Androstenedione, LC/MS/MS 17182X Clinical Use Clinical Background • Diagnose hirsutism, polycystic Androstenedione is an androgenic ovarian disease, virilization, and steroid hormone produced by both the congenital adrenal hyperplasia adrenal cortex and the gonads. In males, the compound's activity is Test Alphabetical Reference Range relatively unimportant, compared with Section ng/dL the predominant testicular androgen Men testosterone. In females, andros- 18-30 y 50-220 tenedione–and the testosterone and 31-50 y 40-190 dihydrotestosterone to which it is 51-60 y 50-220 metabolized–normally contribute to Women the growth of sexually dependent Follicular 35-250 axillary and pubic hair. In women, the Midcycle 60-285 concentration of androstenedione Luteal 30-235 varies with the menstrual cycle, with Postmenopausal 20-75 the ovaries and adrenals contributing equally during the follicular phase. At Children mid-cycle, increased ovarian andros- 1-12 m 6-78 tenedione secretion accounts for 70% 1-4 y 5-51 of its overall production. 5-9 y 6-115 10-13 y 12-221 Excessive androstenedione production 14-17 y 22-225 may cause hirsutism and contribute to Tanner II-III virilization. This can occur in the polycystic ovary syndrome, idiopathic Males 17-82 hirsutism, ovarian and adrenal Females 43-180 neoplasms, and congenital adrenal Tanner IV-V hyperplasia due to 21-hydroxylase or Males 57-150 17β-hydroxylase deficiencies. In Females 7-68 hirsute patients with an elevated Pediatric data from J Clin Endocrinol Metab. androstenedione concentration, serial 1991;73:674-686 and J Clin Endocrinol Metab. measurements are useful to monitor 1989;69:1133-1136. therapy, since clinical improvement typically lags behind the biochemical Interpretive Information response by months. • Adrenal tumors • Cushing’s disease Method • Congenital adrenal hyperplasia • Liquid chromatography tandem mass spectrometry (LC/MS/MS) • Polycystic ovarian disease • Analytical sensitivity: 5 ng/dL • Idiopathic hirsutism Specimen Requirements • Addison's disease 1 mL refrigerated serum 0.25 mL minimum No additive red top tube SST red top unacceptable 25.