Dehydroepiandrosterone sulfate as an indicator of adrenal androgen function

This study was undertaken to determine whether serum dehydroepiandrosterone sulfate (DHEA-S) assays could be used in lieu of urinary 17-ketosteroid (17-KS) determinations. To delineate normal values, serum DHEA-S levels were measured in 41 normal women (controls). These averaged 1.78 +/- 0.1 (SE) micrograms/ml and ranged from 0.3 to 2.8 micrograms/ml. Serum DHEA-S and urinary 17-KS and creatinine were measured in 71 patients with and without signs of androgen excess who were attending the Reproductive Endocrinology/Infertility Clinic. Serum DHEA-S levels did not correlate with body weight, surface area, or ponderal index, and were not elevated in obese women without androgen excess. Both normal and elevated serum DHEA-S concentrations correlated well with total urinary 17-KS when corrected for creatinine (P < .0005). In another group of 26 patients, the 2 urinary 17-KS fractions androsterone (A) and dehydroepiandrosterone (DHEA) correlated well with serum DHEA-S levels, but the third urinary 17-KS fraction, etiocholanolone (E), did not correlate. Eleven of the 26 patients who had elevated serum DHEA-S concentrations excreted increased amounts of urinary A and DHEA but not E. It is concluded that serum DHEA-S levels are much more conveniently measured than urinary 17-KS and should replace the latter because DHEA-S is a better indicator of adrenal "androgen" secretion.