Aged ; Aged, 80 and over ; Androgen Antagonists/therapeutic use* ; Biomarkers, Tumor/blood* ; Dehydroepiandrosterone Sulfate/blood* ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms/mortality* ; Prostatic Neoplasms, Castration-Resistant/mortality* ; Survival Analysis ; Treatment Outcome

OBJECTIVETo assess the utility of serum steroids measurement in monitoring the treatment of children with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD).

METHODNineteen Patients with CAH 21OHD aged (3.67±1.54) years treated with hydrocortisone and fluorocortisone replacement were followed up at an intervals of 0.33 - 1.0 years over a period of (1.47±0.7) years. At each visit, roentgenograms of the hands and wrists were taken, fasting peripheral blood were collected to test serum dehydroepiandrosterone sulfate, progesterone, 17-hydroxyprogesterone (17-OHP), androstenedione (Δ4-A), testosterone, free testosterone, estrone, and estradiol concentrations at 8 AM in the morning before the first dose of glucocorticoid. Then the patients were classified as being in "Good Control" or in "Poor Control" based on clinical criteria including signs of androgen excess, growth velocity and bone age increment at each interval. Comparisons were carried out between the serum steroid concentrations of the two groups. The receiver operating characteristic (ROC) curves were used to determine the cut-off values for diagnosing "Poor Control".

RESULTBoth of serum Δ4-A and 17-OHP concentrations were higher in "Poor Control" group than those in "Good Control" group [5.95 (2.23-11.2) nmol/L versus 1.05 (1.05-9.89) nmol/L, t=2.19; 13.85 (6.06-20) µg/L versus 3.67 (0.42-21.1) µg/L, t=2.17; P<0.05, respectively]. The ROC curves for serum Δ4-A concentrations, serum 17-OHP concentrations, serum Δ4-A in combination with 17-OHP concentrations were constructed with areas under the ROC curves (95%CI) of 0.76 (0.62, 0.90), 0.75 (0.62, 0.88), 0.69 (0.54, 0.84), P<0.05, respectively. Serum Δ4-A of 3.9 nmol/L had 0.78 of sensitivity and 0.75 of specificity in diagnosing "Poor Control". Serum 17-OHP of 7.1 µg/L has 0.67 of sensitivity and 0.71 of specificity in diagnosing "Poor Control".

CONCLUSIONEach of serum 17-OHP or/and Δ4-A concentration was of significance in diagnosing "Poor Control" during the glucocorticoid replacement treatment of CAH 21OHD, with the diagnostic efficacy being serum Δ4-A concentration, serum 17-OHP concentration and serum Δ4-A in combination with 17-OHP concentration in descending order. Serum Δ4-A and 17-OHP concentrations may be used as the biochemical indicators to monitor the therapy of CAH 21OHD.

17-alpha-Hydroxyprogesterone ; blood ; Adrenal Hyperplasia, Congenital ; blood ; diagnosis ; therapy ; Androstenedione ; blood ; Child, Preschool ; Dehydroepiandrosterone Sulfate ; blood ; Female ; Humans ; Hydrocortisone ; blood ; Male ; Progesterone ; blood ; Steroid 21-Hydroxylase ; blood ; Testosterone ; blood

OBJECTIVETo study the effect of intrahepatic cholestasis of pregnancy (ICP) on the functions of the hypothalamic-pituitary-adrenocortical (HPA) axis and adrenal cortex in normal neonates.

METHODSDemographic characteristics, prenatal anxiety and depression, and perceived stress during delivery were investigated in 32 ICP women and 32 controls. The cord blood levels of cortisal, adrenocorticotropic hormone (ACTH), and dehydroepiandrosterone sulfate (DHEAS) were measured by the radioimmunity technique in normal neonates immediately after birth.

RESULTSThe scores of prenatal anxiety and depression in ICP women were significantly higher than those in controls (p<0.05 and p<0.01, respectively). There were no significant differences in the perceived stress during delivery between the two groups. The cord blood levels of cortisol and ACTH in neonates from ICP women were significantly lower (p<0.01), while the DHEAS level was significantly higher (p<0.01) than in neonates from controls. The DHEAS/ACTH ratio was significantly higher (p<0.01), while the cortisol/DHEAS ratio was significantly lower in the ICP group (p<0.01) than in the control group. The glycocholic acid level in ICP women was positively correlated with the DHEAS level in neonatal cord blood (r=0.47, p<0.01).

