[ consequences of prenatal excess androgen exposure in anatomy of the reproductive system and physiology]

Introduction: The effects of environmental exposure during critical periods of gestational life on fetal growth and development have been confirmed by a large number of studies on human and animal models. Sex hormons are among the most influential environmental factor which affect on growth and development of different organs of fetus. Among them, androgens are the most important ones because they have various sources of production and secretion. Result previous studies that exposure to androgens during pregnancy may act as a teratogenic agent and cause defects, deministrated in offspring's endocrine and neural system developments. Considering the importance of this critical period for the development of some abnormal features in adulthood, basic research and clinical prevention efforts need to be run at this stage. This review article presents evidence on the effect of excessive androgens during fetal life on embryo development and evolution, which can lead to the development of certain phenotypes / diseases in adulthood

[The study of peripheral blood mononuclear cells activity of women with polycystic ovary syndrome [PCOS] by co-culture with breast cancer cell lines compared with the healthy controls]

Introduction: polycystic ovary Syndrome [PCOS] is one of the most prevalent endocrinology disorders in women, in whom the state of systemic inflammatory cytokines, especially TNF-alpha is the main reason for immunological disturbances. Some PCOS manifestations such as infertility, hyperandrogenism, obesity and chronic inflammation are considered as risk factors for breast cancer. The risk of developing breast cancer in women with PCOS is being investigated in some epidemiological studies. In this research, the ability of peripheral blood mononuclear cells [PBMCs] of women with PCOS to develop antitumor response was studied and evaluated using an experimental co-culture approach between PBMCs and breast tumor cell lines

Materials and Methods: PBMCs were isolated from 50 heparinized venous blood samples [patient and healthy groups] by density gradient centrifugation byficoll. Breast cancer cell lines [MDA-MB-468 and MCF-7] were incubated as two target cells and were cultured adjacent to PBMCs in a transwell co-culture system. At different time intervals [48 and 72 hours] after co-culture, the proliferation rate of the effectors cells was evaluated by the BrdU cell proliferation assay. Determination of T CD3+CD8+ lymphocytes was determined by flow cytometry

Results: the proliferation of PBMCs after 48 hours of co-culture with MDA-468 [P=0.002] and MCF-7 [P=0.021] was significantly higher in the PCOS group compared to healthy controls. No pronounced differences were observed in T CD3+CD8+ cell numbers between the PCOS group and healthy controls [P>0.05] although T CD3+CD8+ percentage increased after 72 hours of co-culture in most samples. There was no statistically significant difference between MDA-468 and MCF-7 co-cultures in any of the tests

Conclusion: the stimulation threshold for mononuclear cells was reduced in women with PCOS. Differences between proliferation responses of PCOS and control groups may be caused by a chronic inflammatory condition in these patients

[Effects of nulliparity and multiparity on probability of breast tumor incidences: a review]

Breast cancer is the most common malignancy in women. Despite much progress in its identification, advanced surgical techniques and chemotherapies, physicians have not been successful in the control and inhibition of its metastasis. The aim of this study is notification fertility specialist and stakeholders of malignant disease to inform the role of normal pregnancy, which support immunological response of mothers, special anti-tumor and anti-metastatic mechanism against breast cancer in women. Epidemiological studies in the field of cancer associated with pregnancy history show that pregnancy has a dual impact, short-and long term, on the development of breast cancer; the first, a transient effect the after delivery, stimulates the growth of cancer cells in the early stages of transformation and increases risk of cancer, a result of a short-term effect of pregnancy. In addition, the increased differentiation of stem cells that are capable of forming tumors in the breast due to pregnancy and hormonal changes, reduce the risk of cancer, a phenomenon related to the long-term effect of pregnancy. The immune system of multiparous women due to multiple chimerism that occur as a result of the contact of the maternal immune system with common tumor antigens and embryonic cells, is more powerful and resistant against breast tumors than their nulliparous counterparts

[ comparative study of depression in women with polycystic ovary syndrome and control group]

