Concentrations of total and free dehydroepiandrosterone in plasma and dehydroepiandrosterone in saliva of normal and hirsute women under basal conditions and during administration of dexamethasone/synthetic corticotropin.

Using a specific and sensitive radioimmunoassay involving extraction with diethyl ether and chromatographic separation of steroids, we measured concentrations of salivary and plasma dehydroepiandrosterone (DHEA) in 22 women with normal ovulatory cycles (ages 18-45 years). Salivary DHEA values closely correlated with total and free DHEA in plasma. In the follicular phase the mean concentrations of salivary and plasma free DHEA were virtually equal [mean (SD): 0.61 (0.32) and 0.56 (0.34) nmol/L, respectively]. In the luteal phase, salivary DHEA slightly exceeded the plasma free DHEA [0.68 (0.40) vs 0.56 (0.38) nmol/L, P less than 0.01]. Also, during combined dexamethasone/synthetic corticotropin administration in 25 patients with androgenizing disorders and in 10 normal subjects (each in the follicular and luteal phases), the concentration of DHEA in saliva strongly correlated with total and free DHEA in plasma. During these dynamic tests, the mean concentrations of free DHEA in plasma and salivary DHEA in the hirsute women were significantly higher than the mean concentrations in the control women at all times before and after corticotropin infusion (P less than 0.05- less than 0.0001). In contrast, plasma total DHEA in patients exceeded nonhirsute values only at 15 min after corticotropin administration. In six of 25 patients total DHEA during combined administration of dexamethasone/synthetic corticotropin exceeded normal values by at least 2 SD. The response of salivary and free DHEA to synthetic corticotropin in this subgroup was also excessive.