Androstenedione

Androstenedione

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Androstenedione production in the adrenal glands is under effect of the adrenocorticotropic hormone (ATCH), whereas in the gonadal is controlled by the luteinizing hormone/follicle-stimulating hormone (LH/FSH). Each laboratory has its own reference range for androstenedione, depending on the assay. The table below shows the reference ranges.^[1]

Table 1. Androstenedione Reference Ranges (Open Table in a new window)

Conventional Units

SI Units

Men

18-30 y

50-220 ng/dL

175-768 nmol/L

31-50 y

40-190 ng/dL

140-663 nmol/L

51-60 y

50-220 ng/dL

175-768 nmol/L

Women

Follicular

35-250 ng/dL

122-873 nmol/L

Midcycle

60-285 ng/dL

209-995 nmol/L

Luteal

30-235 ng/dL

105-820 nmol/L

Postmenopausal

20-75 ng/dL

70-262 nmol/L

Children

1-12 mo

6-78 ng/dL

21-272 nmol/L

1-4 y

5-51 ng/dL

17-178 nmol/L

5-9 y

6-115 ng/dL

21-401 nmol/L

10-13 y

12-221 ng/dL

42-771 nmol/L

14-17 y

22-225 ng/dL

77-785 nmol/L

Tanner II-III

Male

17-82 ng/dL

59-286 nmol/L

Female

43-180 ng/dL

150-628 nmol/L

Tanner IV-V

Male

57-150 ng/dL

199-523 nmol/L

Female

7-68 ng/dL

24-237 nmol/L

Androstenedione is increased in the following:

Polycystic ovarian syndrome (PCOS)^[2]

Congenital adrenal hyperplasia (CAH)

21-hydroxylase deficiency

17β-hydroxysteroid dehydrogenase

Androgen-secreting tumors of the ovary and adrenal gland

Androstenedione is decreased in the following:

A rare form of CAH

17α-hydroxylase/17,20-lyase deficiency (the enzyme is also called P450c17 or CYP17)

Collection details are as follows:

Patient instruction – No need for fasting

Specimen type – Serum

Collection tube – Red-top tube or Lavender-top (EDTA) tube

Unacceptable conditions – Grossly hemolyzed specimens or gross lipemia

Specimen preparation – Separate serum from cells and transfer to transport tube

Storage/transport temperature – Refrigerated

Stability – Refrigerated: 2 weeks; Frozen: 2 weeks

Panels: None

A new method has been developed that simultaneously measures serum testosterone, androstenedione, and DHEA in serum and plasma.^[3]

Androstenedione is a C-19 (19 carbon atoms) steroid hormone found in men as well as in premenopausal women. Androstenedione originates in the gonads, with minor contribution from the adrenal glands (1.5-3 mg/day); in postmenopausal women, the adrenal gland constitutes the major source of this hormone. Androstenedione production in the adrenal glands is under effect of the adrenocorticotropic hormone (ATCH), whereas in the gonadal is controlled by the luteinizing hormone/follicle-stimulating hormone (LH/FSH).^{[4, 5, 6]}

Androstenedione is a biologically inert hormone; in the peripheral tissues like skin and adipose tissue, it can be converted to estrone or testosterone.

Androstenedione can be measured in conjunction with other hormones for the following:

In the diagnosis and differential diagnosis of hyperandrogenism and PCOS

In the diagnosis and treatment monitoring of CAH

In the diagnosis of premature adrenarche

Appendix: Normal Hormone Reference Ranges. Greenspan’s Basic & Clinical Endocrinology. 9th Edition. McGraw-Hill Companies; 2011.

Cinar N, Cetinozman F, Aksoy DY, Elcin G, Yildiz BO. Comparison of adrenocortical steroidogenesis in women with post-adolescent severe acne and polycystic ovary syndrome. J Eur Acad Dermatol Venereol. 2014 Aug 29. [Medline].

Büttler RM, Martens F, Kushnir MM, Ackermans MT, Blankenstein MA, Heijboer AC. Simultaneous measurement of testosterone, androstenedione and dehydroepiandrosterone (DHEA) in serum and plasma using Isotope-Dilution 2-Dimension Ultra High Performance Liquid-Chromatography Tandem Mass Spectrometry (ID-LC-MS/MS). Clin Chim Acta. 2014 Aug 27. 438C:157-159. [Medline].

Achemann JA, Hughes IA. Disorders of Sex Development. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Company; 2011. Chapter 23.

Stewart PM, Krone NP. The Adrenal Cortex. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Company; 2011. Chapter 15.

Bulun SE. Physiology and Pathology of the Female Reproductive Axis. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Company; 2011. Chapter 17.

Conventional Units

SI Units

Men

18-30 y

50-220 ng/dL

175-768 nmol/L

31-50 y

40-190 ng/dL

140-663 nmol/L

51-60 y

50-220 ng/dL

175-768 nmol/L

Women

Follicular

35-250 ng/dL

122-873 nmol/L

Midcycle

60-285 ng/dL

209-995 nmol/L

Luteal

30-235 ng/dL

105-820 nmol/L

Postmenopausal

20-75 ng/dL

70-262 nmol/L

Children

1-12 mo

6-78 ng/dL

21-272 nmol/L

1-4 y

5-51 ng/dL

17-178 nmol/L

5-9 y

6-115 ng/dL

21-401 nmol/L

10-13 y

12-221 ng/dL

42-771 nmol/L

14-17 y

22-225 ng/dL

77-785 nmol/L

Tanner II-III

Male

17-82 ng/dL

59-286 nmol/L

Female

43-180 ng/dL

150-628 nmol/L

Tanner IV-V

Male

57-150 ng/dL

199-523 nmol/L

Female

7-68 ng/dL

24-237 nmol/L

Georges Elhomsy, MD, ECNU, FACE Assistant Professor of Medicine, University of Kansas School of Medicine-Wichita

Georges Elhomsy, MD, ECNU, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, American College of Physicians, Endocrine Society, The Obesity Society

Disclosure: Received income in an amount equal to or greater than $250 from: Corcept and Novo-nordisk .

Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital

Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology

Disclosure: Nothing to disclose.

Androstenedione

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