scholarly journals The Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A745-A746
Author(s):  
Samih A Odhaib ◽  
Abbas A Mansour ◽  
Khalil I Al Hamdi
Keyword(s):  
Hair Loss ◽  
Significant Relationship ◽  
Premenopausal Women ◽  
Sex Hormone Binding Globulin ◽  
Diagnostic Process ◽  
Total Testosterone ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Bioavailable Testosterone ◽  
Female Pattern Hair Loss

Abstract Background: The exact association between clinical and biochemical hyperandrogenism (HA) is heterogeneous and cannot be ascertained, especially in normoandrogenic women. Aim: Evaluate any association between clinical HA phenotypes and biochemical parameters in premenopausal women with female pattern hair loss (FPHL). Methods: A cross-sectional observational study on 362 women with different degrees of FPHL, who were assessed for general characteristics, the degree of FPHL by Sinclair’s score, hirsutism by modified Ferriman-Gallwey (mFG) score. Evaluation for biochemical HA included total testosterone (TT), sex-hormone-binding globulin (SHBG), calculated free testosterone (FT), calculated bioavailable testosterone (BT), and dehydroepiandrosterone sulfate (DHEA-S). The variables of clinical HA which were used in this study are FPHL, hirsutism, and acne. We used the Free and Bioavailable Testosterone Calculator to calculate the FT and BT. Results: The enrolled young premenopausal women’s age range was (14-47 years). Around 78% of them were overweight or obese. Eighty-percent of women had a mild FPHL, with a median duration of three years where 2/3 of women had a duration < 3 years, and had no significant relationship to FPHL degree. About 73% of women had either a mild to moderate hirsutism, and around 16% had acne. The biochemical HA was confirmed in around 52% of women (n=188), who show high levels of calculated FT. The calculated BT is high in 78.5% of the enrolled women (n=284). The means of biochemical indicators for HA were in their reference ranges or slightly above, with no specific change pattern with the corresponding FPHL severity. None of these parameters had a significant relationship to the severity of FPHL. The duration of FPHL was not affected by any presumed variable of clinical or biochemical HA. Conclusions: FPHL severity is associated with other clinical HA signs like hirsutism and acne, but not to HA’s biochemical parameter. Other parameters, like SHBG, HOMA-IR, and BMI, had no significant relation to the severity of FPHL. Clinical implications: FPHL severity does not correlate with the magnitude of hyperandrogenism. The assessment of women with FPHL is primarily clinical. The biochemical picture assists the diagnostic process.

Urinary Equol is Associated with Bioavailable Testosterone but not Total Testosterone in Women

2019 ◽  
Author(s):  
Hong-li Dong ◽  
Feng Xiong ◽  
Qing-wei Zhong ◽  
Yi-hong Li ◽  
Meng Liu ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Positive Association ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Bioavailable Testosterone

Little is known about the association between equol and bioavailable testosterone (BT) in adults. We examined the associations of urinary equol concentrations with serum total, bioavailable and free testosterone (FT), dehydroepiandrosterone sulfide (DHEAS), free androgen index (FAI) and sex hormone-binding globulin (SHBG) concentrations. This cross-sectional study included 1904 women aged 59.7 years. Urinary equol and serum sex hormone concentrations were measured. Overall, urinary equol tended to be inversely associated with bioactive forms of androgenic indices (BT, FT or FAI) but not with total testosterone (TT) or DHEAS. Urinary equol was also positively associated with SHBG. In multi-covariate-adjusted analyses stratified by menopausal status, graded and inverse associations between urinary equol and bioactive forms of androgenic indices (BT, FT and FAI) were observed in postmenopausal women (all p-trends <0.05), but not in premenopausal women. A significant positive association between urinary equol and SHBG was observed only in postmenopausal women. No significant associations were observed between urinary equol and TT or DHEAS in either group. A path analysis indicated that these associations of equol with androgens in postmenopausal women might be mediated by SHBG. Our findings indicated urinary equol exhibited graded and inverse associations with BT or FT but not TT in women.

scholarly journals SAT-LB5 Prevalence of Hypogonadism in Young Obese Males

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anup Halappanavar ◽  
Rajiv Pakhetra
Keyword(s):  
Hypogonadotropic Hypogonadism ◽  
Armed Forces ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
P Value ◽  
Total Testosterone ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Testosterone Levels ◽  
The Impact

