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Submitted on July 1, 2005
Accepted on October 20, 2005
Department of Endocrinology (E.C., F.R., A.J.) University of Palermo, Department of Clinical Medicine (E.C., R.A.L., M.R.), University of Palermo, Via delle Croci 47, 90139 Palermo, Italy
* To whom correspondence should be addressed. E-mail: enricocarmina{at}libero.it.
Context: To estimate the prevalence of the different androgen excess disorders using the new criteria suggested for the diagnosis of PCOS.
Setting: Two endocrine departments in University of Palermo, Italy
Patients: The records of all patients referred between 1980 and 2004 for evaluation of clinical hyperandrogenism were re-evaluated. All past diagnoses were reviewed using the actual diagnostic criteria. To be included in this study, the records of the patients had to present the following available data: clinical evaluation of hyperandrogenism, body weight and height, testosterone (T), free T, dehydroepiandrosterone sulfate (DHEAS), 17-hydroxy-progesterone (17OHP), progesterone (P) and pelvic sonography. A total of 1226 consecutive patients were seen during the study period but only the scores of 950 patients satisfied all criteria and were re-assessed for the diagnosis.
Results: The prevalence of androgen excess disorders was: Polycystic Ovary Syndrome (PCOS) 72.1% (classic anovulatory patients 56.6%; mild ovulatory patients 15.5%), Idiopathic Hyperandrogenism 15.8%, Idiopathic Hirsutism 7.6%, 21-hydroxylase-deficient Non classic Adrenal Hyperplasia (NCAH) 4.3%, Androgen-secreting Tumors 0.2%. Compared with other androgen excess disorders, patients with PCOS had increased body weight while NCAH patients were younger, more hirsute and had higher serum levels of T, free T and 17OHP.
Conclusions: Classic PCOS is the most common androgen excess disorder. However, mild androgen excess disorders (Ovulatory PCOS and Idiopathic Hyperandrogenism) are also common and, in an endocrine setting, include about 30% of patients with clinical hyperandrogenism.
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