Wolf Amber T, Wang Zifan, Onnela Jukka-Pekka, Baird Donna D, Jukic Anne Marie Z, Curry Christine L, Fischer-Colbrie Tyler, Williams Michelle A, Hauser Russ, Coull Brent A, Mahalingaiah Shruthi
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
J Clin Endocrinol Metab. 2025 May 19;110(6):1667-1679. doi: 10.1210/clinem/dgae674.
Androgen excess (AE)-related symptoms can vary widely and may appear across the life course.
We assessed the prevalence of signs of potential AE and heterogeneity by demographic/health characteristics.
We used data of 24 435 participants who consented and enrolled during November 2019 to December 2022 in a US digital cohort to evaluate the prevalence and heterogeneity of self-reported signs of potential AE: possible hirsutism (having thick coarse hair on ≥4 of 8 body locations), hair level on the chin, hair loss on top of the head, and moderate to severe acne.
The prevalence of possible hirsutism, having several/a lot of hair on the chin, significantly reduced hair/visible scalp on top of the head, and moderate to severe acne were 6.9%, 12.6%, 1.7%, and 31.8%, respectively. While possible hirsutism and moderate to severe acne decreased with age (range: 18-86 years), hair on the chin and hair loss on the head increased with age. Participants who self-identified as Hispanic or South Asian reported a higher prevalence of possible hirsutism (11.2%, 16.9%, vs 6.3% among non-Hispanic White participants). Participants with higher body mass index had a higher prevalence of possible hirsutism. Moderate to severe acne was more common among those with polycystic ovary syndrome. Possible hirsutism and hair loss were less common among participants using hormones for contraception.
In this large cohort, signs of potential AE varied by demographic and health factors. These results could provide a new understanding of how potential AE may appear differently in diverse groups, informing future work to develop more inclusive evaluation at a population level.
雄激素过多（AE）相关症状差异很大，可能出现在整个生命过程中。
我们根据人口统计学/健康特征评估了潜在AE体征的患病率和异质性。
我们使用了2019年11月至2022年12月期间在美国一个数字队列中同意并登记的24435名参与者的数据，以评估自我报告的潜在AE体征的患病率和异质性：可能的多毛症（在身体8个部位中的≥4个部位有浓密粗糙的毛发）、下巴毛发量、头顶脱发以及中度至重度痤疮。
可能的多毛症、下巴有几根/很多毛发、头顶毛发明显减少/可见头皮以及中度至重度痤疮的患病率分别为6.9%、12.6%、1.7%和31.8%。虽然可能的多毛症和中度至重度痤疮随年龄（范围：18 - 86岁）增长而减少，但下巴毛发和头顶脱发随年龄增长而增加。自我认定为西班牙裔或南亚裔的参与者报告的可能多毛症患病率更高（分别为11.2%、16.9%，而非西班牙裔白人参与者为6.3%）。体重指数较高的参与者可能多毛症的患病率更高。中度至重度痤疮在多囊卵巢综合征患者中更常见。使用激素避孕的参与者中，可能的多毛症和脱发较少见。
在这个大型队列中，潜在AE的体征因人口统计学和健康因素而异。这些结果可以为潜在AE在不同群体中可能出现的不同表现提供新的认识，为未来在人群层面开展更具包容性的评估工作提供参考。