CONCLUSIONSThere may be a dissociation between cortisol and DHEAS in neonates with normal birth outcome from ICP women. ICP may result in a decreased responsiveness of HPA axis and an increased secretion of DHEAS by adrenal cortex in these neonates. This suggests that there might be dysfunction of the fetal zones of the adrenal cortex.

Adrenal Cortex ; physiopathology ; Adrenocorticotropic Hormone ; blood ; Adult ; Cholestasis, Intrahepatic ; physiopathology ; Dehydroepiandrosterone Sulfate ; blood ; Female ; Humans ; Hydrocortisone ; blood ; Hypothalamo-Hypophyseal System ; physiopathology ; Infant, Newborn ; Pituitary-Adrenal System ; physiopathology ; Pregnancy ; Pregnancy Complications ; physiopathology

OBJECTIVETo observe the psychological behavior of girls with idiopathic central precocious puberty (ICPP) before and after treatment by gonadotropin-releasing hormone analogue (GnRHa).

METHODSRaven's Standard Progressive Matrices(SPM), Achenbach's Child Behavior Checklist (CBCL), Self-Esteem Scale (SES), and Body-Esteem Scale (BES) were used to assess the psychological behavior in the ICPP girls before and after GnRHa treatment, as well as in control girls. The serum levels of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) were measured by ELISA before and after GnRHa treatment.

RESULT(1) The SES and BES scores in ICPP were significantly lower than those of controls(P <0.05). The CBCL scores in depressed, withdrawn,aggressive and somatic complaint assessment were significantly higher in ICPP group than those of control group. (2) The SES score, the body strength scores for BES 12 months after treatment were significantly higher than those pretreatment (P <0.05). Serum DHEA levels in ICPP group and control group were Log(0.77 +/-0.36)microg/L and Log (0.28 +/-0.22) microg/L respectively, with a significant difference (P <0.01). Serum DHEA and DHEAS of ICPP 3 months after treatment were decreased from Log(0.83 +/-0.35)microg/L and Log(2.27 +/-0.30)microg/L to Log(0.68 +/-0.44)microg/L and Log (2.11 +/-0.43)microg/L (both P <0.05). The serum DHEA and DHEAS levels 12 months after treatment were Log(0.78 +/-0.30)microg/L and Log(2.40 +/-0.34)microg/L, there was no significant difference before and after treatment (P >0.05). (3) The SES score,the weight concern and body strength scores for BES were negatively correlated with serum DHEA and DHEAS levels in precocious puberty girls (r=-0.492,-0.356,-0.202 and -0.216, all P <0.05). The nine CBCL factors were not correlated with serum DHEA levels.

CONCLUSIONPrecocious puberty girls are prone to lower self-esteem and less confidence, which are correlated with the increase of serum DHEA levels. There is more frequency to be depressed, withdrawn, aggressive and complaining in these girls, however, which are not correlated with serum DHEA levels. GnRHa may reverse the problem of psychological behavior in ICPP girls.

Child ; Dehydroepiandrosterone ; blood ; Dehydroepiandrosterone Sulfate ; blood ; Female ; Gonadotropin-Releasing Hormone ; analogs & derivatives ; therapeutic use ; Humans ; Puberty, Precocious ; drug therapy ; psychology ; Surveys and Questionnaires

PURPOSE: To determine whether sleep-related erections(SREs) occur during chronic vegetative state and if so, to investigate what factors are involved. MATERIALS AND METHODS: Twenty-six men in a vegetative state aged 16~65 were selected. Exclusion criteria were the lack of informed consent, mean blood pressure under 90/60 mmHg during last 3 days, erectile dysfunction before brain injury, and a history of any anti-androgen treatment. Serum testosterone, albumin, sex hormone binding globulin(SHBG), and dehydroepiandrosterone sulfate(DHEAS) were assayed, and bioavailable testosterone(cBT) and free testosterone(cFT) were calculated. Nocturnal penile erections were counted and evaluated using the Rigiscan device for72 hours. Data on the number of erections, erection duration, minimal and maximal base tumescence, minimal and maximal tip tumescence, and base and tip rigidity were taken. RESULTS: SREs were noted in 25 patients. The mean erection number was 4.65+/-3.93(1~15), and the mean erection duration was 128.85+/-46.86 minutes(0~478.5). SREs were negatively correlated with age(r=-0.445, p<0.05), systolic BP(r=-0.394, p<0.05) and diastolic BP(r=-0.403, p<0.05), but positively correlated with DHEAS(r=0.395, p<0.05). SREs were not correlated with total testosterone, cBT or cFT. CONCLUSIONS: These preliminary findings suggest that SREs are a normal occurrence in vegetative patients. They contribute to penile blood perfusion if the supraspinal erection control center is intact and serum testosterone level is above the minimum required for SREs.
Blood Pressure ; Brain Injuries ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Erectile Dysfunction ; Humans ; Informed Consent ; Male ; Perfusion ; Persistent Vegetative State* ; Testosterone

