scholarly journals A mathematical comparison of techniques to predict biologically available testosterone in a cohort of 1072 men

2004 ◽  
pp. 241-249 ◽  
Author(s):  
PD Morris ◽  
CJ Malkin ◽  
KS Channer ◽  
TH Jones
Keyword(s):  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Free Androgen Index ◽  
Good Marker ◽  
Bioavailable Testosterone ◽  
Ammonium Sulphate Precipitation ◽  
Comparison Of Techniques ◽  
Operator Curve

OBJECTIVE: In the absence of widely available measures of determining free and/or bioavailable testosterone (BioT) physicians may use formulae such as the free androgen index (FAI) to estimate free testosterone. We compared the efficacy of calculated markers of androgen status in predicting serum BioT and hypogonadism. DESIGN: Total testosterone (TT), sex hormone binding globulin (SHBG) and BioT were determined in a large cohort of men. Comparison of calculated androgen levels was performed following endocrine assessment. METHODS: TT and SHBG were determined by ELISA, and BioT was determined by ammonium sulphate precipitation. From these data we calculated FAI and free testosterone using two other published formulae - FTnw (free testosterone as calculated by the method of Nanjeee and Wheeler) and FTv (free testosterone as calculated by the method of Vermeulen). A novel formula was derived to calculate BioT from given levels of TT and SHBG (BTcalculated). The ability of the methods (FAI, FTnw, FTv, BTcalc) to predict BioT were compared using regression analysis. The ability of these markers of androgen status to predict biochemical hypogonadism was compared using area under receiver operator curve (auROC). RESULTS: The equation derived from our data was the best predictor of BioT (R(2)=0.73, P<0.0001) although TT was also a good marker (R(2)=0.68, P=0.0001). In the determination of hypogonadism, of all currently available formulae none were better that the TT (auROC: TT=0.93, FAI=0.72, FTnw=0.91, FTv=0.88) although when TT is borderline (7.5<TT<12 nmol/l) estimates of free testosterone are superior to TT alone (auROC: TT=0.63, FAI=0.74, FTnw=0.75 and FTv=0.75). CONCLUSIONS: TT is the best marker of hypogonadism and BioT, when TT is borderline calculated indices of free testosterone or BioT are useful and may help confirm hypogonadism.

scholarly journals Comparison of Clinical and Biochemical Markers of Hirsutism in Polycystic Ovary Syndrome – A Study from a Teaching Hospital in Sri Ramachandra Institute, Chennai, India

2021 ◽  
Vol 10 (16) ◽  
pp. 1140-1144
Author(s):  
Nandhini Logaprabhu ◽  
Sarmishta Murugesan
Keyword(s):  
Biochemical Markers ◽  
Polycystic Ovarian Syndrome ◽  
Free Testosterone ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Hormone Binding ◽  
Free Androgen Index ◽  
Bioavailable Testosterone ◽  
Ovarian Syndrome

BACKGROUND We wanted to analyse the clinical profile of polycystic ovarian syndrome (PCOS) women with history, examination and ultrasonogram and correlate hirsutism with biochemical markers as free testosterone, dehydro-epiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG), free testosterone, DHEAS, and SHBG. METHODS This study is a prospective observational study conducted from 2011 to 2013 in the Department of Obstetrics and Gynaecology, Shree Balaji Medical College and Hospital, Chrompet in patients attending Gynaecology OPD. 100 women visiting the OPD were taken as control and 100 women were taken for PCOS study. RESULTS Hyperandrogenism was studied and all the biochemical markers were significantly higher in polycystic ovarian syndrome patients than in controls (P < 0.0001). The highest AUC-ROC was found for bioavailable testosterone (0.852) followed by free androgen index (0.847) and free testosterone (0.837). Lower AUC-ROC was found for androstenedione, total testosterone and SHBG (0.706, 0.799 and 0.76, respectively). When free androgen index of 4.97 was taken as a cut off value, sensitivity was 71.4 % and specificity was 85.2 %. A cut off of 0.78 nmol / L for bioavailable testosterone had even higher sensitivity of 75.9 %, but slightly lower specificity of 83.3 %. Bioavailable testosterone and free androgen index correlated significantly (all P < 0.05) with DHEAS, LH / FSH ratio, androstenedione and total testosterone. In addition, bioavailable testosterone, free androgen index, and free testosterone correlated significantly with follicle count, ovarian volume, and hirsutism scores. CONCLUSIONS White women have about 20 % of excess of dehydro-epiandrosterone sulphate (DHEAS) and black women have 30 % excess of dehydro-epiandrosterone sulphate (DHEAS) in those having poly cystic ovaries patients. There is an age-associated decline in DHEAS levels which is similar in both control and poly cystic ovaries women, regardless of the race which was seen in this study. KEY WORDS Free Testosterone, Dehydro–Epiandrosterone Sulphate (DHEAS), Sex Hormone Binding Globulin (SHBG)

