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Cited by 123Ovarian function and disordersSexual Differentiation and DisordersAdrenal Hormones and Disorders

The DOI matches its Crossref record; 33 of the 37 references it cites were found in a registry or an index.

The phenotype of hirsute women: a comparison of polycystic ovary syndrome and 21-hydroxylase-deficient nonclassic adrenal hyperplasia

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Pall, Marita, Azziz, Ricardo, Beires, Jorge, Pignatelli, Duarte·2010·Fertility and Sterility
DOI 10.1016/j.fertnstert.2009.06.025
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Abstract

Objective To test the hypothesis that women with polycystic ovary syndrome (PCOS) are distinguishable from those with 21-hydroxylase-deficient nonclassic adrenal hyperplasia on the basis of having polycystic ovaries and metabolic dysfunction. Design Prospective observational. Setting Tertiary care center. Patient(s) Fifty-two lean and 54 obese women with PCOS according to the 1990 National Institutes of Health criteria, 23 women with nonclassic adrenal hyperplasia, and 27 controls. Intervention(s) History and physical examination, blood sampling, ovarian sonography, oral glucose tolerance, and acute adrenocorticotropin stimulation testing. Main outcome measure(s) The frequency of clinical, biochemical, and metabolic features. Result(s) Women with PCOS had a higher frequency of oligomenorrhea or amenorrhea than those with nonclassic adrenal hyperplasia. Mean androstenedione and DHEAS levels were highest in nonclassic adrenal hyperplasia. The degree of metabolic dysfunction was greatest in obese women with PCOS; women with nonclassic adrenal hyperplasia and lean women with PCOS did not differ in degree of metabolic dysfunction. Women with nonclassic adrenal hyperplasia had a lower prevalence of polycystic ovaries than those with PCOS. The proportion of patients with an LH/FSH ratio >2 was greater in women with PCOS, compared with those with nonclassic adrenal hyperplasia. Basal 17-hydroxyprogesterone levels >2 ng/mL were found in 87%, 25%, 20%, and 7% of women with nonclassic adrenal hyperplasia, lean women with PCOS, obese women with PCOS, and controls, respectively. Conclusion(s) Nonclassic adrenal hyperplasia should be excluded in all women presenting with hirsutism, with use of a basal follicular phase 17-hydroxyprogesterone level, regardless of the presence of polycystic ovaries or metabolic dysfunction; however, women with nonclassic adrenal hyperplasia have a higher prevalence of normal ovulation and lower likelihood of having an LH/FSH ratio >2 or polycystic ovaries.

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Crossref · 10.1016/j.fertnstert.2009.06.025

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  1. Azziz, 1994, Non-classic adrenal hyperplasia: current concepts, J Clin Endocrinol Metab, 78, 810

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Metadata

Authors
Pall, M., Azziz, R., Beires, J., & Pignatelli, D.
Affiliations
  • Cedars-Sinai Medical Center (US)
  • Hospital de São João (PT)
  • Universidade do Porto (PT)
Corresponding author
Pignatelli, Duarte
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2010-07
Volume
94
Issue
2
Pages
684-689
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2009.06.025
OpenAlex
W2051943519
Cited by
123
References
37
Citations by year
2026: 10 · 2025: 10 · 2024: 8 · 2023: 4 · 2022: 8 · 2021: 9 · 2020: 6 · 2019: 10 · 2018: 6 · 2017: 7 · 2016: 11 · 2015: 5 · 2014: 12 · 2013: 5 · 2012: 6
FWCI
4.48
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
polycystic ovary syndrome, 21-hydroxylase deficiency, hirsutism, 17-hydroxyprogesterone, LH/FSH ratio, metabolic dysfunction, androstenedione, dehydroepiandrosterone sulfate, polycystic ovary, oligomenorrhea, obesity, differential diagnosis
MeSH terms
Adolescent, Adrenal Hyperplasia, Congenital, Adrenocorticotropic Hormone, Adult, Amenorrhea, Diagnosis, Differential, Female, Follicle Stimulating Hormone, Glucose Tolerance Test, Hirsutism, Humans, Insulin Resistance, Luteinizing Hormone, Middle Aged, Obesity, Oligomenorrhea, Phenotype, Polycystic Ovary Syndrome, Prospective Studies, Steroid 21-Hydroxylase, 17-alpha-Hydroxyprogesterone, Young Adult

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