Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 Caucasian premenopausal women with hirsutism as the referral diagnosis.
OBJECTIVE
To perform an audit on the examination of hirsute patients and to establish a rational routine examination program in an outpatient endocrine clinic.


METHODS
Systematic, retrospective audit.


METHODS
Academic tertiary-care medical center.


METHODS
Three hundred forty women with hirsutism as the referral diagnosis.


METHODS
Hormone analyses and ACTH tests during cycle days 2-8, 2 hours of oral glucose tolerance test (OGTT), and vaginal ultrasound.


METHODS
End diagnosis, fasting, 30-, 60-, and 120-minute oral glucose-stimulated levels of insulin and capillary blood glucose.


RESULTS
Two hundred one patients were diagnosed as having idiopathic hirsutism (IH) and 134 as having polycystic ovary syndrome (PCOS). End diagnosis: prolactinoma: n = 1, Cushing's syndrome: n = 1, androgen-producing ovarian tumor: n = 1, late-onset 21-hydroxylase defects: n = 2. During OGTT, 4.9% (13 of 263) had previously undiagnosed diabetes; no significant difference in diabetes prevalence was found between idiopathic hirsutism and PCOS. For 50.8%, fasting insulin values were in the upper quartile for a reference population.


CONCLUSIONS
Initial evaluation of hirsute patients with irregular menses should include serum (s)-17alpha-hydroxyprogesterone, s-prolactin, s-Testosterone (T), and s-sex hormone-binding globulin. Further evaluation is needed in patients with markedly elevated s-T or with clinical Cushing's syndrome. Hirsute patients have a high risk of diabetes, although this could be due to the high number of overweight patients among this population.
Glintborg
Dorte
D
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark. dorte.glintborg@ouh.fyns-amt.dk
Henriksen
Jan Erik
JE
Andersen
Marianne
M
Hagen
Claus
C
Hangaard
Jørgen
J
Rasmussen
Per Emil
PE
Schousboe
Karoline
K
Hermann
Anne Pernille
AP
D000312:Adrenal Hyperplasia, Congenital / Q000145:classification / Q000453:epidemiology; D000328:Adult; D000728:Androgens / Q000096:biosynthesis; D003480:Cushing Syndrome / Q000150:complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004700:Endocrine System Diseases / Q000150:complications* / Q000453:epidemiology*; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000150:complications* / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006628:Hirsutism / Q000150:complications*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000378:metabolism; D010911:Pituitary Neoplasms / Q000150:complications / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology; D017697:Premenopause; D015995:Prevalence; D015175:Prolactinoma / Q000150:complications / Q000453:epidemiology; D012017:Referral and Consultation; D044465:White People
D000728:Androgens; D007328:Insulin