The comparison of free androgen index and serum free testosterone levels in women with hirsutism or polycystic ovary syndrome

Abstract

Objectives: In many laboratories free testosterone can not be measured, so that free androgen index is suggested in-stead. The aim of this study was to compare free androgen index and serum free testosterone levels measured by ra-dioimmunoassay in women with hirsutism or polycystic ovary syndrome. Materials and methods: Totally 94 women referred to the polyclinics of Ankara Numune Hospital were retrospectively included. Three patient groups were composed; 55 of hirsutism, 20 of polycystic ovary syndrome and 19 of both hirsutism and polycystic ovary syndrome. Total testosterone and sex hormone binding globuline levels were measured by chemiluminescence method and free testosterone levels were measured by radioimmunoassay. Free androgen index was calculated from total testosterone and sex hormone binding globuline. Results: There was a significant positive correlation between free testosterone and free androgen index in patients with hirsutism, in patients with polycystic ovary syndrome, in patients with hirsutism and polycystic ovary syndrome, and in total patient group [r(hirsutism)=0,597, r(PCOS)=0,617, r(hirsutism and PCOS)=0,779, r(total patient group)=0,649, P

Keywords

• Free androgen index, free testosterone, hirsutism, polycystic ovary syndrome.

Hirsutizmli veya polikistik over sendromlu kadın hastalarda serbest androjen indeksi ile serum serbest testosteron düzeylerinin karşılaştırılması

Öz

Amaç: Birçok laboratuvarda serbest testosteron ölçümü yapılamadığı için yerine serbest androjen indeksi önerilmiştir. Bu çalışmanın amacı hirsutizmli veya polikistik over sendromlu kadınlarda, serbest androjen indeksi ile radyoimmuno-assay yöntemle ölçülen serbest testosteron düzeylerinin karşılaştırmaktır. Gereç ve yöntem: Retrospektif olarak yapılan çalışmaya, Ankara Numune Eğitim ve Araştırma Hastanesi poliklinikleri-ne başvuran toplam 94 kadın hasta dahil edildi. 55 hirsutizmli, 20 polikistik over sendromlu, 19 hirsutizm ve polikistik over sendromlu üç hasta grubu oluşturuldu. Total testosteron ve seks hormon bağlayıcı globulin düzeyleri kemilümi-nesans yöntemle, serbest testosteron düzeyleri radyoimmunoassay yöntemle çalışıldı. Serbest androjen indeksleri total testosteron ve seks hormon bağlayıcı globulin kullanılarak hesaplandı. Bulgular: ‘Hirsutizmli hastalarda', ‘polikistik over sendromlu hastalarda', ‘hirsutizm ve polikistik over sendromlu hasta-larda' ve ‘toplam hasta grubunda'; serbest testosteron ile serbest androjen indeksi arasında pozitif yönde anlamlı bir ilişki saptandı [r(hirsutizm)=0,597, r(PKOS)=0,617, r(hirsutizm ve PKOS)=0,779, r(toplam hasta grubu)=0,649, P

Anahtar Kelimeler

• Serbest androjen indeksi, serbest testosteron, hirsutizm, polikistik over sendromu

References

1. Haymond S, Gronowski AM. Reproductive Related Disor- ders. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Text-book of Clinical Chemistry and Molecular Diagnos- tics. 4th Ed. USA: Elsevier Saunders, 2006: 2097-152.
2. Marshall WJ, Bangert SK. The Gonads. Clinical Chemistry. 5th Ed. UK: Mosby Elsevier, 2004:177-90.
3. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 1999;84(10):3666-72.
4. Wilke TJ, Utley DJ. 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 glob- ulin. Clin Chem 1987;33(8):1372-5.
5. Christ-Crain M, Meier C, Huber P, Zimmerli L, Trummler M, Müller B. Comparison of different methods for the meas- urement of serum testosterone in the aging male. Swiss Med Wkly 2004;134(13-14):193-7.
6. Morris PD, Malkin CJ, Channer KS, Jones TH. A mathemati- cal comparison of techniques to predict biologically avail- able testosterone in a cohort of 1072 men. Eur J Endocrinol 2004;151(2):241-9.
7. Morimoto I, Izumi M, Nagataki S, Iwasaki H, Hakariya S. Free testosterone index: comparison with plasma free testos- terone. Nippon Naibunpi Gakkai Zasshi 1986;62(7):797- 806.
8. Qiao FY, Lauritzen C. Significance of sex hormone bind- ing globulin and free androgen index in the estimation of andro-genic cases. J Tongji Med Univ 1990;10(2):124-8.

9. Brannian JD, Long P, Kreger DO. Is the free androgen in- dex a useful clinical marker in male patients? S D J Med 1998;51(12):449-51.
10. Eden JA, Place J, Carter GD, Jones J, Alaghband-Zadeh J, Pawson M. Elevated free androgen index as an indicator of polycystic ovaries in oligomenorrhoea without obesity or hirsuties. Ann Clin Biochem 1988;25(Pt4):346-9.
11. Urdl W, Schweditsch MO, Kowatsch AW, Tscherne G, Pürst- ner P, Haas J. Value of laboratory parameters in androgeni- zation in the female with special reference to the free andro- gen index. Geburtshilfe Frauenheilkd 1986;46(10):743-7.
12. Hahn S, Kuehnel W, Tan S, et al. Diagnostic value of cal- culated testosterone indices in the assessment of polycystic ovary syndrome. Clin Chem Lab Med 2007;45(2):202-7.
13. Vermeulen A, Kaufman JM. Diagnosis of hypogonadizm in the aging male. Aging male 2002;5(3):170-6.