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Androstenedione, Serum


Definition


  • Androstenedione, also known as 4-androstenedione, is a 19-carbon steroid hormone produced in the adrenal glands and the gonads (testes as well as ovaries) as an intermediate step in the biochemical pathway that produces the androgen testosterone and the estrogens estrone and estradiol. It is a major adrenal androgen in serum.
  • Normal range: 0.0 " “4.4 ng/mL (see Table 16.4).

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TABLE 16 " “4Normal Ranges for Serum AndrostenedioneView LargeTABLE 16 " “4Normal Ranges for Serum Androstenedione Age/Tanner Stage Female (ng/mL) Male (ng/mL) 7 " “9 y 0.0 " “0.9 0.0 " “0.8 10 " “11 y 0.0 " “3.0 0.0 " “1.3 12 " “13 y 0.4 " “3.4 0.0 " “1.6 14 " “15 y 0.7 " “4.3 0.4 " “2.9 16 " “17 y 0.9 " “4.1 1.1 " “3.1 18 " “40 y 0.5 " “4.3 0.9 " “2.9 ≥41 y 0.4 " “2.7 0.8 " “2.2 Postmenopausal women <1.0 Tanner stage I <1.6 <0.9 Tanner stage II <2.2 <1.4 Tanner stage III 0.6 " “4.4 <2.6 Tanner stage IV " “V 0.9 " “3.8 1.0 " “3.0

Use


  • Diagnosis of virilism and hirsutism
  • Suspicion of anabolic steroid abuse

Interpretation


Increased In


  • CAH caused by 21-hydroxylase deficiency; marked increase is suppressed to normal levels by adequate glucocorticoid therapy.
    • Suppressed level reflects adequacy of therapeutic control.
    • Androstenedione may be better than 17-hydroxyprogesterone for monitoring therapy because it shows minimal diurnal variation, better correlation with urinary 17-KS excretion, and plasma levels that are not immediately affected by a dose of glucocorticoid.
  • Adrenal tumors
  • Cushing disease
  • Polycystic ovarian disease

Decreased In


  • Addison disease
  • Any condition that causes partial or complete adrenal or gonadal failure
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