Circadian rhythms of 11-oxygenated C19 steroids and ∆5-steroid sulfates in healthy men.

BACKGROUND: Many hormones display distinct circadian rhythms, driven by central regulators, hormonal bioavailability, and half-life. A set of 11-oxygenated C19 steroids (11-oxyandrogens) and pregnenolone sulfate (PregS) are elevated in congenital adrenal hyperplasia and other disorders, but their circadian patterns have not been characterized. PARTICIPANTS AND METHODS: Peripheral blood was collected every 2 h over 24 h from healthy volunteer men (10 young, 18-30 years, and 10 older, 60-80 years). We used mass spectrometry to quantify 15 steroids, including androstenedione (A4), testosterone (T), 11ß-hydroxy- and 11-ketotestosterone (11OHT, 11KT),11ß-hydroxy- and 11-ketoandrostenedione (11OHA4, 11KA4), and 4 ∆5-steroid sulfates. Diurnal models including mesor (rhythm adjusted median), peak, and nadir concentrations, acrophase, and amplitude were computed. RESULTS: 11OHA4 followed a rhythm similar to cortisol: acrophase 8:00 h, nadir 21:00 h and were similar in young and old men. 11KT had similar diurnal patterns, but the peak was lower in older than in young men, as was the case for A4. All four steroid sulfates were higher in young vs older men. PregS and 17-hydroxypregnenolone sulfate (17OHPregS) showed sustained elevations between 8:00 and 18:00 h, and nadirs around midnight, while DHEAS and AdiolS displayed minimal diurnal variations. All 4 11-oxyandrogens correlated tightly with cortisol (r from 0.54 for 11OHT to 0.81 for 11OHA4, P < 0.0001 for all), but very weakly with T, supporting their adrenal origin and ACTH governance. CONCLUSIONS: 11-Oxyandrogens, PregS, and 17OHPregS display distinct circadian and age variations, which should be accounted for when used as clinical biomarkers.

Cytochrome P450-mediated metabolic alterations in preeclampsia evaluated by quantitative steroid signatures.

Although preeclampsia has been suggested potential risk factors including placental and systemic inflammation, oxidative stress, and abnormal steroid metabolism during pregnancy, the pathogenesis of preeclampsia has not fully been elucidated, particularly in steroid metabolism. The association between various cytochrome P450 (CYP)-mediated steroid metabolic markers and preeclampsia risk was therefore investigated. The serum levels of 54 CYP-mediated regioselective hydroxysteroids and their substrates were quantitatively evaluated from both pregnant women with preeclampsia (n=30; age, 30.8±4.5 years) and normotensive controls (n=30; age, 31.0±3.5 years), who were similar with respect to maternal age, gestational age, and body mass index. The levels of 6ß-, 7a-, and 11ß-hydroxymetabolites of androgens and corticoids were significantly increased in women with preeclampsia. In addition, the levels of oxysterols, including 7a-, 7ß-, 4ß-, 20a-, 24S-, and 27-hydroxycholesterol, were markedly higher, while the levels of 16a-OH-DHEA, 16a-OH-androstenedione, and cholesterol were significantly decreased in patients. The 6ß-hydroxylation of androgens and corticoids by CYP3A4 (P<0.01), the activation of 20,22-desmolase (a cholesterol side-chain cleavage enzyme) by CYP11A1 (P<0.00001), and the multi-hydroxylation of cholesterol at C-4ß, C-7a, C-7ß, C-24S, C-27, and C-20a (P<0.0001) by catalytic or enzymatic reaction (e.g. CYP3A4, CYP7A1, CYP27A1, and CYP46A1) were differed between preeclamptic women and control subjects. In particular, an increased oxysterols (induction>2.0-fold) were positively correlated with the conditions of preeclampsia. Our metabolic profiling suggests the CYP-mediated alterations in steroid metabolism and hydroxylation in pregnancy-induced hypertension. These multiple markers could serve as background information for improved clinical diagnosis and management during pregnancy. This article is part of a Special Issue entitled "Pregnancy and Steroids".

Quantitative analysis of 3alpha,6alpha,24-trihydroxy-24,24-di(trifluoromethyl)-5beta-cholane, a potent synthetic steroidal liver X receptor agonist in plasma using liquid chromatography-tandem mass spectrometry.

