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Analog-Based Free Testosterone Test Results Linked to Total Testosterone Concentrations, Not Free Testosterone Concentrations

¹ Department of Biochemistry, Loma Linda University School of Medicine, Loma Linda, CA; ² Departments of Internal Medicine and Pathology, Loma Linda University School of Medicine, Loma Linda, CA.

^aAddress correspondence to this author at: Department of Biochemistry, Loma Linda University School of Medicine, Mortensen Hall, Room 209, Loma Linda, CA 92350. Fax (909) 558-7916; e-mail bwilcox{at}llu.edu.

Background: Analog-based free testosterone test results, sex hormone binding globulin (SHBG) concentrations, and total testosterone concentrations are somehow related. This study used new experiments to clarify these relationships.

Methods: An analog-based free testosterone immunoassay and a total testosterone immunoassay were applied to well-defined fractions of serum testosterone. First, they were applied to the 2 fractions (retentate and dialysate) of normal male serum obtained by equilibrium dialysis. Second, they were applied to covaried concentrations of SHBG and total testosterone. Third, they were applied to decreasing concentrations of SHBG and protein-bound testosterone, offset by increasing concentrations of protein-free testosterone, while total testosterone was held constant.

Results: The analog-based free testosterone assay and the total testosterone assay detected and reported serum testosterone test results from serum retentate, whereas neither assay detected the free testosterone in serum dialysate. Test results reported by the analog-based free testosterone assay followed varied concentrations of SHBG and total testosterone. When total testosterone was held constant, however, analog-based free testosterone test results did not follow varied concentrations of serum proteins or of free testosterone.

Conclusion: An analog-based free testosterone immunoassay reported free testosterone test results that were related to total testosterone concentrations under varied experimental conditions. This alleged free testosterone assay did not detect serum free testosterone (the test results it reported were nonspecific) and should not be used for this purpose.

The following articles in journals at HighWire Press have cited this article:

				G. Sartorius, L. P Ly, K. Sikaris, R. McLachlan, and D. J Handelsman Predictive accuracy and sources of variability in calculated free testosterone estimates Ann Clin Biochem, March 1, 2009; 46(2): 137 - 143. [Abstract] [Full Text] [PDF]

				R. S. Swerdloff and C. Wang Free Testosterone Measurement by the Analog Displacement Direct Assay: Old Concerns and New Evidence Clin. Chem., March 1, 2008; 54(3): 458 - 460. [Full Text] [PDF]