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Departments of Obstetrics and Gynecology (E.S.K., W.W., L.R.B., R.A.), Occupational Health (T.J.K.), Genetics (M.M.-K.), and Medicine (R.A.), University of Alabama, Birmingham, Alabama 35233
Estimates of the prevalence of the polycystic ovary syndrome (PCOS) in
the general population have ranged from 2–20%. The vast majority of
these reports have studied White populations in Europe, used limited
definitions of the disorder, and/or used bias populations, such as
those seeking medical care. To estimate the prevalence of this disorder
in the United States and address these limitations, we prospectively
determined the prevalence of PCOS in a reproductive-aged population of
369 consecutive women (174 White and 195 Black; aged 18–45 yr),
examined at the time of their preemployment physical. Body measures
were obtained, and body hair was quantified by a modified
Ferriman-Gallwey (F-G) method. All exams were initially performed by 2
trained nurses, and any subject with an F-G score above 3 was
reexamined by a physician, the same for all patients. Of the 369 women,
277 (75.1%) also agreed to complete a questionnaire and have
additional blood drawn. Subjects were studied regardless of current
estrogen/progestin hormonal use (28.5%). PCOS was defined as 1)
oligoovulation, 2) clinical hyperandrogenism (i.e.
hirsutism) and/or hyperandrogenemia, and 3) exclusion of other related
disorders, such as hyperprolactinemia, thyroid abnormalities, and
nonclassic adrenal hyperplasia. Hirsutism was defined by a F-G score of
6 or more, and hyperandrogenemia was defined as a total or free
testosterone, androstenedione, and/or dehydroepiandrosterone sulfate
level above the 95th percentile of control values [i.e.
all eumenorrheic women in the study, who had no hirsutism (F-G 
5) or
acne and were receiving no hormonal therapy; n = 98]. Considering
all 369 women studied, White and Black women had similar mean ages
(29.4 ± 7.1 and 31.1 ± 7.8 yr, respectively), although
White women had a lesser body mass than Black women (24.9 ± 6.1
vs. 29.2 ± 8.1 kg/m2, respectively;
P < 0.001). Of these 7.6%, 4.6%, and 1.9%
demonstrated a F-G score of 6 or more, 8 or 10, respectively, and there
was no significant racial difference, with hirsutism prevalences of
8.0%, 2.8%, and 1.6% in Whites, and 7.1%, 6.1%, and 2.1% in
Blacks, respectively. Of the 277 women consenting to a history and
hormonal evaluation, 4.0% had PCOS as defined, 4.7% (6 of 129) of
Whites and 3.4% (5 of 148) of Blacks.
In conclusion, in our consecutive population of unselected women the prevalence of hirsutism varied from 2–8% depending on the chosen cut-off F-G score, with no significant difference between White and Black women. Using an F-G score of 6 or more as indicative of hirsutism, 3.4% of Blacks and 4.7% of Whites had PCOS as defined. These data suggest that PCOS may be one of most common reproductive endocrinological disorders of women.
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O. Celik, I. Sahin, N. Celik, S. Hascalik, L. Keskin, H. Ozcan, A. Uckan, and F. Kosar Diagnostic potential of serum N-terminal pro-B-type brain natriuretic peptide level in detection of cardiac wall stress in women with polycystic ovary syndrome: a cross-sectional comparison study Hum. Reprod., November 1, 2007; 22(11): 2992 - 2998. [Abstract] [Full Text] [PDF]
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X. Ma, L. Fan, Y. Meng, Z. Hou, Y.-D. Mao, W. Wang, W. Ding, and J.-Y. Liu Proteomic analysis of human ovaries from normal and polycystic ovarian syndrome Mol. Hum. Reprod., August 1, 2007; 13(8): 527 - 535. [Abstract] [Full Text] [PDF]
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 S. D. Pedersen, S. Brar, P. Faris, and B. Corenblum Polycystic ovary syndrome: Validated questionnaire for use in diagnosis Can Fam Physician, June 1, 2007; 53(6): 1041 - 1047. [Abstract] [Full Text] [PDF]
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M. F. Costello, B. Shrestha, J. Eden, N. P. Johnson, and P. Sjoblom Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review Hum. Reprod., May 1, 2007; 22(5): 1200 - 1209. [Abstract] [Full Text] [PDF]
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 H. C. Zisser Polycystic Ovary Syndrome and Pregnancy: Is Metformin the Magic Bullet? Diabetes Spectr, April 1, 2007; 20(2): 85 - 89. [Abstract] [Full Text] [PDF]
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R. L. Rosenfield Identifying Children at Risk for Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., March 1, 2007; 92(3): 787 - 796. [Abstract] [Full Text] [PDF]
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R. Wu, S. Fujii, N.K. Ryan, K.H. Van der Hoek, M.J. Jasper, I. Sini, S.A. Robertson, R.L. Robker, and R.J. Norman Ovarian leukocyte distribution and cytokine/chemokine mRNA expression in follicular fluid cells in women with polycystic ovary syndrome Hum. Reprod., February 1, 2007; 22(2): 527 - 535. [Abstract] [Full Text] [PDF]
