Assessment of hirsutism among Korean women: results of a randomly selected sample of women seeking pre-employment physical check-up

Kim, Jin Ju; Chae, Suchan; Choi, Young Min; Hwang, Seung Sik; Hwang, Kyu Ri; Kim, Sun Mie; Yoon, Sang Ho; Moon, Shin Yong

doi:10.1093/humrep/deq303

Cited by 59 publications

(38 citation statements)

References 22 publications

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“…Although the original study by Ferriman and Gallwey (1961) defined hirsutism as a total score of 8 or higher, the proposal to adjust mFG criteria on the basis of ethnicity has already been implemented through the utilization of distinct mFG criteria by different research groups (Cheewadhanaraks et al, 2004, Guo et al, 2012, Ichikawa et al, 1988, Kim et al, 2014, Li et al, 2013, Welt et al, 2006, Zhang et al, 2013, Zhao et al, 2011, Zhao et al, 2010). Studies within the general population (not necessarily patients with PCOS) have provided validation for this practice and suggest distinct ethnic-specific mFG diagnostic criteria for clinical hirsutism on the basis of the 95th percentile of the ethnic population (Asuncion et al, 2000, Cheewadhanaraks et al, 2004, DeUgarte et al, 2006, Kim et al, 2011, Moran et al, 2010, Tellez and Frenkel, 1995, Zhao et al, 2007). On the basis of these studies, lower diagnostic cutoff points for East Asian women (mFG > 2 to > 5) and higher cutoff points for Middle Eastern (mFG > 8 to > 10), Mediterranean (mFG > 7 to > 10), and Mexican (> 11) women have been recommended (Api et al, 2009, Asuncion et al, 2000, Cheewadhanaraks et al, 2004, Kim et al, 2011, Moran et al, 2010, Noorbala and Kefaie, 2010, Sagsoz et al, 2004, Zhao et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…The scale rates hirsutism on a scale from 0 to 36 and clinical hirsutism is typically defined as a total mFG score of 8 or greater. The development of the mFG scoring system was based on the evaluation of primarily Caucasian (Northern European) women, making application of the instrument controversial in the assessment of hirsutism in other ethnicities (Asuncion et al, 2000, Cheewadhanaraks et al, 2004, DeUgarte et al, 2006, Ferriman and Gallwey, 1961, Kim et al, 2011, Moran et al, 2010, Sagsoz et al, 2004, Tellez and Frenkel, 1995, Wong et al, 2014, Zhao et al, 2007). The Androgen Excess-PCOS (AE-PCOS) Society has proposed the need for ethnic-specific mFG cutoff scores to define hirsutism in women with PCOS (Escobar-Morreale et al, 2012, Fauser et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Association of ethnicity, Fitzpatrick skin type, and hirsutism: A retrospective cross-sectional study of women with polycystic ovarian syndrome

Afifi

Saeed

Pasch

et al. 2017

International Journal of Women's Dermatology

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BackgroundThe complex interplay between ethnicity, Fitzpatrick skin type (FST), and hirsutism in patients with polycystic ovarian syndrome (PCOS) is poorly understood.ObjectiveIn this cross-sectional, retrospective analysis, we examined the prevalence, severity, and distribution of hirsutism with clinician-rated site-specific and total modified Ferriman-Gallwey (mFG) visual scoring in a diverse cohort of American patients with PCOS.MethodsIndependent analyses were conducted on the basis of patient-reported FST ratings and ethnicity.ResultsIn this PCOS cohort, a correlation was found between hirsutism and ethnicity and the highest prevalence of hirsutism and total mFG scores was observed in Hispanic, Middle Eastern, African American, and South Asian patients. A positive correlation between hirsutism and FST was also observed with an increasing prevalence of hirsutism in the group of patients with higher FSTs. Significant trends in the anatomic distribution of hirsutism were observed between ethnic groups as well. A higher facial mFG score was found in African American patients but higher mFG scores in the truncal and extremity regions were observed in Middle Eastern patients. Truncal hirsutism was also associated with higher FSTs.ConclusionsEthnicity and FST may be important variables in both the quantitative and qualitative presentations of hirsutism in women with PCOS and should be considered in the diagnostic evaluation of any patient who is suspected of having the condition. Previously published studies that examined ethnicity, FST, and hirsutism in homogeneous cohorts limited comparison and generalizability but the strength of this study lies in its detailed analysis within a single large and diverse PCOS cohort. Validated studies are needed to determine whether clinical criteria for hirsutism should be adjusted for ethnicity and FST in the PCOS population and particularly within diverse cohorts and patients of mixed ancestry.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of ethnicity, Fitzpatrick skin type, and hirsutism: A retrospective cross-sectional study of women with polycystic ovarian syndrome

Afifi

Saeed

Pasch

et al. 2017

International Journal of Women's Dermatology

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show abstract

“…Hirsutism was assessed using the modified Ferriman and Gallwey score (mF-G score) system, and clinical hyperandrogenism (HA) was defined as an mF-G score of 6 or greater [26]. Biochemical HA was defined as follows: total testosterone (T) >0.68 ng/mL, free T >1.72 pg/mL, and free androgen index (FAI) >5.36 [27].…”

