Journal article

Publication year: 2014

Pages: 280-284

Journal: The Journal of Pediatrics

Volume number: 165

Issue number: 2

ISSN: 0022-3476

eISSN: 1097-6833

DOI Link: https://doi.org/10.1016/j.jpeds.2014.04.011

Publisher: Elsevier

Abstract: 

Objective To characterize the urinary steroid metabolome of neonates and infants born either at term or preterm.

Study design We retrospectively analyzed urinary steroid hormone metabolites determined by gas chromatography-mass spectrometry of 78 neonates and infants born at term and 83 neonates and infants born preterm (median 34 weeks of gestational age). The subjects' 11 beta-hydroxylase and 21-hydroxylase activities were assessed on the basis of urinary metabolite substrate-to-product ratios.

Results Preterm neonates and infants had elevated urinary concentrations of 17 alpha-hydroxyprogesterone (17OHP) metabolites (P < .001) but lower urinary concentrations of the 21-deoxycortisol metabolite pregnanetriolone (PTO) (P < .01). One reason was lower 11 beta-hydroxylase activity in preterms. We could demonstrate a correlation between low 11 beta-hydroxylase activity and high urinary concentrations of 17OHP metabolites (r = 0.51, P < .001) but low urinary concentrations of the 21-deoxycortisol metabolite PTO (r = -0.24, P = .03) in preterms.

Conclusions Low 11 beta-hydroxylase activity may explain increased 17OHP but decreased 21-deoxycortisol metabolite excretion in preterms. Our analysis clarifies, first, why preterms have higher 17OHP levels and thus higher rates of false-positive screening results for congenital adrenal hyperplasia than do term infants, and, second, why 21-deoxycortisol or its urinary metabolite PTO is more specific than 17OHP for the diagnosis of 21-hydroxylase deficiency.

Harvard Citation style: Kamrath, C., Hartmann, M., Boettcher, C. and Wudy, S. (2014) Reduced Activity of 11β-Hydroxylase Accounts for Elevated 17α-Hydroxyprogesterone in Preterms, The Journal of Pediatrics, 165(2), pp. 280-284. https://doi.org/10.1016/j.jpeds.2014.04.011

APA Citation style: Kamrath, C., Hartmann, M., Boettcher, C., & Wudy, S. (2014). Reduced Activity of 11β-Hydroxylase Accounts for Elevated 17α-Hydroxyprogesterone in Preterms. The Journal of Pediatrics. 165(2), 280-284. https://doi.org/10.1016/j.jpeds.2014.04.011