Introduction: Polycystic Ovary Syndrome [PCOS] is the most common endocrine disorder in the gynecological field and considering the importance of mental health, this study was designed to compare the prevalence of depression among women with PCOS and the control group

Materials and Methods: The present cross sectional study was conducted as a case control research, which included 73 cases of PCOS and 116 healthy women [controls]. Data was gathered in 2 sections, i. e.1. participant characteristics and 2. an assessment of their depression levels using the Beck questionnaire. Reproductive aged women [15-45 years old] completed the questionnaire. Statistics analysis was done using SPSS version 19

Results: Mean scores of depression was 11.8+/-9.6 and 8.6+/-8.2 in the case and control groups respectively, with a statistically significant difference [P<0.01]. Sixteen [21%] patients and 10 [8%] women controls had moderate to severe depression, levels, both significantly higher in cases than in controls [P<0.01]

Conclusion: Considering the higher prevalence of depression in PCOS patients, compared to controls, early screening and counseling are recommended to provide appropriate care for these affected women

[ study of cell proliferation, TNF-alpha cytokine production and expression of CD8 marker in peripheral blood lymphocytes of women with polycystic ovary syndrome [PCOS] by co-culture with ovarian tumor cell lines [SKOV3, A2780]]

Introduction: Polycystic ovarian syndrome [PCOS] is a proinflammatory state that underpins the development of metabolic aberration and ovarian dysfunction in the disorder. Chronic inflammation and increased levels of androgens in these patients and their impact on the immune system, may be able to disrupt antitumor activity and thus increase the risk of developing malignancies including ovarian cancer

Materials and Methods: Peripheral blood mononuclear cells of 50 patients with PCOS and healthy controls were purified by Ficoll density gradient centrifugation. We then measured cell proliferation and concentrations of cytokines TNF- alpha at different time intervals [48 and 72 hours] after co-culture of ovarian [SKOV3, A2780] and breast [MCF-7, MDA-468] tumor cell lines with PBMC in indirect contact of trans well system

Results: Proliferative response of executive cells during stimulation with tumor cell lines after 48 hours was not statistically significant between patients and healthy controls. Between the 2 groups, proliferation rates at the end of 72h were significantly higher than after 48h [P<0.01]. The production of TNF- alpha in co-culture of A2780 cell lines significantly increased in the patient group in time compared to the controls [P<0.05]

Conclusion: Our findings confirmed that, compared to healthy individuals low levels of chronic inflammation in patients with PCOS exhibit increased proliferative response of immune cells and TNF- alpha levels. An increased risk of cancers in patients with PCOS however requires investigation of other aspects of anti-tumor responses in vitro, with larger sample sizes

[Using a scientific map to compare scientific publications on poly cystic ovary syndrome in Iran, Middle East and other countries]

Introduction: Polycystic ovary syndrome [PCOS], one of the most common gynecological diseases, has been the subject of many scientific studies. Scientific map is one way to obtain useful information about a particular research field status. We aimed to compare the quantity of scientific publications on PCOS in Iran to those of the Middle East and other countries

Materials and Methods: In this scientometric study, the samples included all medical scientific publications about PCOS, indexed in the Web of Knowledge from 2000 to 2016. Bibexcel software was used for calculating subject category co-citation, analyzing social networks and two Pajek and VOS viewer software were used for creating maps

Results: Iran ranked eighth among the top ten leading countries in the production of scientific articles in the field of PCOS. Of overall 6598 scientific publications related to PCOS worldwide, 209 articles were authored by Iranian researchers. In other words, 4.3 % of scientific productions in this field are from our country. In this list, America ranks first with 1670 [34.3%] articles, followed by China with 567 [11.7%], and Turkey with 564 [11.6%] publications ranking second and third. Of the fifteen Iranian research pioneers, each one had at least seven papers in the field of PCOS

Conclusion: Iran ranks among the top ten countries with regard to scientific publications worldwide. Considering the lack of knowledge in certain aspects of PCOS identifying more pioneers in this research field will help highlighting new research topics for future researches in this field

[ effects of prenatal excess androgens exposure on the gene expression]

