Salivary steroid profile investigation by high performance liquid chromatography–tandem mass spectrometry in children with congenital adrenal hyperplasia

BACKGROUND: Currently, alternative minimally invasive methods for assessing the steroid profile in patients with congenital adrenal hyperplasia (CAH) are being actively developed. Saliva has proven to be a promising medium in a series of international studies. The use of saliva as an alternative minimally invasive biological material not only reduces the stress associated with venipuncture but also decreases the workload for medical staff, as saliva collection can be performed at home.

AIM: Evaluate the correlation between concentrations of steroid hormones in the blood and saliva in prepubertal and pubertal groups of patients with congenital adrenal hyperplasia using high-performance liquid chromatography with tandem mass spectrometric detection (HPLC-MS/MS).

MATERIALS AND METHODS: A prospective intervention study for diagnosing and disease compensation in 45 patients aged 3 to 17 years undergoing a routine inpatient examination with an established diagnosis of CAH (classic 21-hydroxylase deficiency). All children underwent a one-stage laboratory test at the National Medical Research Center of Endocrinology of the Ministry of Health of the Russian Federation in October 2024.

RESULTS: In the prepubertal group (N=14), a strong positive correlation was found between serum and saliva for the concentration of 17OH-progesterone (p=<0.01; r=0.88), androstenedione (p=<0.001; r=0.84) and dehydroepiandrosterone (p=0.001; r=0.78). In the pubertal group (N=31), a strong positive correlation was found between serum and saliva for the concentrations of 17OH-progesterone (p=<0.01; r=0.94), androstenedione (p=<0.01; r=0.94), testosterone (p=<0.01; r=0.94), and progesterone (p=<0.01; r=0.79), as well as a moderate correlation for 21-deoxycortisol (p=0.003; r=0.52).

CONCLUSION: Most steroids used for diagnosis and monitoring the therapy in patients with CAH have a strong or moderate correlation between serum and saliva.

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