Publication: Measurement of Serum Testosterone in Nondiabetic Young Obese Men: Comparison of Direct Immunoassay to Liquid Chromatography-Tandem Mass Spectrometry.
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Date
2020-12-19
Authors
Martínez-Escribano, Ana
Maroto-García, Julia
Ruiz-Galdón, Maximiliano
Barrios-Rodríguez, Rocío
Álvarez-Millán, Juan J
Cabezas-Sánchez, Pablo
Plaza-Andrades, Isaac
Molina-Vega, María
Tinahones, Francisco J
Queipo-Ortuño, María Isabel
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Abstract
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.
Description
MeSH Terms
Adult
Chromatography
Chromatography, Liquid
Humans
Immunoassay
Limit of Detection
Male
Middle Aged
Obesity
Regression Analysis
Reproducibility of Results
Sensitivity and Specificity
Tandem Mass Spectrometry
Testosterone
Chromatography
Chromatography, Liquid
Humans
Immunoassay
Limit of Detection
Male
Middle Aged
Obesity
Regression Analysis
Reproducibility of Results
Sensitivity and Specificity
Tandem Mass Spectrometry
Testosterone
DeCS Terms
CIE Terms
Keywords
chromatography, immunoassay, obesity, testosterone