Relative Diagnostic Value of Serum Non-SHBG-Bound Testosterone, Free Androgen Index and Free Testosterone in the Assessment of Mild to Moderate Hirsutism

Abstract

Recent evidence suggests that steroid hormone loosely bound to albumin is available for target-cell entry. Preliminary studies have suggested that a measure of this fraction, non-sex-hormone-binding globulin-bound testosterone (NSB-T), provides the best in vitro diagnostic test for idiopathic hirsutism. We compared the diagnostic value of NSB-T, total testosterone (T), free testosterone (fT), and the free androgen index (FAI) in supporting the clinical diagnosis in 22 pre-menopausal women with hirsutism. NSB-T supported the diagnosis in 50% of cases, compared with 23% for T, 55% for fT by analogue RIA, and 68% for FAI. We conclude that in mild to moderate hirsutism the measurement of NSB-T does not yield diagnostic information addition to that provided by the FAI.