title: Prevalence of 21-hydroxylase-deficient nonclassic adrenal hyperplasia and insulin resistance among hirsute women from Puerto Rico.
abstract: 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.
authors.affiliation: University of Puerto Rico, School of Medicine, San Juan, USA.
authors.forename: J
authors.initials: J
authors.lastname: Romaguera
authors.forename: C
authors.initials: C
authors.lastname: Moran
authors.forename: T P
authors.initials: TP
authors.lastname: Diaz-Montes
authors.forename: G A
authors.initials: GA
authors.lastname: Hines
authors.forename: R I
authors.initials: RI
authors.lastname: Cruz
authors.forename: R
authors.initials: R
authors.lastname: Azziz
mesh_terms: 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
chemical_list: D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate