Determination of serum steroids in monitoring therapy of congenital adrenal hyperplasia

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

Bibliographische Detailangaben
Veröffentlicht in:Zhonghua er ke za zhi = Chinese journal of pediatrics. - 1960. - 50(2012), 4 vom: 28. Apr., Seite 301-7
1. Verfasser: Xiao, Hui-wen (VerfasserIn)
Weitere Verfasser: Ma, Hua-mei, Su, Zhe, Du, Min-lian, Li, Yan-hong, Chen, Hong-shan, Chen, Qiu-li
Format: Aufsatz
Sprache:Chinese
Veröffentlicht: 2012
Zugriff auf das übergeordnete Werk:Zhonghua er ke za zhi = Chinese journal of pediatrics
Schlagworte:Journal Article Testosterone 3XMK78S47O Androstenedione 409J2J96VR Progesterone 4G7DS2Q64Y Dehydroepiandrosterone Sulfate 57B09Q7FJR 17-alpha-Hydroxyprogesterone mehr... 68-96-2 Steroid 21-Hydroxylase EC 1.14.14.16 Hydrocortisone WI4X0X7BPJ
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100 1 |a Xiao, Hui-wen  |e verfasserin  |4 aut 
245 1 0 |a Determination of serum steroids in monitoring therapy of congenital adrenal hyperplasia 
264 1 |c 2012 
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500 |a Date Completed 08.04.2013 
500 |a Date Revised 25.11.2016 
500 |a published: Print 
500 |a Citation Status MEDLINE 
520 |a OBJECTIVE: To assess the utility of serum steroids measurement in monitoring the treatment of children with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) 
520 |a METHOD: Nineteen 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" 
520 |a RESULT: Both 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" 
520 |a CONCLUSION: Each 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 
650 4 |a Journal Article 
650 7 |a Testosterone  |2 NLM 
650 7 |a 3XMK78S47O  |2 NLM 
650 7 |a Androstenedione  |2 NLM 
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650 7 |a Progesterone  |2 NLM 
650 7 |a 4G7DS2Q64Y  |2 NLM 
650 7 |a Dehydroepiandrosterone Sulfate  |2 NLM 
650 7 |a 57B09Q7FJR  |2 NLM 
650 7 |a 17-alpha-Hydroxyprogesterone  |2 NLM 
650 7 |a 68-96-2  |2 NLM 
650 7 |a Steroid 21-Hydroxylase  |2 NLM 
650 7 |a EC 1.14.14.16  |2 NLM 
650 7 |a Hydrocortisone  |2 NLM 
650 7 |a WI4X0X7BPJ  |2 NLM 
700 1 |a Ma, Hua-mei  |e verfasserin  |4 aut 
700 1 |a Su, Zhe  |e verfasserin  |4 aut 
700 1 |a Du, Min-lian  |e verfasserin  |4 aut 
700 1 |a Li, Yan-hong  |e verfasserin  |4 aut 
700 1 |a Chen, Hong-shan  |e verfasserin  |4 aut 
700 1 |a Chen, Qiu-li  |e verfasserin  |4 aut 
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