Steroid reference intervals in women: influence of menopause, age and metabolism

in European Journal of Endocrinology
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  • 1 M Mezzullo, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 2 A Gambineri, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 3 G Di Dalmazi, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 4 A Fazzini, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 5 M Magagnoli, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 6 M Baccini, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 7 V Vicennati, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 8 C Pelusi, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 9 U Pagotto, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy
  • 10 F Fanelli, Unit of Endocrinology and of Prevention and Care of Diabetes, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, S.Orsola Policlinic, Bologna, Italy

Correspondence: Flaminia Fanelli, Email: flaminia.fanelli2@unibo.it
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Objective. To investigate the impact of age, obesity and metabolic parameters on thirteen circulating steroids in reproductive and menopausal age. To define reference intervals (RI).

Design. Cross-sectional.

Methods. 325 drug-free, healthy and eumenorrheic women were selected from the general population. Independent relationships of LC-MS/MS-determined steroid levels with age, body mass index (BMI) and metabolic parameters were estimated. Reference sub-cohorts were defined for calculating upper and lower limits in reproductive age, menstrual phases and menopause, and these were compared with limits in dysmetabolic sub-cohorts.

Results. Lower androgens, pro-androgens and estrogens, but higher cortisol and metabolites were found in menopausal compared to reproductive age women. Androgens and precursors decreased during reproductive age (P<0.001–P=0.002) but not after menopause. 17OH-progesterone decreased with BMI (P=0.006) and glucocorticoids with waist circumference (P<0.001–P=0.002) in reproductive age, but increased with triglycerides (P=0.011-P=0.038) after menopause. Inverse associations of dihydrotestosterone with BMI (P=0.004) and HDL-cholesterol (P=0.010), estrone with total cholesterol (P=0.033) and estradiol with triglycerides (P=0.011) were found in reproductive age. After menopause, estrone increased with waist circumference (P<0.001) and decreased with insulin resistance (P=0.012). Ovarian steroid RI were estimated in menstrual phases and menopause. Age- and reproductive status-specific RI were generated for androgens, precursors and corticosteroids. Lower limits for reproductive age cortisol (P=0.020) and menopausal 11-deoxycortisol (P=0.003) in dysmetabolic sub-cohorts were reduced and increased, respectively, compared to reference limits.

Conclusions: Obesity and dysmetabolism differently influence circulating steroids in reproductive and menopausal status. Age, menstrual and menopausal status-specific RI were provided by LC-MS/MS for a broad steroid panel.

 

     European Society of Endocrinology