Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Clin Endocrinol (Oxf). 2019 Apr;90(4):586-591. doi: 10.1111/cen.13936. Epub 2019 Jan 31.
Hirsutism affects 5%-10% of reproductive-aged women worldwide and exhibits clinical importance as a cutaneous manifestation of underlying hyperandrogenism. Racial and genetic factors play roles in manifestation of hirsutism, and the prevalence of hirsutism seems to be low in East Asians. However, the reference value of the modified Ferriman-Gallwey (mFG) score to diagnose hirsutism and the prevalence of hirsutism have not been determined in Korean populations to date. We aimed to investigate the distribution of the mFG score and establish its reference value for defining hirsutism and to examine its relationship with metabolic and reproductive traits in reproductive-aged Korean women.
DESIGN, PATIENTS AND MEASUREMENTS: We enrolled 2139 female volunteers of reproductive age (15-39 years). We recorded mFG scores from 0 to 4 on 9 different body locations (upper lip, chin, chest, arm, upper abdomen, lower abdomen, upper back, lower back and thighs). Hirsutism was defined as >95th percentile of mFG score. In addition, a 75-g oral glucose tolerance test was performed, and the homoeostasis model assessment of insulin resistance (HOMA-IR) was calculated.
The mFG values of the 50th, 75th, 90th and 95th percentiles were 0, 1, 4 and 6, respectively. Therefore, the mFG score was indicative of hirsutism when the score was 6 or greater, which represents the 95th percentile. In the correlation analysis, total testosterone, free testosterone, fasting plasma insulin and HOMA-IR were positively correlated with mFG score (all Ps <0.05). Multiple linear regression analysis revealed that HOMA-IR (β = 0.081) was positively associated with mFG score after adjustments for age, body mass index, total testosterone and the number of menses per year (P < 0.001).
In conclusion, setting the 95th percentile of the mFG score as normal, the reference value to define hirsutism was 6 in reproductive-aged Korean women. HOMA-IR was positively associated with the mFG score even after adjustment for biochemical hyperandrogenism.
多毛症影响全球 5%-10%的育龄妇女，作为潜在高雄激素血症的皮肤表现，具有临床重要性。种族和遗传因素在多毛症的表现中起作用，多毛症的患病率在东亚似乎较低。然而，到目前为止，改良 Ferriman-Gallwey（mFG）评分用于诊断多毛症的参考值及其在韩国人群中的患病率尚未确定。我们旨在研究 mFG 评分的分布，并为定义多毛症建立其参考值，并研究其与韩国育龄妇女代谢和生殖特征的关系。
设计、患者和测量：我们招募了 2139 名育龄女性志愿者（15-39 岁）。我们记录了 9 个不同身体部位（上唇、下巴、胸部、手臂、上腹部、下腹部、上背部、下背部和大腿）的 mFG 评分，范围从 0 到 4。mFG 评分≥95 百分位数定义为多毛症。此外，进行了 75g 口服葡萄糖耐量试验，并计算了胰岛素抵抗的稳态模型评估（HOMA-IR）。
mFG 值的 50、75、90 和 95 百分位数分别为 0、1、4 和 6。因此，当评分≥6 时，mFG 评分表示 95 百分位数，表明存在多毛症。在相关性分析中，总睾酮、游离睾酮、空腹血浆胰岛素和 HOMA-IR 与 mFG 评分呈正相关（均 P<0.05）。多元线性回归分析显示，在校正年龄、体重指数、总睾酮和每年月经次数后，HOMA-IR（β=0.081）与 mFG 评分呈正相关（P<0.001）。
总之，将 mFG 评分的 95 百分位数设定为正常，韩国育龄妇女多毛症的参考值为 6。即使在校正生化高雄激素血症后，HOMA-IR 仍与 mFG 评分呈正相关。
