[The diagnostic value of serum hormone parameters in hirsutism]

In 46 patients showing mild or moderate hirsutism, and 49 age-matched regularly menstruating women without symptoms the following hormone and protein serum levels were measured: Total testosterone (T), free testosterone (fT), dehydroepiandrosterone sulfate (DHEAS), androstendione (ASN), sex hormone binding globulin (SHBG), free androgen index (FAI) as expressed by the T/SHBG ratio, cortisol, Prolactin (PRL), LH/FSH ratio, 3 alpha-androstanediol glucuronide (ALG), basal and poststimulated 17-hydroxyprogesteron (17OH-P) and (in some cases) basal and poststimulated 11-deoxycortisol (S). The study was designed for exploring the diagnostic significance of these parameters and evaluating the extent to which they contribute in establishing the source of hyperandrogenism. The mean values of all but one (PRL) of the hormone and protein levels varied significantly from the controls, T, DHEAS, FAI and ALG showing the greatest differences. Most frequently elevations of T, DHEAS, and FAI values were established, the levels of which exhibited a highly significant correlation. In 96% of the hirsute women the elevation of 1 to 3 of these parameters was demonstrated. FAI was shown to be associated with a higher diagnostic accuracy than did SHBG or fT. In 9/43 patients increased values of ALG were found, which as an important metabolite of dihydrotestosterone reflects peripheral androgen activity, particularly of the skin. In every case these abnormal values were combined with elevated levels of other androgens (T, DHEAS, ASN). It is concluded from these limited data that an isolated elevation of ALG due to primary accentuation in 5 alpha-reductase is a rare or even non-existing occurrence.(ABSTRACT TRUNCATED AT 250 WORDS)