Best Marker to Asses Hirsutisim
Keywords:Hirsutism, idiopathic hirsutisim, polycystic ovarian syndrome, Total testosterone, Anti mullerian hormone
Aim:Â To correlate serum levels of Anti Mullerian Hormone and Total Testosterone with severity of hirsutism in females with either polycystic ovarian syndrome or idiopathic hirsutism. Design: retrospective observational study. Setting: private sector endocrine clinic. Patients: eighty- five hirsute patients. Intervention: female presented for hirsutism management were evaluated physically and biochemically. Main outcome: Â Feriman and Gallawy Score for patients and serum levels of Total Testosterone and Anti Mullerian Hormone Rseults: Eighty- five hirsute women were evaluated for severity of their hirsutism by Ferming- Galawy score, serum Total Testosterone and Anti Mullerian Hormone. Mean age of patients was 27.48 Â± 5.6Â Â years.Â Mean Body Mass Index of the patients were 30. 07Â±4.93 kg/m2.Â Mean Total serum testosterone was 51.57Â±4.93ng/ml and mean serum Anti Mullerian Hormone was 6.72Â±29.34 ng/ml. The patients were divided according to their etiology of hirsutism into Poly Cystic Ovarian Syndrome group and Idiopathic HirsutismÂ group. There were significant differences in body mass index, serum levels of Total Testosterone, Anti Mullerian Hormone Â Â and Â Â Feriman and Gallawy score between these two groups. Serum levels of Â Total Testosterone have significant Â positive correlation with severity of hirsutism in Poly Cystic Ovarian Syndrome group only, while Anti Mullerian Hormone have no correlation with Â Â neither of the two groups .Conclusion: Serum level of Â Total Testosterone can serve ideal marker in our study group for Â hirsute patients with Poly Cystic Ovarian Syndrome .
Key words: Hirsutism, idiopathic hirsutisim , polycystic ovarian syndrome, Totaltestosterone,Â Anti mullerian hormone.
BarthJ H , Catalan J,Cherry C A, andDay A: â€œPsychological morbidity in women referred for treatment of hirsutism,â€ Journal of Psychosomatic Research,1993; 37( 6): 615â€“619.
Carmina E: Prevalence of idiopathic hirsutism. Eur J Endocrinol. 1998;139:421-3.
Azziz R, Carmina E and Sawaya ME: Idiopathic hirsutism. Endocr Rev. 2000;21:347-62
RosenfieldR: Hirsutism. The New England Journal of Medicine, 353(24): 2578â€“2588, 2005.
Bhathena R K: Insulin resistance and the long-term consequences of polycystic ovary syndrome. Journal of Obstetrics and Gynaecology,2011;31(2): 105â€“110,
ZhangH Y, F FZhu,Xiong J,Shi X B and FuS X:Characteristics of different phenotypes of polycystic ovary syndrome based on the rotterdam criteria in a large-scale Chinese population, Journal of Obstetrics and Gynaecology,2009;116(12): 1633â€“1639.
Sawaya M E andShalita A R: Androgen receptor polymorphisms in androgenetic alopecia, hirsutism, and acne. Journal of Cutaneous Medicine and Surgery.1998; 3(1): 9â€“15,
Nikolaou D and Gilling-Smith C: Hirsutism. Current Obstetrics and Gynecology,2005;15( 3): 174â€“182.
Ferriman D and Gallwey JD: Clinical assessment of body hair growth in women. J ClinEndocrinolMetab 1961; 21: 1440-7.
Adams J, Polson DW, and Franks S. Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Br Med J. 1986; 293: 355â€“359
Tekin O, IÅŸÄ¯k B, AvcÄ¯ Z et al.: Hirsutism: common clinical problem or index of serious disease? Med Gen Med 2004; 6: 56.
Kippley J and Kippley S. The Art of Natural Family Planning; 1996 (4th ed.) Cincinnati, OH: The Couple to Couple League. p. 92.
Ehrmann DA: Polycystic ovary syndrome. N Engl J Med .2005;32:773-7.
Carmina E, Rosato F, Janni A, Risso M and Longo RA: Relative prevalence of different androgen excess disorders in 950 women referred because of clinical hyperandrogenism. J ClinEndocrinolMetab 2006; 91:2-6.
Rotterdam ESHRE/ASRM sponsored PCOS consensus workshop group 2004 revised 2003 consensus on diagnostic criteria and long term health risk related to polycystic ovary syndrome. Hum Reprod 2004; 19:41-7.
Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endocr Rev; 2000; 21:347-62.
Hatch R, Rosenfield RL, Kim MH and Tredway D: Hirsutism: implications, etiology and management. Am J ObstetGynecol 1981; 140:815-30.
Cupisti S, Dittrich R, Binder H et al.: Influence of body mass index on measured and calculated androgen parameters in adult women with hirsutism and PCOS. ExpClinEndocrinol Diabetes 2007; 115: 380-6.
Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC,et al .: Androgen excess in women: Experience with over 1000 consecutive patients. J ClinEndocrinolMetab 2004; 89:453-62.
Alberata Medical Association guidelines for investigating hirsutism. Web page available at www. tripdatabase.com. Accessed on 2008. 12.03.
World Health Organization 2000. P: 9.
Khalil GM, Al Shobaili RA and Alzolibani A: Relationship between obesity and other risk factorsand skin disease among adult Saudi population. JEgypt Public Health Assoc. 2011; 86(3-4):56â€“62.
Cebeci F,Onsun N, Pekdemir A, Cinkaya A and Arda H:Obesity increases the severity of hirsutism in hirsute women. TÃ¼rkAileHekDerg .2012; 16(3):119-122.
Naeini F F, Najafian J and Jazebi N: Hirsutism and body mass index in a representative sample ofIranian people .ARYA Atheroscler. 2012; 8(1): 43â€“54.
Abdul-Aziz A, Mohammad S ,Nayaf K and Mauloodd J:The relationship of body mass index and hirsutism in adult females . Our Dermatology online. 2015; 6(3):276-279
Bajaj DR,Memon A, Hussain T, Shaikh BF,Iqbal MP.: Serum androgen levels and their relationship to pattern and severity of hair growth in hirsute women presenting at private centre in Hydderabad.Journal of Pakistan A ssociation of Dermatologist, 2008:18: 70- 77.
Andersen CY and Schmidt KT: Concentrations of AMH and inhibin-B in relation to follicular diameter in normal human small antral follicles. Hum. Reprod. 2010; 25:1282â€“1287.
Takayama K and Fukaya T: Immunohistochemical study of steroidogenesis and cell proliferation in polycystic ovarian syndrome. Hum Reprod. 1996; 11:1387â€“1392.
Vendola KA and Zhou J. Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest. 1998; 101:2622â€“2629.
Weil SJ and Vendola K: Androgen receptor gene expression in the primate ovary: cellular localization, regulation, and functional correlations. J ClinEndocrinolMetab. 1998; 83:2479â€“2485.
Ingraham HA and Hirokawa Y: Autocrine and paracrine MÃ¼llerian inhibiting substance hormone signaling in reproduction. Recent ProgHorm Res. 2000; 55:53â€“67.
Hamilton JB:Patterned loss of hair in man: types and incidence. Ann NY AcadSci 1951; 53:708â€“728.
Azziz R, Carmina E, andSawaya M E: Idiopathic Hirsutism.Endocrine Reviews. 2013; 21: 4.
Azziz R, Waggoner WT, Ochoa T, Knochenhauer ES, Boots LR. Idiopathic hirsutism: an uncommon cause of hirsutism in Alabama. FertilSteril; 1998; 70:274â€“278.
Farid-ur-Rehman, Sohail I, Hayat Z and Niazi NA: Etiology of hirsutism: Is there a correlation between menstrual regularity, body mass index and severity ofhirsutism with the cause? J Pak AssociatDermatol. 2010; 20:4-94.
Malik LM, Khursheed K, Haroon TS andMalik MA. An etiological study of moderate to severe hirsutism. Pak J Med Sci. 2007; 23: 167-71.
Teede H, Deeks A, and Moran L: "Polycystic ovary syndrome: a complex conditions with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan". BMC Med 2010; 8 (1): 41.
Huang A, Brennan K, Azziz R: "Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria". Fertil. Steril; 2010; 93(6): 1938.
Mayo Clinic Staff: "Polycystic Ovary Syndrome â€“ All". MayoClinic.com. Mayo Clinic; 2011.
Chhabra S, Gautam R K, Kulshreshtha B, Prasad A, and Sharma N:Hirsutism: A Clinico-investigative StudyInt J Trichology. 2012; 4(4): 246â€“250.
Sahmay S, AydÄ±nb Y, Atakulc N, Aydogand B &Kalelia S Relation of antimullerian hormone with the clinical signs of hyperandrogenism and polycystic ovary morphology Gynecological Endocrinology . 2014; 30(2): 130-134.
Eilertsen T B, Vanky E, and Carlsen S M: Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced.,HumReprod, 2012,27(8):2494â€“2502.
How to Cite
- Papers must be submitted on the understanding that they have not been published elsewhere (except in the form of an abstract or as part of a published lecture, review, or thesis) and are not currently under consideration by another journal published by any other publisher.
- It is also the authors responsibility to ensure that the articles emanating from a particular source are submitted with the necessary approval.
- The authors warrant that the paper is original and that he/she is the author of the paper, except for material that is clearly identified as to its original source, with permission notices from the copyright owners where required.
- The authors ensure that all the references carefully and they are accurate in the text as well as in the list of references (and vice versa).
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Attribution-NonCommercial 4.0 International that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author.