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Piróg M, Pulka A, Zabiegło E, Jach R. Nonclassical congenital adrenal hyperplasia: Metabolic and hormonal profile. Clin Endocrinol (Oxf) 2024; 100:109-115. [PMID: 37997507 DOI: 10.1111/cen.14988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To investigate both metabolic and hormonal profiles of untreated women with nonclassical congenital adrenal hyperplasia (NCCAH). The secondary objective was to compare above profiles with polycystic ovary syndrome (PCOS) women and healthy controls. DESIGN Retrospective, case-control study. PATIENTS Women assigned to one of the groups: (1) NCCAH (n = 216), (2) PCOS (n = 221), (3) regularly menstruating (n = 216). MEASUREMENTS Lipid profile including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol along with both fasting glucose (Glu) and insulin (Ins) levels and hormonal parameters were determined among all participants. RESULTS Both NCCAH and PCOS women had higher body mass index in comparison to the controls (+7% and 18.9%, respectively). NCCAH women exhibited higher TC (+34.1%) and fasting glucose levels (+18.9%) together with elevated testosterone (60.2%), dehydroepiandrosterone sulphate (28.1%), free androgen index (91.9%) and antimüllerian hormone (58%) in comparison to healthy controls. PCOS group showed unfavourably altered metabolic profile reflected by higher TC (+35.4%), TG (+25%), fasting Glu (+22%), fasting Ins (+34.4%) along with homoeostatic model assessment for insulin resistance (HOMA-IR; 36.2%) in comparison to the controls. NCCAH women showed both lower insulin (-28.5%) and HOMA-IR (-31.8%) levels when compared to the PCOS. CONCLUSIONS NCCAH women showed less adversely altered metabolic profile than PCOS women, but not as favourable as in the healthy controls. Optimisation of screening for metabolic and reproductive health may help to initiate the treatment and improve treatment outcomes.
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Affiliation(s)
- Magdalena Piróg
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Pulka
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Zabiegło
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Robert Jach
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland
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Bansal P, Sardana K, Arora P, Khurana A, Garga UC, Sharma L. A prospective study of anti-mullerian hormone and other ovarian and adrenal hormones in adult female acne. Dermatol Ther 2020; 33:e13974. [PMID: 33185003 DOI: 10.1111/dth.13974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/18/2020] [Accepted: 07/02/2020] [Indexed: 11/30/2022]
Abstract
Polycystic ovarian syndrome (PCOS) diagnosis in adult female acne (AFA) is tough owing to unreliable ultrasonography in virgins or obese females and inconsistent hyperandrogenemia. We analyzed hormones in AFA and established a diagnostic cut-off value of anti-mullerian hormone (AMH) for PCOS. Female acne patients aged ≥25 years were assessed with total testosterone (TT), sex hormone binding globulin (SHBG), free androgen index (FAI), AMH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Rotterdam's criteria defined PCOS. AMH was measured (Access AMH assay) to calculate the diagnostic cut off value using receiver operating characteristic (ROC) curve. Of 120 cases, 25.83% had PCOS. This group had significant clinical hyperandrogenism, truncal and adolescent acne, polycystic ovarian morphology (PCOM), and raised hormones (AMH, TT, FAI, LH, and LH/FSH). AMH levels were significantly higher in the PCOS group (6.91 ± 3.85 ng/mL) and positively correlated with TT, FAI, 17OHP, LH, and LH/FSH ratio. AMH at >5.1 ng/mL (sensitivity-70.97% and specificity-82.02%) predicted PCOS and correlated with PCOM. AMH (>5.1 ng/mL) is useful for diagnosing PCOS and surrogate for hyperandrogenemia and PCOM. Its correlation with hormones in non PCOS AFA highlights its sensitivity to diagnose endocrinological derangements.
