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. 2022 Jan 24:12:808254.
doi: 10.3389/fendo.2021.808254. eCollection 2021.

First Morning Pregnanetriol and 17-Hydroxyprogesterone Correlated Significantly in 21-Hydroxylase Deficiency

Tomoyo Itonaga  1   2 , Masako Izawa  3 , Takashi Hamajima  3 , Yukihiro Hasegawa  1
Affiliations

First Morning Pregnanetriol and 17-Hydroxyprogesterone Correlated Significantly in 21-Hydroxylase Deficiency

Tomoyo Itonaga et al. Front Endocrinol (Lausanne). .

Abstract

Background: Biochemically monitoring 21-hydroxylase deficiency (21-OHD) is challenging. Serum/blood 17-hydroxyprogesterone (17OHP) measurements are normally used for this purpose. Urinary pregnanetriol (PT), a urinary metabolite of 17OHP, may also be used. Based on auxological data, we previously reported that the optimal first morning PT value fell in the range of 2.2-3.3 mg/gCr (95% confidence interval of the mean) and 0.59-6.0 mg/gCr (10th - 90th percentile) for monitoring 21-OHD treatment. No report thus far has directly compared the first morning urinary PT value with the 17OHP value at various times during the day.

Objective: To explore the correlation between the first morning urinary PT value before glucocorticoid administration and the serum/blood 17OHP value at three time points, namely, before and two and four hours after glucocorticoid administration.

Design: This was a prospective study done at two children's hospitals.

Methods: In total, 25 patients with 21-OHD aged 3-25 years were recruited. Their urinary PT levels and 17OHP levels were measured for three days within a total period of one week. The first morning PT value was collected on all three days. Dried blood spots and serum were used to measure 17OHP.

Results: The range for the first morning PT value for all the samples (n=69) was 0.10-56.1 mg/gCr. A significant, positive correlation was found between the first morning PT and 17OHP values before medication (r=0.87, p<0.01), and weaker correlation was observed between the first morning PT and 17OHP values after medication.

Conclusions: The first morning PT correlated more significantly with 17OHP before the morning medication. Measuring the first morning PT value may be more practical and useful for monitoring 21-OHD biochemically.

Keywords: 17-hydroxyprogesterone; 21-hydroxylase deficiency; Urinary pregnanetiol; congenital adrenal hyperplasia; first morning urine sample; therapy monitoring, glucocorticoid.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Correlation between morning PT and 17OHP. (A) Morning PT and morning DBS 17OHP showed a significant correlation (n =46, p <0.0001, r =0.87). (B) Regression formula between morning PT and morning DBS 17OHP. By log transformation, morning PT values were normally distributed. There were weaker correlations between (C) morning PT and 17OHP at 2 hours after morning GC administration (DBS 2h-17OHP) and (D) morning PT and 17OHP at 4 hours after morning GC administration (DBS 4h-17OHP).
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