[PART 3] [GONADAL] Clinical Chemistry [RODRIGUEZ]

Androgen and Estrogen

The testes and ovaries produce hormones such as

Estradiol

Ovary converts testosterone to?

estrone

Ovary converts androstenedione to?

1. Testosterone to dihydrotestosterone (DHT)

2. Hydroxylate estradiol to estriol

3. adrenal androgens to Testosterone

4. Androgens to estrone and estradiol.

Peripheral tissues (including those targeted by androgens) reduce what?

1. sex hormone-binding globulin (SHBG),

2. corticosteroid-binding globulin (CBG)

3. albumin

Major transport proteins:

sex hormone-binding globulin (SHBG)

transports androgens and esttogens

corticosteroid-binding globulin (CBG)

delivers progesterone and glucocorticoids.

only the free form can DIFFUSE into the vascular system and interact with target cells

Only the free fraction of the hormone is biologically active because?

1% to 2%

About _______________ of the sex steroids are free

Testosterone

It is the principal androgen hormone in the blood

Testosterone

most potent male androgen.

Leydig cells

Testosterone is synthesized by the of the _____________________testis of the male

FSH and LH

Testosterone is controlled primarily

progesterone

Testosterone is also derived from

growth and development of the reproductive system, prostate and external genitalia

Testosterone Functions:

awakening (8am)

Testosterone is high at what time?

8pm

Testosterone is lowest at what time?

30 y/o

There is a gradual reduction in testosterone after what age?

110 ng/dl.

decade = 10

so 110 >_<

testosterone has an average decline of about _____________ every decade

Obesity

______________ may cause decrease plasma testosterone concentration.

50 y/o

After age________, MEN experience a DECREASE in secretion rate and concentration of testosterone, and WOMEN have an INCREASE in pituitary gonadotropins, especially follicle-stimulating hormone

Semen analysis, testosterone, FSH and LH

Tests for male infertility:

3.9-7.9 ng/mL (serum)

Reference values MALE infertility test

50%

Under Transport protein, ALBUMIN is how many percent?

45%

Under Transport protein, Sex hormone binding-globulin (SHBG) is how many percent?

total testosterone

free testosterone

The concentration of binding protein determines the level of _______________________ but not the ___________________ levels during laboratory estimation.

1. Pretesticular infertility (Secondary hypodonadism)

2. Testicular infertility (Primary hypogonadism)

3. Post-testicular infertility

Give the 3 types of Testicular infertility (Hypogonadism)

Pretesticular infertility (Secondary hypodonadism)

It is due to hypothalamic or pituitary lesions.

cryptorchidism, Klinefelter's syndrome and 5-alpha-reductase deficiency

Testicular infertility (Primary hypogonadism) may be congenital. Give example

cryptorchidism

Isa lang ang testicle

5-alpha-reductase

Enzyme responsible of converting testosterone to dehydroepitestosterone?

varicocele

tumor

orchitis

Testicular infertility (Primary hypogonadism) may be acquired. Give example

Primary hypogonadism (Testicular infertility)

it is characterized by having decreased testosterone levels and increased FSH and LH levels.

Post-testicular infertility

It is due to disorders of sperm transport and function. Normal blood level:

Post-testicular infertility

Normal blood level oftestosterone, FSH and LH levels

Testicular Feminization Sundrome

It is the MOST severe form of androgen resistance syndrome, resulting in LACK of testosterone action in the target tissue.

Testicular Feminization Sundrome

The physicai development pursues the female phenotype, with fully developed breast and female distribution of fat and hair.

Yung lalake mukhang babae

True

True or False

There is no utility or response to administration of exogenous testosterone in

Testicular Feminization Sundrome

NORMAL levels of testosterone with ELEVATED FSH and LH levels

In Testicular Feminization Sundrome, lab tests shows a result of?

Sertoli Cell-Only Syndrome

It is characterized by a lack of germ cells.

Sertoli Cell-Only Syndrome

Men present with small testes, high FSH levels, azoospermia, and normal testosterone levels.

azoospermia

No semen in ejaculate

Testicular biopsy

is the only procedure to confirm Sertoli Cell-Only Syndrome

Kallmann's Syndrome

It is a result of an inherited, X-linked recessive trait that manifests as hypogonadism during puberty.

