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To perform an audit on the examination of hirsute patients and to establish a rational routine examination program in an outpatient endocrine clinic. Systemat ic, retrospective audit. Academic tertiary-care medical center. Three hundred f orty women with hirsutism as the referral diagnosis. Hormone analyses and ACTH t ests during cycle days 2-8, 2 hours of oral glucose tolerance test (OGTT), and vaginal ultrasound. End diagnosis, fasting, 30-, 60-, and 120-minute oral glu cose-stimu-lated levels of insulin and capillary blood glucose. Two hundred on e patients were diagnosed as having idiopathic hirsutism (IH) and 134 as having polycystic ovary syndrome (PCOS). End diagnosis: prolactinoma: n = 1, Cushing’s syndrome: n = 1, androgen-producing ovarian tumor: n = 1, late-onset 21-hy- droxylase defects: n = 2. During OGTT, 4.9%(13 of 263) had previously undiagnos ed diabetes; no significant difference in diabetes prevalence was found between idiopathic hirsutism and PCOS. For 50.8%, fasting insulin values were in the up per quartile for a reference population. Initial evaluation of hirsute patients with irregular menses should include serum (s)-17α-hydroxyprogesterone, s-pr olactin, s-Testosterone (T), and s-sex hormone-binding globulin. Further eval uation is needed in patients with markedly elevated s-T or with clinical Cush- ing’s syndrome. Hirsute patients have a high risk of diabetes, although this co uld be due to the high number of overweight patients among this population.
To perform an audit on the examination of hirsute patients and to establish a rational conventional examination program in an outpatient endocrine clinic. Systemat ic, retrospective audit. Academic tertiary-care medical center. Three hundred f orts women with hirsutism as the referral diagnosis. Hormone analyzes and ACTH ests during cycle days 2-8, 2 hours of oral glucose tolerance test (OGTT), and vaginal ultrasound. End diagnosis, fasting, 30-, 60-, and 120-minute oral glu cose-stimu-lated levels of insulin and capillary blood glucose. Two hundred on e patients were diagnosed as having idiopathic hirsutism (IH) and 134 as having polycystic ovary syndrome (PCOS). End diagnosis: prolactinoma: n = 1, Cushing’s syndrome: During ovarian tumor: n = 1, late-onset 21-hy-droxylase defects: n = 2. During OGTT, 4.9% (13 of 263) previously previously undiagnos ed diabetes; no significant difference in diabetes prevalence was found between idiopathic hirsutism and PCOS. For 50.8%, fast ing insulin values were in the up per quartile for a reference population. Initial evaluation of hirsute patients with irregular menses should include serum (s) -17α-hydroxyprogesterone, s-pr olactin, s-Testosterone (T), and s-sex hormone -Binding globulin. Further eval uation is needed in patients with markedly elevated sT or with clinical Cush ing syndrome. Hirsute patients have a high risk of diabetes, although this co uld be due to the high number of overweight patients among this population.