Salivary androgens in adolescence and their value as a marker of puberty: results from the SCAMP cohort

Abstract

Context: Salivary androgens represent non-invasive biomarkers of puberty that may have utility in clinical and population studies. Objective: To understand normal age-related variation in salivary sex steroids and demonstrate their correlation to pubertal development in young adolescents. Design, Setting, and participants: School-based cohort study of 1,495 adolescents at two time points for collecting saliva samples approximately two years apart. Outcome measures: The saliva samples were analyzed for five androgens (testosterone, androstenedione (A4), 17-hydroxyprogesterone (17-OHP), 11-ketotestosterone (11-KT) and 11β-hydroxyandrostenedione (11-OHA4)) using LC-MS/MS; in addition, salivary dehydroepiandrosterone (DHEA) and oestradiol (OE2) were analyzed by ELISA. Pubertal staging was self-reported using the pubertal development scale (PDS). Results: In 1,236 saliva samples from 903 boys aged between 11-16 years, salivary androgens except DHEA exhibited an increasing trend with an advancing age (ANOVA, p<0.001), with salivary testosterone and A4 concentration showing the strongest correlation (r=0.55, p<0.001 and r=0.48, p<0.001, respectively). In a subgroup analysis of 155 and 63 saliva samples in boys and girls, respectively morning salivary testosterone concentrations showed the highest correlation with composite PDS scores and voice-breaking category from PDS self-report in boys (r=0.75, r=0.67, respectively). In girls, salivary DHEA and OE2 had negligible correlations with age or composite PDS scores. Conclusion: In boys aged 11-16 years, increase in salivary testosterone and A4 is associated with self-reported pubertal progress and represent valid non-invasive biomarkers of puberty in boys.