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内分泌学会女性雄激素过多评估临床实践指南

Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women.

作者信息

Elhassan Yasir S, Hawley James M, Cussen Leanne, Abbara Ali, Clarke Sophie A, Kempegowda Punith, Dhillon-Smith Rima K, Thadani Puja, Busby Maureen, Owusu-Darkwah Lucy, Marrington Rachel, Duncan W Colin, Semple Robert K, Quinton Richard, O'Reilly Michael W

机构信息

Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham, Birmingham, UK.

Department of Endocrinology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.

出版信息

Clin Endocrinol (Oxf). 2025 Oct;103(4):540-566. doi: 10.1111/cen.15265. Epub 2025 May 13.

Abstract

CONTEXT

Androgen excess is common in women and refers to clinical or biochemical evidence of elevated androgenic steroids such as testosterone. It is associated with underlying polycystic ovary syndrome in the majority of cases. However severe androgen excess is less common and may indicate the presence of underlying adrenal or ovarian neoplasms, genetic disorders or severe insulin resistance syndromes. Currently there are few consensus guidelines to assist clinicians with a standardised management approach to the patient with severe androgen excess.

DESIGN

Clinical practice guideline.

METHODS

This guideline has been developed with expertise from colleagues in endocrinology, gynaecology, clinical biochemistry and nursing, and furthermore provides a unique patient perspective to guide clinicians.

RESULTS

The Society for Endocrinology commissioned this new guideline to collate multi-disciplinary guidance for clinical practitioners in the investigation of severe androgen excess. Recommendations have been made in the areas of clinical assessment, biochemical work up, dynamic testing and imaging, informed where possible by the best available evidence.

CONCLUSION

This guideline will provide guidance for clinicians in their approach to patients with severe androgen excess.

摘要

背景

女性雄激素过多较为常见,是指睾酮等雄激素类固醇升高的临床或生化证据。在大多数情况下,它与潜在的多囊卵巢综合征相关。然而,严重雄激素过多较少见,可能提示存在潜在的肾上腺或卵巢肿瘤、遗传疾病或严重胰岛素抵抗综合征。目前,几乎没有共识性指南来协助临床医生对严重雄激素过多的患者采取标准化管理方法。

设计

临床实践指南。

方法

本指南由内分泌学、妇科、临床生物化学和护理领域的同事提供专业知识制定而成,此外还提供了独特的患者视角以指导临床医生。

结果

内分泌学会委托制定了这一新指南,以整理针对严重雄激素过多调查的临床医生多学科指导意见。已在临床评估、生化检查、动态检测和影像学等领域提出建议,并尽可能依据现有最佳证据。

结论

本指南将为临床医生处理严重雄激素过多的患者提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9bf/12413683/b98e2fd93556/CEN-103-540-g002.jpg

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