Research question

Is the sole measurement of total testosterone sufficient to assess the presence of hyperandrogenism in women with polycystic ovary syndrome (PCOS)?

Design

Serum samples from 294 patients with PCOS who met the Rotterdam criteria were used for the analysis of total testosterone by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) and chemiluminescent immunoassay (CLIA). The free androgen index (FAI) was calculated as total testosterone (TT)/sex hormone-binding globulin (SHBG) × 100%, and the presence/degree of hirsutism were assessed using the modified and simplified Ferriman–Gallwey (mFG and sFG, respectively) scoring systems.

Results

The hirsute subjects presented higher LC-MS/MS-based total testosterone and FAI values than the non-hirsute subjects (all P < 0.001), including those defined based on mFG ≥5 or sFG ≥3. Total testosterone and FAI were both positively correlated with the mFG (rank correlation coefficient [RCC] 0.598 and 0.443, P < 0.001) or sFG (RCC 0.747 and 0.568, P < 0.001) score, and a receiver operating characteristic curve analysis indicated that both parameters could significantly predict the presence of hirsutism determined by the mFG (area under the curve [AUC] 0.797 and 0.725, P < 0.001) or sFG (AUC 0.894 and 0.817, P < 0.001) score. However, similar results were not obtained with the CLIA platform.

Conclusions

In this East Asian population, total testosterone was found to be a strong predictor of the presence and degree of hyperandrogenism (i.e. assessed by the presence and degree of hirsutism), but this finding was obtained only if the total testosterone level was measured by LC-MS/MS and not by CLIA. These findings might have important implications for global epidemiologic, phenotypic and clinical studies of PCOS.

中文翻译：

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单用总睾酮对多囊卵巢综合征临床雄激素过多症的预测价值。

研究问题

仅测量总睾酮是否足以评估多囊卵巢综合征 (PCOS) 女性是否存在高雄激素血症？

设计

294 名符合鹿特丹标准的 PCOS 患者的血清样本用于通过液相色谱-质谱/质谱 (LC-MS/MS) 和化学发光免疫分析 (CLIA) 分析总睾酮。游离雄激素指数 (FAI) 计算为总睾酮 (TT)/性激素结合球蛋白 (SHBG) × 100%，并使用改良和简化的 Ferriman-Gallwey（mFG 和 sFG，分别）评分系统。

结果

多毛受试者的基于 LC-MS/MS 的总睾酮和 FAI 值高于非多毛受试者（所有P  < 0.001），包括基于 mFG ≥5 或 sFG ≥3 定义的那些。总睾酮和 FAI 均与 mFG（等级相关系数 [RCC] 0.598 和 0.443，P  < 0.001）或 sFG（RCC 0.747 和 0.568，P  < 0.001）得分呈正相关，接受者操作特征曲线分析表明两者参数可以显着预测由 mFG（曲线下面积 [AUC] 0.797 和 0.725，P  < 0.001）或 sFG（AUC 0.894 和 0.817，P  < 0.001）评分确定的多毛症的存在。但是，使用 CLIA 平台并没有获得类似的结果。

结论

在这个东亚人群中，总睾酮被发现是雄激素过多症的存在和程度的强预测因子（即通过多毛症的存在和程度进行评估），但只有通过 LC 测量总睾酮水平才能获得这一发现。 MS/MS 而不是 CLIA。这些发现可能对 PCOS 的全球流行病学、表型和临床研究具有重要意义。