Relative Diagnostic Value of Serum Non-SHBG-Bound Testosterone, Free Androgen Index and Free Testosterone in the Assessment of Mild to Moderate Hirsutism

1989 ◽  
Vol 26 (4) ◽  
pp. 311-316 ◽  
Author(s):  
Lesley F Blight ◽  
Stephen J Judd ◽  
Graham H White
Keyword(s):  
Free Testosterone ◽  
Diagnostic Value ◽  
Cell Entry ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Free Androgen Index ◽  
Idiopathic Hirsutism ◽  
Menopausal Women ◽  
In Vitro Diagnostic

Recent evidence suggests that steroid hormone loosely bound to albumin is available for target-cell entry. Preliminary studies have suggested that a measure of this fraction, non-sex-hormone-binding globulin-bound testosterone (NSB-T), provides the best in vitro diagnostic test for idiopathic hirsutism. We compared the diagnostic value of NSB-T, total testosterone (T), free testosterone (fT), and the free androgen index (FAI) in supporting the clinical diagnosis in 22 pre-menopausal women with hirsutism. NSB-T supported the diagnosis in 50% of cases, compared with 23% for T, 55% for fT by analogue RIA, and 68% for FAI. We conclude that in mild to moderate hirsutism the measurement of NSB-T does not yield diagnostic information additional to that provided by the FAI.

Total testosterone, free-androgen index, calculated free testosterone, and free testosterone by analog RIA compared in hirsute women and in otherwise-normal women with altered binding of sex-hormone-binding globulin.

1987 ◽  
Vol 33 (8) ◽  
pp. 1372-1375 ◽  
Author(s):  
T J Wilke ◽  
D J Utley
Keyword(s):  
Free Testosterone ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Diagnostic Efficiency ◽  
Hormone Binding ◽  
Clinical Value ◽  
Free Androgen Index ◽  
Normal Limits ◽  
Normal Women

Abstract We compared the clinical value of information on free testosterone as measured with the Coat-A-Count (Diagnostic Products Corp.) radioimmunoassay kit involving a ligand analog with that of total testosterone, the free-androgen index, and free testosterone calculated from concentrations of testosterone, sex-hormone-binding globulin, and albumin, in hirsute women, pregnant women, oral-contraceptive users, women with thyroid disease, and epileptic women taking phenytoin. Total testosterone, the free-androgen index, calculated free testosterone, and free testosterone by RIA were increased in 41-68% of hirsute women. Values for free testosterone increased in the first and third trimesters of pregnancy but remained within normal limits in all non-hirsute groups. Total testosterone was increased in patients having increased sex-hormone-binding globulin, whereas the free-androgen index and, to a lesser extent, calculated free testosterone were significantly decreased. Free testosterone measured by analog RIA not only has greater diagnostic efficiency than total testosterone, it also is technically simpler to determine than the free-androgen index and calculated free testosterone.

Determination of testosterone in serum not bound by sex-hormone-binding globulin: diagnostic value in hirsute women.

1988 ◽  
Vol 34 (9) ◽  
pp. 1826-1829 ◽  
Author(s):  
S Loric ◽  
J Guéchot ◽  
F Duron ◽  
P Aubert ◽  
J Giboudeau
Keyword(s):  
Ammonium Sulfate ◽  
Free Testosterone ◽  
Diagnostic Value ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Hormone Binding ◽  
Ammonium Sulfate Precipitation ◽  
Clinical Value ◽  
Free Androgen Index

Abstract We compared the diagnostic value of information given by total testosterone (I), free testosterone (II), the free androgen index (III), and testosterone not bound by sex-hormone-binding globulin (SHBG) (IV) as measured by a new differential ammonium sulfate precipitation technique, each step of which is conducted at 37 degrees C. SHBG and albuminemia were also measured. To examine the clinical value of IV, we analyzed single blood samples from 15 hirsute women and 15 age-matched healthy control volunteers. Values for I, II, III, and IV testosterone were all significantly higher in the hirsute group (P less than 0.01), whereas SHBG was decreased (P less than 0.01) and albumin concentrations were similar for the two groups. Overlap between values for normal and for hirsute women was 33.3% for I, 13.3% for II, and 0% for III and IV. The presented data suggest that IV measured by ammonium sulfate precipitation is the preferred discriminator for detecting hyperandrogenism, because this assay is technically simpler and less expensive than the II assay for routine investigation. It closely reflects the pool of bioavailable testosterone; thus, its main use might be as a screening test for androgen excess in women.

