Measurement of Serum Testosterone in Nondiabetic Young Obese Men: Comparison of Direct Immunoassay to Liquid Chromatography-Tandem Mass Spectrometry
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Mdpi
Materia
Testosterone Obesity Immunoassay Chromatography
Date
2020-12-19Referencia bibliográfica
Martínez-Escribano, A., Maroto-García, J., Ruiz-Galdón, M., Barrios-Rodríguez, R., Álvarez-Millán, J. J., Cabezas-Sánchez, P., ... & Fernández-García, J. C. (2020). Measurement of Serum Testosterone in Nondiabetic Young Obese Men: Comparison of Direct Immunoassay to Liquid Chromatography-Tandem Mass Spectrometry. Biomolecules, 10(12), 1697. [doi:10.3390/biom10121697]
Sponsorship
Servicio Andaluz de Salud (SAS) B-0003-2017; Instituto de Salud Carlos III CM18-00120; Instituto de Salud Carlos III CPI13/00003; European Union (EU); Junta de Andalucía C-0030-2018; Servicio Andaluz de Salud PI-0173-2013Abstract
Hypoandrogenemia, a frequent finding in men with obesity, is defined by low concentrations
of serum testosterone. Although immunoassay (IA) is the most used method for the determination of
this steroid in clinical practice, liquid chromatography-mass spectrometry (LC-MS/MS) is considered
a more reliable method. In this study, we aimed to compare IA versus LC-MS/MS measurement for
the diagnosis of hypoandrogenemia in a cohort of 273 nondiabetic young obese men. Mean total
testosterone (TT) levels were 3.20 1.24 ng/mL for IA and 3.78 1.4 ng/mL for LC-MS/MS. 53.7% and
26.3% of patients were classified as presenting hypoandrogenemia with IA and LC-MS/MS, respectively.
Considering LC-MS/MS as the reference method, sensitivity and specificity of IA were 91.4% (95%
CI 82.3–96.8) and 61.1% (95% CI 54.0–67.8), respectively. IA presented an AUC of 0.879 (95% CI
0.83–0.928). Multivariate regression analysis indicated that sex hormone-binding globulin (SHBG)
concentrations (p = 0.002) and insulin resistance (p = 0.008) were factors associated with discrepant
IA values. In conclusion, the determination of TT by IA in nondiabetic young men with obesity
yields lower concentrations of TT than LC-MS/MS, resulting in an equivocal increased diagnosis of
hypoandrogenemia, which could lead to inaccurate diagnosis and unnecessary treatment.