Prospective and Descriptive Study on Serum Androstenedione Concentration in Healthy Children from Birth until 18 Years of Age and Its Associated Factors

Abstract

Introduction. Androstenedione (A4) is an adrenal and gonadal steroid biomarker, useful in the assessment of children in whom steroidogenic disorders are suspected. The first key step in the evaluation of a diagnostic test resides on confident reference intervals (RI). The lack of updated A4-RI with current methods in pediatrics may mislead A4 results and limit its diagnosis accuracy.Aim. To provide A4 reference ranges in healthy children.Methods. Prospective, descriptive study. 283 children aged 4 days to 18 years were included. Inchildren<1 yr, A4 was measured directly in serum (NE-A4) and postorganic solvent extraction (E-A4) for the assessment of interfering steroids. The influence of chronological age (CA), gender, and Tanner stage (T) were investigated.Results. In the neonatal period, E-A4 was significantly lower than NE-A4; boys had higher NE-A4; sexual dimorphism disappeared after extraction procedure. In children older than 4 months, A4 concentration remained low until the age of 5 years. Thereafter, A4 increased significantly in association with CA and T (r2=0.65;p<0.001), obtaining the highest concentrations in children within pubertal ages without sexual dimorphism.Conclusion. We recommend to perform solvent extraction in neonates and to take into account age and sexual development to properly interpret A4 results in childhood.