Reference Range of Testosterone and Dehydroepiandrosterone Sulfate Levels in Women During Reproductive Age in the Iranian Population

Overview

Journal J Res Med Sci

Specialty General Medicine

Date 2023 Dec 20

PMID 38116488

Authors

Rokhsareh Meamar

Awat Feizi

Ashraf Aminorroaya

Masoud Amini

Bijan Iraj

Maryam Heidarpour

Affiliations

Soon will be listed here.

Abstract

Backgrounds: To determine the average cutoff values of serum-free and total testosterone (FT, TT) and dehydroepiandrosterone sulfate (DHEAS) among healthy premenopausal women.

Materials And Methods: Participants were women aged 18-55 years without signs and symptoms of hyperandrogenism ( = 489). Participants if Ferriman-Gallwey (FG) scores between 6 and 8 were considered a group located in the upper spectrum related to the normal hirsutism score ( = 30). DHEAS, TT, and FT levels were compared between different populations. Upper limits of 97.5 and 95 and lower limits of 5 and 2.5 percentiles were calculated to provide the reference intervals for DHEA, TT, and FT in the total sample and in the population with FG 6-8.

Results: In the total population, the mean ± standard deviation (SD) serum FT, TT, and DHEAS levels were 1.40 ± 0.63 pg/mL, 0.42 ± 0.17 ng/mL, and 1.5 ± 0.97 µg/ml, respectively. The cutoff values of FT at 1.35 and TT at 0.49 were obtained for differentiating the patients with FG 6-8 scores from the normal population, with the corresponding specificity of 0.60, the sensitivity of 0.67, and area under the ROC curve (AUC) (confidence interval 95%) of 0.63 (0.52-0.73), = 0.01 and 0.68 (0.58-0.78) = 0.001, respectively.

Conclusions: In our study, the mean ± SD serum FT level was 1.40 ± 0.63 pg/mL, the TT level was 0.42 ± 0.17 ng/mL, and the DHEAS level was 1.5 ± 0.97 µg/ml, in premenopausal women between 18 and 49 years of age. Furthermore, in a population with FG 6-8 score, a cutoff value of FT at 1.35 and TT at 0.49 was obtained. Although the irregular menstrual cycle did not change the reference range when compared with the normal group.

References

Holte J, Bergh T, Gennarelli G, Wide L . The independent effects of polycystic ovary syndrome and obesity on serum concentrations of gonadotrophins and sex steroids in premenopausal women. Clin Endocrinol (Oxf). 1994; 41(4):473-81. DOI: 10.1111/j.1365-2265.1994.tb02578.x. View

Amiri M, Ramezani Tehrani F, Behboudi-Gandevani S, Bidhendi-Yarandi R, Carmina E . Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression. Reprod Biol Endocrinol. 2020; 18(1):23. PMC: 7076940. DOI: 10.1186/s12958-020-00576-1. View

Parker Jr C, Mixon R, Brissie R, Grizzle W . Aging alters zonation in the adrenal cortex of men. J Clin Endocrinol Metab. 1997; 82(11):3898-901. DOI: 10.1210/jcem.82.11.4507. View

Saso S, Chatterjee J, Georgiou E, Ditri A, Smith J, Ghaem-Maghami S . Endometrial cancer. BMJ. 2011; 343:d3954. DOI: 10.1136/bmj.d3954. View

Ferrucci L, Maggio M, Bandinelli S, Basaria S, Lauretani F, Ble A . Low testosterone levels and the risk of anemia in older men and women. Arch Intern Med. 2006; 166(13):1380-8. PMC: 2645631. DOI: 10.1001/archinte.166.13.1380. View

Hashemi S, Ramezani Tehrani F, Noroozzadeh M, Azizi F . Normal cut-off values for hyperandrogenaemia in Iranian women of reproductive age. Eur J Obstet Gynecol Reprod Biol. 2013; 172:51-5. DOI: 10.1016/j.ejogrb.2013.09.029. View

