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The Journal of Clinical Endocrinology & Metabolism Vol. 83, No. 9 3078-3082
Copyright © 1998 by The Endocrine Society


Original Studies

Prevalence of the Polycystic Ovary Syndrome in Unselected Black and White Women of the Southeastern United States: A Prospective Study1

E. S. Knochenhauer, T. J. Key, M. Kahsar-Miller, W. Waggoner, L. R. Boots and R. Azziz

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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J. Clin. Endocrinol. Metab.Home page
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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J. Clin. Endocrinol. Metab.Home page
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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J. Clin. Endocrinol. Metab.Home page
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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Hum ReprodHome page
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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J EndocrinolHome page
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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Arch Pediatr Adolesc MedHome page
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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Eur J EndocrinolHome page
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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J. Clin. Endocrinol. Metab.Home page
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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J. Clin. Endocrinol. Metab.Home page
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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Hum ReprodHome page
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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NEJMHome page
R. L. Rosenfield
Hirsutism
N. Engl. J. Med., December 15, 2005; 353(24): 2578 - 2588.
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J. Clin. Endocrinol. Metab.Home page
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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Hum ReprodHome page
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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Am. J. Physiol. Endocrinol. Metab.Home page
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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Hum Reprod UpdateHome page
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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J. Clin. Endocrinol. Metab.Home page
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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J. Clin. Endocrinol. Metab.Home page
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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J. Clin. Endocrinol. Metab.Home page
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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The Annals of PharmacotherapyHome page
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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J. Clin. Endocrinol. Metab.Home page
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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