The steroidal liver X receptor agonist, 3alpha,6alpha,24-trihydroxy-24,24-di(trifluoromethyl)-5beta-cholane (ATI-829) is a potential therapeutic agent for the treatment of atherosclerosis. A sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS-MS) method for the quantification of ATI-829 in mouse plasma was developed and validated. Proteins in a 25 microL aliquot of mouse plasma were precipitated, and ATI-829 was extracted from the precipitate by the addition of 125 microL methanol. The overall extraction efficiency was greater than 99%. LC-MS-MS with negative ion electrospray and selected reaction monitoring was used for the quantitative analysis of ATI-829. The lower limit of quantitation of ATI-829 corresponded to 5.0 ng/mL (9.7 nM) plasma. Interference from matrix was negligible. The calibration curve was linear over the range 5-2000 ng/mL. The intra-day precision and inter-day precision of the analyses were <4.5% and <6%, respectively, and the accuracy ranged from 92% to 103%. ATI-829 in plasma was stable for at least 6 h at room temperature, 1 week at 4 degrees C, and 3 weeks at -20 degrees C. The validated method was then utilized for pharmacokinetic studies of ATI-829 administered to mice.

A capillary gas chromatography/mass spectrometric method for the quantification of hydroxysteroids in human plasma.

A specific and sensitive methodology for the quantitative determination of hydroxysteroids dehydroepiandrosterone and pregnenolone and their main metabolites in human plasma is described. Hydroxysteroids were extracted using methanol and steroids were further separated by reverse-phase high-performance liquid chromatography, allowing for minimization of the possible chromatographic interferences. Eluted fractions were collected, pooled, and analyzed by gas chromatography-mass spectrometry as trimethylsilyl ether derivatives. The quantification was performed with single-ion monitoring of the highly abundant m/z 129 or m/z 358 fragments. The combination of the chromatographic characteristics to the specific fragments ensured the selectivity and specificity of the method. Under these conditions the method was linear (typical R2 is superior to 0.98 for all hydroxysteroids studied) over the concentration range of 2 x 10(-9) to 10(-6)M with good precision and accuracy.

[Effect of N-acylethanolamines on adrenal cortex function]. / Diia N-atsyletanolaminiv na funktsiiu kory nadnyrkovykh zaloz.

The possibility of NAE to take part in the regulation of the function of adrenal glands was studied. It was shown that two times NAE (18:0) injection in a dose 5 mg/kg of weight increased the content of 11-hydroxysteroids in blood of intact male rats. NAE caused the raise of the blood hormone content by 4 times under the immobilization stress. It is apparent that augment of stress response under the influence of NAE in vivo is explained by the activation of hypophysis-adrenal cortex system. In vitro NAE lowered steroidogenesis by near 40%. One can suggest that this decrease is caused by membranotropic properties of NAE.

Immunoassay of 7-hydroxysteroids: 2. Radioimmunoassay of 7alpha-hydroxy-dehydroepiandrosterone.

High sensitivity radioimmunoassay of 3beta, 7alpha-dihydroxy-5-androsten-17-one (7alpha-OH-DHEA) has been developed and evaluated. The method is based on polyclonal rabbit antisera raised against 19-O-(carboxymethyl)oxime bovine serum albumin conjugate and bridge- and position homologous [(125)I]iodotyrosine methyl ester as a tracer. Sensitivity of the assay amounted to 3.12 fmol (0.95 pg)/tube, precision as a mean intra- and interassay coefficient of variation was 7.1 and 10.6%, respectively, and the average recovery of the analyte added to steroid-free serum was 110%. Out of the steroids occurring in human serum which may interfere with the assay, the only important cross-reactants were dehydroepiandrosterone and 3beta, 7beta-dihydroxy-5-androsten-17-one (7beta-OH-DHEA) with cross-reactivities of 1.95 and 1.16%, respectively. The levels of free (unconjugated) 7alpha-OH-DHEA have been determined in 29 sera from healthy volunteers (23 females and 6 males), and from 48 patients (43 females and 5 males) in which dehydroepiandrosterone and its sulfate (DHEA/S) had been measured for various endocrinopathies. The levels in healthy subjects ranged from 0.21 to 6.57 (mean 2.33+/-1.50) nM, while those of the patients from 0 to 5. 99 (mean 1.46+/-1.52) nM. The levels of 7alpha-OH-DHEA in patients significantly correlated with those of DHEA and its sulfate.

C16 hydroxylation of 3beta-hydroxy-delta5-steroids during the early neonatal period.

