Chanukvadze D, Kristesashvili J
Javakhishvili Tbilisi State University, Department of Gynecology, Obstetrics and Reproductology, Medical faculty, Georgia.
Georgian Med News. 2011 Nov;11(200):25-9.
Free testosterone is the most common marker of hyperandrogenism in women. Its measurement by equilibrium dialysis and liquid chromatography-tandem mass spectroscopy is the "gold standard", but determination of free testosterone routinely not feasible in all laboratories. In some cases the level of free testosterone may be elevated when the total testosterone level is normal. Low level of sex-hormone binding globulin determines the fraction of plasma testosterone that is free or bound to albumin. Recently, some models for calculating free testosterone and bioavailable testosterone from total testosterone, sex hormone binding globulin and albumin have been developed. The aim of this study was to compare effectiveness of diagnostic methods, such as serum free testosterone measured by ELISA-method and free androgen index and calculated androgen parameters for assessment of hyperandrogenism in young women with hirsutism. In 35 patients with hirsutism and different diagnosis free androgen index, free and bioavailable testosterone were calculated from total testosterone, sex hormone binding globulin and albumin. Free testosterone was measured by Elisa- method. Receiver operating characteristics (ROC) curves were drawn to assess diagnostic power of androgen parametres for different hirsutism degree. Significant positive correlation between free testosterone (FT) measured by ELISA -method and free androgen index (FAI) in patients with hirsutism was detected. The diagnostic power of cFT (calculated free testosterone) was greater than diagnostic power of FT and FAI in the group with severe hirsutism (for severe hirsutism (n=14) auROC (FT) =0,446; auROC (cFT)= 0,507; auROC (FAI)=0,461). FAI, cFT and cBio-T may be more adequate and alternative methods for assessment hyperandrogenism in women with hirsutism, than only free testosterone measured by ELISA-method. Furthermore, the calculated androgen parameters may be important to determinate the mechanisms of hyperandrogenism development.
游离睾酮是女性高雄激素血症最常见的标志物。通过平衡透析和液相色谱 - 串联质谱法进行测定是“金标准”，但在所有实验室常规测定游离睾酮并不可行。在某些情况下，当总睾酮水平正常时，游离睾酮水平可能会升高。性激素结合球蛋白水平较低决定了血浆中游离或与白蛋白结合的睾酮比例。最近，已经开发了一些从总睾酮、性激素结合球蛋白和白蛋白计算游离睾酮和生物可利用睾酮的模型。本研究的目的是比较诊断方法的有效性，例如通过酶联免疫吸附测定法（ELISA法）测定的血清游离睾酮、游离雄激素指数以及计算得出的雄激素参数，以评估多毛年轻女性的高雄激素血症。对35例患有多毛症且诊断不同的患者，根据总睾酮、性激素结合球蛋白和白蛋白计算游离雄激素指数、游离和生物可利用睾酮。采用ELISA法测定游离睾酮。绘制受试者工作特征（ROC）曲线以评估雄激素参数对不同多毛症程度的诊断能力。检测到多毛症患者中通过ELISA法测定的游离睾酮（FT）与游离雄激素指数（FAI）之间存在显著正相关。在重度多毛症组中，计算得出的游离睾酮（cFT）的诊断能力大于FT和FAI的诊断能力（对于重度多毛症（n = 14），auROC（FT）= 0.446；auROC（cFT）= 0.507；auROC（FAI）= 0.461）。对于评估多毛症女性的高雄激素血症，FAI、cFT和cBio - T可能比仅通过ELISA法测定的游离睾酮更合适且可作为替代方法。此外，计算得出的雄激素参数对于确定高雄激素血症的发生机制可能很重要。
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