Dikkeschei L D, Willemse P H, Wolthers B G, de Ruyter-Buitenhuis A W, Nagel G T
Central Laboratory for Clinical Chemistry, University Hospital, Groningen, The Netherlands.
Clin Endocrinol (Oxf). 1993 Oct;39(4):475-82. doi: 10.1111/j.1365-2265.1993.tb02396.x.
We evaluated the role of delta-5-androstenediol (adiol) and its sulphates in health and endocrine diseases.
Serum and urine samples from healthy adult men and pre and post-menopausal women were analysed by gas chromatography-mass spectrometry to establish reference values. In patients who were either evaluated or treated for endocrine diseases, sequential serum samples were collected and analysed.
Reference values were obtained from 24 healthy male, 23 premenopausal and 30 post-menopausal female volunteers. Adiol and delta-5-androstenediol-3-sulphate (adiol-3S) concentrations were determined in combination with other relevant steroids in patients with either pituitary (n = 5), adrenal (n = 2) or gonadal dysfunction (n = 1), or testicular carcinoma (n = 19).
After addition of deuterated adiol as internal standard, serum and urine samples were extracted. Steroid sulphates were hydrolysed. The extracts and hydrolysates were purified on HPLC, adiol was derivatized and finally quantified by gas chromatography-mass spectrometry.
The calculated reference ranges for adiol and adiol-3S concentrations in serum are respectively: in men 1.78-7.24 and 123-579 nmol/l, in premenopausal women 0.65-6.93 and 21.2-298 nmol/l and in post-menopausal women 0.29-2.90 and 6.1-184 nmol/l. Urinary values varied considerably. In the population with endocrine abnormalities serum adiol and adiol-3S concentrations were compared with other relevant steroids.
The wide concentration range of adiol and adiol-3S in urine makes analysis of these steroids in urine of little clinical value. Serum concentrations of adiol and adiol-3S are higher in men than in women. Premenopausal values are higher than post-menopausal. Adiol and adiol-3S in serum are significantly correlated in pre and post-menopausal women, r = 0.51 and r = 0.69 respectively, but not in men. In endocrine patients the serum concentrations of adiol show an ACTH or LH dependency in women; adiol correlates with cortisol, dehydroepiandrosterone or androstenedione and, in males, additionally with testosterone. However, in several situations adiol correlates with none of these steroids. Although adiol secretion can be stimulated by ACTH and LH, the level of serum adiol is also determined by other factors. Finally, in adrenal carcinoma serum adiol and adiol-3S may be used as tumour markers.
我们评估了δ-5-雄烯二醇（adiol）及其硫酸盐在健康和内分泌疾病中的作用。
采用气相色谱-质谱法对健康成年男性以及绝经前和绝经后女性的血清和尿液样本进行分析，以确定参考值。对于接受内分泌疾病评估或治疗的患者，收集并分析连续的血清样本。
从24名健康男性、23名绝经前女性和30名绝经后女性志愿者中获取参考值。在患有垂体功能障碍（n = 5）、肾上腺功能障碍（n = 2）或性腺功能障碍（n = 1）或睾丸癌（n = 19）的患者中，将adiol和δ-5-雄烯二醇-3-硫酸盐（adiol-3S）浓度与其他相关类固醇联合测定。
加入氘代adiol作为内标后，对血清和尿液样本进行提取。将类固醇硫酸盐进行水解。提取物和水解产物在高效液相色谱上进行纯化，adiol进行衍生化，最后通过气相色谱-质谱法定量。
血清中adiol和adiol-3S浓度的计算参考范围分别为：男性为1.78 - 7.24和123 - 579 nmol/l，绝经前女性为0.65 - 6.93和21.2 - 298 nmol/l，绝经后女性为0.29 - 2.90和6.1 - 184 nmol/l。尿液值差异很大。在内分泌异常人群中，将血清adiol和adiol-3S浓度与其他相关类固醇进行比较。
尿液中adiol和adiol-3S的浓度范围广泛，使得对尿液中这些类固醇的分析临床价值不大。男性血清中adiol和adiol-3S的浓度高于女性。绝经前的值高于绝经后。绝经前和绝经后女性血清中的adiol和adiol-3S显著相关，r分别为0.51和0.69，但在男性中不相关。在内分泌疾病患者中，女性血清中adiol的浓度显示出对促肾上腺皮质激素（ACTH）或促黄体生成素（LH）的依赖性；adiol与皮质醇、脱氢表雄酮或雄烯二酮相关，在男性中还与睾酮相关。然而，在几种情况下，adiol与这些类固醇均无相关性。尽管ACTH和LH可刺激adiol分泌，但血清adiol水平也由其他因素决定。最后，在肾上腺癌中，血清adiol和adiol-3S可作为肿瘤标志物。
