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Labordiagnostik des Testosterons

Laboratory work-up of testosterone

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Zusammenfassung

Die Bestimmung der Testosteronkonzentration ist ein zentraler Bestandteil der andrologischen Routinediagnostik. Um eine aufwendige und oft ungenaue direkte Messung des bioverfügbaren Testosterons zu vermeiden, kann dieses mittels SHBG- und der Albuminkonzentration berechnet werden. Bei der Interpretation einer gemessenen Testosteronkonzentration müssen eine Vielzahl von Einflussfaktoren berücksichtigt werden. Hierbei steht eine zirkadiane Rhythmik im Vordergrund, des Weiteren sinkt die Konzentration mit zunehmendem Lebensalter. Auch krankheitsbedingt oder durch die Einnahme bestimmter Medikamente kann es zu Änderungen der Testosteronkonzentration kommen. Von besonderer Bedeutung ist die SHBG-Konzentration, die im Alter ansteigt. Es fehlen international anerkannte Normwerte, insbesondere beim älteren Patienten, so dass bei der Entscheidungsfindung bezüglich einer Hormonsubstitution immer die Klinik des Patienten mit einbezogen werden sollte.

Abstract

Measuring testosterone concentration is a central component of routine andrological diagnostics. To avoid complicated and often imprecise direct measurement of bioavailable testosterone, calculation by SHBG and albumin concentration is possible. When interpreting a measured testosterone concentration, numerous influencing factors have to be kept in mind. One main factor is circadian rhythm; furthermore, concentration decreases with advancing age. Changes of testosterone concentration can be caused by illness or the intake of specific drugs. The increase in SHBG concentration with age is of particular importance. Since internationally accepted standard values are missing, especially for elderly patients, their symptoms should always be considered when making a decision on hormone substitution.

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  1. Urologische Klinik und Poliklinik, Klinikum der Universität München – Großhadern, Marchioninistraße 15, 81377, München, Deutschland

    M. Trottmann, M. Dickmann, C.G. Stief & A.J. Becker

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  1. M. Trottmann
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  2. M. Dickmann
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  3. C.G. Stief
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  4. A.J. Becker
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Correspondence to M. Trottmann.

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Trottmann, M., Dickmann, M., Stief, C. et al. Labordiagnostik des Testosterons. Urologe 49, 11–15 (2010). https://doi.org/10.1007/s00120-009-2192-0

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