Temporal changes of the serum levels of 16-hydroxypregnenolone (3beta,16alpha-dihydroxy-5-pregnen-20-one) 3-sulfate (16-OH-Preg S) and 16-hydroxydehydroepiandrosterone (3beta,16alpha-dihydroxy-5-androsten-17-one) 3-sulfate (16-OH-DHEA S) were investigated by analyzing the levels of their precursor steroids, pregnenolone (3beta-hydroxy-5-pregnen-20-one) 3-sulfate (Preg S) and dehydroepiandrosterone (3beta-hydroxy-5-androsten-17-one) 3-sulfate (DHEA S), respectively, in the early neonatal period. The serum levels of these steroids were measured by GC-MS in full-term (gestational age: 37-41 weeks), pre-term (gestational age: 28-36 weeks) and extremely immature (gestational age: 24-27 weeks) infants. The changes in 16-hydroxysteroid production were also investigated by analyzing the ratios of the serum levels of 16-OH-Preg S and Preg S (16-OH-Preg S/Preg S ratio), and 16-OH-DHEA S and DHEA S (16-OH-DHEA S/DHEA S ratio). It was confirmed that the 16-hydroxylation of DHEA S and Preg S increased after birth, and the 16-OH-Preg S/Preg S ratio in full-term infants was significantly higher than in pre-term and extremely immature infants at days 0, 1-6 and 7-13. On the other hand, there were no significant differences between the 16-OH-DHEA S/DHEA S ratios of the three groups at days 0, 1-6 or 7-13. The mechanism of differences in the 16-hydroxylation of Preg S and DHEA S is also discussed.

Plasma 3 beta-hydroxy-delta 5-steroids in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

There is little information about the plasma concentrations of 3 beta-hydroxy-delta 5-steroids (delta 5-steroids) in untreated patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. To further study the delta 5 pathway, we measured plasma levels of delta 5- and delta 4-steroids in 21 adult patients with different degrees of 21-hydroxylase deficiency (11 salt-wasters, 5 simple virilizers, and 5 patients with the nonclassical form of the disease). In all patients, investigations were performed after withdrawal of steroid treatment for at least 10 days. In addition, catheterization of gonadal and adrenal veins was performed in two salt-wasting male patients displaying bilateral testicular tumors to study adrenal secretion of delta 5- and delta 4-steroids. In one of them, surgical resection of the intratesticular adrenal rests gave the opportunity to measure 3 beta-hydroxysteroid dehydrogenase (3 beta HSD) activity. In all untreated patients, an increase in plasma delta 4-steroids was observed. In contrast, although plasma levels of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) were not significantly modified in simple virilizers, a paradoxical decrease in all delta 5-steroids was observed in salt-wasters. Catheterization of the adrenal veins confirmed the decrease in delta 5-steroids, particularly DHEA and DHEAS. The androstenedione/DHEA ratio was increased in all patients proportionally to the severity of the disease, suggesting an increase in adrenal 3 beta HSD. In vitro analysis of 3 beta HSD activity showed a 4-fold increase in intratesticular adrenal tissue compared to that in normal adrenals. A positive correlation between the androstenedione/DHEA ratio and plasma ACTH levels was observed, suggesting a long term stimulatory effect of ACTH on 3 beta HSD. Angiotensin-II could have an additive effect on ACTH-induced 3 beta HSD activity.

Studies on anabolic steroids--12. Epimerization and degradation of anabolic 17 beta-sulfate-17 alpha-methyl steroids in human: qualitative and quantitative GC/MS analysis.

