Marcondes J A, Minanni S L, Luthold W W, Lerário A C, Nery M, Mendonça B B, Wajchenberg B L, Kirschner M A
Endocrine Service, Hospital das Clínicas de São Paulo, Brazil.
J Endocrinol Invest. 1995 Jun;18(6):431-5. doi: 10.1007/BF03349741.
This study explored the effect of the anti-androgen spironolactone on sex-hormone binding globulin (SHBG) and the distribution of circulating testosterone (T) into various free and bound fractions in seven women with hirsutism assessed before and then monthly for three months on a regimen of spironolactone, 100 mg bid as the sole therapeutic agent. Blood samples were taken at each assessment time for a battery of androgen parameters and serum T fractions studies. None of the women were judged obese based upon body mass index values. After three months of spironolactone therapy, there was little change in the hirsutism index, and measurement of serum T, androstenedione, DHEA-S and 17 beta-estradiol showed no significant changes, the same occurring with SHBG-binding capacity. However, there was a shift in the distribution of circulating T, with a decrease in SHBG-bound T and an increase in albumin-bound and free T (non-SHBG-bound fractions). As previous reports suggest that non-SHBG-bound fractions represent bioavailable fractions, the current data suggests that T fraction studies may not be clinically useful parameters of hyperandrogenism in women receiving antiandrogen therapy.
本研究探讨了抗雄激素药物螺内酯对7名多毛症女性性激素结合球蛋白（SHBG）以及循环睾酮（T）在各种游离和结合组分中分布的影响。这7名女性在接受评估前以及之后连续三个月每月接受一次评估，评估期间以100 mg bid的螺内酯作为唯一治疗药物。每次评估时采集血样，用于一系列雄激素参数和血清T组分研究。根据体重指数值判断，这些女性均不肥胖。经过三个月的螺内酯治疗后，多毛症指数几乎没有变化，血清T、雄烯二酮、硫酸脱氢表雄酮（DHEA-S）和17β-雌二醇的测量结果也没有显著变化，SHBG结合能力亦是如此。然而，循环T的分布发生了变化，与SHBG结合的T减少，与白蛋白结合的T和游离T（非SHBG结合组分）增加。由于先前的报告表明非SHBG结合组分代表生物可利用组分，目前的数据表明，在接受抗雄激素治疗的女性中，T组分研究可能不是高雄激素血症的临床有用参数。
