Plasma androgens in childhood and adolescence.
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Biomedical subjects
Publications and source records attributed to S D Frasier.
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The plasma concentration, production rate, and conversion ratio of androstenedione and testosterone were studied in seven children with congenital adrenal hyperplasia (CAH) of the 21-hydroxylase type. Plasma androstenedione and testosterone measured by double isotope derivative assay and estimated blood production rates were manyfold increased in the untreated state, markedly suppressed with glucocorticoid, and increased after the administration of ACTH. The metabolic clearance rate when corrected for body size and the conversion ratio of androstenedione to testosterone were similar to previously determined values in normal adults. Consideration of the androgen concentrations and conversion ratios indicates that in children with CAH, 76% of the plasma testosterone in prepubertal females and 36% in males are derived from peripheral conversion of blood androstenedione. The calculated amount of testosterone unaccounted for by peripheral conversion is similar to normal prepubertal values. This approach indicates that virilization in these children results from increased levels of testosterone but that the major source in CAH of this potent androgen is androstenedione secreted by the adrenal cortex.
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The 24-hour urinary excretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH) was determined for 30 days in an 8.3-year-old girl with isosexual precocity and for 25 days in a normal 11.9-year-old girl. The pattern of daily variation in urinary LH and FSH excretion observed in the girl with sexual precocity was similar to that of the normal menstrual cycle. The LH and FSH midcycle peaks were 132.5 IU/24 hours and 26.3 IU/24 hours, respectively. Excluding the midcycle peak, the daily excretion of LH was 28.4 +/- 9.3 (SD) IU/24 hours, and the excretion of FSH was 8.9 +/- 1.9 (SD) IU/24 hours, values comparable to those of normal adult females. In contrast, the daily excretion of LH in the normal 11.9-year-old girl was 6.9 +/- 1.1 (SD) IU/24 hours and FSH excretion was 3.9 +/- 0.9 (SD) IU/24 hours. No LH or FSH surge was observed. The data are consistent with early maturation of the hypothalamic-pituitary-gonadal axis in idiopathic isosexual precocity.
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