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Salivary testosterone: a reliable approach to the diagnosis of male hypogonadism

2007; Wiley; Volume: 67; Issue: 5 Linguagem: Inglês

10.1111/j.1365-2265.2007.02937.x

1365-2265

Alejandro L. Arregger, Liliana N. Contreras, Omar R. Tumilasci, Daniel R. Aquilano, Estela Cardoso,

Hypothalamic control of reproductive hormones

Summary Objective This study was to demonstrate that Sal‐T is a reliable biomarker of androgen status in the diagnosis of male hypogonadism. Design In order to validate the salivary testosterone assay (Sal‐T), its reproducibility, the agreement with serum free testosterone levels (Free‐T), the correlation with other circulating androgen markers (bioavailable testosterone, total testosterone) and cut‐off values were defined. Patients and methods We studied 52 eugonadic (E) and 20 hypogonadic (Hy) men. Sal‐T was assayed using an adapted radioimmunoassay for serum testosterone. Sal‐T concentrations were compared in nine cases before and after citric acid stimulation of salivary flow rate. Free‐T and bioavailable testosterone (Bio‐T) were calculated by Vermeulen equation and SHBG were determined by binding assay. Results Sal‐T did not depend on salivary flow rate and morning samples from 07·00 h to 09·00 h were stable. Agreement between Sal‐T and Free‐T measurements was confirmed in all subjects. Sal‐T levels correlated positively with all circulating androgens, showing the best correlation with Free‐T in E ( r = 0·92) as well as in Hy ( r = 0·97). A cut‐off value of Sal‐T ≤ 0·195 n m showed 100% sensibility and specificity to rule out hypogonadism. Conclusions Our data showed that Sal‐T is a reliable marker of testosterone bioavailability. The results support the inclusion of this biomarker as a noninvasive approach in the diagnosis of male androgen deficiency.