Steroid 17-Hydroxyprogesterone in Hair as a Potential Long-Term Biomarker of Androgen Control in Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

This study demonstrated that measuring 17-hydroxyprogesterone (17-OHP) concentrations in scalp hair could serve as a promising noninvasive long-term biomarker for monitoring androgen control in adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The study included 27 women and 15 men with CAH, along with 37 women and 42 men as controls. Significant correlations were found between hair and serum 17-OHP levels in both CAH men and women, and between hair and serum testosterone levels in CAH men. A cutoff value of 21.7 pg/mg for hair 17-OHP provided high sensitivity and specificity for identifying men with elevated serum androstenedione. For CAH women, a cutoff value of 27.6 pg/mg for hair 17-OHP was effective in identifying significant hyperandrogenism. However, hair cortisol and other adrenal androgen markers did not show significant associations with cardiometabolic outcomes or bone health.