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M. C Amato, A. Galluzzo, S. Merlino, A. Mattina, P. Richiusa, A. Criscimanna, and C. Giordano Lower insulin sensitivity differentiates hirsute from non-hirsute Sicilian women with polycystic ovary syndrome Eur. J. Endocrinol., December 1, 2006; 155(6): 859 - 865. [Abstract] [Full Text] [PDF]
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R. Azziz, E. Carmina, D. Dewailly, E. Diamanti-Kandarakis, H. F. Escobar-Morreale, W. Futterweit, O. E. Janssen, R. S. Legro, R. J. Norman, A. E. Taylor, et al. Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4237 - 4245. [Abstract] [Full Text] [PDF]
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X. Chen, D. Yang, L. Li, S. Feng, and L. Wang Abnormal glucose tolerance in Chinese women with polycystic ovary syndrome Hum. Reprod., August 1, 2006; 21(8): 2027 - 2032. [Abstract] [Full Text] [PDF]
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 L. J Moran, M. Noakes, P. M Clifton, G. A Wittert, G. Williams, and R. J Norman Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome Am. J. Clinical Nutrition, July 1, 2006; 84(1): 77 - 87. [Abstract] [Full Text] [PDF]
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J. M. Vink, S. Sadrzadeh, C. B. Lambalk, and D. I. Boomsma Heritability of Polycystic Ovary Syndrome in a Dutch Twin-Family Study J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2100 - 2104. [Abstract] [Full Text] [PDF]
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M. F. Costello, M. Chapman, and U. Conway A systematic review and meta-analysis of randomized controlled trials on metformin co-administration during gonadotrophin ovulation induction or IVF in women with polycystic ovary syndrome Hum. Reprod., June 1, 2006; 21(6): 1387 - 1399. [Abstract] [Full Text] [PDF]
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D. J. Handelsman The Rationale for Banning Human Chorionic Gonadotropin and Estrogen Blockers in Sport J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1646 - 1653. [Abstract] [Full Text] [PDF]
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C. R. McCartney, K. A. Prendergast, S. Chhabra, C. A. Eagleson, R. Yoo, R. J. Chang, C. M. Foster, and J. C. Marshall The Association of Obesity and Hyperandrogenemia during the Pubertal Transition in Girls: Obesity as a Potential Factor in the Genesis of Postpubertal Hyperandrogenism J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1714 - 1722. [Abstract] [Full Text] [PDF]
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T. L. Setji, N. D. Holland, L. L. Sanders, K. C. Pereira, A. M. Diehl, and A. J. Brown Nonalcoholic Steatohepatitis and Nonalcoholic Fatty Liver Disease in Young Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1741 - 1747. [Abstract] [Full Text] [PDF]
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N. Xita and A. Tsatsoulis Fetal Programming of Polycystic Ovary Syndrome by Androgen Excess: Evidence from Experimental, Clinical, and Genetic Association Studies J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1660 - 1666. [Abstract] [Full Text] [PDF]
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E. Yesilada, I. Sahin, H. Ozcan, I. H. Yildirim, S. Yologlu, and C. Taskapan Increased micronucleus frequencies in peripheral blood lymphocytes in women with polycystic ovary syndrome. Eur. J. Endocrinol., April 1, 2006; 154(4): 563 - 568. [Abstract] [Full Text] [PDF]
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J. C. Lo, S. L. Feigenbaum, J. Yang, A. R. Pressman, J. V. Selby, and A. S. Go Epidemiology and Adverse Cardiovascular Risk Profile of Diagnosed Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1357 - 1363. [Abstract] [Full Text] [PDF]
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C. M. DeUgarte, K. S. Woods, A. A. Bartolucci, and R. Azziz Degree of Facial and Body Terminal Hair Growth in Unselected Black and White Women: Toward a Populational Definition of Hirsutism J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1345 - 1350. [Abstract] [Full Text] [PDF]
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N. I. Leibel, E. E. Baumann, M. Kocherginsky, and R. L. Rosenfield Relationship of Adolescent Polycystic Ovary Syndrome to Parental Metabolic Syndrome J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1275 - 1283. [Abstract] [Full Text] [PDF]
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S. Elsenbruch, S. Benson, S. Hahn, S. Tan, K. Mann, K. Pleger, R. Kimmig, and O. E. Janssen Determinants of emotional distress in women with polycystic ovary syndrome Hum. Reprod., April 1, 2006; 21(4): 1092 - 1099. [Abstract] [Full Text] [PDF]
