title: Diagnostic performance of serum total testosterone for Japanese patients with polycystic ovary syndrome.
abstract: It is reported that the incidence of clinical and biochemical hyperandrogenism may be lower in Japanese patients with PCOS. Hyperandrogenism is included as a referential but not as an essential factor in the diagnostic criteria of the Japanese Society of Obstetrics and Gynecology (JSOG 1993). However, some patients with the typical clinical features of PCOS are not diagnosed with PCOS using JSOG 1993 criteria because they do not have a high LH level, which is defined as essential for diagnosis. In this study, we compared total testosterone (T) levels between Japanese patients with PCOS diagnosed using the JSOG 1993 criteria and normal menstrual women (controls). Fifty controls and 46 patients with PCOS were enrolled in this study. Furthermore, we evaluated the sensitivity and specificity of each cut-off value of T. The mean T level of patients with PCOS was significantly higher than that of the control (86 +/- 48 vs 68 +/- 46, P<0.01), and the prevalence rates of hyperandrogenism (T >114 ng/dL; defined as the mean +2SD of the control) were 10.2% in patients with PCOS and 4% in controls. The area under the ROC curve of T was 0.72, and there was no decision threshold to diagnose PCOS by T alone with both high sensitivity and high specificity. If the threshold is set as 110 ng/dL in order to gain high specificity, 94% of women whose serum level passed the threshold will be patients with PCOS. Although T should not be used as an independent essential factor of Japanese PCOS, it might be useful as a complementary factor in order to diagnose patients who have typical clinical features of PCOS but does not fulfill the JSOG 1993 criteria for PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Health Biosciences, The University of Tokushima Graduate School, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwasa
authors.forename: Toshiya
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Minakuchi
authors.forename: Naoko
authors.initials: N
authors.lastname: Tanaka
authors.forename: Fumi
authors.initials: F
authors.lastname: Shimizu
authors.forename: Yohko
authors.initials: Y
authors.lastname: Hirata
authors.forename: Akira
authors.initials: A
authors.lastname: Kuwahara
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yasui
authors.forename: Masahiko
authors.initials: M
authors.lastname: Maegawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Irahara
mesh_terms: D044466:Asian People; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000453:epidemiology; D007118:Immunoassay; D008163:Luminescent Measurements; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology; D015995:Prevalence; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone