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Objectives. It was aimed to evaluate the relationship of Dehydroepiandrosterone-sulphate(DHEAS) level with pregnancy, fertility, abortion, ovarian reserve and endothelial functions. Patients and Method. Ninety-six fertile women aged 20-35 years whose DHEAS levels were measured and 28 women aged 40-55 years with oligomenorrheaamenorrhea were included in the study. The DHEAS values of the patients, which were measured at least 12 months apart, were recorded. Results. The first measured mean DHEAS level was 208.34±119.7ug/dL and the last measured mean DHEAS level was 187.5±101.7ug/dL. Among 28 patients with oligomenorrhea-amenorrhea, the levels of DHEAS increased in 10 patients and decreased in 18 patients. Although the annual decrease in DHEAS levels was greater in those who had pregnancy than in those who had not given birth, the difference was not statistically significant (p=0.085). Although the initial DHEAS level in 5 patients who had an abortion was higher than in those who did not have an abortion, the difference was not statistically significant (p=0.427). The increase in systolic blood pressure was statistically significant in patients with decreased DHEAS levels (p=0.03). While the mean DHEAS level was 85.3±47.3ug/dL in menopausal patients, the DHEAS level was 82.1±49.2ug/dL in non-menopausal patients (p=0.435). Conclusion. The age at which the DHEAS level reaches its peak level shows individual differences. While pregnancy slows down the decrease in DHEAS levels, abortion accelerates the decrease in DHEAS levels. A decrease in serum DHEAS levels can increase systolic blood pressure. [ABSTRACT FROM AUTHOR]

Objective:Dehydroepiandrosterone (DHEA) and its sulfate derivative DHEA-sulfate (DHEA-s) are major androgen hormones which are synthesis from the adrenal origin. The purpose of this study was to investigate DHEA-s levels in male patients with idiopathic hypogonadotropic hypogonadism (IHH) and to determine whether DHEA-s level are a useful marker for diagnosis of IHH.Methods:A total of 91 subjects, 31 males with IHH (mean age 19.7±2.6 years) and 60 healthy males (mean age 20.7±2.6 years), were enrolled in this study. The patients with IHH were selected from the subjects who had not yet started treatment for hypogonadism and who had no additional disease, while the healthy control group consisted entirely from individuals admitted to the same hospital outpatient clinic for routine check-ups. Both groups’ blood sampling, anthropometric measures, and physical examination were undertaken.Results:Mean DHEA-s level was 133.4±56.5 μg/dL in the IHH group and 433.3±160.3 μg/dL in the control group (p=0.000). The low DHEA-s level in patients with IHH was independent of age, cortisol, and adrenocorticotropic hormone (ACTH) at multivariate logistic regression analysis. The ROC analysis showed that DHEA-s ≤38.2 μg/dL supports a diagnosis of IHH with 100% specificity and 100% sensitivity. DHEA-s was as predictive as total testosterone which is used in the diagnosis of patients with IHH.Conclusion:DHEA-s level was significantly lower in the males with IHH compared to controls. Therefore, DHEA-s may be a potential predictive marker for diagnosis of IHH.

