| Research Abstract |
In the present study we developed a combination method of high-performance liquid chromatography(HPLC) and radioimmunoassay(RIA) to determine cortisol(F), 21-dehydroxycortisol(21DOF), 11-deoxycortisol(S), estrone(E_1), estradiol(E_2), androstenedione(A), dehydroepiandrosterone(DHEA), deoxycorticosterone(DOC), 17-hydroxypregnenolone(17OHPreg), 17-hydroxyprogesterone(17-OHP), testosterone(T), pregnenolone(Preg) and progesterone(P) simultaneously in one hundred microliters of serum, and performed the comprehensive analysis of steroid profiles in mature and premature infants and infants with congenital adrenal hyperplasia(CAH). No marked difference in these steroid hormones was observed between mature male and female infants. Serum concentrations of F in mature male and female were 270<plus-minus>17 and 240<plus-minus>21(M<plus-minus>S.D.)nM/L. In 3B-hydroxy-5-ene steroids (DHEA, 17-OHPreg, Preg), 17-OHPreg was highest (male 8.03<plus-minus>0.61, female 8.10<plus-minus>0.32(M<plus-minus>S.
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D.)nM/L.
It is remarkable that serum concentrations of Preg, P, 17-OHP, S and F, which are intermetabolites from Preg to F, were significantly higher in premature infants than in mature infants. Concentration of 17-OHP in premature infants (4.24.<plus-minus>O.45nM/L) was 1.6 times higher than that in mature infants(2.66<plus-minus>0.32nM/L). 3B-hydroxy-5ene steroids (Preg, 170HPreg, DHEA) were also high in premature infa
In patients with CAH, F was very low, while Prog, 170HProg, Preg, 17-OHPreg, DHEA, T, Ei, Ez and 21-DOF were all high. After treatment with F, in some patients T, EI,EZ and DHEA were still high allowing the possibility of the acceleration of bone development and external genitalia.
In conclusion, a combination of HPLC and RIA is useful for the precise diagnosis of premature infants and patients with CAH, and also for the follow up of the effects of the treatment in CAH. Steroid hormones determined in premature infants by this method revealed that the increase in 17-OHP is not due to a transient block of 21-hydroxylase deficiency but due to increased F precursor steroid synthesis produced under stressful condition. Less
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