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Measurement of Free Testosterone in Normal Women and Women with Androgen Deficiency: Comparison of Methods
Abstract
Androgen deficiency in women is increasingly recognized as a new clinical syndrome and has raised our awareness of the importance of accurate and well-validated measurements of serum free testosterone (T) concentrations in women. Therefore, we compared serum free T levels measured by equilibrium dialysis to those measured by a direct RIA (analog method) and to those calculated from the law of mass action (requires the measurement of total T and SHBG). We also calculated the free androgen index, 100 x T/SHBG, as a simple index known to correlate with free T. Subjects were 147 women with variable androgen and estrogen statuses. All were studied three times in 1 month and included women 1) with regular menses (estrogen positive, T positive), 2) more than 50 yr old and not receiving estrogen (estrogen negative, T positive), 3) receiving estrogen (estrogen positive, T negative), and 4) with severe androgen deficiency secondary to hypopituitarism (estrogen negative, T negative). Calculated values for free T using the laws of mass action correlated well with those obtained from equilibrium dialysis (r = 0.99; P < 0.0001). However, the agreement depended strongly on the specific assays used for total T and SHBG. In contrast, the direct RIA method had unacceptably high systematic bias and random variability and did not correlate as well with equilibrium dialysis values (r = 0.81; P < 0.0001). In addition, the lower limit of detection was higher for the direct RIA than for equilibrium…
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“Essentially obtaining accurate results, execution of this assay is, however, very labor intensive and technically challenging, resulting in limited availability of the method in everyday clinical routine [222].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [222]
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Metadata
- Authors
- Miller, K. K., Rosner, W., Lee, H., Hier, J., Sesmilo, G., Schoenfeld, D., Neubauer, G., & Klibanski, A.
- Affiliations
- Harvard University (US)
- St. Luke's-Roosevelt Hospital Center (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-02
- Volume
- 89
- Issue
- 2
- Pages
- 525-533
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2157527766
- Cited by
- 301
- References
- 31
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 10 · 2019: 5 · 2018: 11 · 2017: 13 · 2016: 9 · 2015: 9 · 2014: 17 · 2013: 18 · 2012: 16
- FWCI
- 18.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r03dk059297-02)
- National Institute of Diabetes and Digestive and Kidney Diseases (R03-DK-59297)
- National Center for Research Resources (M01RR001066, M01 RR01066-27S1, M01-RR01066)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Keywords
- free testosterone, equilibrium dialysis, radioimmunoassay, mass action law, sex hormone-binding globulin, free androgen index, hypopituitarism, estrogen therapy, assay comparison, diagnostic accuracy
- MeSH terms
- Adult, Androgens, Dialysis, Female, Humans, Middle Aged, Radioimmunoassay, Sensitivity and Specificity, Sex Hormone-Binding Globulin, Testosterone, Reproducibility of Results, Case-Control Studies
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