The epimerization and dehydration reactions of the 17 beta-hydroxy group of anabolic 17 beta-hydroxy-17 alpha-methyl steroids have been investigated using the pyridinium salts of 17 beta-sulfate derivatives of methandienone 1, methyltestosterone 4, oxandrolone 7, mestanolone 10 and stanozolol 11 as model compounds. Rearrangement of the sulfate conjugates in buffered urine (pH 5.2) afforded the corresponding 17-epimers and 18-nor-17,17-dimethyl-13(14)-enes in a ratio of 0.8:1. These data indicated that both epimerization and dehydration of the 17 beta-sulfate derivatives were not dependent upon the respective chemical features of the steroids studied, but were instead inherent to the chemistry of the tertiary 17 beta-hydroxy group of these steroids. Interestingly, in vivo studies carried out with human male volunteers showed that only methandienone 1, methyltestosterone 4 and oxandrolone 7 yielded the corresponding 17-epimers 2, 5 and 8 and the 18-nor-17,17-dimethyl-13(14)-enes 3, 6 and 9 in ratios of 0.5:1, 2:1 and 2.7:1, respectively. No trace of the corresponding 17-epimers and 18-nor-17,17-dimethyl-13(14)-enes derivatives of mestanolone 10 and stanozolol 11 was detected in urine samples collected after administration of these steroids. These data suggested that the in vivo formation of the 17-epimers and 18-nor-17,17-dimethyl-13(14)-enes derivatives of 17 beta-hydroxy-17 alpha-methyl steroids is also dependent upon phase I and phase II metabolic reactions other than sulfation of the tertiary 17 beta-hydroxyl group, which are probably modulated by the respective chemical features of the steroidal substrates. The data reported in this study demonstrate that the 17-epimers and 18-nor-17,17-dimethyl-13(14)-enes are not artifacts resulting from the acidic or microbial degradation of the parent steroids in the gut as previously suggested by other authors, but arise from the rearrangement of their 17 beta-sulfate derivatives. Unchanged oxandrolone 7 was solely detected in the unconjugated steroid fraction whereas unchanged steroids 1, 4 and 11 were recovered from the glucuronide fraction. These data are indirect evidences suggesting that the glucuronide conjugates of compounds 1 and 4 are probably enol glucuronides and that of compound 11 is excreted in urine as a N-glucuronide involving its pyrazole moiety. The urinary excretion profiles of the epimeric and 18-nor-17,17-dimethyl-13(14)-ene steroids are presented and discussed on the basis of their structural features.

Simultaneous assay for individual sulphated 3 alpha- and beta-hydroxysteroids in serum using high-performance liquid chromatography combined with 3 alpha- and beta-hydroxysteroid dehydrogenases immobilized on one column.

A high-performance liquid chromatographic method for the simultaneous determination of individual sulphated 3 alpha- and beta-hydroxysteroids in serum using 3 alpha- and beta-hydroxysteroid dehydrogenases (3 alpha-HSD and beta-HSD, respectively) immobilized on one column and a fluorimeter to detect the resulting NAD+ to NADH transformation is described. Individual sulphated 3 alpha- and beta-hydroxysteroids in serum are extracted with ethanol, solvolysed with sulphuric acid in ethyl acetate and then separated by high-performance liquid chromatography. The hydroxysteroids thus separated are subsequently mixed with NAD+ and then passed through the column in which the following catalytic reaction occurs: (formula, see text) The detection limits are as low as 0.5-1.0 microgram/dl for sulphated 3 alpha- or beta-hydroxysteroids in serum. The present assay method is highly specific, reliable and reproducible and is thus applicable to a clinical study on the metabolism of sulphated 3 alpha- and beta-hydroxysteroids in patients with adrenal or gonadal diseases.

Ectopic ACTH syndrome caused by a bronchial carcinoid tumor responsive to dexamethasone, metyrapone, and corticotropin-releasing factor.

Cushing's syndrome due to bronchial carcinoid tumors that secrete adrenocorticotropin (ACTH) may be difficult to distinguish from pituitary Cushing's disease, since the responses to dexamethasone and metyrapone are sometimes similar. Recently, the ACTH and cortisol responses to ovine corticotropin-releasing factor (oCRF) have been shown to be different in pituitary Cushing's disease than in Cushing's syndrome due to other causes. It is not known if the response to oCRF can distinguish pituitary Cushing's disease from those ACTH-secreting bronchial carcinoid tumors that respond to dexamethasone and metyrapone. A case of Cushing's syndrome due to an ACTH-secreting bronchial carcinoid is described in which the responses to dexamethasone, metyrapone, and oCRF were indistinguishable from the responses observed in pituitary Cushing's disease. A bronchial carcinoid tumor should be considered even when responses to dexamethasone, metyrapone, and oCRF suggest pituitary Cushing's disease.

[Circadian course of delta 5,3 beta-hydroxysteroids and glucocorticosteroids in the plasma and brain of rats]. / Evolution circadienne de delta 5-3 beta-hydroxystéroïdes et de glucocorticostéroïdes dans le plasma et le cerveau de rat.

