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A recent clinical study conducted by Revanasiddappa et al., published in early 2025, has established detailed reference ranges for basal and adrenocorticotropic hormone (ACTH)-stimulated blood steroid profiles in apparently healthy Indian women aged 18 to 40 years. This landmark research addresses a significant gap in endocrinology diagnostics by providing population-specific data critical for accurate interpretation of adrenal steroid hormone tests in Indian women.
Key Findings
The cross-sectional study involved 30 healthy volunteers whose blood samples were analyzed during the early follicular phase of their menstrual cycles, both at baseline and after stimulation with a standardized dose (250 µg) of synthetic ACTH (1-24). Steroid levels were quantified using the highly accurate liquid chromatography-tandem mass spectrometry (LC-MS/MS) technique, allowing precise hormone measurements.
Post-ACTH stimulation, certain steroids showed marked elevations:
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11-deoxycorticosterone increased 10.16-fold (2.44±0.8 ng/dl to 24.8±19.4 ng/dl)
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Corticosterone rose 9.55-fold (226.0±184.0 ng/dl to 2159.0±779.0 ng/dl)
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11-deoxycortisol increased 7.28-fold (47.4±52.4 ng/dl to 344.7±246.0 ng/dl)
Moderate increases (2 to 3.5-fold) were observed in:
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17α-hydroxyprogesterone
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Dehydroepiandrosterone (DHEA)
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Cortisol
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Aldosterone
These steroid response patterns provide a detailed profile baseline and stimulated hormone levels specific to Indian women, allowing more reliable differentiation between normal physiology and pathological states.pmc.ncbi.nlm.nih+1
Expert Commentary
Dr. Anjali Mehta, an endocrinologist unaffiliated with the study, commented:
“The establishment of ethnicity- and gender-specific reference ranges for adrenal steroids is crucial for accurate diagnosis of disorders like congenital adrenal hyperplasia (CAH), Cushing’s syndrome, and other adrenal pathologies. Having Indian-specific ranges means clinicians can better interpret ambiguous hormonal test results and avoid misdiagnoses.”
Background and Clinical Relevance
Polycystic ovary syndrome (PCOS) affects up to 22.5% of Indian women and presents overlapping features with rare adrenal disorders such as CAH. Current diagnostic practices largely rely on immunoassay-measured serum 17-hydroxyprogesterone (17-OHP) levels to exclude 21-hydroxylase deficiency, but this approach may fail to identify rarer forms of adrenal dysfunction.
ACTH-stimulated blood steroid profiling using LC-MS/MS is a more sensitive method that evaluates multiple adrenal hormones simultaneously. However, the lack of established reference ranges tailored to the Indian population has limited its clinical utility in India until now.
This study’s findings enable endocrinologists to utilize ACTH-stimulation tests with greater confidence, distinguishing between various forms of hyperandrogenism and adrenal disorders prevalent in Indian women.
Public Health Implications
The availability of accurate reference ranges supports timely and precise diagnosis, guiding appropriate treatment and management. This advances personalized medicine and reduces overtreatment or delayed therapy for adrenal diseases. As precision endocrinology grows, such foundational data are vital for equitable healthcare delivery across diverse populations.
Limitations and Future Directions
While the study provides valuable baseline data, the sample size was relatively small (30 participants), all recruited from a single region. Broader studies incorporating larger and more diverse cohorts across India are needed to validate and refine these ranges further.
Additionally, the study focused on women aged 18-40 without chronic illness or medication use, so applicability to other age groups or those with comorbidities requires further research. Ongoing research should also explore longitudinal hormone variability and implications for conditions like PCOS and adrenal insufficiency.
What This Means for Readers
For health-conscious individuals and healthcare providers, this research highlights the importance of population-specific medical testing standards. Blood tests measuring adrenal steroids can be better interpreted with relevant reference data, especially for women experiencing symptoms of hormonal imbalance or suspected adrenal disorders.
Medical Disclaimer
This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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