title: Correlation of clinical and biochemical hyperandrogenism in Thai women with polycystic ovary syndrome.
abstract: OBJECTIVE
  The aim of this study was to determine the correlation of clinical hyperandrogenism and biochemical hyperandrogenism (hyperandrogenemia) in Thai women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  This cross-sectional study was conducted at Siriraj Hospital, Thailand. Subjects were 145 women with PCOS who were diagnosed in accordance with the revised Rotterdam 2003 criteria and registered during January to July 2008. Clinical hyperandrogenism was assessed using the modified Ferriman-Gallwey score for hirsutism, the American Academy of Dermatology criteria for severity of acne, and the Ludwig scale for androgenic alopecia and virilization. Biochemical hyperandrogenism was determined from serum concentration of total testosterone (TT), dehydroepiandrosterone sulfate and free testosterone (FT).
  
  
  RESULTS
  The participants had a mean age of 25.5 ± 6.5 years and a body mass index of 26.2 ± 6.9 kg/m(2) . The most common presenting symptom was oligomenorrhea or amenorrhea. The most common expression of clinical hyperandrogenism was acne (56.6%). Most of the participants (84.8%) had high serum-FT. There was a statistically significant correlation between clinical and biochemical hyperandrogenism in the following pairs: hirsutism and FT (r = 0.3, P < 0.001); hirsutism and TT (r = 0.26, P < 0.001); and acne and TT (r = 0.26, P = 0.002). The others had little or no correlations.
  
  
  CONCLUSIONS
  Clinical hyperandrogenism is not a good predictor for biochemical hyperandrogenism in Thai women with PCOS. A modified Ferriman-Gallwey score cut-off point of 8 has low sensitivity but high specificity for hyperandrogenemia; therefore, it is useful for the diagnosis but not useful for the exclusion of hyperandrogenemia in Thai women with PCOS.
authors.affiliation: Gynecologic Endocrinology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pichai
authors.initials: P
authors.lastname: Leerasiri
authors.affiliation: Gynecologic Endocrinology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Thanyarat
authors.initials: T
authors.lastname: Wongwananuruk
authors.affiliation: Gynecologic Endocrinology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Suchada
authors.initials: S
authors.lastname: Indhavivadhana
authors.affiliation: Gynecologic Endocrinology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kitirat
authors.initials: K
authors.lastname: Techatraisak
authors.affiliation: Gynecologic Endocrinology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Manee
authors.initials: M
authors.lastname: Rattanachaiyanont
authors.affiliation: Gynecologic Endocrinology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Surasak
authors.initials: S
authors.lastname: Angsuwathana
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D044466:Asian People; D003430:Cross-Sectional Studies; D005260:Female; D006628:Hirsutism / Q000150:complications / Q000453:epidemiology; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009839:Oligomenorrhea / Q000150:complications / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D013739:Testosterone / Q000097:blood; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D013739:Testosterone
keywords: PCOS, Thai women; correlation; hyperandrogenemia; hyperandrogenism