Corticosterone (B), pregnenolone (P) and dehydroepiandrosterone (D) undergo circadian variations in the rat plasma and brain. When the data are interpreted by the Cosinor method, the acrophases of P in brain and of D in plasma significantly precede the acrophase of B. The asynchrony of delta 5-3 beta-hydroxysteroid and glucocorticosteroid rhythms brings an additional argument in favor of separate regulatory mechanisms.

Plasma androgens in women with acne vulgaris.

We have studied a group of young adult women of mean age 23.8 +/- 6.5 (SD) years with only acne (A, n = 46), only hirsutism (H, n = 10), and acne plus hirsutism (A + H, n = 19) who sought dermatologic care. We measured the androgens, total and free testosterone (T), free 17 beta-hydroxysteroids (17-beta), dehydroepiandrosterone sulfate (DS), and the androgen precursors 17 alpha-hydroxypregnenolone (17-Preg) and 17 alpha-hydroxyprogesterone (17-Prog), as well as testosterone-estrogen binding globulin in all patients. Plasma hormone levels of the patients were compared to those of 23 controls of mean age 25.6 +/- 6.6 years who had neither acne nor hirsutism. Mean levels of all hormones measured, except 17-Preg, were elevated in the women with acne. Fifty-two percent of Group A, 60% of Group H, and 63% of Group A + H patients had at least one abnormal hormone level. The most frequently elevated plasma androgens in all the women with acne were: free T 25%, free 17-beta 23%, and DS 19%. Total T was high in only 12%. Elevations of plasma androgens were present in some women who did not have hirsutism or irregular menses. Identification of endocrine abnormalities in women with acne may potentially offer an opportunity for hormonal therapy.

Fluid-solute regulation systems in patients with Meniere's disease.

A comprehensive endocrinologic evaluation of water electrolyte balance system was performed on 25 patients with Meniere's disease, 6 persons with sudden deafness, and 20 normal persons. In the controlled environment, the following studies were performed: (1) plasma and urine NA+K+ and Cl-, (2) plasma 17-ketosteroid and 17-hydroxysteroids, (3) plasma cortisol and ACTH, (4) urine steroids, (5) urinary excretion of aldosterone, (6) plasma activity of the renin (PRA) in clinostatism and in orthostatism, (7) plasma aldosterone in clinostatism and orthostatism. In patients with Meniere's disease and sudden deafness, the walter-electrolyte balance results were normal, as were the hormonal system directly (renin-aldosterone) or indirectly (cortisol-ACTH) involved. A further confirmation of the integrity of the explored enzymatic-endocrinologic complex derived from the normal response observed in all patients when they were subjected to a physiologic stimulus as represented by the orthostatism. The results of the present study do not confirm previous findings by Arenberg and Goodfriend.

Nonsalt-losing congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency with normal glomerulosa function.

In studies of a 6-yr-old boy and his non-HLA identical 8-yr-old sister, we demonstrated 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) deficiency in the biosynthetic pathways of glucocorticoids and androgens, but not mineralocorticoids. The sister did not manifest abnormal genital development at birth, but developed premature adrenarche at the age of 4 yr, with clitoromegaly and advanced bone age. The brother had perineal hypospadias at birth and developed premature adrenarche at the age of 6 yr. In both siblings, baseline and ACTH-stimulated delta 5 steroids were markedly elevated. The baseline and ACTH-stimulated ratios of delta 5 to delta 4 steroids remained extremely high, and all steroids promptly suppressed with dexamethasone (DEX). Normal baseline PRA and serum and urinary aldosterone (Aldo) levels increased after stimulation with a low Na+ diet. Renal Na+ conservation was normal after dietary Na+ deprivation with and without DEX administration. The PRA to pH 1 Aldo ratio remained normal with normal and low Na+ diets, regardless of DEX administration, indicating normal glomerulosa function with renin stimulation. In both siblings, ACTH increased PRA and Aldo levels, maintaining the PRA to pH 1 Aldo ratio unchanged from the baseline value. In contrast, in control children, PRA was suppressed, while Aldo increased, resulting in a fall of the PRA to pH 1 Aldo ratio. The increase in PRA with exogenous ACTH in these siblings suggests there may be an ACTH-stimulable mineralocorticoid antagonist. During prolonged DEX administration, hCG administration caused a slight increase in 17-hydroxypregnenolone and dehydroepiandrosterone in both the siblings, while testosterone (T) rose poorly in the brother, and estradiol did not rise at all in the sister. These results suggest the possibility of a deficiency of 3 beta-HSD in the gonads as well as the adrenals. After [3H]dehydroepiandrosterone iv infusion, there was normal conversion to [3H]-conjugated testosterone glucuronide, suggesting the presence of normal peripheral 3 beta-HSD activity. We propose that in these siblings, there is a deficiency of 3 beta-HSD in the adrenal zona fasciculata and zona reticularis, whereas 3 beta-HSD activity is intact in the zona glomerulosa. In addition, in these siblings, 3 beta-HSD deficiency was present in the gonads, while peripheral 3 beta-HSD activity appeared to be intact. These cases demonstrate further the heterogeneity of congenital adrenal hyperplasia due to 3 beta-HSD deficiency.

