Reference intervals of nine steroid hormones over the life-span analyzed by LC-MS/MS: Effect of age, gender, puberty, and oral contraceptives.
Level 4 - case-series / case-control
Cross-sectional normative reference interval study
PubMed 31201927 · doi:10.1016/j.jsbmb.2019.105409
What was done
Serum samples were collected between 7:00 a.m. and 10:00 a.m. from 4,678 individuals aged 0.3 to 79 years, excluding those with endocrine diseases or a body mass index ≥ 33. Nine steroid hormones (cortisol, cortisone, progesterone, 17-hydroxyprogesterone [17-OHP], androstenedione, testosterone, estradiol, DHEAS, and aldosterone) were measured using LC-MS/MS. Reference intervals across age, sex, and pubertal stage were modeled using generalized additive models for location, scale, and shape (GAMLSS), nonparametric, or robust methods.
What was found
Reference intervals were established across the lifespan. Infants under age one showed androgen and estrogen surges indicative of mini-puberty, alongside elevated aldosterone and cortisone reflecting physiological hyperaldosteronism. Steroids increased during puberty, peaked in early adulthood, and gradually declined toward senescence. Oral contraceptives significantly elevated cortisol (p < 0.0001) while suppressing progesterone, 17-OHP, androstenedione, and estradiol (p < 0.0001). Specific numerical interval cut-offs are not reported in the abstract.
Why it matters
As LC-MS/MS replaces traditional immunoassays for steroid profiling, these standardized reference intervals across the lifespan provide an essential baseline for endocrine diagnostics and account for the impact of oral contraceptive use.
Limits
The study is cross-sectional and relies on single morning timepoint samples. Specific numerical interval bounds, cohort ethnic composition, and menopausal status stratification details are not provided in the abstract.
Cited by
- supports Males have between 10 and 80 times more testosterone than females.