Androstenedione

Androstenedione

Number

004705

CPT

82157

Related Information

5α-Androstane-3α, 17β-Diol Glucuronide, Serum

Dehydroepiandrosterone (DHEA)

Dehydroepiandrosterone (DHEA) Sulfate

Testosterone, Total, Serum

Synonyms

Delta⁴-Androstene,3,17-dione

Specimen

Serum or plasma

Volume

0.3 mL

Minimum Volume

0.2 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube, gel-barrier tube, or lavender-top (EDTA) tube

Collection

If tube other than a gel-barrier tube is used, transfer separated serum or plasma to a plastic transport tube.

Storage Instructions

Refrigerate

Patient Preparation

No isotopes administered 24 hours prior to venipuncture

Causes for Rejection

Gross hemolysis; recently administered radioisotopes; lipemia

Reference Interval

Pediatrics: See table.^1,2
Adults: male: 57-265 ng/dL, female: 47-268 ng/dL

Age	Male (ng/dL)	Female (ng/dL)
0-5 mo	5-45	5-35
6-11 mo	5-30	5-25
1-5 y	5-45	5-40
6-9 y	5-55	5-45
10-11 y	10-30	25-80
12-14 y	20-85	15-175
15-17 y	35-100	55-200
Tanner Stage
I (<7 y)	<35	<42
I (>7 y)	<49	<83
II	<89	<143
III	11-91	<152
IV	<219	28-252

Use

Evaluation of androgen production in hirsute females; less useful in evaluation of other aspects of virilization. Very elevated in congenital adrenal hyperplasia (adrenogenital syndrome) due to C21-hydroxylase deficiency.

Limitations

Poor correlation of serum levels with clinical severity

Methodology

Radioimmunoassay (RIA)

Additional Information

Androstenedione is a major precursor in the biosynthesis of androgens and estrogens. It serves as prohormone for testosterone and estrone, particularly in menopausal females. Androstenedione is produced in equal amounts by adrenal glands and ovaries in normal women.³ The predominant androgens in the female are androstenedione and dehydroepiandrosterone. Androstenedione is increased in cases of hirsutism, including Stein-Leventhal syndrome, and in other virilizing conditions as well as in congenital adrenal hyperplasia (adrenogenital syndrome), Cushing syndrome, ectopic ACTH-producing tumors, and ovarian hyperplasia of tumor. About 60% of cases of female hirsutism will show elevations of androstenedione. A marked diurnal variation exists, with a peak around 7 AM and a nadir around 4 PM. Levels rise sharply after puberty to peak at about age 20. An abrupt decline occurs after menopause.

Footnotes

Soldin SJ and Hicks JM, eds, Pediatric Reference Ranges, Washington, DC: AACC Press, 1995, 30.
Meites S, Buffone GJ, Cheng MH, et al, Pediatric Clinical Chemistry, Reference (Normal) Values, 3rd ed, Washington, DC: AACC Press, 1989, 56.
Watts NB and Keffer JH, “Adrenal Cortex,” Practical Endocrinology, 4th ed, Philadelphia, PA: Lea & Febiger, 1989, 91-120

References

Baxendale PM, Jacobs HS, and James VH, “Plasma and Salivary Androstenedione and Dihydrotestosterone in Women With Hyperandrogenism,” Clin Endocrinol (Oxf), 1983, 18(5):447-57.

Gompel A, Wright F, Kuttenn F, et al, “Contribution of Plasma Androstenedione to 5 Alpha-Androstanediol Glucuronide in Women With Idiopathic Hirsutism,” J Clin Endocrinol Metab, 1986, 62(2):441-4.

Holdaway IM, Croxson MS, Frengley PA, et al, “Clinical and Biochemical Evaluation of Patients With Hirsutism,” Aust N Z J Obstet Gynaecol, 1984, 24(1):23-9.

Klonoff DC, “Hirsutism,” Basic and Clinical Endocrinology, Greenspan FS and Forsham PH, eds, Los Altos, CA: Lange Medical Publications, 1983, 408-13.

Mahlck CG, Backstrom T, Kjellgren O, et al, “Plasma Progesterone and Androstenedione in Relation to Changes in Tumor Volume and Recurrence in Women With Ovarian Carcinoma,” Gynecol Obstet Invest, 1986, 22(3):157-64.

Ylikorkala O, Stenman UH, and Halmesmaki E, “Testosterone, Androstenedione, Dehydroepiandrosterone Sulfate, and Sex-Hormone-Binding Globulin in Pregnant Alcohol Abusers,” Obstet Gynecol, 1988, 71(5):731-5.