Sex hormone-binding globulin response to human chorionic gonadotropin stimulation in children with cryptorchidism, anorchia, male pseudohermaphroditism, and micropenis.

Sex hormone-binding globulin serum concentrations (SHBG) were measured before and after a 5-day hCG stimulation test in 11 prepubertal boys with cryptorchidism, 6 with anorchia, 5 with male pseudohermaphroditism, and 5 with micropenis. Cryptorchid boys had decreased SHBG levels after hCG, by 55 +/- 17% (mean +/- SE) of the basal concentration. Patients with anorchia, who did not show an elevation in serum androgens, did not have decreased SHBG concentrations. Four of the 5 patients with male pseudohermaphroditism had an adequate elevation of serum androgens, did not have decreased SHBG concentrations. Four of the 5 patients with male pseudohermaphroditism had an adequate elevation of serum androgens after hCG, but in only 3 of them did SHBG decrease. None of the 5 patients with micropenis had decreased serum SHBG levels despite normal increments in serum androgens. The administration of a long-acting preparation of testosterone to sexually infantile subjects produce a similar decrease in the SHBG concentration. This change in SHBG concentration after hCG or testosterone in prepubertal boys could be used as a convenient test of biological response to androgens.

[The problem of extirpation of gonads in "testicular feminisation"]. / Zur Frage der Gonadenexstirpation bei "testikulärer Feminisierung".

The 15-year old female patient G. G. was referred to the outpatient department for child gynaecology on account of a primary amenorrhoea. The endocrinal parameters found (testosterone, oestradiol, 17 OHCS, 17 KS), chromosome analysis, vaginoscopy and the result of a laparoscopy led to the clinical diagnosis of "testicular feminisation". Satisfactory development of secondary female sex characteristics and sudden increase of complaints caused by an inguinal hernia on the left (gonad situated in the inner inguinal ring) prompted us to perform bilateral extirpation of gonads with simultaneous treatment of the inguinal hernia. Histological examination revealed the existence of a seminoma of the right gonad. This case confirm our stand in respect of extirpation of gonads at the onset of puberty, but it also raised the question as to whether it would be advisable to operate at an even earlier stage in order to avoid the risk of malignant degeneration of intra-abdominally positioned testes.

Indices of serum androgens in normal puberty: correlations of two indices with chronological age, bone age and pubertal development in boys and girls.

Two indices of free serum androgenic activity, the normalized androgen ration (NAR) and the free androgen index (FAI) were determined in 218 normal children aged 8-17.9 years. Before the onset of puberty and between chronological age 8 and 11.9 years, NAR and FAI were similar in both sexes, the NAR being less than 0.8 and FAI less than 0.1. In boys mean NAR value increased from 0.87 to 1.39 between 12.5 and 17.5 years, and mean FAI from 0.14 to 1.85 between 12.5 and 17.5 years. In girls mean NAR increased from 0.79 to 0.85 between 12.5 and 15.5 years, and mean FAI from 0.11 to 0.23, between 12.5 and 15.5 years. Both indices did not change significantly between 15.5 and 17.5 years in girls. A rapid increase in NAR and FAI occurred in boys from a mean testicular volume of 4.1 to greater than 20 ml and from genital stage G2+ to 5+. In girls a gradual increase in NAR and FAI occurred from breast stage B2+ to 5+ . Although the androgen indices increased in both sexes between pubic hair stages PH2+ and 6+, the values in girls were always less than in boys at corresponding stages suggesting an increased androgen sensitivity of the female pubic hair follicle during adolescence. The peak rise in NAR and FAI in boys between 13 and 15 years correlated closely with the timing of the pubertal growth spurt in this sex. A similar rise was not seen in girls at the time of their peak growth velocity between 11 and 13 years and suggested that androgens play only a minor or complementary part in the female growth spurt.