Pinto Joana, Cera Nicoletta, Camerino Claudia, Beires Jorge, Pignatelli Duarte
Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal.
J Clin Med. 2025 Jan 21;14(3):673. doi: 10.3390/jcm14030673.
: Hirsutism is excessive male-patterned hair in postpubertal women with multifactorial etiology and is an indicator of hyperandrogenism associated with polycystic ovary syndrome (PCOS). Indeed, it can be caused by the enhanced peripheral conversion of androgen precursors to testosterone, as in idiopathic hirsutism (IH). Moreover, hirsutism can be caused by hirsutism-related hyperandrogenic syndromes like non-classic congenital adrenal hyperplasia (NCAH) and idiopathic hyperandrogenism (IHA). : In this study, we characterized a large cohort of Portuguese women referred for hirsutism and estimated the prevalence of PCOS, NCAH, IHA, and IH. The levels of androgens and gonadotropins and body mass index (BMI) were measured and compared with controls. The correlation between each variable was calculated. : In the cohort, we found a prevalence of PCOS of 56.2%, IH of 20.2%, IHA of 17.3%, and NCAH of 6.2%. Subjects with PCOS were the only ones showing a significant difference in BMI compared to the controls and had the lowest levels of sex hormone-binding globulin (SHBG). Those with NCAH were younger and more hirsute with higher levels of testosterone, among other androgens. Those with IH had lower luteinizing hormone (LH) and LH/follicle-stimulating hormone (FSH) ratios than those with PCOS. Those with IH had lower SHBG levels compared to the controls and a higher free androgen index (FAI). Those with IHA had higher androgens compared to those with IH, in particular, adrenal-derived androgens. : The pathogenesis of hirsutism is complex, and the contributions of the pituitary gland, ovaries, adrenals, adipose tissue, and liver have to be ascertained to understand the clinical manifestations and delineate appropriate treatments. This study sheds new light on the fine hormonal regulation of these diseases.
多毛症是青春期后女性出现的过多男性型毛发，病因多因素，是与多囊卵巢综合征（PCOS）相关的高雄激素血症的一个指标。实际上，它可能是由雄激素前体向睾酮的外周转化增强所致，如特发性多毛症（IH）。此外，多毛症可由与多毛症相关的高雄激素综合征引起，如非经典型先天性肾上腺皮质增生症（NCAH）和特发性高雄激素血症（IHA）。：在本研究中，我们对一大群因多毛症前来就诊的葡萄牙女性进行了特征分析，并估计了PCOS、NCAH、IHA和IH的患病率。测量了雄激素、促性腺激素水平和体重指数（BMI），并与对照组进行比较。计算了各变量之间的相关性。：在该队列中，我们发现PCOS的患病率为56.2%，IH为20.2%，IHA为17.3%，NCAH为6.2%。与对照组相比，PCOS患者是唯一在BMI上有显著差异的人群，且其性激素结合球蛋白（SHBG）水平最低。NCAH患者更年轻，多毛更严重，睾酮及其他雄激素水平更高。IH患者的黄体生成素（LH）和LH/促卵泡生成素（FSH）比值低于PCOS患者。与对照组相比，IH患者的SHBG水平较低，游离雄激素指数（FAI）较高。与IH患者相比，IHA患者的雄激素水平更高，尤其是肾上腺来源的雄激素。：多毛症的发病机制复杂，必须确定垂体、卵巢、肾上腺、脂肪组织和肝脏的作用，以了解临床表现并确定适当的治疗方法。这项研究为这些疾病的精细激素调节提供了新的线索。
