The Value of Androgen Measures for Diagnosing Polycystic Ovary Syndrome (PCOS) in an Unselected Population.

Autor: Pace L; Dept. of Ob/GynHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA., Kummer N; Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA., Wallace M; Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA., Azziz R; Dept. of Ob/GynHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. razziz@uabmc.edu.; Dept. of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. razziz@uabmc.edu.; Dept. of Healthcare Organization & Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. razziz@uabmc.edu.; Dept. of Health Policy, Management, and Behavior, School of Public Health, University at Albany, SUNY, Rensselaer, NY, USA. razziz@uabmc.edu.
Jazyk: angličtina
Zdroj: Reproductive sciences (Thousand Oaks, Calif.) [Reprod Sci] 2024 Oct 17. Date of Electronic Publication: 2024 Oct 17.
DOI: 10.1007/s43032-024-01702-9
Abstrakt: Objective: Polycystic Ovary Syndrome (PCOS) is diagnosed by a combination of three features: hyperandrogenism (biochemical and/or clinical), ovulatory dysfunction, and polycystic ovarian morphology, usually detected by ultrasonography. Our study aimed to determine the need for androgen measurements by using hirsutism to establish hyperandrogenism for diagnosing PCOS in a medically unbiased population.
Materials and Methods: We utilized a pre-existing cohort of unselected (medically unbiased) females aged 18-45 years. All underwent a history and physical, including a modified Ferriman-Gallwey (mFG) hirsutism score. Subjects were categorized clinically as eumenorrheic non-hirsute (CONTROLS), menstrual dysfunction only (OLIGO-ONLY), hirsutism only (HIRSUTE-ONLY), or menstrual dysfunction and hirsutism (OLIGO + HIRSUTE). All subjects underwent measurements of androgens using high-quality assays. CONTROLS established the upper normal limit for androgen levels. We defined PCOS using the NIH 1990 criteria.
Results: Of 462 individuals with complete evaluations, 311 (67.3%) were CONTROLS, 71 (15.4%) were OLIGO-ONLY, 64 (13.9%) were HIRSUTE-ONLY, and 16 (3.5%) were OLIGO + HIRSUTE. Neither HIRSUTE-ONLY nor OLIGO-HIRSUTE women required androgen measures to demonstrate hyperandrogenism. Among OLIGO-ONLY, 19 (26.8%) demonstrated hyperandrogenemia without hirsutism, with White women significantly more likely than Black women to demonstrate this.
Conclusions: In our study of medically unbiased reproductive-aged women using the NIH 1990 criteria for PCOS, only 15.4% of women evaluated (those with menstrual dysfunction only) required androgen measurements. In these women only one-quarter demonstrated hyperandrogenemia. These data provide a strategy to minimize the need for androgen assays, including firstly categorizing subjects by clinical presentation and then assessing circulating androgens in the subgroup with menstrual dysfunction only.
(© 2024. The Author(s).)
Databáze: MEDLINE
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