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Ljubicic ML, Madsen A, Juul A, et al. The Application of Principal Component Analysis on Clinical and Biochemical Parameters Exemplified in Children With Congenital Adrenal Hyperplasia. Front Endocrinol (Lausanne). 2021;12:652888doi: 10.3389/fendo.2021.652888.
Ljubicic, M. L., Madsen, A., Juul, A., Almstrup, K., & Johannsen, T. H. (2021). The Application of Principal Component Analysis on Clinical and Biochemical Parameters Exemplified in Children With Congenital Adrenal Hyperplasia. Frontiers in endocrinology, 12652888. https://doi.org/10.3389/fendo.2021.652888
Ljubicic, Marie Lindhardt, et al. "The Application of Principal Component Analysis on Clinical and Biochemical Parameters Exemplified in Children With Congenital Adrenal Hyperplasia." Frontiers in endocrinology vol. 12 (2021): 652888. doi: https://doi.org/10.3389/fendo.2021.652888
Ljubicic ML, Madsen A, Juul A, Almstrup K, Johannsen TH. The Application of Principal Component Analysis on Clinical and Biochemical Parameters Exemplified in Children With Congenital Adrenal Hyperplasia. Front Endocrinol (Lausanne). 2021 Aug 31;12:652888. doi: 10.3389/fendo.2021.652888. eCollection 2021. PMID: 34531821; PMCID: PMC8438425.
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Front Endocrinol (Lausanne). 2021 Aug 31;12:652888. doi: 10.3389/fendo.2021.652888. eCollection 2021.

The Application of Principal Component Analysis on Clinical and Biochemical Parameters Exemplified in Children With Congenital Adrenal Hyperplasia.

Frontiers in endocrinology

Marie Lindhardt Ljubicic, Andre Madsen, Anders Juul, Kristian Almstrup, Trine Holm Johannsen

Affiliations

  1. Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  2. International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  3. Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.

PMID: 34531821 PMCID: PMC8438425 DOI: 10.3389/fendo.2021.652888

Abstract

PURPOSE: Principal component analysis (PCA) is a mathematical model which simplifies data into new, combined variables. Optimal treatment of pediatric congenital adrenal hyperplasia (CAH) remains a challenge and requires evaluation of all biochemical and clinical markers. The aim of this study was to introduce PCA methodology as a tool to optimize management in a cohort of pediatric and adolescent patients with CAH by including adrenal steroid measurements and clinical parameters.

METHODS: This retrospective, longitudinal cohort of 33 children and adolescents with CAH due to 21-hydroxylase deficiency included 406 follow-up observations. PCAs were applied to serum hormone concentrations and compared to treatment efficacy evaluated by clinical parameters.

RESULTS: We provide and describe the first PCA models with hormone parameters denoted in sex- and age-adjusted standard deviation (SD) scores to comprehensibly describe the combined 'endocrine profiles' of patients with classical and non-classical CAH, respectively. Endocrine profile scores were predictive markers of treatment efficacy for classical (AUC=92%; accuracy 95%; p=1.8e-06) and non-classical CAH (AUC=80%; accuracy 91%; p=0.004). A combined PCA demonstrated clustering of patients with classical and non-classical CAH by serum 17-hydroxyprogesterone (17-OHP) and dehydroepiandrosterone-sulphate (DHEAS) concentrations.

CONCLUSION: As an example of the possibilities of PCA, endocrine profiles were successfully able to distinguish between patients with CAH according to treatment efficacy and to elucidate biochemical differences between classical and non-classical CAH.

Copyright © 2021 Ljubicic, Madsen, Juul, Almstrup and Johannsen.

Keywords: CAH; congenital adrenal hyperplasia; endocrine profiling; principal component analysis; treatment efficacy

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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