Sinha-Hikim I, Arver S, Beall G, Shen R, Guerrero M, Sattler F, Shikuma C, Nelson J C, Landgren B M, Mazer N A, Bhasin S
Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California 90059, USA.
J Clin Endocrinol Metab. 1998 Apr;83(4):1312-8. doi: 10.1210/jcem.83.4.4718.
Measurements of total and free testosterone levels in women have lacked precision and accuracy because of limited assay sensitivity. The paucity of normative data on total and free testosterone levels in healthy women has confounded interpretation of androgen levels in women with human immunodeficiency virus (HIV) infection and other disease states. Therefore, the objectives of this study were to develop sensitive assays for the measurement of the low total and free testosterone levels in women to define the range for these hormones during the normal menstrual cycle and assess the total and free testosterone levels in HIV-infected women. By using a larger volume of serum, increasing the incubation time, and reducing the antibody concentration, the sensitivity of the total testosterone assay was increased to 0.008 nmol/L, and that of the free testosterone assay was increased to 2 pmol/L. The mean percent free testosterone was 1.0 +/- 0.1% of the total testosterone. Serum total and free testosterone levels in the follicular and luteal phases were not significantly different, but both demonstrated a modest preovulatory increase, 3 days before the LH peak. Serum total [0.50 +/- 0.32 (14.60 +/- 9.22) vs. 1.2 +/- 0.7 nmol/L (34.3 +/- 21.0 ng/dL); P < 0.0001] and free testosterone levels (5.56 +/- 2.70 (1.58 +/- 0.80) vs. 12.8 +/- 5.5 pmol/L (3.4 +/- 1.7 pg/mL); P < 0.0001) were significantly lower in HIV-infected women (n = 37) than in healthy women (n = 34). Serum total and free testosterone levels were also significantly lower in HIV-infected women who were menstruating normally. There were no significant differences in serum total and free testosterone levels between those who had lost weight and those who had not. Testosterone levels correlated inversely with plasma HIV ribonucleic acid copy number. Serum FSH, but not LH, levels were significantly higher in HIV-infected women than in controls. Using assays with sufficient sensitivity, we defined the range for total and free testosterone levels during the normal menstrual cycle. Serum total and free testosterone levels are lower in HIV-infected women and correlate inversely with plasma HIV ribonucleic acid levels. The hypothesis that androgen deficiency contributes to wasting in HIV-infected women remains to be tested.
由于检测灵敏度有限，女性总睾酮和游离睾酮水平的测量缺乏精确性和准确性。健康女性总睾酮和游离睾酮水平的规范性数据匮乏，这使得对感染人类免疫缺陷病毒（HIV）的女性及其他疾病状态女性雄激素水平的解读变得复杂。因此，本研究的目的是开发灵敏的检测方法，用于测量女性低水平的总睾酮和游离睾酮，确定这些激素在正常月经周期中的范围，并评估HIV感染女性的总睾酮和游离睾酮水平。通过使用更大体积的血清、延长孵育时间以及降低抗体浓度，总睾酮检测的灵敏度提高到了0.008 nmol/L，游离睾酮检测的灵敏度提高到了2 pmol/L。游离睾酮占总睾酮的平均百分比为1.0±0.1%。卵泡期和黄体期的血清总睾酮和游离睾酮水平无显著差异，但在促黄体生成素（LH）峰值前3天，两者均出现适度的排卵前升高。HIV感染女性（n = 37）的血清总睾酮[0.50±0.32（14.60±9.22）对1.2±0.7 nmol/L（34.3±21.0 ng/dL）；P < 0.0001]和游离睾酮水平（5.56±2.70（1.58±0.80）对12.8±5.5 pmol/L（3.4±1.7 pg/mL）；P < 0.0001）显著低于健康女性（n = 34）。月经正常的HIV感染女性的血清总睾酮和游离睾酮水平也显著较低。体重减轻者与未减轻者的血清总睾酮和游离睾酮水平无显著差异。睾酮水平与血浆HIV核糖核酸拷贝数呈负相关。HIV感染女性的血清促卵泡生成素（FSH）水平显著高于对照组，而LH水平无显著差异。通过使用具有足够灵敏度的检测方法，我们确定了正常月经周期中总睾酮和游离睾酮水平的范围。HIV感染女性的血清总睾酮和游离睾酮水平较低，且与血浆HIV核糖核酸水平呈负相关。雄激素缺乏导致HIV感染女性消瘦这一假说仍有待验证。
