BSPED2022 Poster Presentations Adrenal 1 (6 abstracts)
1Alder Hey Childrens NHS Foundation Trust, Liverpool, United Kingdom; 2University of Liverpool, Liverpool, United Kingdom; 3Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom
Background: Saliva is ideal for measuring free, biologically active hormones. Measurements of salivary androgens may be valuable in diagnosis and monitoring of adrenal disorders, however the diurnal profile and robust reference ranges in healthy children are currently undefined. We report salivary testosterone, androstenedione (A4), 11-ketotestosterone (11-KT), 11-β hydroxyandrostenedione (11β-OHA4) concentrations measured throughout the day in healthy children.
Methods: Participants provided salivary samples using Salivettes (Salimetrics®) 30 minutes after waking and 2-hourly thereafter. Participants did not eat or brush their teeth prior to sampling. Children with a family history of inherited adrenal disorders, oral lesions or conditions/medications likely to affect cortisol concentrations were excluded. Pubertal examinations were not performed to optimise recruitment. An age of nine in girls and ten in boys was used to define pre-puberty and puberty. Samples were analysed by LC-MS/MS.
Results: 54 (30M) healthy children, aged 10.4 ± 3.9 (5.0-17.5) years participated. Body mass index standard deviation score was 0.4 ± 1.1. All hormones showed a circadian rhythm, with a steep decline between measurements made 30 minutes and 2 hours after waking. Area under the curve (AUC) for testosterone, A4, 11-KT and 11β-OHA4 are given below.
Hormone | Mean area under the curve (95%CI) | |||||||
Prepubertal | Pubertal | |||||||
Girls, n=12 | Boys, n=14 | P-value | Girls, n=12 | Boys, n=16 | P-value | P-value | ||
Testosterone (pmol/l) | 321.8 (215.8-427.8) | 357.3 (265.7-448.9)a | <0.0001 | 573.2 (363.8-782.6) | 859.5 (443.1-1276.0) | <0.0001 | ||
343.2 (248.6-437.8) | 741.0 (389.5-1094.0) | <0.0001 | ||||||
A4 ( |
1953.0 (1178.0-2728.0) | 1478.0 (891.0-2057.0) | <0.0001 | 1675.0 (978.8-2372.0) | 1332.0 (917.8-1746.0) | <0.0001 | ||
1688.0 (1005.0-2371.0) | 1259.0 (741.8-1775.0) | <0.0001 | ||||||
11-KT (pmol/l) | 459.4 (190.2-728.5) | 383.0 (234.5-531.5)b | 0.0001 | 1304.0 (833.2-1775.0)a | 1209.0 (638.0-1779.0)a | 0.0271 | ||
424.1 (205.5-642.8) | 1259 (741.8-1775.0) | <0.0001 | ||||||
11β-OHA4 (pmol/l) | 1285.0 (478.9-2092.0) | 929.1 (495.7-1363.0)b | <0.0001 | 1546.0 (814.5-2277.0)a | 732.3 (456.2-1008.0)a | <0.0001 | ||
1106 (462.0-1751.0) | 1131 (539.3-1722.0) | 0.4867 |
Conclusion: To our knowledge, this is the first description of the circadian profile of salivary androgens, and age and sex differences, in healthy children. Testosterone was higher in boys than in girls, the converse was true for other androgens. The significant differences between sex, and age groups indicate that larger data sets are required to define reference data for children.