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Androstenedione (Delta-4)

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The measurement of delta-4 androstenedione is used in the diagnosis and differential diagnosis of androgen overproduction (hyperandrogenism - in combination with measurements of other steroid hormones), in the diagnosis and monitoring of congenital adrenal hyperplasia, and in the diagnosis of premature adrenarche (early onset of androgen secretion in children).

Delta-4 androstenedione is mainly secreted by the adrenal glands and its production is controlled, at least in part, by the adrenocorticotropic hormone (ACTH). It is also produced, independently of ACTH, in the testes and ovaries by dehydroepiandrosterone sulfate (DHEA-S) secreted by the adrenals. Androstenedione is an essential precursor molecule in the synthesis of steroid hormones.

Elevated androstenedione levels can cause symptoms or signs of hyperandrogenism in women. Men are usually asymptomatic, but because of the peripheral (in adipose tissue and liver) conversion of androgens to estrogens, mild symptoms of elevated estrogen concentrations, such as gynecomastia, can sometimes be observed.

Most mild to moderate elevations of delta-4 androstenedione are idiopathic or related to conditions such as polycystic ovary syndrome. However, large increases in androstenedione may be indicative of adrenal or gonad tumors (ovarian and testicular). If for any reason, the production of androstenedione increases in a child, premature sexual development may occur. In postmenopausal women, increased production of androstenedione can lead to bleeding, endometriosis, ovarian stimulation, and polycystic ovaries.

Increased production of androstenedione in obesity can cause menstrual abnormalities in women and signs of feminization such as gynecomastia in men. Determination of delta-4 androstenedione is useful in the diagnosis of menstrual abnormalities, early sexual development, and postmenopausal abnormalities.

Possible Interpretations of Pathological Values
  • Increase: Adrenal tumors, congenital adrenal hyperplasia, Cushing's syndrome, tumors with ectopic ACTH production, hypertension, ovarian tumors, Stein-Leventhal's disease, testicular tumors
  • Decrease: Hypogonadism, menopause



Important Note

Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".

Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.

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