Salivary testosterone: a non invasive approach to screen hypogonadism in patients with end stage renal disease

ARREGGER AL, CONTRERAS LN, TUMILASCI OR, AQUILANO DR, CARDOSO EML

Toronto, Canadá

Congreso; The Endocrine Society, 89 th Annual Meeting, Endo 07; 2007

Endocrine Society

Hypogonadism is a common feature among men with end stage renal disease (ESRD). The measurement of salivary testosterone (ST) has been proposed as a non invasive method for the assessment of gonadal function. The aim of this study was to determine the usefulness of ST as an alternative to conventional serum measurements for the diagnosis of hypogonadism in men with ESRD. We studied 27 male patients aged 29-55 y/o attending a dialysis centre who complained of sexual dysfunction. Whole saliva and blood samples obtained between 7 and 9 a.m. were analyzed for ST, Total Testosterone (TT), SHBG and albumin. Serum free testosterone (Free-T) and bio-available testosterone (Bio-T) were calculated by Vermeulen¢¥s equation. Androgen deficiency was diagnosed considering the following criteria: levels of TT ¡Â10.1 nM, Free-T¡Â 0.229 nM, Bio-T¡Â 5.3 nM and ST¡Â0.195 nM (data obtained from 52 eugonadic and 20 hypogonadic subjects with normal renal function). Results: ST correlated significantly with Free-T (r:0.77) and Bio-T (r:0.609) in ESRD (p=0.001 ). Six ERSD had low TT (6.88 ¡¾ 1.14nM), FreeT (0.17 ¡¾ 0.03 nM), Bio-T(3.78 ¡¾ 0.66 nM ) and ST(0.12 ¡¾ 0.04 nM); 18 ESRD showed normal testosterone levels in saliva and serum. Discordant results were found in 3 cases: 2 patients had low TT but normal Free-T, Bio-T and ST , and 1 showed normal TT but low Free-T, Bio-T and ST concentrations. Conclusions: 26 % of ESRD had low ST levels in accordance to low Free-T and Bio-T concentrations, suggesting hypogonadism. Salivary testosterone was a practical less invasive tool to screen gonadal status in these high risk patients