Relative Diagnostic Value of Serum Non-SHBG-Bound Testosterone, Free Androgen Index and Free Testosterone in the Assessment of Mild to Moderate Hirsutism

Recent evidence suggests that steroid hormone loosely bound to albumin is available for target-cell entry. Preliminary studies have suggested that a measure of this fraction, non-sex-hormone-binding globulin-bound testosterone (NSB-T), provides the best in vitro diagnostic test for idiopathic hirsutism. We compared the diagnostic value of NSB-T, total testosterone (T), free testosterone (fT), and the free androgen index (FAI) in supporting the clinical diagnosis in 22 pre-menopausal women with hirsutism. NSB-T supported the diagnosis in 50% of cases, compared with 23% for T, 55% for fT by analogue RIA, and 68% for FAI. We conclude that in mild to moderate hirsutism the measurement of NSB-T does not yield diagnostic information additional to that provided by the FAI.