Circulating androgens and SHBG during the normal menstrual cycle in two ethnic populations

Abstract

The objective of this study was to study possible ethnic differences in steroid hormones and sex hormone-binding globulin (SHBG) during the menstrual cycle. Serum levels of the ovarian steroids estradiol (E2) and progesterone (P) and of follicle-stimulating hormone (FSH), luteinizing hormone (LH), SHBG, dehydroepiandrosterone (DHEA) and testosterone (T-ria) were all measured by immunoassay during the menstrual cycle in 15 Swedish and 11 West Asian regularly menstruating women. Testosterone (T-ms) was also measured by LC-MS/MS and so were 4-androstene-3,17-dione (A-4) and 17-alpha-hydroxyprogesterone (17-OHP). There were no ethnic differences in levels of ovarian steroids, gonadotrophins, A-4, 17-OHP and T-ms. DHEA were significantly higher and SHBG significantly lower in West Asian than in Swedish women. Surprisingly, T-ria was significantly higher in West Asian than in Swedish women and higher than T-ms (47% in Swedish and 107% in West Asian women). The difference (T-ria − T-ms) showed strong positive correlations to DHEA in the total and in West Asian but not in Swedish women, indicating an influence of DHEA/DHEAS metabolites on the T-ria results. In conclusion, ethnic differences in cross reacting steroids may cause erroneous results in one ethnic group by a steroid immunoassay having reasonable specificity in another. The reasons for the lower SHBG and the higher DHEA levels in West Asian women are not known. The results raise the question about establishing different reference values for certain analytes in different ethnic groups.

Keywords:

• Dehydroepiandrosterone
• ethnic difference
• immunoassay
• LC-MS/MS
• menstrual cycle
• SHBG
• testosterone

Acknowledgements

The help by Research on Women’s Health (‘Kvinnohälsan’), Division of Obstetrics and Gynecology, Huddinge, with blood sampling is humbly acknowledged. This study was supported by funds from the Swedish Research Council K2009-52X-20944-01-1 (ME), and 20324 (ALH), Karolinska Institutet, Stockholm County Council, and the Swedish Dental Association.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

The help by Research on Women’s Health (‘Kvinnohälsan’), Division of Obstetrics and Gynecology, Huddinge, with blood sampling is humbly acknowledged. This study was supported by funds from the Swedish Research Council K2009-52X-20944-01-1 (ME), and 20324 (ALH), Karolinska Institutet, Stockholm County Council, and the Swedish Dental Association.