Evaluating the four most important salivary sex steroids during male puberty: testosterone best characterizes pubertal development

Abstract

Background During pubertal development in healthy boys, increased levels of different sex steroids occur which are responsible for sexual maturation and physical changes. However, relationships between various sex hormones and pubertal development stages have not been sufficiently studied. Methods The investigation included 165 normal boys (mean age 12.7±2.8 years, mean body mass index [BMI] 19.6±4.2 kg/m2). Pubic hair (PH) stages were stratified by Tanner and testicular volume (TV) by means of the Prader orchidometer and assigned to the prepubertal, pubertal and postpubertal development phase. Four different sex steroids (testosterone [TE], dehydroepiandrosterone [DHEA]/dehydroepiandrosterone-sulfate [DHEAS], androstenedione (AE), 17-hydroxyprogesterone [17-OHP]) were measured in saliva by enzyme-linked immunosorbent assay (ELISA) and as serum total steroids by different assays (radioimmunoassay [RIA], chemiluminescence immunoassay [CLIA], electrochemiluminescence immunoassay [ECLIA]). Validation of saliva-based ELISA tests included data related to inter- and intra-assay coefficients of variation (CVs), recovery and linearity. Results Using Spearman rank correlation, salivary steroids significantly correlated (p<0.001) with pubertal development: TE (TV r=0.74 and PH stages r=0.72), DHEA (r=0.58 and 0.62), AE (r=0.38 and 0.45) and 17-OHP (r=0.42 and 0.43). Correlations between salivary and serum concentrations of steroids were also statistically significant (p<0.001). Binomial logistic regression analysis revealed significant correlations between salivary TE and pubertal maturation during the development phases of prepuberty-puberty and puberty-postpuberty. Inclusion of further salivary steroids did not improve analysis results. Conclusions Salivary TE permits a good non-invasive characterization of pubertal maturation stages. The consideration of further salivary sex steroids did not improve diagnostic accuracy.

Multidimensional and Intersectional Gender Identity and Sexual Attraction Patterns of Adolescents for Quantitative Research

“…In working to further understand the complexity and the fit of sexual attraction within the concept of gender identity, we recognize that there is a need to also include biological components in these models. We therefore need to include biological gender markers, such as measures of steroid hormones such as androstenedione and estrogen to assist in understanding sexual development in puberty so that we can develop a more advanced and bio-psycho-sexual-social understanding of gender identity (Søeborg et al, 2014;Krebs et al, 2019;Merino et al, 2019). Combining the complex factorial net of biological, social, and individual factors concerning gender is a demanding undertaking, and with that comes the additional challenge of understanding what these respective combinations imply for various adolescent groups' gender development and the call for ongoing research in this burgeoning field.…”

Field methods and strategies for assessing female reproductive functioning

“…Bound steroids (whether cortisol, testosterone, progesterone, estradiol, or others) cannot diffuse into the salivary glands, but because unbound steroids diffuse rapidly across salivary acinar cells, a salivary steroid concentration is thought to represent the synchronous unbound steroid level in serum (Campbell, 1994; Ellison, 1988; Walker et al, 1978). Reported correlations of paired salivary and serum steroid concentrations vary across steroids, assay methods, and individuals but are generally good to excellent (Adebero et al, 2019; El‐Farhan, Rees, & Evans, 2017; Krebs et al, 2019; Riad‐Fahmy et al, 1987; Turpeinen & Hämäläinen, 2013; Walker et al, 1978; Wang & Knyba, 1985).…”