scholarly journals Prevalence and Influence of Diagnostic Criteria in the Assessment of Hypogonadism in Intrathecal Opioid Therapy Patients

2013 ◽  
Vol 1;16 (1;1) ◽  
pp. 9-14 ◽  
Author(s):  
Rui V. Duarte
Keyword(s):  
Diagnostic Criteria ◽  
Alternative Assessment ◽  
Serum Testosterone ◽  
Free Testosterone ◽  
Opioid Therapy ◽  
Sex Hormone Binding Globulin ◽  
Total Serum ◽  
Total Testosterone ◽  
Bioavailable Testosterone

Background: Hypogonadism is frequently diagnosed based on total testosterone (TT) levels alone. However, 99% of testosterone is bound to the sex hormone-binding globulin (SHBG) with only 1% free testosterone. Alternative assessment methods consist of assay of free testosterone (FT) or bioavailable testosterone (BT) by equilibrium dialysis, calculation of FT and BT through the Vermeulen equations, and calculation of the free androgen index (FAI). Objectives: The aim of this study was to investigate the prevalence of hypogonadism in male chronic non-cancer pain patients undertaking long-term intrathecal opioid therapy and the existence of diagnostic discrepancies according to the criteria used. Study design: Prospective observational study. Setting: Department of Pain Management, Russells Hall Hospital, Dudley, United Kingdom. Methods: Twenty consecutive male patients undertaking long-term intrathecal opioid therapy had the gonadal axis evaluated by assays of luteinising hormone (LH), follicle stimulating hormone (FSH), TT, SHBG and by calculating the FT, BT and FAI. Results: Hypogonadism was present in 17 (85%) of the patients based on TT; 17 (85%) according to FT and BT calculations; and 14 (70%) when calculating FAI. Based on either TT or FT being low or borderline/low, 19 (95%) of the investigated patients were biochemically hypogonadal. Significant differences were observed between diagnosis based on FT and FAI (P < 0.05). No significant differences were observed between diagnosis based on TT and FT (P = 0.40) or TT and FAI (P = 0.20). Conclusion: Hypogonadism is common in patients undertaking intrathecal opioid therapy for the management of chronic non-malignant pain; however, diagnostic criteria can influence the diagnosis of this side effect. The assessment of the hypothalamic-pituitarygonadal axis should include evaluation of total serum testosterone, free testosterone, or bioavailable testosterone. Key words: Diagnostic criteria, free testosterone, hypogonadism, implantable drug delivery systems, total serum testosterone

scholarly journals Association of total testosterone, free testosterone, bioavailable testosterone, sex hormone–binding globulin, and hypertension

Medicine ◽  
2019 ◽  
Vol 98 (20) ◽  
pp. e15628 ◽  
Author(s):  
Qingtao Yang ◽  
Zhenjie Li ◽  
Wencai Li ◽  
Liang Lu ◽  
Haoqiang Wu ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Hormone Binding ◽  
Bioavailable Testosterone

Sex-specific young adult reference ranges for sex hormone concentrations measured on the Siemens ADVIA Centaur/Geschlechtsspezifische Referenzbereiche für Sexualhormonkonzentrationen junger Erwachsener gemessen auf dem Siemens ADVIA Centaur

2012 ◽  
Vol 36 (1) ◽  
Author(s):  
Anke Hannemann ◽  
Nele Friedrich ◽  
Christin Spielhagen ◽  
Matthias Nauck ◽  
Robin Haring
Keyword(s):  
Regression Models ◽  
Free Testosterone ◽  
Dehydroepiandrosterone Sulfate ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Reference Ranges ◽  
Serum Concentrations ◽  
Hormone Binding ◽  
Free Androgen Index

AbstractThe present study aims to determine reference ranges for sex hormone concentrations measured on the Siemens ADVIA CentaurThe study sample consisted of 1638 individuals (814 men and 824 women) aged 18–60 years with measured serum concentrations of total testosterone (TT), sex hormone-binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS). Values for free testosterone (free T) and free androgen index (FAI) were calculated. Sex- and age-specific (18 to <25, 25 to <35, 35 to <45, and ≥45 years) reference ranges for these sex hormones were determined using quantile regression models for each sex hormone separately.Sex hormone reference ranges were determined across each single year of age separately for men (TT: 5.60–29.58 nmol/L, SHBG: 17.65–73.64 nmol/L, DHEAS: 0.96–4.43 mg/L, free T: 0.10–0.51 nmol/L, and FAI: 15.04–70.37 nmol/L) and women (TT: 0.77–2.85 nmol/L, SHBG: 27.06–262.76 nmol/L, DHEAS: 0.50–3.15 mg/L, free T: 0.005–0.05 nmol/L, and FAI: 0.51–8.30 nmol/L), respectively.

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.

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