Kallmann's Syndrome - idi "kallman" kuma ngem na delay - ilocano

What syndrome delays puberty

anosmia (inability to smell)

midline defects (cleft palate and lip)

Kallmann's Syndrome Associated defects:_________________ and __________________

anosmia

inability to smell

Dehydroepiandrosterone (DHEA)

It is the principal androgen formed by adrenal cortex; weak androgen.

Dehydroepiandrosterone (DHEA)

It is valuable in the assessment of adrenal cortical function.

Estrogen

It is carbon-18 steroid hormones that have a phenol A ring.

testosterone

Estrogen arises through structural alteration of the___________________________ molecule.

False

True or False

Estrogen is produced by the ovaries after menopause.

promotion of breast development, maturation of the external genitalia, deposition of body fat and termination of linear growth (secondary sexual characteristic in the female) In conjunction with progesterone, they function in uterine growth and regulation of menstrual cycle, and maintenance of pregnancy.

Estrogen Functions:

irregular and incomplete development of the endometrium

Estrogen deficiencey may cause?

Acetate, cholesterol, progesterone and testosterone

What is the precursor of estrogen?

estrone. estradioland estriol

What are the 3 forms of ESTROGEN?

Estrone and estriol

are metabolites of intraovarian and extraglandular conversion.

Estrone (E1) "d"ONE" na kasi POST

it is the most abondant estrogen in POST menopausal women.

Estradiol(E2)

It is the most potent estrogen secreted by the ovary; major estrogen

Estradiol(E2)

major estrogen.

Estradiol(E2)

it is the most abundant estrogen in PRE menopausal women; low levels in the menopausal stage

Estradiol (E2)

It is the precorsure of Estrone (E1) and Estriol (E3)

Estradiol (E2)

It is used to assess ovarian function; serves as negative feedback for FSH.

albumin (60%) and SHBG (38%)

2% ang natira yun ang FREE form

Estradiol (E2) Transport proteins

Estriol (E3)

it is a metabolite of estradiol.

Estriol (E3)

It is the estrogen found in MATERNAL urine.

Estriol (E3)

It is the major estrogen secreted by the placenta during pregnancy

Estriol (E3)

It is used as a marker for Down syndrome

plasma

Preferred specimen for Estriol (E3)

Progesterone

it is a carbon-21 compound in the steroid family

granulose (lutein) cells

Corpus luteum

Progesterone is produced mainly by the ______________________________ of the __________________ in the female.

Progesterone

Is the prime secretory product of the ovary.

Progesterone

It is a dominant hormone responsible for the luteal phase cycle among females.

Progesterone

What is the single best hormone to determine whether OVULATION has occurred

failure of implantation of embryo

Sa OVULATION

Progesterone deficiency may casue?

estrogen, progesterone, FSH, LH

Test for Female Infertility

Sertoli cells

secretes inhibin

inhibin

inhibits FSH activity

LH (luteinizing hormone)

Leydig cells is activated by?

FSH (follicle stimulating hormone)

Sertoli cells is activated by?

anti-Müllerian hormone

Sertoli cells secretes?

androstenediol

A5

androstenedione

A4

Dihydrotestosterone (DHT)

more potent androgen than testosterone

also derived from progesterone

TESTOSTERONE

gynecomastia

male breasts

aromatase

testosterone will be converted to estradiol by waht enzyme?

dystonia

inability of the muscle to relax adequately after contraction

Primary deficiency

Klinefelter's syndrome

Secondary deficiency

Panhypopituitarism

Primary excess

Testicular tumor

Inhibin A

inhibits corpus luteum

Inhibin B

Inhibits developing follicles

Activin

enhances FSH secretion

Thelarche

development of breast tissue earliest sign

menarche

initiation of menstruation

25 ul

For Progesterone, Pipette __________ of Serum to the asssigned well

10 ul

For Testosterone, Pipette __________ of Serum to the asssigned well

Competitive EIA

Microplate Enzyme Immunoassay

Colorimetric

Principle of Test for Progesterone and Testosterone

60 days at 2-8 C

Progesterone and Testosterone test reagents are stable for _______________days at__________C