Dehydroepiandrosterone (DHEA) Sulfate
UFHPL Epic order code: LAB524
DHEA-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.2,5
From 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.2
The 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.8,10
Together 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
- Gronowski AM, Landau-Levine M. Reproductive endocrine function. In: Burtis CA, Ashwood ER, eds. Tietz Textbook of Clinical Chemistry. 3rd ed. Philadelphia, Pa: WB Saunders; 1999:1601-1641, chapter 45.
- Goldfien A, Monroe SE. Ovaries. In: Greenspan FS, Baxter JD, eds. Basic and Clinical Endocrinology. 4th ed. Norwalk, Conn: Appleton & Lange;1994:419-470,chap 10.
- DHEA-S on Elecsys 1010/2010 and Modular Analytics E170, package insert 2006-11, V 11, Indianapolis, Ind: Roche Diagnostics; 2006.
- Hatch R, Rosenfield RL, Kim MH, Tredway D. Hirsutism: Implications, etiology, and management. Am J Obstet Gynecol. 1981 Aug 1; 140(7):815-830.PubMed 7258262
- Mooradian AD, Morley JE, Korenman SG. Biological actions of androgens. Endocr Rev. 1987 Feb, 8(1):1-28.PubMed 3549275
- Zappulla F, Ventura D, Capelli M, et al. Gonadal and adrenal secretion of dehydroepiandrosterone sulfate in prepubertal and pubertal subjects. J Endocrinol Invest. 1981 Apr-Jun; 4(2):197-202.PubMed 6268694
- Ziegler R. Endokrinologische Erkrankungen. In: Schettler G, ed.Innere Medizin. Stuttgart, Germany: Ausgabe Thieme; 1987: 434-437.
- Haning RV. Using DHEAS to monitor androgen disorders. Contemp Ob/Gyn.1981; 18(9):117-131.
- Longcope C. Dehydroepiandrosterone metabolism. J Endocrinol. 1996 Sep; 150(Suppl):S125-S127.PubMed 8943796
- Lobo RA, Paul WL, Goebelsmann U. Dehydroepiandrosterone sulfate as an indicator of adrenal androgen function. Obstet Gynecol. 1981 Jan; 57(1):69-73.PubMed 6450345
- Lobo RA, Paul WL, Goebelsmann U. Serum levels of DHEAS in gynecologic endocrinopathy and infertility. Obstet Gynecol. 1981 May; 57(5):607-612.PubMed 6261197
- If a red-top tube is used, transfer the separated serum to a plastic transport tube.
Sample Volume: 0.8 mL
Minimum Volume: 0.3 mL (Repeat testing is not possible with this specimen volume.)
Storage: Refrigerate specimens after collection.
- Ambient: 14 days
- Refrigerated: 14 days
- Frozen: 14 days
- Freeze/Thaw cycles: Stable (x3)
- Citrate plasma specimen
- Improper labeling
Electrochemiluminescence immunoassay (ECLIA)
|0 − 30 days||Not established||Not established|
|1 − 12 months||4.8 − 64.1||4.8 − 64.1|
|1 − 4 years||0.1 − 56.4||1.8 − 97.2|
|5 − 8 years||18.0 − 194.0||26.1 − 141.9|
|9 − 11 years||49.5 − 270.5||35.0 − 192.6|
|12 − 14 years||49.5 − 270.5||67.8 − 328.6|
|15 − 19 years||115.3 − 459.6||110.0 − 433.2|
|20 − 24 years||164.3 − 530.5||
110.0 − 431.7
|25 − 34 years||138.5 − 475.2||84.8 − 378.0|
|35 − 44 years||102.6 − 416.3||57.3 − 279.2|
|45 − 54 years||71.6 − 375.4||41.2 − 243.7|
|55 − 64 years||48.9 − 344.2||
29.4 − 220.5
|65 − 74 years||30.9 − 295.6||20.4 − 186.6|
|≥ 75 years||20.8 − 226.4||13.9 − 142.8|
Monday - Friday