Extensive Alteration of Androgen Precursor Levels After Castration in Prostate Cancer Patients and Their Association With Active Androgen Level.

Under eugonadal conditions, AST levels showed a trend in approximating DHT level, whereas under ADT, AST was strongly associated with DHT level, highlighting the contribution of the “backdoor” pathway in the production of this potent androgen, as supported by the strong correlation between the level of these 2 steroids. 26 This alternative pathway bypasses the conventional intermediates AD and testosterone to synthesize the active androgen DHT using AST and 5alpha-androstane-3alpha,17beta-diol (3α-diol).

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