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Androsterone sulfate: physiology and clinical significance in hirsute women.
J Clin Endocrinol Metab. 1993 Jan; 76(1):112-6.JC

Abstract

Androsterone sulfate (Andros-S) is the most abundant 5 alpha-reduced androgen metabolite in serum. To determine whether this steroid could serve as a marker of 5 alpha-reductase activity, we developed a specific RIA, using tritiated Andros-S to assess procedural losses. Baseline serum Andros-S levels (mumol/L; mean +/- SEM) in 14 hirsute women (3.0 +/- 0.4) were not reduced by ovarian suppression with leuprolide (3.0 +/- 0.3), but were decreased by 79% with combined ovarian and adrenal suppression with leuprolide and dexamethasone. The mean Andros-S level in polycystic ovarian syndrome (3.2 +/- 0.4) and in idiopathic hirsutism (3.5 +/- 0.5) was not significantly different from levels in normal women (3.0 +/- 0.5), but were significantly greater than levels in obese women (1.7 +/- 0.3; P < 0.05). The serum concentrations of Andros-S were about 10-fold greater than those of androsterone glucuronide and 100-fold greater than those of androstanediol glucuronide. Serum Andros-S concentrations correlated strongly with dehydroepiandrosterone sulfate (R = 0.59; P < 0.001) and to a lesser degree with androstanediol glucuronide and androsterone glucuronide (R = 0.28 and 0.49, respectively). There was a weak correlation with androstenedione levels and the androstenedione response to ACTH (R = 0.38 and 0.34, respectively), and no significant correlation with serum testosterone (R = 0.19). The ratio of any of the 5 alpha-reduced products (Andros-S, androstanediol glucuronide, and androsterone glucuronide) to precursors (androstenedione and testosterone) was not increased in hirsute women, suggesting that these women did not have a generalized increase in 5 alpha-reductase activity. In conclusion, these results confirm that Andros-S is the most abundant 5 alpha-reduced androgen metabolite in serum. It is primarily, if not exclusively, of adrenal origin in hirsute women. The fact that its levels were not elevated in hirsutism, although those of other adrenal androgens and androgen metabolites (androstanediol glucuronide and androsterone glucuronide) were, suggests that variations in sulfotransferase activity or metabolic clearance of Andros-S may be important determinants of serum Andros-S levels. Although Andros-S may be a marker of systemic 5 alpha-reductase activity, there was no evidence of a generalized increase in 5 alpha-reductase activity in hirsute women. Andros-S is therefore not recommended as a marker of either adrenal androgen production or of hirsutism.

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Authors+Show Affiliations

Zwicker H
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Rittmaster RS
No affiliation info available

MeSH

17-alpha-HydroxyprogesteroneAdrenocorticotropic HormoneAdultAndrostenedioneAndrosteroneBiomarkersBody Mass IndexDehydroepiandrosteroneDehydroepiandrosterone SulfateDexamethasoneFemaleFollicle Stimulating HormoneGlucuronatesHirsutismHumansHydrocortisoneHydroxyprogesteronesLeuprolideLuteinizing HormoneObesityReference ValuesTestosterone

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8380602

Citation

Zwicker, H, and R S. Rittmaster. "Androsterone Sulfate: Physiology and Clinical Significance in Hirsute Women." The Journal of Clinical Endocrinology and Metabolism, vol. 76, no. 1, 1993, pp. 112-6.
Zwicker H, Rittmaster RS. Androsterone sulfate: physiology and clinical significance in hirsute women. J Clin Endocrinol Metab. 1993;76(1):112-6.
Zwicker, H., & Rittmaster, R. S. (1993). Androsterone sulfate: physiology and clinical significance in hirsute women. The Journal of Clinical Endocrinology and Metabolism, 76(1), 112-6.
Zwicker H, Rittmaster RS. Androsterone Sulfate: Physiology and Clinical Significance in Hirsute Women. J Clin Endocrinol Metab. 1993;76(1):112-6. PubMed PMID: 8380602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Androsterone sulfate: physiology and clinical significance in hirsute women. AU - Zwicker,H, AU - Rittmaster,R S, PY - 1993/1/1/pubmed PY - 1993/1/1/medline PY - 1993/1/1/entrez SP - 112 EP - 6 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 76 IS - 1 N2 - Androsterone sulfate (Andros-S) is the most abundant 5 alpha-reduced androgen metabolite in serum. To determine whether this steroid could serve as a marker of 5 alpha-reductase activity, we developed a specific RIA, using tritiated Andros-S to assess procedural losses. Baseline serum Andros-S levels (mumol/L; mean +/- SEM) in 14 hirsute women (3.0 +/- 0.4) were not reduced by ovarian suppression with leuprolide (3.0 +/- 0.3), but were decreased by 79% with combined ovarian and adrenal suppression with leuprolide and dexamethasone. The mean Andros-S level in polycystic ovarian syndrome (3.2 +/- 0.4) and in idiopathic hirsutism (3.5 +/- 0.5) was not significantly different from levels in normal women (3.0 +/- 0.5), but were significantly greater than levels in obese women (1.7 +/- 0.3; P < 0.05). The serum concentrations of Andros-S were about 10-fold greater than those of androsterone glucuronide and 100-fold greater than those of androstanediol glucuronide. Serum Andros-S concentrations correlated strongly with dehydroepiandrosterone sulfate (R = 0.59; P < 0.001) and to a lesser degree with androstanediol glucuronide and androsterone glucuronide (R = 0.28 and 0.49, respectively). There was a weak correlation with androstenedione levels and the androstenedione response to ACTH (R = 0.38 and 0.34, respectively), and no significant correlation with serum testosterone (R = 0.19). The ratio of any of the 5 alpha-reduced products (Andros-S, androstanediol glucuronide, and androsterone glucuronide) to precursors (androstenedione and testosterone) was not increased in hirsute women, suggesting that these women did not have a generalized increase in 5 alpha-reductase activity. In conclusion, these results confirm that Andros-S is the most abundant 5 alpha-reduced androgen metabolite in serum. It is primarily, if not exclusively, of adrenal origin in hirsute women. The fact that its levels were not elevated in hirsutism, although those of other adrenal androgens and androgen metabolites (androstanediol glucuronide and androsterone glucuronide) were, suggests that variations in sulfotransferase activity or metabolic clearance of Andros-S may be important determinants of serum Andros-S levels. Although Andros-S may be a marker of systemic 5 alpha-reductase activity, there was no evidence of a generalized increase in 5 alpha-reductase activity in hirsute women. Andros-S is therefore not recommended as a marker of either adrenal androgen production or of hirsutism. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/8380602/Androsterone_sulfate:_physiology_and_clinical_significance_in_hirsute_women_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem.76.1.8380602 DB - PRIME DP - Unbound Medicine ER -