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Scalp hair 17‐hydroxyprogesterone and androstenedione as a long‐term therapy monitoring tool in congenital adrenal hyperplasia
Author(s) -
Noppe Gerard,
Rijke Yolanda B.,
Koper Jan W.,
Rossum Elisabeth F.C.,
Akker Erica L.T.
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13078
Subject(s) - androstenedione , scalp , congenital adrenal hyperplasia , medicine , endocrinology , hair loss , glucocorticoid , cabello , androgen , dermatology , hormone
Summary Background Glucocorticoid replacement therapy in congenital adrenal hyperplasia ( CAH ) is challenging, especially in children, because both over‐ and under‐dosing may have profound and long‐lasting adverse effects. Clinical follow‐up parameters are largely nonspecific and slow to develop. Steroid concentrations in scalp hair may be a useful monitoring tool, as it provides information on both long‐term steroid precursor and glucocorticoid exposure. Aim We aimed to evaluate scalp hair steroid precursor concentrations as a monitoring tool for treatment follow‐up in children with CAH . Methods Scalp hair 17‐hydroxyprogesterone (17‐ OHP ) and androstenedione concentrations, measured by LC ‐ MS / MS , of children with CAH ( N = 26) were correlated with concentrations in serum and saliva, and compared to scalp hair concentrations in patient controls with adrenal insufficiency ( AI ) ( N = 12) and healthy controls ( N = 293). Results Hair cortisol concentrations were higher in children with CAH , compared to both healthy controls ( P < 0·001) and patient controls ( P = 0·05), and did not differ significantly between patient controls with AI and healthy controls. Concentrations of androstenedione in scalp hair were strongly correlated with concentrations in serum (ρ = 0·72, P < 0·001) and saliva (ρ = 0·82, P = 0·002). This was also seen for 17‐ OHP in hair with serum (ρ = 0·94, P < 0·001) and saliva (ρ = 0·69, P = 0·009). Both hair 17‐ OHP and androstenedione were higher in CAH patients (mean concentration 17‐ OHP 2·9 pg/mg; androstenedione 1·3 pg/mg), when compared to healthy controls (17‐ OHP 0·44 pg/mg; androstenedione 0·65 pg/mg) and when compared to patients with AI (17‐ OHP 0·12 pg/mg; androstenedione 0·32 pg/mg). Conclusion This study shows that scalp hair 17‐hydroxyprogesterone and androstenedione concentrations seem to be a promising parameter for treatment monitoring in patients with CAH .