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 F Gonzalez, N S Rote, J Minium, and J P Kirwan In vitro evidence that hyperglycemia stimulates tumor necrosis factor-{alpha} release in obese women with polycystic ovary syndrome. J. Endocrinol., March 1, 2006; 188(3): 521 - 529. [Abstract] [Full Text] [PDF]
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T. Bridger, S. MacDonald, F. Baltzer, and C. Rodd Randomized Placebo-Controlled Trial of Metformin for Adolescents With Polycystic Ovary Syndrome Arch Pediatr Adolesc Med, March 1, 2006; 160(3): 241 - 246. [Abstract] [Full Text] [PDF]
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M. Mohlig, J. Spranger, M. Ristow, A. F H Pfeiffer, T. Schill, H. W Schlosser, L. Moltz, G. Brabant, and C. Schofl Predictors of abnormal glucose metabolism in women with polycystic ovary syndrome Eur. J. Endocrinol., February 1, 2006; 154(2): 295 - 301. [Abstract] [Full Text] [PDF]
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E. Carmina, F. Rosato, A. Janni, M. Rizzo, and R. A. Longo Relative Prevalence of Different Androgen Excess Disorders in 950 Women Referred because of Clinical Hyperandrogenism J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 2 - 6. [Abstract] [Full Text] [PDF]
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E. Tasali, E. Van Cauter, and D. A. Ehrmann Relationships between Sleep Disordered Breathing and Glucose Metabolism in Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 36 - 42. [Abstract] [Full Text] [PDF]
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P. Dursun, E. Demirtas, A. Bayrak, and H. Yarali Decreased serum paraoxonase 1 (PON1) activity: an additional risk factor for atherosclerotic heart disease in patients with PCOS? Hum. Reprod., January 1, 2006; 21(1): 104 - 108. [Abstract] [Full Text] [PDF]
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R. L. Rosenfield Hirsutism N. Engl. J. Med., December 15, 2005; 353(24): 2578 - 2588. [Full Text] [PDF]
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M. Urbanek, A. Woodroffe, K. G. Ewens, E. Diamanti-Kandarakis, R. S. Legro, J. F. Strauss III, A. Dunaif, and R. S. Spielman Candidate Gene Region for Polycystic Ovary Syndrome on Chromosome 19p13.2 J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6623 - 6629. [Abstract] [Full Text] [PDF]
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J. Vrbikova, K. Vondra, D. Cibula, K. Dvorakova, S. Stanicka, D. Sramkova, G. Sindelka, M. Hill, B. Bendlova, and J. Skrha Metabolic syndrome in young Czech women with polycystic ovary syndrome Hum. Reprod., December 1, 2005; 20(12): 3328 - 3332. [Abstract] [Full Text] [PDF]
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 S. E. Recabarren, V. Padmanabhan, E. Codner, A. Lobos, C. Duran, M. Vidal, D. L. Foster, and T. Sir-Petermann Postnatal developmental consequences of altered insulin sensitivity in female sheep treated prenatally with testosterone Am J Physiol Endocrinol Metab, November 1, 2005; 289(5): E801 - E806. [Abstract] [Full Text] [PDF]
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E. Diamanti-Kandarakis and C. Piperi Genetics of polycystic ovary syndrome: searching for the way out of the labyrinth Hum. Reprod. Update, November 1, 2005; 11(6): 631 - 643. [Abstract] [Full Text] [PDF]
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C. K. Welt, A. E. Taylor, J. Fox, G. M. Messerlian, J. M. Adams, and A. L. Schneyer Follicular Arrest in Polycystic Ovary Syndrome Is Associated with Deficient Inhibin A and B Biosynthesis J. Clin. Endocrinol. Metab., October 1, 2005; 90(10): 5582 - 5587. [Abstract] [Full Text] [PDF]
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F. Gonzalez, J. Minium, N. S. Rote, and J. P. Kirwan Hyperglycemia Alters Tumor Necrosis Factor-{alpha} Release from Mononuclear Cells in Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., September 1, 2005; 90(9): 5336 - 5342. [Abstract] [Full Text] [PDF]
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M. Kravariti, K. K. Naka, S. N. Kalantaridou, N. Kazakos, C. S. Katsouras, A. Makrigiannakis, E. A. Paraskevaidis, G. P. Chrousos, A. Tsatsoulis, and L. K. Michalis Predictors of Endothelial Dysfunction in Young Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., September 1, 2005; 90(9): 5088 - 5095. [Abstract] [Full Text] [PDF]
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 N. A Christy, A. S Franks, and L B. Cross Spironolactone for Hirsutism in Polycystic Ovary Syndrome Ann. Pharmacother., September 1, 2005; 39(9): 1517 - 1521. [Abstract] [Full Text] [PDF]
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I. Munir, H.-W. Yen, T. Baruth, R. Tarkowski, R. Azziz, D. A. Magoffin, and A. J. Jakimiuk Resistin Stimulation of 17{alpha}-Hydroxylase Activity in Ovarian Theca Cells in Vitro: Relevance to Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4852 - 4857. [Abstract] [Full Text] [PDF]
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