OBJECTIVESTo investigate whether the association between low birth weight and increased risk of developing premature adrenarche, adrenal hyperandrogenism, hyperinsulinism and insulin resistance is apparent in prepubertal girls born small for gestational age (SGA) and analyze when adrenarche occurs in SGA infants and normal birth weight girls.

METHODSThe study was performed in 39 prepubertal SGA girls with a mean age of 7.4 +/- 1.7 years and 42 prepubertal appropriate for gestational age (AGA) girls with a mean age of 7.4 +/- 1.7 years served as controls. All children were born at term and were prepubertal. Detailed physical examination was performed for all the children after 12 h of overnight fasting. Blood samples were taken for the measurement of fasting glucose (FPG), insulin (FIns), dehydroepiandrosterone sulfate (DHEAS), cortisol and estradiol concentrations. Insulin sensitivity was assessed by insulin sensitivity index [IAI = log(e) (FPG x FIns)].

RESULTThere was no premature adrenarche in SGA and AGA groups. Birth weight was significantly lower in SGA group (P < 0.001). Gestational age was similar in both groups. At the time of the study, the ages, body mass index (BMI), fasting glucose, cortisol and estradiol did not significantly differ between the two groups. But body height and weight were significantly lower in the SGA group (P < 0.05 for both). The fasting plasma insulin in the SGA group was higher than that in AGA group (common logarithmic transformation: 1.076 +/- 0.041 vs. 1.050 +/- 0.051, P < 0.05). The insulin sensitivity index was not significantly different between the two groups (-4.0165 +/- 0.1761 vs. -3.9768 +/- 0.2314). The serum DHEAS was significantly higher in SGA children than in AGA children (common logarithmic transformation: 2.637 +/- 0.271 vs. 2.514 +/- 0.250, P < 0.05). From about age 7 the concentration of DHEAS had a gradual rise in AGA children. The time of DHEAS rise tended to be earlier in SGA children compared with AGA children.

CONCLUSIONSAdrenarche commences at approximately 7 years of age in AGA girls. The time of adrenarche tended to be earlier in SGA girls compared with AGA girls. There were adrenal hyperandrogenism and hyperinsulinism in prepubertal girls born small for gestational age. But there was no insulin resistance as assessed by insulin sensitivity index.

Body Size ; Case-Control Studies ; Child ; Dehydroepiandrosterone Sulfate ; blood ; Female ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Insulin ; blood ; Insulin Resistance ; Puberty ; physiology ; Risk Factors

OBJECTIVE: The aim of this study was to measure maternal plasma androgens and estrogen levels and to assess the role of these hormones in the pathogenesis of preeclampsia. METHODS: The groups consisted of 28 healthy pregnant women as well as 24 pregnant women with severe preeclampsia. Plasma total testosterone (T), estradiol (E2), dehydroepiandrosterone sulfate (DHEAS) and androstenedione (ADD) levels were measured. Statistical analysis was achieved with Student's t-test by using SPSS for Windows and the Pearson's coefficient of correlation was calculated. RESULTS: No significant differences were observed between the two groups regarding age, gestational age, body mass index, parity, hematocrit and platelet, whereas significant differences were noted regarding systolic and diastolic blood pressure, gestational weeks at delivery, birth weight, serum creatinine, uric acid and urea. In preeclampsia group, serum total testosterone and ADD levels were determined to be higher than the control group (p<0.05). However, there was no significant differences in plasma levels of DHEAS and E2 among the two groups (p>0.05). Serum testosterone levels were positively correlated with systolic and diastolic pressure and uric acid and negatively correlated with birth weight. CONCLUSION: These results suggest that the elevated plasma levels of testosterone could contribute to the pathogenesis of preeclampsia.
Androgens ; Androstenedione ; Birth Weight ; Blood Platelets ; Blood Pressure ; Body Mass Index ; Creatinine ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Estradiol ; Estrogens* ; Female ; Gestational Age ; Hematocrit ; Humans ; Parity ; Plasma* ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy* ; Pregnant Women ; Testosterone ; Urea ; Uric Acid

