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

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          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.

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          Most cited references26

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          What is principal component analysis?

          Markus Ringnér (2008)
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            Generalized additive models for location, scale and shape (with discussion)

            R. Rigby, D. M. Stasinopoulos (2005)
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              Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation

              K Hajian-tilaki, K. Hajian-Tilaki, H-T K … (2013)
              Article 0 comments Cited 240 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Endocrinol (Lausanne)
                Journal ID (iso-abbrev): Front Endocrinol (Lausanne)
                Journal ID (publisher-id): Front. Endocrinol.
                Title: Frontiers in Endocrinology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-2392
                Publication date (Electronic): 31 August 2021
                Publication date Collection: 2021
                Volume: 12
                Electronic Location Identifier: 652888
                Affiliations
                [1] 1Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen , Copenhagen, Denmark
                [2] 2International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen , Copenhagen, Denmark
                [3] 3Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital , Bergen, Norway
                Author notes

                Edited by: Oksana Lekarev, Weill Cornell Medical Center, United States

                Reviewed by: Maria G. Vogiatzi, University of Pennsylvania, United States; Jarmo Jääskeläinen, Kuopio University Hospital, Finland

                *Correspondence: Trine Holm Johannsen, trine.holm.johannsen@ 123456regionh.dk

                This article was submitted to Pediatric Endocrinology, a section of the journal Frontiers in Endocrinology

                Article
                DOI: 10.3389/fendo.2021.652888
                PMC ID: 8438425
                PubMed ID: 34531821
                SO-VID: 68bce7ac-8b15-435f-bb81-9df7a56d3637
                Copyright © Copyright © 2021 Ljubicic, Madsen, Juul, Almstrup and Johannsen
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 11 February 2021
                Date accepted : 09 August 2021
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 26, Pages: 8, Words: 4731
                Categories
                Subject: Endocrinology
                Subject: Original Research

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: principal component analysis,congenital adrenal hyperplasia,cah,endocrine profiling,treatment efficacy
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: principal component analysis, congenital adrenal hyperplasia, cah, endocrine profiling, treatment efficacy

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