title: CAG repeat testing of androgen receptor polymorphism: is this necessary for the best clinical management of hypogonadism?
abstract: BACKGROUND
  It is controversial whether or not testing the length of the androgen receptor polymorphism in clinical practice is useful for correct diagnosis and treatment of hypogonadism.
  
  
  OBJECTIVE
  To describe the molecular and clinical implications of testing the length of the androgen receptor polymorphism for treatment of hypogonadism in both male and female subjects.
  
  
  METHODS
  A systematic Medline search was conducted using several terms related to and including the terms "androgen receptor," "CAG-repeat polymorphism," "male hypogonadism," "female hypogonadism," and "neurodegenerative disease."
  
  
  METHODS
  Clinical evidence that demonstrates the importance of CAG repeat number investigation in male and female hypogonadism.
  
  
  RESULTS
  A thorough review of the clinical utility of CAG repeat polymorphism investigation in men and women with hypogonadism is presented.
  
  
  CONCLUSIONS
  The role of AR CAG repeat number investigation in hypogonadism (male and female) is not yet established in the clinical practice. In both sexes, a role during clinical management of hormonal replacement therapies may be hypothesized, but the CAG repeat number's relationship with the presence or absence of hypogonadal symptoms remains unclear. Pharmacogenomic investigations of the AR polymorphism may be a future option to tailor testosterone titration individually and to better identify subjects as potentially more or less responsive to treatments; also, investigation may be important to individually predict beneficial and side effects in special subpopulations, specifically, obese men and postmenopausal women.
authors.affiliation: Department of Experimental Medicine, Endocrinology and Food and Science Section, Sapienza University of Rome, Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Francomano
authors.forename: Emanuela A
authors.initials: EA
authors.lastname: Greco
authors.forename: Andrea
authors.initials: A
authors.lastname: Lenzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
mesh_terms: D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010597:Pharmacogenetics; D010641:Phenotype; D011110:Polymorphism, Genetic; D057285:Precision Medicine; D011237:Predictive Value of Tests; D011944:Receptors, Androgen / Q000187:drug effects / Q000235:genetics*; D013739:Testosterone / Q000627:therapeutic use; D016896:Treatment Outcome; D018911:Trinucleotide Repeats
chemical_list: C410798:AR protein, human; D011944:Receptors, Androgen; D013739:Testosterone
keywords: Androgen Receptor; CAG Repeat Polymorphism; Cancer; Female Hypogonadism; Male Hypogonadism; Neurodegenerative Disease