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Affiliation(s)
- Prekshi Bansal
- Department of Dermatology, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Pooja Arora
- Department of Dermatology, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Umesh Chandra Garga
- Department of Radiodiagnosis, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Lokesh Sharma
- Department of Biochemistry, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
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Prieto-Sánchez MT, Hernández-Peñalver AI, Sánchez-Ferrer ML, Mendiola J, Torres-Cantero AM. Anogenital distance and anti-Müllerian hormone combined improves the diagnosis of polycystic ovary syndrome. HUM FERTIL 2020; 25:274-282. [PMID: 32713212 DOI: 10.1080/14647273.2020.1795574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this study was to assess the accuracy of the combination of anogenital distance (AGD) and anti-Müllerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS). The study included women diagnosed with PCOS and a control group who attended the Clinical University Hospital 'Virgen de la Arrixaca' in Murcia (Spain). Serum concentrations of AMH were measured and two AGD measurements were obtained: (i) from the anterior clitoral surface to the upper verge of the anus (AGDAC); and (ii) from the posterior fourchette to the upper verge of the anus (AGDAF). Data were assessed by receiver operator characteristic (ROC) curves. Women with PCOS (n = 126) had significantly larger AGDAC (80.5 ± 11.3 versus 76.0 ± 10.4 mm; p < 0.001) and higher AMH (7.2 ± 4.7 versus 3.1 ± 2.2; p < 0.001) compared to control women (n = 159). Women with serum AMH above 3.8 ng/mL (clinical cut-off used in PCOS) were 9.1 times more likely to have PCOS (95% CI: 5.1-16.2). The area under the ROC curve of combined model of AMH and AGDAC was 0.87 (95% CI: 0.83-0.91). The combined model for predicting PCOS based on AMH and AGDAC has better diagnostic accuracy than that of AMH or AGDAC alone. This model could be useful for clinicians and improve diagnosis and clinical management of these women.
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Affiliation(s)
- María T Prieto-Sánchez
- Department of Obstetrics and Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, Murcia, Spain.,Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Ana I Hernández-Peñalver
- Department of Obstetrics and Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, Murcia, Spain
| | - María L Sánchez-Ferrer
- Department of Obstetrics and Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, Murcia, Spain.,Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Jaime Mendiola
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Murcia, Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Murcia, Spain.,Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alberto M Torres-Cantero
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Murcia, Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Murcia, Spain.,Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Preventive Medicine, "Virgen de la Arrixaca" University Clinical Hospital, Murcia, Spain
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Cunha MGD, Moraes C, Cebrian G, Silva RFD, Reple SIF, Machado Filho CD, Fonseca FLA. Dosages of androgenic hormones in adolescent patients with severe acne. ACTA ACUST UNITED AC 2020; 66:36-41. [PMID: 32130379 DOI: 10.1590/1806-9282.66.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/01/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Acne vulgaris in female adolescents, when severe or accompanied by other signs of androgenization, may represent a sign of hyperandrogenemia often underdiagnosed, which will have harmful consequences for adult life. The objective of this cross-sectional and retrospective study was to demonstrate the incidence of hormonal changes in the cases of female adolescents with severe or extensive acne, with or without other signs of hyperandrogenism, and propose a hormonal research pattern which should be indicated in order to detect early hyperandrogenemia. METHODS The medical records of 38 female patients aged between 9 and 15 years old with grade II and/or III acne were analyzed. The dehydroepiandrosterone sulfate, dehydroepiandrostenedione, and androstenedione, total testosterone, and dihydrotestosterone sulfate hormones were required prior to initiation of treatment. The hormonal dosages were performed in the serum after at least 3 hours of fasting by means of radioimmunoassay tests. RESULTS Of the 38 patients included, 44.7% presented changes in androgen levels (hyperandrogenemia), and the two most frequently altered hormones were DHEA and androstenedione, with the same incidence (23.6%). CONCLUSIONS The correct and early diagnosis provides an effective and agile approach, including antiandrogen therapy, with the purpose of avoiding the reproductive and metabolic repercussions, besides controlling the inflammatory picture and avoid aesthetic complications.
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Affiliation(s)
- Marisa Gonzaga da Cunha
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Caio Moraes
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Giovana Cebrian
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Rafaela Ferreira da Silva
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Sônia Isabel Friedlaender Reple
- . Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | | | - Fernando Luiz Affonso Fonseca
- . Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil.,. Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, R. Prof. Artur Riedel, 275, CEP 09972-270, Diadema, SP, Brasil
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Dréno B. What is new in the pathophysiology of acne, an overview. J Eur Acad Dermatol Venereol 2017; 31 Suppl 5:8-12. [DOI: 10.1111/jdv.14374] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/30/2017] [Indexed: 12/11/2022]
Affiliation(s)
- B. Dréno
- Department of Dermatology; Nantes University; Nantes France
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Sardana K, Singh C, Narang I, Bansal S, Garg VK. The role of antimullerian hormone in the hormonal workup of women with persistent acne. J Cosmet Dermatol 2016; 15:343-349. [PMID: 27320497 DOI: 10.1111/jocd.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Kabir Sardana
- Dermatology; Maulana Azad Medical College; Delhi India
| | - Chanchal Singh
- Department of Obstetrics and Gynecology; Indraprastha Apollo Hospital; Delhi India
| | - Isha Narang
- Dermatology; Maulana Azad Medical College; Delhi India
| | | | - Vijay K Garg
- Dermatology; Maulana Azad Medical College; Delhi India
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