Testosterone concentrations in hair and its potential relation with symptoms of testosterone deficiency syndrome

초록

Introduction & Objectives: The measurement of serum testosterone (T) is essential for diagnosis of testosterone deficiency syndrome. It is indicated to obtain at least two separate measurements with both conducted in an early morning due to circadian rhythms in T production, intraindividual variability, and inconsistencies in the assays themselves. Meanwhile, previous studies have demonstrated that hair offered the possibility of reflecting endogenous hormones status over several months. Thus, we hypothesized that T concentration in hair can reflect hypogonadism related symptoms better than serum testosterone. Materials & Methods: We enrolled 17 patients with hypogonadal symptoms and 16 healthy controls. Serum total T and T concentration in hair was measured. Hair fibers were obtained by cutting the proximal part hair from occipital scalp and T levels were evaluated using gas chromatographymass spectrometry (GS-MS). All subjects completed the Aging Males' Symptom scale (AMS). This study was approved by the Institutional Review Board of the Korea University Hospital. Results: Compare with control group, T concentration in hair was significantly lower in patients with hypogonadal symptoms (0.055 ng/mg ± 0.040 vs 0.025 ng/mg ± 0.019, p=0.022), while serum total T was not significantly different between groups (5.01 ng/ml ± 3.24 vs 4.04 ± 2.00, p=0.317). AMS were correlated with T concentration in hair (rho= -0.632, p=0.037), while there was no correlation with serum total T (rho= -0.427, p=0.194). On receiver operating characteristic curve analysis, patients with T concentration ≤ 0.033ng/mg (area under the curve [AUC]=0.869, P=0.002, Youden index=0.7143) were likely to have moderate aging-male symptoms (AMS≥37). Conclusions: We found a marked association between aging-male symptomatology and T concentration in hair. Additionally, T concentration in hair had sufficient value as diagnostic tool indicating moderate hypogonadism related symptoms. However, further study with large number and analyzing with confounding factors should be consider to elucidate the role of T concentration in hair.