Newcastle Laboratories

Androstenedione, serum

Clinical Background:

Androstenedione, the precursor of testosterone is an androgenic (C19) steroid secreted by the adrenal cortex, the ovary and the testes. It binds very weakly to sex hormone binding globulin (SHBG) a...

Androstenedione, the precursor of testosterone is an androgenic (C19) steroid secreted by the adrenal cortex, the ovary and the testes. It binds very weakly to sex hormone binding globulin (SHBG) and likewise with low affinity to albumin. Androstenedione and testosterone are interconvertible; in the female around 60% of plasma testosterone is derived from peripheral conversion of androstenedione. In the testes, ovaries and adrenals, androstenedione and testosterone are precursors of the oestrogen (C18) steroids. Peripheral conversion of androgens to oestrogens may also occur.
Measurement of androstenedione may be useful in the investigation of hyperandrogenism. Elevated androstenedione concentrations can cause symptoms or signs of hyperandrogenism in women. Men with raised androstenedione may be asymptomatic, but through peripheral conversion of androgens to oestrogens can occasionally experience mild symptoms of oestrogen excess. Mild elevations in androstenedione may be idiopathic. However, pronounced elevations of androstenedione may be indicative of androgen-producing adrenal or gonadal tumours. In children, adrenal and gonadal tumours are uncommon, but many forms of congenital adrenal hyperplasia can lead to increased serum androstenedione concentrations. Diagnosis always requires measurement of other androgen precursors in addition to androstenedione.

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Test Details

  • Discipline:

    Biochemistry

    Biochemistry

  • Specimen Container Adult:

    Serum-SST

    Serum-SST

  • Specimen Container Paediatric:

    Serum-Plain tube

    Serum-Plain tube

  • Minimum Volume Adult:

    1 mL blood

    1 mL blood

  • Minimum Volume Paediatric:

    1 mL blood

    1 mL blood

  • Sample Stability:

    Unseparated: day of collection

    Separated:

    4 days at 4-8°C,

    1 year at -20°C

    Unseparated: day of collection

    Separated:

    4 days at 4-8°C,

    1 year at -20°C

  • Transport Requirements:

    Ambient temperature

    Ambient temperature

  • Interpretation:

    Elevated androstenedione concentrations indicate increased adrenal or gonadal androgen production. Mild elevations in adults may be idiopathic, or related to conditions such as polycystic ovarian s...

    Elevated androstenedione concentrations indicate increased adrenal or gonadal androgen production. Mild elevations in adults may be idiopathic, or related to conditions such as polycystic ovarian syndrome (PCOS) in women. However, higher concentrations can suggest the presence of an androgen-secreting adrenal, or less commonly, gonadal tumour. Androstenedione levels are elevated in many patients with benign androgen-producing adrenal tumours. Most androgen-secreting adrenal carcinomas also exhibit elevated androstenedione levels and often elevations in 17-alpha-hydroxyprogesterone (17OHP) and dehydroepiandrosterone sulfate (DHEA-S). Most androgen-secreting gonadal tumours produce androstenedione as well as testosterone.

    Diagnosis and differential diagnosis of congenital adrenal hyperplasia (CAH) always requires the measurement of several steroids. Patients with CAH due to 21-hydroxylase deficiency usually have very high serum concentrations of androstenedione. 17OHP concentrations are usually even higher. In the much less common 11-beta-hydroxylase deficiency, androstenedione levels are elevated but 17OHP is usually only mildly, if at all, elevated. Androstenendione may be measured alongside 17OHP and testosterone to monitor the treatment of CAH, where normalisation of androgen concentrations is a goal.

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  • Reference Ranges:


    Pre-puberty (<10y): up to about 3 nmol/L
    Puberty: gradual rise to adult levels
    Adult Male: 1.4 - 9.1 nmol/L
    Adult Female: 1.4 - 14.3 nmol/L


    Pre-puberty (<10y): up to about 3 nmol/L
    Puberty: gradual rise to adult levels
    Adult Male: 1.4 - 9.1 nmol/L
    Adult Female: 1.4 - 14.3 nmol/L

  • Factors Affecting Result:

    Haemolysis (elevated), lipaemia (depressed) or icterus (elevated) may interfere.
    Heterophilic antibodies can interfere with immunoassays.

    Haemolysis (elevated), lipaemia (depressed) or icterus (elevated) may interfere.
    Heterophilic antibodies can interfere with immunoassays.

  • Routine Contact Name:

    Duty Biochemist

  • Routine Telephone:

    Freeman: 0191 244 8889

    RVI: 0191 282 9719

    Freeman: 0191 244 8889

    RVI: 0191 282 9719

  • Routine Email:

    - For external users: TNU-Tr.duty.biochemist@nhs.net

    - For Trust users: DutyBiochemist@nuth.nhs.uk

  • Specialist Test:

    Yes

    Yes

  • Specialist Contact Name:

    Endocrine Lab

    Endocrine Lab

  • Specialist Telephone:

    0191 282 4025

    0191 282 4025

Availability:

Available during full access hours
Assayed weekly
Site of analysis: RVI

Turn Around:

Within 2 weeks

Send To:

Department of Blood Sciences

Level 3
Leazes Wing
Royal Victoria Infirmary
Queen Victoria Road
Newcastle upon Tyne
NE1 4LP

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