Increased Urinary 6-sulfatoxymelatonin Excretion in Women with Non-classical Steroid 21-hydroxylase Deficiency
by Rafael Luboshitzky, Ghali Qupti, Avraham Ishay,
Zilla Shen-Orr & Paula Herer
melatonin, testosterone, adrenal hyperplasia, hyperandrogenism, androgens
Submitted: September 5, 2001
Accepted: September 12, 2001
OBJECTIVES: To determine melatonin production in hyperandrogenic women.
MATERIAL AND METHODS: Seventeen women with late onset adrenal hyperplasia due to 21-hydroxylase deficiency (LOCAH) and 15 control women were studied in early follicular phase of the menstrual cycle. Fasting serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), testosterone, dihydroepiandrosterone sulfate (DHEA-S), 17-hydroxyprogesterone (17-OHP) as well as the peak 17-OHP response to ACTH (250 µg IV) and 24h urinary 6-sulfatoxymelatonin (aMT6s) were determined in all participants.
RESULTS: All 17 hyperandrogenic women were carrying mutations of the CYP21 gene. Women with LOCAH had significantly higher serum testosterone, DHEA-S, 17-OHP and ACTH stimulated 17-OHP values compared with controls. Their aMT6s values (44.6±20.3 µg/24h) were significantly higher than the values in control women (31.5±20.3) (p<0.03). The urinary aMT6s values were positively correlated with testosterone (p<0.04), DHEA-S (p<0.02) and peak 17-OHP (p<0.04).
CONCLUSIONS: Women with LOCAH have increased melatonin production. There is a relationship between adrenal androgens and melatonin in these women.