The pharmacological treatment of benign prostatic hyperplasia involves the use of mainly two groups of drugs: selective alpha 1 blocker and 5 alpha reductase inhibitors (5ARI). In patients who undergo 5ARI pharmacotreatment, adverse effects such as sexual disturbances such as erectile dysfunction and decreased libido may occur. The purpose of this study is to investigate the occurrence of these side effects, particularly erectile dysfunction in order to predict and overcome them more easily. We conducted a controlled prospective pharmaco-epidemiological study to evaluate the side effects with the use of 5ARI in 250 men with benign prostatic hyperplasia (BPH). Erectile function was assessed at the time of the initiation of therapy and at the time of active use of therapy in two consecutive periods of 6 months and 12 months. We evaluated two groups of patients: the control group of patients treated with alpha 1 blocker (tamsulosin), and the investigated group of patients treated with combination therapy of alpha 1 blocker (tamsulosin) and 5 alpha reductase inhibitors (dutasteride). The evaluation was conducted through questionnaires: IPSS (International Prostate Score System) to calculate the symptoms of benign prostatic hyperplasia (light, medium or severe) and IIEF-5 (International Index for Erectile Function-5) questionnaire for calculating erectile function. During the study measurement of serum levels of testosterone and dehydroepiandrosterone sulphate were performed respectively. Statistical results of nonparametric group analysis showed that erectile dysfunction appeared in 27 patients (22.5%) in the investigated group after 6- and 12-months therapy respectively which was statistically significant (p<0,05). Twenty six of these patients (96,3%) have had lowered testosterone and dehydroepiandrosterone sulphate serum levels (p<0,05). As a conclusion we recommend investigation of testosterone and DHEAS serum levels prior to starting therapy should be considered valuable in order to avoid 5ARI related erectile dysfunction. [ABSTRACT FROM AUTHOR]

The aim of the present pilot study was to determine the allostatic load by analysing the hair cortisol and dehydroepiandrosterone‑sulphate (DHEA‑S) of commercial pigs belonging to different farms having good overall animal welfare according to the CREnBA (Centro di Referenza Nazionale per il Benessere Animale – Brescia, Italy) assessment protocol. The study was conducted on 86 pigs belonging to three farms with a grade higher than 8 on the CReNBA welfare evaluation system. Hair samples were taken by shaving on sows 1‑10 days after weaning (Farms 1 and 2) and at the age of 8‑10 months (Farm 3). The hormone concentrations were measured by radioimmunoassay. From the box plots, it is evident that the hair cortisol concentrations of animals were different between farms. Conversely, the variability of the hair DHEA‑S concentration was similar between the F1 and F2 farms but much lower at F3. For all the variables considered (cortisol, DHEA‑S and cortisol/DHEA‑S ratio), F2 showed a higher hair concentration level than F1 (P < 0.05). The study’s results indicate that the measurement of cortisol and DHEA‑S in pig hair shows a different allostatic load between them, although the official welfare evaluation method assessed the farms as having good overall animal welfare.

• DHEAs is routinely measured in clinical laboratories using immunoassay methodology but suffers from poor specificity. • LC-MSMS represents a more specific method with which to measure steroids. • Use of LC-MSMS methodology improves DHEAs specificity particularly in the immediate new-born period. • We report a paediatric reference range for DHEAs. The measurement of dehydroepiandrosterone-sulphate (DHEAs) is an important second-line test to aid in the diagnosis of premature adrenarche, peripubertal gynaecomastia in males and in identifying the source of elevated androgens in females. Historically, DHEAs has been measured by immunoassay platforms which are prone to poor sensitivity and more importantly poor specificity. The aim was to develop an LC-MSMS method for the measurement of DHEAs in human plasma and serum, develop an in-house paediatric (<6 year old) reference limit and compare the performance against the Abbott Alinity DHEAs immunoassay method. Following pre-treatment with an internal standard, samples were loaded onto EVOLUTE® EXPRESS ABN plate. Analytes were separated with reverse-phase chromatography using ACQUITY® UPLC® HSS T3 2.1 mm × 50 mm, 1.8 μm column. Mass spectrometry detection was performed using a Waters® Xevo TQ-XS in electrospray negative mode. For the paediatric reference range, samples were collected from an inpatient setting (age ≤ 6 years old) with no evidence of adrenal dysfunction or history of/current steroid use. The method comparison was performed using samples from this cohort aged between 0 and 52 weeks. The assay demonstrated linearity up to 15 µmol/L (r2 > 0.99) with a functional sensitivity of 0.1 µmol/L. Accuracy results revealed a mean bias of 0.7% (−14% to 15%) when compared against the NEQAS EQA LC-MSMS consensus mean (n = 48). The paediatric reference limit was calculated as ≤ 2.3 µmol/L (95% C.I. 1.4 to 3.8 µmol/L) for ≤ 6 year olds (n = 38). Comparison of neonatal (<52 weeks) DHEAs with the Abbott Alinity revealed that the immunoassay ran at a 166% positive bias (n = 24) which appeared to lessen with increasing age. Described is a robust LC-MSMS method for the measurement of plasma or serum DHEAs validated against internationally recognised protocols. Comparison of paediatric samples of <52 weeks against an immunoassay platform demonstrated that in the immediate new-born period results generated from the LC-MSMS method offer superior specificity than an immunoassay platform. [ABSTRACT FROM AUTHOR]

