Premium
Salivary testosterone may not serve as a screening test in the diagnosis of biochemical hyperandrogenism
Author(s) -
Ambroziak Urszula,
Kuryłowicz Alina,
KępczyńskaNyk Anna,
Kondracka Agnieszka,
Gajda Sylvia,
Sieńko Damian
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13628
Subject(s) - hyperandrogenism , testosterone (patch) , androstenedione , medicine , immunoassay , endocrinology , dehydroepiandrosterone , androgen , hormone , diabetes mellitus , insulin resistance , immunology , polycystic ovary , antibody
Aim The diagnosis of biochemical hyperandrogenism is still challenging because a set of appropriate, recommended diagnostic tests has not been established. In our study, we aimed to answer the question of whether salivary testosterone is a reliable test to establish the diagnosis of biochemical hyperandrogenism as compared to serum total testosterone (TT) measured either by liquid chromatography–tandem mass spectrometry (LC–MS/MS) or immunoassay and to assess which set of biochemical tests would be the most appropriate for the identification of biochemical hyperandrogenism. Methods A total of 39 women, aged 18–45 years, with clinical or biochemical hyperandrogenism and 41 healthy individuals, aged 19–45 years, were enrolled in the study. Salivary testosterone was measured using the Salimetrics test. Serum TT was measured either using the LC–MS/MS method or immunoassay, and dehydroepiandrosterone sulphate (DHEA‐S) and androstenedione were measured using LC–MS/MS. Results In 15 of 17 (88%) patients with elevated serum TT measured by LC–MS/MS and in 14 of 16 (87%) measured with immunoassay, salivary testosterone showed normal levels. In 11 of 39 women (28%) with normal serum testosterone levels, DHEA‐S was elevated. All patients with elevated androstenedione presented with an elevated concentration of either serum testosterone or DHEA‐S. Conclusion Salivary testosterone measurement may lead to the underdiagnosis of biochemical hyperandrogenism. Both serum testosterone and DHEA‐S should be measured in the endocrine work‐up toward biochemical hyperandrogenism.