Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 caucasian premenopausal women with hirsutism as the referral diagnosis

Dorte Glintborg, Jan Erik Henriksen, Marianne Andersen, Claus Hagen, Jørgen Hangaard, Per Emil Rasmussen, Karoline Schousboe, Anne Pernille Hermann

Research output: Contribution to journalJournal articleResearchpeer-review

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.

DESIGN: Systematic, retrospective audit.

SETTING: Academic tertiary-care medical center.

PATIENT(S): Three hundred forty women with hirsutism as the referral diagnosis.

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

MAIN OUTCOME MEASURE(S): End diagnosis, fasting, 30-, 60-, and 120-minute oral glucose-stimulated levels of insulin and capillary blood glucose.

RESULT(S): 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.

CONCLUSION(S): 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.

Original languageEnglish
JournalFertility and Sterility
Volume82
Issue number6
Pages (from-to)1570-1579
Number of pages10
ISSN0015-0282
DOIs
Publication statusPublished - 2004

Keywords

  • Adrenal Hyperplasia, Congenital
  • Adult
  • Androgens
  • Cushing Syndrome
  • Diabetes Mellitus
  • Endocrine System Diseases
  • European Continental Ancestry Group
  • Fasting
  • Female
  • Glucose Intolerance
  • Glucose Tolerance Test
  • Hirsutism
  • Humans
  • Insulin
  • Insulin Resistance
  • Ovarian Neoplasms
  • Pituitary Neoplasms
  • Polycystic Ovary Syndrome
  • Premenopause
  • Prevalence
  • Prolactinoma
  • Referral and Consultation

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