Test #004020Work up women with infertility, amenorrhea, or hirsutism to identify the source of excessive androgen; aid in the evaluation of androgen excess (hirsutism and/or virilization), including Stein-Leventhal syndrome and adrenocortical diseases, including congenital adrenal hyperplasia and adrenal tumor. DHEA-S is not increased with hypopituitarism. It is low in Addison disease.
Also Known As: DHEA Sulfate, DHEA-S, DHEA-SO4
Preparation: No fasting required.Test Type: BloodTest Results: 2-3 daysDHEA-S is a steroid hormone which is produced from the precursor cholesterol in the zona reticularis and broad fascia of the adrenal cortex.1 The determination of elevated DHEA-S values is an important aid in the diagnosis of hirsutism and virilism.2,4 In addition to a differential diagnosis of hirsutism and virilism, further indications for this parameter are all forms of androgenization, hyperprolactinemia, polycystic ovarian syndrome, and the exclusion of an androgen-producing tumor of the adrenal cortex.2 DHEA-S exhibits only a weak androgenic activity but can be metabolized to more active androgens, such as androstenedione and testosterone, which can indirectly cause hirsutism and virilism.2,5From 7 years of age onwards, an increase in DHEA-S levels is observed which then gradually after the age of 30 begins to fall again.6 Only elevated DHEA-S concentrations are of clinical importance; other factors which can be responsible for DHEA-S excess production are genetic enzyme defects of the adrenal cortex (adrenogenital syndrome),7 hyperplasia of the adrenal cortex, as well as androgen-producing tumors.2The rate of secretion of DHEA-S into the blood stream is only slightly more than the rate observed for DHEA. As a consequence of the DHEA-S half-life of approximately one day, the DHEA-S level is, however, about a thousand-fold greater.8 DHEA-S is relatively strongly bound to albumin, only a small portion is nonprotein bound, and none appears to be bound to sex hormone-binding globulin (SHBG).9 Due to its high concentration and low inter- and intra-day variability, DHEA-S is an excellent indicator of adrenal cortex androgen production.8,10Together with testosterone, DHEA-S assays represent the assay of choice for initial screening tests to determine whether androgen values are elevated in hirsutism. Approximately 84% of the women suffering from hirsutism exhibit elevated androgen levels.11 The main purpose of this is to exclude the presence of androgen-producing tumors (from the adrenal cortex or the ovaries).7