SERUM LEVELS OF FREE AND BOUND TESTOSTERONE IN HYPERTHYROIDISM

被引:37
作者
FORD, HC
COOKE, RR
KEIGHTLEY, EA
FEEK, CM
机构
[1] WELLINGTON CLIN SCH MED,DEPT OBSTET & GYNAECOL,WELLINGTON,NEW ZEALAND
[2] WELLINGTON CLIN SCH MED,DEPT MED,WELLINGTON,NEW ZEALAND
关键词
D O I
10.1111/j.1365-2265.1992.tb00956.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE The aim of this study was to improve knowledge about the relationships between free and bound forms of testosterone in serum and the major testosterone-binding proteins during hyperthyroidism. DESIGN Nine men and 11 women were studied when hyperthyroid due to Graves' disease and again after at least 3 months of euthyroldism. MEASUREMENTS The serum concentrations of free T3, free T4, TSH, sex hormone-binding globulin (SHBG), LH, progesterone and free, non-SHBG bound and total testosterone were determined. RESULTS For both sexes, hyperthyroidism was associated with significant elevations of the mean total testosterone and sex hormone-binding globulin (SHBG) levels and significant depressions of the mean percentage and concentration of non-SHBG-bound testosterone and the mean percentage of free testosterone. For women, the mean free testosterone concentration was significantly lower during hyperthyroidism than during euthyroldism; no significant difference in mean free testosterone concentration was observed between hyperthyroid and euthyroid men. When the experimentally derived data were analysed according to a model based on the binding constants of testosterone with SHBG and albumin, the simulated results for each patient when hyperthyrold and euthyroid paralleled the actual results. However, the model consistently overestimated the actual amounts of non-SHBG-bound testosterone. There was a significant correlation between SHBG concentration and the severity of thyrotoxicosis as measured by the change in thyroid hormone levels between euthyroidism and hyperthyroidism. CONCLUSIONS Our results support the following pathogenetic sequence: thyrotoxicosis leads to a rise in serum SHBG concentration which is accompanied by an increase in testosterone concentration, a fall in the concentration of non-SHBG-bound testosterone and little or no change in the concentration of free testosterone.
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页码:187 / 192
页数:6
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