Albumin and Sex Hormone Binding Globulin based Testosterone Indices in Polycystic Ovarian Syndrome

Sikandar Hayat  Khan; Uzma Urooj; Zeeshan Ali  Quereshi; Urwa Sarwar; Rahat Shahid; Chaudhry Qamar Ul Haq Noor

doi:10.51253/pafmj.v74i6.8627

Authors

Sikandar Hayat Khan Department of Pathology, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
Uzma Urooj Department of Obstetrics & Gynecology, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
Zeeshan Ali Quereshi Department of Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Urwa Sarwar Department of Pathology, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Rahat Shahid Department of Radiology, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
Chaudhry Qamar Ul Haq Noor Medical Directorate, Naval Headquarters, Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.8627

Keywords:

% Bioavailable testosterone, % calculated free testosterone (cFT), Calculated Bioavailable testosterone (cBT), Free Androgen Index (FAI), Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), Polycystic ovarian syndrome (PCOS), Sex Hormone Binding Globulin (SHBG), Total Testosterone.

Abstract

Objective: To evaluate total testosterone, “Free Androgen Index”, calculated free testosterone, % free testosterone, calculated bioavailable testosterone, and % testosterone as a possible biomarker to predict presence of Polycystic ovarian syndrome as per Rotterdam criteria.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Pakistan Naval Hospital, Islamabad Pakistan, from Jan 2018 to Jul 2020.

Methodology: A total of 328 female subjects were included in the study, which included 166 subjects with polycystic ovarian syndrome and 162 without polycystic ovarian syndrome as per Rotterdam criteria. Various albumin and sex hormone binding globulin-based androgen measures, including calculated free testosterone and calculated bioavailable testosterone, and only the included measure Free Androgen Index were calculated. These various measures were evaluated between polycystic ovarian syndrome and non-polycystic ovarian syndrome. Following that, receiver operating curve analysis was carried out to see area under curve for various androgen excess parameters to measure the diagnostic performance of each measure for diagnosing polycystic ovarian syndrome.

Results: Almost all androgen excess measures demonstrated significant differences between subjects with or without polycystic ovarian syndrome. Area under curve as measured by receiver operator curve analysis shows highest area under curve for as: Bioavailable testosterone =0.792[95% CI: 0.743-0.842], Free testosterone =0.791[95% CI: 0.743-0.842], Free Androgen Index =0.782[95% CI: 0.731-0.833], Total testosterone =0.748[95% CI: 0.696-0.800], %Bioavailable testosterone =0.675[95% CI: 0.619-0.734], % Free testosterone =0.671[95% CI: 0.612-0.729], and Sex Hormone Binding Globulin =0.337[95% CI: 0.0.78-395].

Conclusion: Free testosterone followed by Bioavailable testosterone and Free Androgen Index, have demonstrated higher Area Under Curve ....

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