Reference intervals for serum 11-oxygenated androgens in children

Area of Science:

• Endocrinology
• Clinical Chemistry
• Pediatric Endocrinology

Background:

• Classic androgens are routinely measured for hyperandrogenism diagnosis in children.
• Adrenally-derived 11-oxygenated androgens also contribute to androgen levels but lack pediatric reference intervals.
• This gap hinders comprehensive assessment in pediatric hyperandrogenism.

Purpose of the Study:

• To develop and validate a serum assay for quantifying four 11-oxygenated androgens alongside four classic androgens.
• To establish pediatric reference intervals for these eight androgens.
• To enable improved clinical evaluation of hyperandrogenism in children.

Main Methods:

• A sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay was developed and validated.
• Serum samples from 256 healthy children (aged 0-17 years) were analyzed.
• Reference intervals were computed for prepubertal and pubertal age groups, considering observed age-dependency.

Main Results:

• The assay successfully quantified eight serum androgens, including four 11-oxygenated forms.
• Age-dependent variations were observed for all measured androgens.
• While some classic androgens showed sex differences in puberty, 11-oxygenated androgens did not exhibit significant sex differences in either prepubertal or pubertal groups.

Conclusions:

• A validated assay for 11-oxygenated androgens and classic androgens was established.
• Pediatric reference intervals for these androgens have been successfully determined.
• This work facilitates a more complete assessment of androgen status in pediatric hyperandrogenism.