Abstract Ageing, obesity, and chronic illness are major factors affecting serum testosterone (T) levels in men.The magnitude of the impact of ageing on serum T levels is well established, for obesity this is less clear. Severe obesity may lead to isolated hypogonadotropic hypogonadism (IHH). Several explanations have been offered to clarify the presence of reduced T levels in obese men. One relates to the technique that is generally employed to measure serum androgen levels, i.e. measurement of total testosterone (TT) instead of free testosterone (FT). TT represents the sum of FT and T bound to albumin and sex hormone binding globulin (SHBG). A profound reduction in SHBG level is commonly found in obese men, and this is a major factor causing a decrease in TT.Measurement of free testosterone levels may provide a more accurate assessment of androgen status than the (usually preferred) measurement of total testosterone in situations where SHBG levels are outside the reference range. However, reference ranges for free testosterone levels are not well established, especially in older men, and some have argued that the measurement of free testosterone levels merely reintroduces age in a covert form. This is a cross sectional study to estimate prevalence of hypogonadism in young obese males. In this study 147 young obese men participated, of which we confirmed low total testosterone (TT) levels in 35.37% of subjects with a p value of 0.06. Since only Total Testosterone was measured for categorizing subjects with or without hypogonadism, Free Testosterone measurement would be a better indicator for the diagnosis of hypogonadism as in cases where the total testosterone is borderline-low or when SHBG concentrations are abnormal. As such, the study is valuable in the context of the ongoing controversy as to whether testosterone treatment should be limited to men with classical hypogonadism, or be considered for appropriately selected men with functional hypogonadism as well. The principal findings are in general agreement with existing literature reporting correlation between levels of testosterone, body mass index and constitutional symptoms. However, this has never been shown before in context of Indian population. The present study was carried out at Armed Forces Medical College and Command Hospital, Pune between October 2017 to August 2019.We studied to see if there is association between testosterone levels and BMI. In our study we found no statistical association as the p value was 0.26 (>0.05)

scholarly journals Hypogonadism and liver fibrosis in HIV-infected patients

2021 ◽  
Author(s):  
E. Quiros-Roldan ◽  
T. Porcelli ◽  
L. C. Pezzaioli ◽  
M. Degli Antoni ◽  
S. Paghera ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Univariate Analysis ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Pituitary Dysfunction ◽  
Consequent Reduction ◽  
Secondary Hypogonadism ◽  
The Relationship

Abstract Purpose Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. Methods We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Results Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Conclusion Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.

scholarly journals In men older than 70 years, total testosterone remains stable while free testosterone declines with age. The Health in Men Study

2007 ◽  
Vol 156 (5) ◽  
pp. 585-594 ◽  
Author(s):  
Bu B Yeap ◽  
Osvaldo P Almeida ◽  
Zoë Hyde ◽  
Paul E Norman ◽  
S A Paul Chubb ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Older Men ◽  
Early Morning ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Limited Data ◽  
Cross Sectional ◽  
Testosterone Concentration ◽  
Age Related ◽  
Clinical Consequences

Objective: An age-related decline in serum total and free testosterone concentration may contribute to ill health in men, but limited data are available for men > 70 years of age. We sought to determine the distribution and associations of reduced testosterone concentrations in older men. Design: The Health in Men Study is a community-representative prospective cohort investigation of 4263 men aged ≥ 70 years. Cross-sectional hormone data from 3645 men were analysed. Methods: Early morning sera were assayed for total testosterone, sex hormone binding globulin (SHBG) and LH. Free testosterone was calculated using the Vermeulen method. Results: Mean (± s.d.) serum total testosterone was 15.4 ± 5.6 nmol/l (444 ± 162 ng/dl), SHBG 42.4 ± 16.7 nmol/l and free testosterone 278 ± 96 pmol/l (8.01 ± 2.78 ng/dl). Total testosterone correlated with SHBG (Spearman’s r = 0.6, P < 0.0001). LH and SHBG increased with age (r = 0.2, P < 0.0001 for both). Instead of declining, total testosterone increased marginally (r = 0.04, P = 0.007) whilst free testosterone declined with age (r = −0.1, P < 0.0001). Free testosterone was inversely correlated with LH (r = −0.1, P < 0.0001). In multivariate analyses, increasing age, body mass index (BMI) and LH were associated with lower free testosterone. Conclusions: In men aged 70–89 years, modulation of androgen action may occur via an age-related increase in SHBG and reduction in free testosterone without a decline in total testosterone concentration. Increasing age, BMI and LH are independently associated with lower free testosterone. Further investigation would be required to assess the clinical consequences of low serum free testosterone, particularly in older men in whom total testosterone may be preserved.

