| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on June 25, 2004
Accepted on December 7, 2004
Department of Endocrinology, Odense University Hospital, Denmark; Department of Clinical Chemistry, Odense University Hospital, Denmark
* To whom correspondence should be addressed. E-mail: dorte.glintborg{at}ouh.fyns-amt.dk.
Objective. To investigate whether elevated ACTH-stimulated 17-hydroxyprogesterone (17OHP) levels are caused by CYP21 genetic defects or by a general adrenal hyper-responsiveness in hirsute patients.
Methods. 337 hirsute patients were evaluated by Ferriman-Gallwey score, s-testosterone, ACTH-stimulated 17OHP and cortisol during follicular phase. A cut-off value of 16 nmol/l for maximum ACTH-stimulated 17OHP (M17OHP) responses was defined as the upper limit of the 95% CI for the 97.5 percentile in 42 female controls. All patients were offered total screening of the CYP21 gene and 252 healthy, premenopausal women with regular menses underwent genetic screening.
Results. Patients were divided in idiopatic hirsutism (IH) (n = 180) and polycystic ovary syndrome (PCOS) (n = 157). M17OHP levels were significantly higher in IH (geometric mean value (nmol/l ±2SD) 12.2(4.6-32.3) and PCOS 11.9(5.3-27.2) compared with controls 8.5(5.1-14.2); (P < 0.001). A similar percentage of IH and PCOS patients had elevated M17OHP (20.5% vs. 20.8%, NS) and these also had significantly higher 30 min. cortisol levels compared with controls (P < 0.05).
The prevalence of CYP21 mutations in patients was 8.6% compared with 6.3% in controls (P = 0.38). 10/19 carriers had M17OHP levels below cut-off limit.
Conclusion. The significantly higher ACTH-stimulated levels of cortisol and 17OHP in hirsute patients indicated adrenal hyper-responsiveness in IH and PCOS. CYP21-carrier status could not explain the observed high prevalence of abnormal ACTH-stimulated 17OHP levels in the hirsute population.
This article has been cited by other articles:
 |
|
 |
|
  R. Pasquali, L. Patton, P. Pocognoli, G. E. Cognigni, and A. Gambineri 17-Hydroxyprogesterone Responses to Gonadotropin-Releasing Hormone Disclose Distinct Phenotypes of Functional Ovarian Hyperandrogenism and Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4208 - 4217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Codner, N. Soto, P. Lopez, L. Trejo, A. Avila, F. C. Eyzaguirre, G. Iniguez, and F. Cassorla Diagnostic Criteria for Polycystic Ovary Syndrome and Ovarian Morphology in Women with Type 1 Diabetes Mellitus J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2250 - 2256. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kourtis, D. Rousso, C. Balaris, D. Farmakiotis, I. Katsikis, and D. Panidis Association of polycystic ovary syndrome and fibromyalgia in a patient with primary hyperparathyroidism: a novel triad? - reply. Clin. Chem., June 1, 2006; 52(6): 1209 - 1210. [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Rosenfield Hirsutism N. Engl. J. Med., December 15, 2005; 353(24): 2578 - 2588. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
