Prevalence of 21-hydroxylase-deficient nonclassic adrenal hyperplasia and insulin resistance among hirsute women from Puerto Rico.
OBJECTIVE
To determine the prevalence of 21-hydroxylase (21-OH)-deficient nonclassic adrenal hyperplasia (NCAH) and insulin resistance in hirsute women from Puerto Rico.


METHODS
Cross-sectional prospective study.


METHODS
Clinical research center.


METHODS
100 consecutive untreated hirsute women.


METHODS
Fasting total T, free T, DHEAS, insulin, and glucose were measured, and a 60-minute acute ACTH-(1-24) stimulation for 17-hydroxyprogesterone (17-HP) was performed. A diagnosis of 21-OH-deficient NCAH was considered when the stimulated 17-HP level was >30.3 nmol/L. The glucose/insulin ratio was calculated as a measure of insulin resistance (normal value, > or =4.5).


RESULTS
Patients had a mean (+/-SD) age of 26.8+/-6.6 years; 82 were oligomenorrheic. Overall, 12%, 8%, and 60% of patients had elevated levels of DHEAS, total T, or free T, respectively. One patient was identified as having 21-OH-deficient NCAH. Eight women, none of whom had NCAH, were found to be hyperglycemic; four of these women had type 2 diabetes mellitus. Excluding hyperglycemic patients, a glucose/insulin ratio of <4.5, consistent with IR, was found in 51.7%.


CONCLUSIONS
The prevalence of 21-OH-deficient NCAH among patients from Puerto Rico does not differ significantly from that reported for other non-Jewish, non-Hispanic white populations.
Romaguera
J
J
University of Puerto Rico, School of Medicine, San Juan, USA.
Moran
C
C
Diaz-Montes
T P
TP
Hines
G A
GA
Cruz
R I
RI
Azziz
R
R
D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000201:enzymology; D000328:Adult; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005951:Glucose Tolerance Test; D006628:Hirsutism / Q000150:complications* / Q000201:enzymology; D006801:Humans; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology*; D011647:Puerto Rico / Q000453:epidemiology; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate