Reference range of testosterone and dehydroepiandrosterone sulfate levels in women during reproductive age in the Iranian population

Backgrounds: To determine the average cutoff values of serum-free and total testosterone (FT, TT) and dehydroepiandrosterone sulfate (DHEAS) among healthy premenopausal women. Materials and Methods: Participants were women aged 18-55 years without signs and symptoms of hyperandrogenism (n = 489). Participants if Ferriman-Gallwey (FG) scores between 6 and 8 were considered a group located in the upper spectrum related to the normal hirsutism score (n = 30). DHEAS, TT, and FT levels were compared between different populations. Upper limits of 97.5 and 95 and lower limits of 5 and 2.5 percentiles were calculated to provide the reference intervals for DHEA, TT, and FT in the total sample and in the population with FG 6-8. Results: In the total population, the mean +/- standard deviation (SD) serum FT, TT, and DHEAS levels were 1.40 +/- 0.63 pg/mL, 0.42 +/- 0.17 ng/mL, and 1.5 +/- 0.97 mu g/ml, respectively. The cutoff values of FT at 1.35 and TT at 0.49 were obtained for differentiating the patients with FG 6-8 scores from the normal population, with the corresponding specificity of 0.60, the sensitivity of 0.67, and area under the ROC curve (AUC) (confidence interval 95%) of 0.63 (0.52-0.73), P = 0.01 and 0.68 (0.58-0.78) P = 0.001, respectively. Conclusions: In our study, the mean +/- SD serum FT level was 1.40 +/- 0.63 pg/mL, the TT level was 0.42 +/- 0.17 ng/mL, and the DHEAS level was 1.5 +/- 0.97 mu g/ml, in premenopausal women between 18 and 49 years of age. Furthermore, in a population with FG 6-8 score, a cutoff value of FT at 1.35 and TT at 0.49 was obtained. Although the irregular menstrual cycle did not change the reference range when compared with the normal group.