Androstenedione, Serum

Specimen requirement

Adult patient (for female):

 

Clotted blood tube (Serum gel separator clot activator tube)

 

Minimum blood volume: 5 mL

 
Paediatric patient:

Paediatric clotted blood tube

Number of vials: 1

Minimum blood volume: 0.8 mL

Authorisation code required

No (for female or unknown sex);
Yes (for male)

24 Hr available service

No

Method

Liquid chromatography-tandem mass spectrometry

Reference interval (nmol/L)

(Unit: nmol/L)

Age Female Male Unknown Sex
0 – < 14 days < 2.5 < 2.5 < 2.5
14 days – < 1 year < 2.1 < 2.1 < 2.1
1 – < 6 years < 0.6 < 0.6 < 0.6
6 – < 10 years < 0.9 < 0.9 < 0.9
10 – < 12 years < 2.5 < 2.5 < 2.5
12 – < 15 years 0.7 - 6.0 0.5 - 2.0 -
15 – < 18 years 0.5 - 6.5 0.9 - 3.6 -
18 – < 40 years 1.1 - 6.5 1.2 - 4.7 -
> 40 years 1.1 - 6.5 0.8 - 3.1 -

(Source:

  1. Paediatrics (< 18 years): Modified from Clin Biochem. 2013; 46(7 - 8): 642 - 51 and CALIPER Pediatric Reference Interval Database (https://caliper.research.sickkids.ca/#/search) (accessed on 10/9/2020)
  2. Adult females (> 18 years): Reference Range was derived locally from 180 apparently healthy females.
  3. Adult males (> 18 years): Modified from Clin Chem. 2010 Jul; 56(7): 1138 - 47)

Clinical indication

 Assessment of hyperandrogenism in females with clinical symptoms of hirsutism, virilisation and oligomenorrhoea. Diagnosis and monitoring treatment of congenital adrenal hyperplasia (CAH). Diagnosis of premature adrenarche. Diagnosis of androgen-secreting tumor.

Result interpretation

An elevated level of androstenedione indicates increased adrenal, ovarian or testicular production. Elevated androstenedione levels can cause symptoms or signs of hyperandrogenism in women. Small fluctuations in concentration are usually normal. However, pronounced elevations may indicate androgen-producing adrenal or gonadal tumors, or CAH. An increased level is not diagnostic of a specific condition; it usually indicates the need for further testing of other androgen precursors (e.g. 17a-hydroxyprogesterone and DHEA-S) and cortisol, in addition to androstenedione, to investigate for the underlying cause.

A low level of androstenedione may be due to adrenal gland dysfunction, adrenal insufficiency, or to ovarian or testicular failure.

In those with CAH who are being treated with glucocorticoid steroids, normal levels of androstenedione tend to indicate that treatment is effective in suppressing excess androgen production, while elevated levels indicate the need for treatment adjustment.

Measurement of uncertainty

See table.

Frequency of measurement

Weekly