Section: Methodsmentioning

confidence: 99%

Vitamin D deficiency in women with polycystic ovary syndrome

Kim

Choi

Chae

et al. 2014

Clin Exp Reprod Med

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ObjectiveTo investigate: the prevalence of vitamin D deficiency in Korean women with polycystic ovary syndrome (PCOS), and the relationship between vitamin D status and clinical or metabolic features in this group.MethodsWe recruited 38 women with PCOS using the Rotterdam criteria. A total of 109 premenopausal control women were matched with patients based on age and body mass index. Serum 25-hydroxy vitamin D concentrations less than 20 ng/mL were classified as frank vitamin D deficiency. Since vitamin D may play a significant role in metabolic disturbances in women with PCOS, correlations between clinical or metabolic parameters and vitamin D status were analyzed separately in patients and controls.ResultsWomen with PCOS showed no differences in the level of 25-hydroxy vitamin D (19.6±6.6 ng/mL in patients vs. 20.1±7.4 ng/mL in controls, respectively, p=0.696) or prevalence of vitamin D deficiency (57.9% in patients vs. 56.5% in controls, respectively, p=0.880). In addition, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles in either PCOS patients or controls.ConclusionOur study found no differences in the absolute level of serum vitamin D between PCOS patients and matched controls. Prevalence of vitamin D deficiency was equally common among both patients and controls. Additionally, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles, suggesting that the role of vitamin D in the pathogenesis of PCOS is not yet clear.

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“…Oligo or anovulation was defined as a cycle length in excess of 35 days or less than 8 cycles per year or absence of menstruation for more than 3 months. Biochemical HA was defined as total testosterone (T) >0.68 ng/mL, free T>1.72 pg/mL, or a free androgen index (FAI) value >5.36, and a modified Ferriman–Gallwey score (mF-G score) of more than 6 was defined as clinical HA [18]. Ovaries were considered polycystic on ultrasound if there were 12 or more follicles measuring 2–9 mm in diameter in each ovary and/or enlarged ovarian volume (>10 mm 3 ) [5].…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Metabolic Syndrome Is Higher among Non-Obese PCOS Women with Hyperandrogenism and Menstrual Irregularity in Korea

et al. 2014

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BackgroundHyperandrogenism (HA) has been linked with several components of metabolic syndrome (MetS). Few studies in Asian women have evaluated the important risk factors for and prevalence of MetS according to PCOS subtype. In this study, we investigated differences in metabolic parameters and the prevalence of MetS in two major phenotypic subgroups of PCOS in Korea. Furthermore, we investigated the relationship between HA-associated parameters and MetS.Materials and MethodsThis cross-sectional observational study was conducted from May 2010 to December 2011 in Korea. A total of 837 females with PCOS, aged 15–40, were recruited from Departments of Obstetrics and Gynecology at 13 hospitals. Of those, 700 subjects with either polycystic ovaries (PCO)+HA+oligomenorrhea/amenorrhea (O) or PCO+O were eligible for this study. MetS was diagnosed according to the modified National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines and the International Diabetes Federation (IDF) criteria.ResultsMetS was more prevalent in the PCO+HA+O group (19.7%) than in the PCO+O (11.9%) group. There were statistically significant trends for an increased risk of MetS in the PCO+HA+O group compared to the PCO+O group. After adjustment for age, the odds ratio of MetS was 2.192 in non-obese subjects with PCO+HA+O compared to those with PCO+O, whereas the risk of MetS was not different in obese patients. Multivariate logistic regression analysis showed that high free androgen index and low sex hormone-binding globulin were significantly associated with MetS in non-obese women with PCOS, with odds ratios of 4.234 (95% CI, 1.893–9.474) and 4.612 (95% CI, 1.978–10.750), respectively. However, no associations were detected between MetS and SHBG and FAI in obese PCOS subjects.ConclusionsOur results indicate that HA and its associated parameters (FAI and SHBG) are significantly associated with MetS in non-obese PCOS subjects, whereas this association was not observed in obese subjects.

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Assessment of hirsutism among Korean women: results of a randomly selected sample of women seeking pre-employment physical check-up

Abstract: mF-G scores greater that six represent the appropriate diagnostic cutoff for the detection of hirsutism in Korean women. Increased serum total T and HbA1(c,) and decreased SHBG concentrations were associated with the presence of hirsutism.

Cited by 59 publications

References 22 publications

Association of ethnicity, Fitzpatrick skin type, and hirsutism: A retrospective cross-sectional study of women with polycystic ovarian syndrome

Association of ethnicity, Fitzpatrick skin type, and hirsutism: A retrospective cross-sectional study of women with polycystic ovarian syndrome

Vitamin D deficiency in women with polycystic ovary syndrome

Prevalence of Metabolic Syndrome Is Higher among Non-Obese PCOS Women with Hyperandrogenism and Menstrual Irregularity in Korea

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