Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid E-28034, Spain.
Hum Reprod. 2012 Apr;27(4):1209-16. doi: 10.1093/humrep/des028. Epub 2012 Feb 17.
The polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. On the contrary, the prevalences of other disorders of androgen excess such as idiopathic hyperandrogenism and idiopathic hirsutism remain unknown. We aimed to obtain an unbiased estimate of the prevalence in premenopausal women of (i) signs of androgen excess and (ii) PCOS, idiopathic hyperandrogenism and idiopathic hirsutism.
A multicenter prevalence survey included 592 consecutive premenopausal women (393 from Madrid, Spain and 199 from Bologna, Italy) reporting spontaneously for blood donation. Immediately before donation, we conducted clinical and biochemical phenotyping for androgen excess disorders. We determined the prevalence of (i) hirsutism, acne and alopecia as clinical signs of androgen excess and (ii) functional disorders of androgen excess, including PCOS, defined by the National Institute of Child Health and Human Development/National Institute of Health criteria, idiopathic hyperandrogenism and idiopathic hirsutism.
Regarding clinical signs of hyperandrogenism, hirsutism and acne were equally frequent [12.2% prevalence; 95% confidence interval (CI): 9.5-14.8%], whereas alopecia was uncommon (1.7% prevalence, 95% CI: 0.7-2.7%). Regarding functional disorders of androgen excess, PCOS and idiopathic hirsutism were equally frequent (5.4% prevalence, 95% CI: 3.6-7.2) followed by idiopathic hyperandrogenism (3.9% prevalence, 95% CI: 2.3-5.4).
Clinical signs of hyperandrogenism and functional disorders of androgen excess show a high prevalence in premenopausal women. The prevalences of idiopathic hyperandrogenism and idiopathic hirsutism are similar to that of PCOS, highlighting the need for further research on the pathophysiology, consequences for health and clinical implications of these functional forms of androgen excess.
多囊卵巢综合征（PCOS）是女性最常见的内分泌疾病之一。相反，其他雄激素过多疾病的患病率，如特发性高雄激素血症和特发性多毛症，仍不清楚。我们旨在获得绝经前妇女（i）雄激素过多迹象和（ii）PCOS、特发性高雄激素血症和特发性多毛症患病率的无偏估计。
一项多中心患病率调查包括 592 名连续的绝经前妇女（393 名来自西班牙马德里，199 名来自意大利博洛尼亚），她们自愿献血。在献血前，我们对雄激素过多疾病进行了临床和生化表型分析。我们确定了（i）多毛症、痤疮和脱发作为雄激素过多的临床体征，以及（ii）包括多囊卵巢综合征在内的雄激素过多功能障碍的患病率，多囊卵巢综合征由国家儿童健康与人类发育研究所/国家卫生研究院标准定义，特发性高雄激素血症和特发性多毛症。
关于高雄激素血症的临床体征，多毛症和痤疮的患病率相同[12.2%；95%置信区间（CI）：9.5-14.8%]，而脱发罕见（1.7%；95%CI：0.7-2.7%）。关于雄激素过多功能障碍，多囊卵巢综合征和特发性多毛症的患病率相同（5.4%；95%CI：3.6-7.2%），其次是特发性高雄激素血症（3.9%；95%CI：2.3-5.4%）。
绝经前妇女的高雄激素血症临床体征和雄激素过多功能障碍的患病率较高。特发性高雄激素血症和特发性多毛症的患病率与多囊卵巢综合征相似，这突显了需要进一步研究这些雄激素过多功能形式的病理生理学、对健康的影响和临床意义。
