Trial of Serum 5alpha-androstane-3alpha,17beta-diol glucuronide for Androgen Therapy in Children

Han, Sang Won; Choi, Seung Kang

Abstract

Androgen treatment in boys with underdeveloped external genitalia requires close attention to avoid the side effects. The dose and duration of androgen have usually been decided according to the validation of the effects and the side effects. However, the dosage that showed the desirable effect or undesirable side effects already exceeded the optimal dosage. So the indicator to predict the effect of androgen is necessary for boys during androgen treatment. To evaluate serum 5alpha-androstane-3alpha, 17beta-diol glucuronide as this indicator we tried to obtain the correlation between the increase of penile length and serum 5alpha-androstane-3alpha, 17beta-diol-glucuronide and dihydro-testosterone during dihydrotestosterone treatment. While the mean serum level of 5alpha-androstane-3 alpha,17beta-diol glucuronide was higher than that of dihydrotestosterone in 17 patients without defects of androgen action,the opposite result was observed in 6 patients with defect of androgen action. The increase in penile length estimated by the calculation of the 8 weeks difference of deviation/normal S.D.significantly correlated with the serum 5alpha-androstane-3alpha, 17beta-diol glucuronide but not with serum DHT. Therefore the responsibility of the target cell to androgen seems to determine both the effect of androgen treatment and the serum level of 5alpha-androstane-3alpha, 17beta-diol glucuronide. In conclusion the serum 5alpha-androstane3alpha, 17beta-diol glucuronide could have a value as the indicator to predict the effect of androgen treatment in children with underdeveloped external genitalia.