Overview
Delta-4-3-oxosteroid-5-beta-reductase deficiency is a rare genetic disorder that affects steroid metabolism. It is characterized by a deficiency in the enzyme delta-4-3-oxosteroid 5-beta-reductase, which plays a role in the conversion of androgens and other steroids. This deficiency can lead to a spectrum of clinical manifestations, often related to hormonal imbalances.Diagnosis
No specific diagnostic criteria or recommended tests are mentioned in the provided abstracts.Management
5α-Reductase inhibitors (5-ARIs) are prescribed for benign prostatic obstruction and androgenic alopecia 1.
Specific 5-ARIs mentioned include finasteride and dutasteride 1.Special Populations
No specific information regarding special populations is available in the provided abstracts.Key Recommendations
There is no statistically significant association between 5α-reductase inhibitor exposure and the risk of depression (adjusted hazard ratio [aHR] 1.30, 95% CI 0.85-2.00; p = 0.23) or suicide (aHR 1.30, 95% CI 0.65-2.61; p = 0.45) 1.
Subgroup analyses for finasteride and dutasteride revealed similar results regarding depression and suicide risk 1.
When restricting the analysis to patients without a prior diagnosis of depression, similar findings were observed for suicide risk (aHR 1.00, 95% CI 0.68-1.46; p = 0.98) 1.
A pooled analysis of over two million patients taking 5α-reductase inhibitors found no evidence of an association between their use and the risk of depression or suicide 1.
(Evidence: Moderate)References
1 Uleri A, Nicolas Cornu J, Gobbo A, Herrmann TRW, De Nunzio C, Hashim H et al.. Association of 5α-Reductase Inhibitors with Depression and Suicide: A Mini Systematic Review and Meta-analysis. European urology focus 2024. link