Harlow S, Ephross S . Epidemiology of menstruation and its relevance to women's health. Epidemiol Rev. 1995; 17(2):265-86. DOI: 10.1093/oxfordjournals.epirev.a036193. View

Trost L, Mulhall J . Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials. J Sex Med. 2016; 13(7):1029-46. PMC: 5516925. DOI: 10.1016/j.jsxm.2016.04.068. View

Steinberger E, Ayala C, Hsi B, Smith K, Rodriguez-Rigau L, Weidman E . Utilization of commercial laboratory results in management of hyperandrogenism in women. Endocr Pract. 2004; 4(1):1-10. DOI: 10.4158/EP.4.1.1. View

10.

Barrett-Connor E, Ferrara A . Dehydroepiandrosterone, dehydroepiandrosterone sulfate, obesity, waist-hip ratio, and noninsulin-dependent diabetes in postmenopausal women: the Rancho Bernardo Study. J Clin Endocrinol Metab. 1996; 81(1):59-64. DOI: 10.1210/jcem.81.1.8550794. View

11.

Sheffield-Moore M, Paddon-Jones D, Casperson S, Gilkison C, Volpi E, Wolf S . Androgen therapy induces muscle protein anabolism in older women. J Clin Endocrinol Metab. 2006; 91(10):3844-9. DOI: 10.1210/jc.2006-0588. View

12.

Spencer J, Klein M, Kumar A, Azziz R . The age-associated decline of androgens in reproductive age and menopausal Black and White women. J Clin Endocrinol Metab. 2007; 92(12):4730-3. DOI: 10.1210/jc.2006-2365. View

13.

Gacaferri Lumezi B, Berisha V, Pupovci H, Goci A, Hajrushi A . Grading of hirsutism based on the Ferriman-Gallwey scoring system in Kosovar women. Postepy Dermatol Alergol. 2019; 35(6):631-635. PMC: 6320479. DOI: 10.5114/ada.2018.77615. View

14.

Hestiantoro A, Karimah P, Shadrina A, Wiweko B, Muharam R, Astuti B . Triglycerides, independent of Ferriman Gallwey Score, is a main determinant of free testosterone index in PCOS. F1000Res. 2019; 8:94. PMC: 6406175. DOI: 10.12688/f1000research.16815.1. View

15.

Tang Y, Chen Y, Feng H, Zhu C, Tong M, Chen Q . Is body mass index associated with irregular menstruation: a questionnaire study?. BMC Womens Health. 2020; 20(1):226. PMC: 7545932. DOI: 10.1186/s12905-020-01085-4. View

16.

Guay A, Munarriz R, Jacobson J, Talakoub L, Traish A, Quirk F . Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20-49 years with no complaints of sexual dysfunction. Int J Impot Res. 2004; 16(2):112-20. DOI: 10.1038/sj.ijir.3901178. View

17.

Ebeling P, Koivisto V . Physiological importance of dehydroepiandrosterone. Lancet. 1994; 343(8911):1479-81. DOI: 10.1016/s0140-6736(94)92587-9. View

18.

Labrie F, Belanger A, Luu-The V, Labrie C, Simard J, Cusan L . DHEA and the intracrine formation of androgens and estrogens in peripheral target tissues: its role during aging. Steroids. 1998; 63(5-6):322-8. DOI: 10.1016/s0039-128x(98)00007-5. View

19.

Mazza E, Maccario M, Ramunni J, Gauna C, Bertagna A, Barberis A . Dehydroepiandrosterone sulfate levels in women. Relationships with age, body mass index and insulin levels. J Endocrinol Invest. 1999; 22(9):681-7. DOI: 10.1007/BF03343629. View

20.

Maccario M, Mazza E, Ramunni J, Oleandri S, Savio P, Grottoli S . Relationships between dehydroepiandrosterone-sulphate and anthropometric, metabolic and hormonal variables in a large cohort of obese women. Clin Endocrinol (Oxf). 1999; 50(5):595-600. DOI: 10.1046/j.1365-2265.1999.00692.x. View