Performance of total testosterone measurement to predict free testosterone for the biochemical evaluation of male hypogonadism

The Journal of Urology
Bradley D AnawaltAlvin M Matsumoto

Abstract

Guidelines recommend serum total testosterone measurement as the initial test to evaluate male hypogonadism, reserving free testosterone assessment for men with suspected sex hormone-binding globulin abnormalities or total testosterone near the lower limit of normal. We determined the performance of total testosterone measurement as a test to identify men with normal vs low free testosterone. We examined the electronic medical records of all 3,672 men evaluated for hypogonadism by a serum testosterone panel, including total testosterone, sex hormone-binding globulin, albumin and calculated free testosterone, from January 1, 1997 through December 31, 2007 in a network that serves veterans in Washington. The sensitivity and specificity of low total testosterone (less than 280 ng/dl) to rule out and predict low calculated free testosterone was 91.0% and 73.7%, respectively. At thresholds of less than 350 and less than 400 ng/dl the sensitivity of total testosterone for low calculated free testosterone increased to 96.8% and 98.2%, and at thresholds of less than 150 and less than 200 ng/dl specificity increased to 98.9% and 92.6%, respectively. Total testosterone between 280 and 350 ng/dl is not sensitive enough to reliably exclude...Continue Reading

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Citations

Nov 30, 2013·The Urologic Clinics of North America·James M Hotaling
May 25, 2013·Endocrinology and Metabolism Clinics of North America·Alvin M Matsumoto
Apr 20, 2016·Nature Reviews. Urology·Martin Kathrins, Craig Niederberger
Nov 14, 2014·American Journal of Alzheimer's Disease and Other Dementias·M M CherrierA M Matsumoto
Mar 22, 2018·The Journal of Clinical Endocrinology and Metabolism·Shalender BhasinMaria A Yialamas
Apr 18, 2014·The Aging Male : the Official Journal of the International Society for the Study of the Aging Male·Renan Desimon CabralWalter José Koff
Sep 10, 2014·The Aging Male : the Official Journal of the International Society for the Study of the Aging Male·Hanna KwonJun Ho Lee
May 9, 2019·Obesity Surgery·Fernanda Augustini RigonSimone van de Sande-Lee
Aug 9, 2020·The Journal of International Medical Research·Zhongbao ChenYuanzhong Zhou
Jun 3, 2017·Medical Oncology·Pawel J WiechnoTomasz Demkow
Aug 3, 2019·Journal of Clinical Medicine·Daniel Castellano-CastilloJosé C Fernandez-Garcia
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Aug 15, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Shalender Bhasin, Noelle Ozimek

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