This study assessed sexual orientation and psychobiological stress indices in relation to salivary sex hormones as part of a well-validated laboratory-based stress paradigm. Participants included 87 healthy adults that were on average 25 years old who self-identified as lesbian/bisexual women ( n = 20), heterosexual women ( n = 21), gay/bisexual men ( n = 26), and heterosexual men ( n = 20). Two saliva samples were collected fifteen minutes before and fifteen minutes after exposure to a modified Trier Social Stress Test to determine testosterone, estradiol, and progesterone concentrations via enzyme-immune assaying. Mean sex hormones were further tested in association to stress indices related to cortisol systemic output (area under the curve with respect to ground) based on ten measures throughout the two-hour visit, allostatic load indexed using 21 biomarkers, and perceived stress assessed using a well-validated questionnaire. Results revealed that lesbian/bisexual women had higher overall testosterone and progesterone concentrations than heterosexual women, while no differences were found among gay/bisexual men in comparison to heterosexual men. Lesbian/bisexual women and heterosexual men showed positive associations between mean estradiol concentrations and allostatic load, while gay/bisexual men and heterosexual women showed positive associations between mean testosterone and cortisol systemic output. In summary, sex hormone variations appear to vary according to sexual orientation among women, but also as a function of cortisol systemic output, allostatic load, and perceived stress for both sexes. [ABSTRACT FROM AUTHOR]

Adrenal incidentaloma is a clinically unapparent adrenal mass more than one cm in diameter detected during imaging performed not for adrenal disease. A 34-year-old man was evaluated for AI with a diameter of 3.5 cm in the left adrenal. He was obese with body mass index of 33,9. Blood pressure was 110-120/90 mmHg. The general laboratory tests were unremarkable. An adrenal hormone screening set revealed that ACTH was 6.9 pg/mL, cortisol 14.9 μg/dL, renin activity 0.9 ng/mL/h, aldosterone 79.4 pg/mL, dehydroepiandrosterone-sulfate (DHEA-S) measured on two occasions 5,217 ng/mL and 6,477 ng/mL (gender- and age-adjusted reference values, 1,060-4,640 ng/mL). The levels of metanephrine and normetanephrine were normal. The tumor was thought to produce solely DHEA-S. The excised left adrenal tissue contained a tumor with a diameter of 26 mm and neighboring adrenal tissue. The tumor consisted mostly of acidophil cells without necrosis, capsular or vascular invasion, and mitosis. Immunohistochemical study revealed followings: the cells of the tumors were stained positive for 3β-hydroxysteroid dehydrogenase, and 17α-hydroxylase, and 11β-hydroxylase, weakly positive for DHEA sulphotransferase, and negative for aldosterone synthetase. The atrophy of neighboring tissue was presumably caused by excess cortisol production. Four months after surgery, the cortisol level was 11.2 μg/dL and DHEA-S level 1,462 ng/mL. The tumor is considered to be a cortisol-producing adenoma with modestly excessive DHEA-S production rather than isolated DHEA-S-producing adenoma. Immunohistochemical study of steroidogenic enzymes is a valuable addition to blood hormone measurement to clarify steroid production profile.

