Abstract
ObjectiveDiagnostic ratios calculated from urinary steroid hormone metabolites are used as a measure for the relative activity of steroidogenic enzymes or pathways in the clinical investigation of steroid metabolism disorders. However, population-based sex- and age-specific reference intervals and day-night differences in adults are lacking.MethodsSixty-five diagnostic ratios were calculated from steroid metabolites measured by GC-MS in day- and night-time and in 24-hour urine from 1128 adults recruited within the Swiss Kidney Project on Genes in Hypertension (SKIPOGH), a population-based, multicenter cohort study. Differences related to sex, age and day- and night-time were evaluated and reference curves in function of age and sex were modelled by multivariable linear mixed regression for diagnostic ratios and were compared to values from the literature.ResultsMost ratios had sex- and age-specific relationships. For each ratio, percentiles were plotted in function of age and sex in order to create reference curves and sex- and age-specific reference intervals derived from 2.5th and 97.5th percentiles were obtained. Most ratios reflected a higher enzyme activity during the day compared to the night.ConclusionsSex- and age-specific references for 24 hours, day and night urine steroid metabolite ratios may help distinguishing between health and disease when investigating human disorders affecting steroid synthesis and metabolism. The day-night differences observed for most of the diagnostic ratios suggest a circadian rhythm for enzymes involved in human steroid hormones metabolism.
Highlights
A urinary steroid hormone profile provides a comprehensive overview about predominantly excreted precursors and products of progestins, androgens, estrogens, mineralocorticoids, and glucocorticoids in urine
Sixty-five diagnostic ratios were calculated from steroid metabolites measured by gas chromatography–mass spectrometry (GC-MS) in day- and night-time and in 24-hour urine from 1128 adults recruited within the Swiss Kidney Project on Genes in Hypertension (SKIPOGH), a population-based, multicenter cohort study
Sex- and age-specific references for 24 hours, day and night urine steroid metabolite ratios may help distinguishing between health and disease when investigating human disorders affecting steroid synthesis and metabolism
Summary
A urinary steroid hormone profile provides a comprehensive overview about predominantly excreted precursors and products of progestins, androgens, estrogens, mineralocorticoids, and glucocorticoids in urine. Ratios used in clinical practice and research often are calculated by dividing a steroid precursor by its product, yielding a measure of the relative activity of a steroidogenic enzyme or pathway. These ratios represent indirect activity markers in the sense that a high ratio indicates a low enzymatic activity and vice versa.
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