Introduction: Prenatal exposure to excess androgens, as environmental factors affecting the fetal epigenome, and also a potent agent for developing special phenotypes in adulthood, has been the subject of many studies during recent decades. Results of various molecular studies conducted in this area indicate that exposure to androgens, during certain periods of growth and development of the fetus, affects cellular processes, tissues and organ development leading to phenotype and behavior alterations, one of which is causing susceptibility to polycystic ovary syndrome in adulthood. Testosterone, the most important androgen, has interfering effects in metabolic and endocrine pathways, usually a result of epigenetic changes. In recognition of diverted pathways leading to the development of disease conditions and considering possible interventions at the molecular level in these directions, control of prenatal environment and conditions can be taken to account as the first and most important step in prevention of related diseases. This article reviews the studies on the epigenetic and gene expression changes of various biological pathways as a result of this exposure, using the polycystic ovarian syndrome as an appropriate model to illustrate this exposure

Relationship between dietary pattern and cardiometabolic risk factors in women with PCOS

To identify a dietary pattern predictive of visceral adiposity index [VAI], using reduced rank regression, and to examine its associations with cardiometabolic risks in the PCOS women. This case-control study was conducted on 53 PCOS women and 167 age-matched healthy women from the population of Tehran Lipid and Glucose Study. Dietary intakes were collected using a semi-quantitative food frequency questionnaire. The associations of dietary pattern with cardiometabolic risks were investigated by Pearson's correlation and linear regression. In this study, a positively correlated VAI dietary pattern, characterized by high consumption of fried vegetables, vegetable oils [except for olive oil], fast foods and low consumption of dairy, and cruciferous vegetables was identified. The dietary pattern was correlated with triglycerides [rcontrols=0.32, rPCOS=0.41], triglycerides/HDL-C ratio [rcontrols=0.35, rPCOS=0.44] and HDL-C [rcontrols=-0.22, rPCOS=-0.26] in both groups. The pattern was also positively correlated with waist circumference, total cholesterol [TC], LDL-C and systolic blood pressure in the controls. After adjustment for age and BMI, dietary pattern was associated with triglycerides [Pcontrol=0.22, p=0.003; betaPCOS=0.48, P=0.001] and triglycerides/HDL-C ratio [Pcontrol= 0.23, P=0.002; betaPCOS= 0.52, P=0.001] in both groups. The dietary pattern was inversely associated with HDL-C in both groups, but the association was attenuated by adjusting for age and BMI in the PCOS group. High adherence to the dietary pattern was associated with cardiometaboiic risks in controls and to a lesser degree in the PCOS group

Study on the correlation between serum androgens and sexual function in post-menopausal women

Sexual dysfunction could be influenced by menopause and related hormonal changes. The purpose of this study is to examine the correlation between serum levels of androgens and sexual function in post-menopausal women. This is a community-based, descriptive-analytical study involving 405 post-menopausal women, aged 40 to 65 years, who had reached menopause during the three years prior to the study. A multi-stage, randomized sampling was conducted. Data was collected using the Female Sexual Function Index [FSFI] questionnaire, a researcher-made questionnaire, and blood samples were obtained to assess serum levels of androgens [testosterone, DHEAS], SHBG and estradiol. Among subjects, 61% had female sexual dysfunction [FSD]. Total testosterone levels had a negative correlation with scores in the domain of desire [r=-0.108, P=0.029], DHEAS levels were positively correlated with scores in the domain of pain [r=0.113, P=0.022] and the free estradiol index [FEI] was also positively correlated with scores in the domain of pain [r=0.115, P=0.020]. Satisfaction with marital relationship had a significant positive correlation with total testosterone levels [r=0.131, P=0.008] and the free androgen index [FAI] [r=0.100, P=0.044]. Examining the correlation between FSFI scores and hormone levels, multiple regression analysis showed that serum levels of total testosterone and FAI were predicting factors, in the domains of lubrication [P=0.042] and satisfaction [P=0.021] respectively. Androgenic hormones can affect certain aspects of sexual function in post-menopausal women, subject, which, however, requires further investigation

association between birth weight and adulthood body fat mass in women with poly cystic ovary syndrome

