Relationship of testosterone, sex hormone binding globulin, and calculated free testosterone to subsequent clinical progress in patients with carcinoma of the prostate treated with bilateral orchidectomy or estrogens

Levell, M. J.; Siddall, J.K.; Rowe, E.; Glashan, R. W.; Robinson, M. R. G.; Pidcock, N.B.

doi:10.1002/pros.2990110103

Cited by 13 publications

(10 citation statements)

References 12 publications

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“…cycle 3 (Day 21)Direct RIAIntra-assay CV: NRInter-assay CV: 8–12%LLQ: NRDirect RIAIntra-assay CV: NRInter-assay CV: 5–9%LLQ: NR7Åkerlund et al (1994)Randomized, double-blind, comparative, parallel groupHealthy women18–40 yearsNo OC: ≥2 months1 n = 25Mean age: 25.0 yearsWeight/BMI: NR12 cycles20 EE/150 DSG 21:7Control cycle (Days 18–21) Tr. cycle 6 (Days 18–21)Direct RIACV: 6.5–8.9% at 3 nmol/lIntra-assay CV: NRInter-assay CV: NRLLQ: NRCalculated based on total T, SHBG and albumin (Levell et al ., 1987) CV: 8.5–12.6% at 50 pmol/l62 n = 26Mean age: 21.8 yearsWeight/BMI: NR12 cycles30 EE/150 DSG 21:7Kuhnz et al (1994)Open-label, non-comparativeHealthy womenNo OC: ≥2 months1 n = 14Mean (SD) age: 23 ± 3 yearsMean (SD) weight: 61 ± 8 kg3 cycles30–40-30 EE/50-75-125 LNG (6-5-10), 21:7Control cycle (day NR) Tr. cycle 3 (Day 21)Direct RIAIntra-assay CV: <10%Inter-assay CV: 4–8%LLQ: NRDirect RIAIntra-assay CV: <10%Inter-assay CV: 7–8%LLQ: NR7Volpe et al .…”

Section: Resultsmentioning

confidence: 99%

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

Zimmerman

et al. 2013

Human Reproduction Update

238

151

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BACKGROUNDCombined oral contraceptives (COCs) reduce levels of androgen, especially testosterone (T), by inhibiting ovarian and adrenal androgen synthesis and by increasing levels of sex hormone-binding globulin (SHBG). Although this suppressive effect has been investigated by numerous studies over many years, to our knowledge no systematic review concerning this issue had been performed. This systematic review and meta-analysis was performed to evaluate the effect of COCs on concentrations of total T, free T and SHBG in healthy women and to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T and free T.METHODSA review of the literature was performed using database searches (MEDLINE, EMBASE and the Cochrane Central Register of Clinical Trials) and all publications (from inception date until July 2012) investigating the effect of COCs on androgen levels in healthy women were considered eligible for selection. Three reviewers were involved in study selection, data extraction and critical appraisal. For the meta-analysis, data on total T, free T and SHBG were extracted and combined using random effects analysis. Additional subgroup analyses were performed to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T or free T.RESULTSA total of 151 records were identified by systematic review and 42 studies with a total of 1495 healthy young women (age range: 18–40 years) were included in the meta-analysis. All included studies were experimental studies and 21 were non-comparative. Pooling of the results derived from all the included papers showed that total T levels significantly decreased during COC use [mean difference (MD) (95% confidence interval, CI) −0.49 nmol/l (−0.55, −0.42); P < 0.001]. Significantly lower levels of free T were also found [relative change (95% CI) 0.39 (0.35, 0.43); P < 0.001], with a mean decrease of 61%. On the contrary, SHBG concentrations significantly increased during all types of COC use [MD (95% CI) 99.08 nmol/l (86.43, 111.73); P < 0.001]. Subgroup analyses revealed that COCs containing 20–25 µg EE had similar effects on total and free T compared with COCs with 30–35 µg EE. In addition, suppressive effects on T levels were not different when comparing different types of progestins. However, subgroup analyses for the estrogen dose and the progestin type in relation to changes in SHBG levels did show significant differences: COCs containing second generation progestins and/or the lower estrogen doses (20–25 µg EE) were found to have less impact on SHBG concentrations.CONCLUSIONSThe current literature review and meta-analysis demonstrates that COCs decrease circulating levels of total T and free T and increase SBHG concentrations. Due to the SHBG increase, free T levels decrease twice as much as total T. The estrogen dose and progestin type of the COC do not influence the decline of total and free T, but both affect SHBG. The clinica...

