Dehydroepiandrosterone (DHEA), Urine

Clinical Significance:
Dehydroepiandrosterone is a 17-Ketosteroid produced primarily by the adrenal gland by side chain cleavage of 17-HydroxyPregnenolone.  It is reversibly converted to Dehydroepiandrosterone-Sulfate and to Androstenediol.  It is also converted to Androstenedione.  It is excreted in the urine as Sulfate and Glucuronide conjugates and unconjugated (Free) forms.  This assay measures the total of the unconjugated and conjugated forms of DHEA present in the urine.  DHEA is one of the first androgens to increase significantly at the onset of adrenarche.  Levels increase throughout puberty until adulthood.  In females, levels drop off sharply after menopause.  DHEA may distinguish adrenal causes of overandrogenization from gonadal causes.  Elevated levels of urine DHEA are found in third trimester pregnancies as DHEA becomes a direct precursor to Estrogen formation.

Reference Ranges:
Male:                                                                  0.5 – 7.2 mg/24 hours
Female:                                                               0.1 – 4.7 mg/24 hours

Procedure:
Urine Dehydroepiandrosterone is measured by radioimmunoassay.

Patient Preparation:
Patient should not be on any steroid, ACTH, estrogen, or gonadotropin medications, if possible, for at least 48 hours prior to collection of specimen.

Specimen Collection:
10 ml of a 24 hour urine collection should be submitted for analysis. No special preservatives are required. Store specimen refrigerated during collection. Specimens should be frozen prior to shipping. Minimum specimen size is 5 ml.

Shipping Instructions:
Ship specimens frozen in dry ice. Provide the total volume per 24 hours.

References:
1. LH Parker and W O’Dell.  Decline of Adrenal Androgen Production as Measured by Radioimmunoassay of Urinary Unconjugated Dehydroepiandrosterone.  Journal of Clinical Endocrinology and Metabolism 47:  600, 1978.

2. E Carmina, JH Levin, G Malizia, and RA Lobo.  Ovine Corticotropin-Releasing Factor and Dexamethasone Responses in Hyperandrogenic Women.  Fertility and Sterility 54: 245-250, 1990.