Evolution of the delta 4-adrenal androgens responsiveness in childhood during insulin test

Serum 11-beta-hydroxy-androstenedione (11OHAD), androstenedione (AD) and cortisol (F) were estimated during an i.v. insulin test in 2 large groups of normal prepubertal children and in normal adults. The results revealed that the basal level and responsiveness of AD were much lower in both groups of children than in adults whereas the corresponding 11OHAD data were similar or superior to those of adults. This suggests that during childhood the limited amount of adrenal AD is preferentially switched to the 11-hydroxylation step. Comparison of hormonal data observed in adults after i.v. insulin (mild ACTH stimulation) and a maximal stimulating dose of synacthen showed that the sensitivity of delta 4-3 keto-androgens pathway is inferior to that of F.