title: Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 Caucasian premenopausal women with hirsutism as the referral diagnosis.
abstract: 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.
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark. dorte.glintborg@ouh.fyns-amt.dk
authors.forename: Dorte
authors.initials: D
authors.lastname: Glintborg
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Henriksen
authors.forename: Marianne
authors.initials: M
authors.lastname: Andersen
authors.forename: Claus
authors.initials: C
authors.lastname: Hagen
authors.forename: Jørgen
authors.initials: J
authors.lastname: Hangaard
authors.forename: Per Emil
authors.initials: PE
authors.lastname: Rasmussen
authors.forename: Karoline
authors.initials: K
authors.lastname: Schousboe
authors.forename: Anne Pernille
authors.initials: AP
authors.lastname: Hermann
mesh_terms: 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
chemical_list: D000728:Androgens; D007328:Insulin