Salivary testosterone measurement for monitoring treatment of children with congenital adrenal hyperplasia (CAH)

R Perry; A Mayo; A Deeb; H MacIntyre; A Wallace; I Hughes; S Ahmed

P143

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Endocrine Abstracts (2005) 9 P143

BES2005 Poster Presentations Steroids (17 abstracts)

Salivary testosterone measurement for monitoring treatment of children with congenital adrenal hyperplasia (CAH)

RJ Perry ¹ , A Mayo ² , A Deeb ³ , H MacIntyre ⁴ , AM Wallace ⁴ , IA Hughes ³ & SF Ahmed ¹

Err

Author affiliations

¹Bone & Endocrine Research Group, Royal Hospital for Sick Children, Glasgow, UK; ²Department of Paediatrics, Royal Aberdeen Children's Hospital, Aberdeen, UK; ³Department of Paediatrics, Addenbrooke's Hospital, Cambridge, UK; ⁴Department of Clinical Biochemistry, Glasgow Royal Infirmary, Glasgow, UK.

Biochemical assessment of control of CAH includes measurement of adrenal-derived androgens in blood. Some androgens like 17-hydroxyprogesterone (17OHP) have a diurnal rhythm and show a widespread of values in well controlled children. Testosterone in children (except pubertal boys) may be useful in monitoring control as it may reflect the potential for androgen action better than weaker androgens. Our salivary testosterone (SalT) assay measures free testosterone and is sensitive and non-invasive.

Methods:

Fifty-four matched plasma 17OHP and SalT samples were obtained from 18 children (4 male) median age 11.3 y (3.7-17.9y). SalT was considered to be normal if within the range obtained from healthy controls. 17OHP over 40 nmol/L was considered to be elevated.

Results:

The nine children under 10y provided 16 samples. SalT normative data are: <25 to 69 pmol/L for girls (n=9) and <25 to 54 for boys (n=26). Ten samples showed normal SalT and 17OHP; 2 showed high SalT and 17OHP; 3 had normal SalT but high 17OHP and 1 had a high SalT but normal 17OHP.

The eight children aged 10 to 14y provided 32 samples. SalT normative data are: 107-119 pmol/L for girls (n=3) and <25 to 450 pmol/L for boys. Eleven samples showed high SalT and 17OHP; 11 showed a normal SalT but a high 17OHP and 10 were normal for both analytes.

One girl aged 17.9y provided 6 samples; the SalT normative data for girls 15-19y are: <25 to 161 pmol/L (n=7). Five samples showed a normal SalT and 17OHP and 1 sample showed a normal SalT but a high 17OHP.

Conclusions:

SalT may be a useful adjuvant in the biochemical monitoring of children with CAH. An exploration of the clinical markers of control is indicated to investigate whether SalT is a more reliable marker of control than 17OHP.