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Prostate-Specific Antigen in Female Serum, a Potential New Marker of Androgen Excess

Department of Pathology and Laboratory Medicine (D.N.M., H.Y., E.P.D.), Mount Sinai Hospital, Toronto, Ontario M5G 1X5; Department of Clinical Biochemistry (D.N.M., H.Y., E.P.D.), University of Toronto, Toronto, Ontario M5G 1L5, Canada; and Department of Obstetrics and Gynecology (M.A., C.W., F.S.), Division of Reproductive Endocrinology and Infertility, University of Southern California School of Medicine, Los Angeles, California 90033

Address correspondence and requests for reprints to: Dr. E. P. Diamandis, Department of Pathology and Laboratory Medicine, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5.

Prostate-specific antigen (PSA) is present at very low concentrations in female serum, but it can now be measured with highly sensitive immunoassays. We have found that in female tissues the PSA gene is regulated by steroid hormones through the action of steroid hormone receptors. Thus, we examined whether female serum PSA is associated with hyperandrogenic states. Serum PSA levels were compared between 22 hirsute women with a Ferriman-Gallwey score higher than 8 and 50 women without hirsutism. The results show that PSA levels were higher in hirsute women in comparison with controls. In hirsute women, levels of PSA and 3-androstanediol glucuronide (3-AG), a specific metabolite of androgen action, showed a significant positive correlation, whereas PSA and 3-AG showed a significant negative correlation with patient age. Receiver operating characteristic (ROC) analysis revealed that 3-AG was a slightly better marker of androgen excess than PSA. We conclude that female serum PSA may be a new biochemical marker of androgen action in females.

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