Can Dehydroepiandrosterone-Sulphate be a New Diagnostic Parameter in Idiopathic Hypogonadotropic Hypogonadism?

Objective: Dehydroepiandrosterone (DHEA) and its sulfate derivative DHEA-sulfate (DHEA-s) are major androgen hormones which are synthesis from the adrenal origin. The purpose of this study was to investigate DHEA-s levels in male patients with idiopathic hypogonadotropic hypogonadism (IHH) and to determine whether DHEA-s level are a useful marker for diagnosis of IHH. Methods: A total of 91 subjects, 31 males with IHH (mean age 19.7±2.6 years) and 60 healthy males (mean age 20.7±2.6 years), were enrolled in this study. The patients with IHH were selected from the subjects who had not yet started treatment for hypogonadism and who had no additional disease, while the healthy control group consisted entirely from individuals admitted to the same hospital outpatient clinic for routine check-ups. Both groups’ blood sampling, anthropometric measures, and physical examination were undertaken Results: Mean DHEA-s level was 133.4±56.5 µg/dL in the IHH group and 433.3±160.3 µg/dL in the control group (p=0.000). The low DHEA-s level in patients with IHH was independent of age, cortisol, and adrenocorticotropic hormone (ACTH) at multivariate logistic regression analysis. The ROC analysis showed that DHEA-s ≤38.2 µg/dL supports a diagnosis of IHH with 100% specificity and 100% sensitivity. DHEA-s was as predictive as total testosterone which is used in the diagnosis of patients with IHH. Conclusion: DHEA-s level was significantly lower in the males with IHH compared to controls. Therefore, DHEA-s may be a potential predictive marker for diagnosis of IHH.