Article Text

  1. A. W. Meikle,
  2. W. L. Roberts,
  3. A. Bunker,
  4. M. Kushner,
  5. A. Rockwood
  1. Department of Pathology, Medicine University School of Medicine, ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT


Introduction Dramatic changes in serum sex steroid concentrations occur in children during puberty, but observations are limited on adrenal steroid concentrations in children before and after puberty. The objective of this study was to determine the reference interval of adrenal steroid concentrations in children before and after puberty.

Methods We collected serum samples from boys and girls in each year of age from 7 to 17 years. Tanner stage was determined in each child by physical examination. The minimum number of each sex for each year of age was 62. Serum concentrations of 11-deoxycortisol (S), pregnenolone (preg), 17-hydroxypreg (17OHPreg), and 17-hydroxyprogesterone (17OHP), which were determined by LC MS/MS, and androstenedione (A) and dehydroepiandrosterone sulfate (DS), which were determined by immunoassay.

Results Nonparametric reference intervals were developed for the steroid concentrations. The median and central 95% of the steroid concentrations were determined. Except for S, all of the steroids exhibited an increase in concentration after age 7-9 years in both boys and girls. DS and A increased three- to fourfold and preg, 17OHpreg and 17OHP increased about twofold in children after age 9 compared to children ages 7-9 years. Since S is exclusively made in the adrenal cortex and does not change with age, it suggests that as children age a rise in gonadal function and adrenarche may contribute somewhat to the increase of the remaining steroids.

Conclusions This is the most extensive reference interval study of adrenal steroids conducted in pubertal age children. Following pubertal occurrence, the rise in serum concentration of all steroids except for S was parallel between boys and girls.

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