Salivary Versus Serum Approaches in Assessment of Biochemical Hyperandrogenemia

Abstract

Background: Biochemically, hyperandrogenism is established by elevated circulating levels of free or total serum testosterone and an increased free androgen index. Approximately, 60‑80% of women with polycystic ovarian syndrome (PCOS) demonstrate elevated circulating androgen levels.

Aim: This prospective observational randomized study was to investigate the likelihood of using the salivary luteinizing hormone (LH), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEAS) levels instead of serum values in diagnosing biochemical hyperandrogenemia in women with PCOS.

Subjects and Methods: This study was conducted on 75 women having PCOS in addition to 20 normal fertile women (control group). Venous blood and salivary samples were taken in the 3^rd day of the cycle to measure LH and FT and DHEAS levels.

Results: Biochemical hyperandrogenemia prevails in 40% of women with PCOS. Salivary levels of LH, FT and DHEAS correlate with their corresponding serum values, with a higher sensitivity of salivary more than serum approach.

Conclusion: Saliva provides a sensitive, simple, reliable, non‑invasive and uncomplicated diagnostic approach for biochemical hyperandrogenemia.

Keywords: Biochemical hyperandrogenemia, dehydroepiandrosterone sulfate, luteinizing hormone, polycystic ovarian syndrome, saliva, testosterone