESTERONE; ADRENOGENITAL syndrome; DISEASES; SCALP; STEROIDS; THERAPEUTICS
- Publication
Clinical Endocrinology, 2016, Vol 85, Issue 4, p522
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1111/cen.13078