Summary: There is a well-established link between dysphoric mood and endocrine dysregulation, but the strength of this association may vary with age. In order to investigate this possibility we assessed anxiety and depression with overnight urinary cortisol and plasma dehydroepiandrosterone-sulphate (DHEAS) in 608 factory employees ranging between 21 and 62 years. As expected, DHEAS declined with age (r =−0.54, P <0.001) while there was a modest age-related increase in nocturnal cortisol (r =0.17, P <0.001). Depressive symptoms were associated with higher nocturnal cortisol (β =0.19, P <0.001), independent of age. While the association between anxiety and cortisol (age by anxiety interaction: β =0.11, P <0.05) became stronger with age, there was a similar decline in the DHEAS/cortisol ratio in high-anxious middle-aged adults (β =−0.10, P =0.018). The current findings suggest that dysphoric mood, and in particular anxiety, may exacerbate the effects of aging on cortisol release. Prospective studies are needed to determine the causal relations between dysphoric mood, cortisol and DHEAS across the lifespan. [ABSTRACT FROM AUTHOR]

Background: Weak androgens have an antioxidant effect in vitro which is represented as a beneficial change in the antioxidant status. Objective: Our aim was to clarify whether dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulphate (DHEAS) oral administration results in beneficial antioxidant changes in Sprague-Dawley adult male rats in vivo. Methods: Groups of experimental animals were fed a high-fat or a normal-fat diet and treated with DHEA or DHEAS in the drinking fluid. The control group was fed a high-fat diet together with untreated drinking fluid. Total scavenger capacity (TSC) was measured before and after 4 weeks of treatment in blood samples using a chemiluminometric assay. Fat content, superoxide dismutase (SOD), catalase and glutathione S-transferase (GST) activity in the liver were determined by Sudan staining and spectrophotometric assessments, respectively, from the fresh frozen tissue. Results: DHEA and the DHEAS treatment showed significantly increased TSC in the groups fed a high-fat diet. The control group and the DHEA- or DHEAS-treated groups on normal diets showed no significant changes in TSC. The total score of liver fat content in the high-fat diet groups showed a marked positivity with Sudan staining, and the groups treated with DHEA or DHEAS had a markedly decreased amount of fat in the liver slides compared to the untreated group on the high-fat diet. Liver SOD activity was decreased in all high-fat diet groups and elevated only in the groups on a normal diet with DHEA or DHEAS treatment. Liver catalase and GST activities were decreased in the groups where TSC was significantly increased. Conclusion: Our results support the hypothesis that DHEA and DHEAS supplementation can improve the antioxidant status in lipid-rich dietary habits. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Nineteen female adolescent inpatients diagnosed with anorexia nervosa, restricting type (AN-R) and 16 non-eating disordered (ED) controls were assessed for plasma dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulphate (DHEA-S), and cortisol levels, and for eating-related and non-eating-related psychopathology. AN-R patients were assessed at admission, 1 month and 4 months following hospitalization. The non-ED controls were assessed once. No baseline between-group differences were found in plasma cortisol, DHEA, and DHEA-S levels, whereas the patient group had a significantly lower Cortisol/DHEA-S ratio and elevated scores on most psychopathological parameters. A significant increase was found in the body mass index of the AN-R patients at 4 months post-hospitalization, accompanied by a decrease in plasma cortisol levels and a trend towards decreased Cortisol/DHEA and Cortisol/DHEA-S ratios, whereas no change occurred in psychopathology. The difference in Cortisol/DHEA-S ratio between AN-R patients and non-ED controls, and the different patterns of change in cortisol vs. DHEA(-S) levels following weight restoration, may in part account for the feeding difficulties in AN, particularly during refeeding. [Copyright &y& Elsevier]