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Section: Resultsmentioning

confidence: 99%

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

Zimmerman

et al. 2013

Human Reproduction Update

238

151

View full text Add to dashboard Cite

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“…SHBG (CV 7.8-10.2% at 100 nmol/l) was analysed by an ELI-SA method (kit from Pharmacia AB, Uppsala, Sweden) with a monoclonal antibody against SHBG and time resolved fluorescent detection (20). Free testosterone (CV 8.5-12.6% at 50 pmol/ 1) was calculated from SHBG, total testosterone and albumin results (21).…”

mentioning

confidence: 99%

Oral contraceptive tablets containing 20 and 30 μg of ethinyl estradiol with 150 μg desogestrel: Their influence on lipids, lipoproteins, sex hormone binding globulin and testosterone

Åkerlund

Almström

Högstedt

et al. 1994

Acta Obstet Gynecol Scand

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The effect of two oral contraceptive (OC) pills, both containing 150 micrograms of desogestrel, but with 20 (Mercilon) or 30 micrograms (Marvelon/Desolett) of ethinyl estradiol on plasma levels of lipids, lipoproteins and sex hormone binding globulin (SHBG), total and free testosterone were compared in a double-blind, randomized, two-center study in a total of 60 women over one year. A significant rise with Marvelon but not with Mercilon was seen in total cholesterol, HDL cholesterol, HDL-3 and apolipoprotein B, whereas LDL cholesterol decreased with Mercilon only. These effects resulted in significant differences between the two groups in the magnitude of responses in all these parameters except HDL-3. HDL-2, apolipoprotein A-1 and total phospholipids were elevated with both pills after treatment and with no difference in the degree of response between groups. The HDL/LDL cholesterol ratio tended to increase in both groups and that of apolipoproteins A-1/B in the women on Mercilon. Total triglycerides increased in both groups, but more in the women on Marvelon. Total testosterone decreased, particularly in the Marvelon group, whereas the two pills caused a similar increase in SHBG and decrease in free testosterone. It is concluded that the direction of changes in plasma lipids and lipoproteins with both these pills may as a whole be interpreted as beneficial, and that the differences in effect on LDL cholesterol and apolipoprotein B may suggest a slightly advantageous effect of Mercilon in this aspect. However, the clinical significance of these changes is uncertain. The results indicate a lack of androgenicity of both pills.

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“…Information collected includes the type of ADT used, the number of patients, the timing of the measurement, the method/assay of measurement, patient demographics, and length of time on ADT, if available. Unfortunately, from our review of the literature, only four published studies 4 28 29 30 directly addressed these important points, the summaries of which are included here.…”

Section: Resultsmentioning

confidence: 99%

How do we define “castration” in men on androgen deprivation therapy?

Itty

Getzenberg

2020

Asian J Androl

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Androgen deprivation therapy (ADT) is the mainstay for the treatment of advanced prostate cancer. Since the clinical evolution from surgical orchiectomy, we have typically used ADT and orchiectomy to be synonymous terms for castration. The goal of this study is to determine if, in contemporary medical practice, surgical and chemical castration provide for similar levels of diminishment of total and free testosterone. Further, what approaches should be used to most accurately measure testosterone levels in men with advanced prostate cancer and what cutoff values, for example for total testosterone 50 ng dl −1 or 20 ng dl −1 , should be utilized. Studies available in the literature have been analyzed and compiled to address these questions. Finally, evidence is provided that free testosterone, the biologically active component, should be utilized to provide clinically relevant state of castration.

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Relationship of testosterone, sex hormone binding globulin, and calculated free testosterone to subsequent clinical progress in patients with carcinoma of the prostate treated with bilateral orchidectomy or estrogens

Cited by 13 publications

References 12 publications

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

Oral contraceptive tablets containing 20 and 30 μg of ethinyl estradiol with 150 μg desogestrel: Their influence on lipids, lipoproteins, sex hormone binding globulin and testosterone

How do we define “castration” in men on androgen deprivation therapy?

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