scholarly journals Hypoactive sexual desire in transsexual women: prevalence and association with testosterone levels

2008 ◽  
Vol 158 (3) ◽  
pp. 393-399 ◽  
Author(s):  
Els Elaut ◽  
Griet De Cuypere ◽  
Petra De Sutter ◽  
Luk Gijs ◽  
Michael Van Trotsenburg ◽  
...  
Keyword(s):  
Sexual Desire ◽  
Free Testosterone ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Oestrogen Treatment ◽  
Testosterone Levels

ObjectiveAn unknown proportion of transsexual women (defined as post-operative male-to-female transsexuals on oestrogen replacement) experience hypoactive sexual desire disorder (HSDD). It has been suggested that the absence of ovarian androgen production together with oestrogen treatment-related increase in sex hormone-binding globulin (SHBG) levels could be leading to HSDD, due to low levels of biologically available testosterone. This study wishes to document the HSDD prevalence among transsexual women and the possible association to androgen levels.DesignCross-sectional study.MethodsTranssexual women (n=62) and a control group of ovulating women (n=30) participated in this study. Questionnaires measuring sexual desire (sexual desire inventory) and relationship and sexual satisfaction (Maudsley Marital Questionnaire) were completed. Serum levels of total testosterone, LH and SHBG were measured in blood samples obtained at random in transsexual women and in the early follicular phase in ovulating women.ResultsThe transsexual group had lower levels of total and calculated free testosterone (both P<0.001) than the ovulating women. HSDD was reported in 34% of the transsexual and 23% of the ovulating women (P=0.30). Both groups reported similar levels of sexual desire (P=0.97). For transsexual women, no significant correlation was found between sexual desire and total (P=0.64) or free testosterone (P=0.82). In ovulating women, these correlations were significant (P=0.006, resp. P=0.003).ConclusionsHSDD is reported in one-third of transsexual women. This prevalence is not substantially different from controls, despite markedly lower (free) testosterone levels, which argues against a major role of testosterone in this specific group.

scholarly journals Age-Associated Discrepancy between Measured and Calculated Bioavailable Testosterone in Men

2007 ◽  
Vol 53 (4) ◽  
pp. 723-728 ◽  
Author(s):  
Henri Déchaud ◽  
Anne Denuzière ◽  
Sabina Rinaldi ◽  
Julien Bocquet ◽  
Hervé Lejeune ◽  
...  
Keyword(s):  
Theoretical Calculations ◽  
Older Men ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Plasma Samples ◽  
Aging Male ◽  
Ammonium Sulfate Precipitation ◽  
Male Population ◽  
Bioavailable Testosterone ◽  
Parallel Increase

Abstract Background: Bioavailable testosterone (BT) concentration is considered the best marker for evaluating testicular function in men. The decrease of BT in older men is more pronounced than the decrease in total testosterone because of the parallel increase in sex hormone–binding globulin (SHBG) concentrations. Measurement of BT is therefore crucial for the diagnosis of hypoandrogenism in the aging male population. Methods: We compared BT concentrations measured by a specific RIA after ammonium sulfate precipitation (BTmeas) with those obtained by theoretical calculations (BTcal) in plasma samples from 694 young men (14 to 49 years old) and 51 older men (50 to 81 years old). We based theoretical calculations on Vermeulen’s simplified mass equation using total testosterone and SHBG concentrations. Results: BTcal and BTmeas correlated significantly in young (Pearson r = 0.87) and aging (r = 0.89) men, but the BTcal:BTmeas ratio differed markedly between the 2 groups (2.28 vs 3.48; P &lt;0.001). Conclusions: In men, there is an age-associated discrepancy between calculated and measured BT concentrations. We suggest some hypotheses for the discrepancy, but additional studies will be performed to finally elucidate this difference in results and to determine the most appropriate method for BT measurements in older men.

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