Metabolic control analysis predicts that effects on tumor growth are likely to be obtained with lower concentrations of drug, if an enzyme with a high control coefficient on tumor growth is being inhibited. Here we measure glucose-6-phosphate dehydrogenase (G6PDH) control coefficient on in vivo tumor growth using mice bearing Ehrlich ascites tumor cells. We used dehydroepiandrosterone-sulphate (DHEA-S), an uncompetitive inhibitor of this enzyme and the in situ cytochemical method to measure the enzyme activity changes that accompany changes on tumor cell growth. This method ensures that the enzyme activity determined is the one existing in the in situ conditions and enables computing a control coefficient in in situ conditions. From the data obtained on tumor cell number and the in situ enzyme activities in absence and presence of DHEA-S, a control coefficient of 0.41 for G6PDH on tumor cell growth was computed. This value is approximately the half of the transketolase control coefficient value of 0.9 previously reported. Moreover, the use of in situ methods to assess enzyme activities, applied for first time for the calculation of control coefficients in this study, opens new avenues to the use of uncompetitive inhibitors for the measurement of in situ control coefficients. [ABSTRACT FROM AUTHOR]

This study examines whether changes in the cytokine milieu of patients with systemic lupus erythematosus (SLE) are associated with abnormal levels of sex hormone levels in serum.'The'con"centration of 17β-estradiol (E2), progesterone (Pg) and dehydroepiandrosterone-sulphate (DHEAS) was monitored in sera from 128 lupus patients and 96 controls, and correlated with the activity of their cytokine secreting cells. Results indicate that SLE patients have (i) significantly fewer cells secreting IFNγ, (ii) increased serum E2 and Pg levels, and (iii) reduced serum DHEAS levels compared to normal controls. However, the observed abnormalities in the cytokine milieu of SLE patients did not correlate with abnormalities in serum sex hormone levels. Instead, the association between IFNγ production and DHEAS levels evident in healthy controls is absent in SLE patients, suggesting that cells from lupus patients are defective in their ability to produce IFNγ in response to physiologic stimuli. Similarly, the normal correlation between IL-4 production and E2 levels was lost in patients with severe disease. Thus, while it remains possible that increased E2 and reduced DHEAS levels in lupus patients may help induce cytokine abnormalities early in disease, the subsequent cytokine imbalance does not correlate with sex hormone levels. [ABSTRACT FROM AUTHOR]

Background & Objectives: : Adrenal insufficiency (AI) is rarely diagnosed in patients with HIV infection, in spite of autopsy studies showing very high rates of adrenal involvement. This study was aimed to determine the presence, patterns and predictors of AI in patients with HIV infection., Methods: : Consecutive HIV patients, 18-70 yr age, without any severe co-morbid state, having at least one-year follow up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays., Results: : From initially screened 527 patients, 359 patients having good immune function were analyzed. Basal morning cortisol <6 μg/dl (<165 nmol/l; Group 1), 6-11 μg/dl (165-300 nmol/l; Group 2), 11-18 μg/dl (300-500 nmol/l; Group 3) and ≥18 μg/dl (500 nmol/l; Group 4) were observed in 13, 71, 199 and 76 patients, respectively. Adrenocorticotropic hormone (ACTH) stimulation test revealed 87 patients (24.23%) to have AI. AI in groups 1-4 was 100, 56.34, 17.09 and 0 per cent, respectively. AI patients were more likely to be females (P< 0.05), having longer disease duration (P< 0.05), immune reconstitution inflammatory syndrome, hyperkalaemia (P< 0.01), lower fasting glucose (P< 0.01), dehydroepiandrosterone sulphate (DHEAS) and vitamin D. Regression analysis revealed morning cortisol and DHEAS to be best predictors of AI (P=0.004 and 0.028, respectively)., Interpretation & Conclusions: : AI is a significant problem in HIV-infected individuals, observed in nearly a quarter of patients. Diagnosis warrants high index of suspicion and low threshold for screening, especially in those having low DHEAS and hyperkalaemia. Morning cortisol is a reasonable screening test, with ACTH stimulation warranted to confirm diagnosis, especially in patients with morning cortisol <11 μg/dl (300 nmol/l)., Competing Interests: None