Animals ; Atherosclerosis ; blood ; drug therapy ; pathology ; Dehydroepiandrosterone ; blood ; physiology ; therapeutic use ; Dehydroepiandrosterone Sulfate ; blood ; therapeutic use ; Hormone Replacement Therapy ; Humans

OBJECTIVE: The aim of this study was to measure maternal plasma androgens, estrogen and leptin levels and to assess the role of these hormones in the pathogenesis of preeclampsia. METHODS: The groups consisted of 32 healthy pregnant women as well as 28 pregnant women with severe preeclampsia. Plasma leptin, total testosterone (T), estradiol (E2), dehydroepiandrosterone sulfate (DHEAS) and androstenedione (ADD) levels were measured. Statistical analysis was achieved with Student's t-test by using SPSS for Windows and the Pearson's coefficient of correlation was calculated. RESULTS: No significant differences were observed between the two groups regarding age, gestational age, body mass index, parity, hematocrit and platelet, whereas significant differences were noted regarding systolic and diastolic blood pressure, gestational weeks at delivery, birth weight, serum creatinine, uric acid and urea (p<0.05). In preeclampsia group, serum total testosterone and ADD levels were determined to be higher than the control group (p<0.05). However, there was no significant differences in plasma levels of DHEAS and E2 among the two groups. The plasma levels of leptin were not significantly increased in the preeclampsia group. Serum testosterone levels were positively correlated with systolic and diastolic pressure and uric acid and negatively correlated with birth weight. CONCLUSION: These results suggest that the elevated plasma levels of testosterone could contribute to the pathogenesis of preeclampsia.
Androgens ; Androstenedione ; Birth Weight ; Blood Platelets ; Blood Pressure ; Body Mass Index ; Creatinine ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Estradiol ; Estrogens ; Female ; Gestational Age ; Gonadal Steroid Hormones* ; Hematocrit ; Humans ; Leptin* ; Parity ; Plasma* ; Pre-Eclampsia* ; Pregnant Women ; Testosterone ; Urea ; Uric Acid

OBJECTIVE: The aim of this study was to measure maternal plasma androgens, estrogen and leptin levels and to assess the role of these hormones in the pathogenesis of preeclampsia. METHODS: The groups consisted of 32 healthy pregnant women as well as 28 pregnant women with severe preeclampsia. Plasma leptin, total testosterone (T), estradiol (E2), dehydroepiandrosterone sulfate (DHEAS) and androstenedione (ADD) levels were measured. Statistical analysis was achieved with Student's t-test by using SPSS for Windows and the Pearson's coefficient of correlation was calculated. RESULTS: No significant differences were observed between the two groups regarding age, gestational age, body mass index, parity, hematocrit and platelet, whereas significant differences were noted regarding systolic and diastolic blood pressure, gestational weeks at delivery, birth weight, serum creatinine, uric acid and urea (p<0.05). In preeclampsia group, serum total testosterone and ADD levels were determined to be higher than the control group (p<0.05). However, there was no significant differences in plasma levels of DHEAS and E2 among the two groups. The plasma levels of leptin were not significantly increased in the preeclampsia group. Serum testosterone levels were positively correlated with systolic and diastolic pressure and uric acid and negatively correlated with birth weight. CONCLUSION: These results suggest that the elevated plasma levels of testosterone could contribute to the pathogenesis of preeclampsia.
Androgens ; Androstenedione ; Birth Weight ; Blood Platelets ; Blood Pressure ; Body Mass Index ; Creatinine ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Estradiol ; Estrogens ; Female ; Gestational Age ; Gonadal Steroid Hormones* ; Hematocrit ; Humans ; Leptin* ; Parity ; Plasma* ; Pre-Eclampsia* ; Pregnant Women ; Testosterone ; Urea ; Uric Acid