The Effect of Three Menstrual Cycle Phases on Adrenal Hormonal Dynamics and Etiologies of Hirsutism in Five Ethnic/Racial Female Populations

抄録

We investigated the etiology of hirsutism in 117 hirsute females (HF) comprised of 5 racial/ethnic groups, and the effect of 3 menstrual cycle phases and dexamethasone (Dex) pre-treatment on the hormonal response to ACTH stimulation in 19 normal females (NF). All HF and control NF (n=33) had an ACTH stimulation test, and 35 HF and 19 NF had an adrenal and/or ovarian suppression test. No significant differences were found in the ACTH stimulated hormonal levels between no-Dex and Dex pre-treatment states, and between the phases of the menstrual cycle in NF. The hirsute etiology findings in all HF revealed no apparent cause (idiopathic) in 48%, polycystic ovary syndrome (PCOS) in 26%, increased adrenal androgen secretion in 12%, mild defect in adrenal 3β-HSD activity in 7.7%, increased adrenal and ovarian androgen secretion in 5%, and 21-hydroxylase deficiency in 1.7%. In each of the Caucasian and African-American HF groups, and in a small number of HF of Ashkenazi Jewish, Hispanic, and Middle Eastern decent, idiopathic or PCOS was the most common etiology, while other etiologies were uncommon or rare.