Polycystic ovary syndrome [PCOS] is the most prevalent endocrinopathy in reproductive aged women. The association of early-life factors such as fetal adipose tissue and birth weight with adulthood outcomes like obesity, body fat mass [BFM] and body lean mass [BLM] is not clearly understood. We aimed to compare the association between birth weight and body composition in women with PCOS and normal controls. For this study we enrolled a total of 70 reproductive aged women with PCOS diagnosis, referring to the Reproductive Endocrinology Research Center and the same number of healthy women without polycystic ovaries by ultrasonography or hirsutism and/or anyovulatory other dysfunction were enrolled. Their birth weights were documented and their body composition was assessed, using standard measuring devices. Cases were younger than the controls [29.7 +/- 4.9 versus 30.8 +/- 5.9 years] and had the same BMI [24.6 +/- 2.4 versus 24.8 +/- 4.5 kg/m2]. Our study demonstrated that BFM and BLM are increased in adult PCOS women born underweight, compared to their normal counterparts [16 +/- 4.7 versus 12.2 +/- 4.1, P= 0.06 and 46.4 +/- 5.8 versus 41.1 +/- 5.8, P=0.07]. The impact of fetal adipose tissue and birth weight on the occurrence adulthood obesity, BFM and BLM vary between women with and without PCOS

[The prevalence of menstrual disorders in reproductive aged women and its related factors]

Normal menstruation is one of important indicators of the general health of reproductive-aged women. We aimed to investigate the prevalence of menstrual disorders and its related factors. This cross-sectional study was conducted among women participants of the Tehran Lipid and Glucose Study, a population-based study aimed identify the prevalence of noncommunicable diseases from March 2013 to 2014. A total of 1393 women, aged 15-49 yr were included and all pregnant, breastfeeding and menopausal women were excluded. Socio-demographic characteristics and menstruation patterns were assessed by a standardized ad-hoc questionnaire. Menstruation was categorized based on last FIGO definitions. Data analyzed using SPSS version 11.0 [SPSS-Inc., Chicago-IL], 0.05 was set as significant level. Mean age of participants was 37.7 [11] y. The results showed that 64.1% of subjects had normal menstruation and 35.8% experienced different forms of menstrual disorders. Heavy menstrual bleeding was one of the most prevalent disorders [17.2%]. Prevalence of menstrual disorders was statistically higher in women <20 yr [47.7%] and >/=40yr [45.5%] than women between the 20-40 yr age range [P=0.001]. Irregular menstrual bleeding in >20 yr, heavy menstrual bleeding in 20-40 yr and >/= 40yr were the most common menstrual disorders. The results remain unchanged for age and BMI after adjustment for potential confounders [OR: 1.08, CI 95%: 1.07-3.97; P<0.03], [OR: 1.05, CI 95%: 1.02-5.04; P<0.04], respectively. Our findings showed that menstrual disorders are prevalent as one-third of reproductive aged women suffer from one or more menstrual disorders. Understanding the prevalence of menstrual disorders could help health care providers to identify some serious diseases, and prioritize strategies to promote these women's quality of life

[Mimetical signs and symptoms of thyroid disorders in healthy pregnant women, a population based study]

Introduction: Although for thyroid disorders are the second most prevalent endocrine abnormalities among reproductive aged women, the signs and symptoms of thyroid disease can often be masked by the physiologic changes of pregnancy. The aim of this study was to identify physiological signs and symptoms common to both pregnancy and thyroid disorders among a community based sample of pregnant women without thyroid dysfunction

Materials and Methods: This population-based cross-sectional study was conducted on 1600 pregnant women. A comprehensive questionnaire including questions regarding the signs and symptoms of thyroid disease was completed for subjects and relevant clinical examinations were conducted. Blood samples were taken and serum thyroxine [T4], T-uptake, thyrotropin [TSH] and thyroid peroxidase antibodies [TPO-Ab] were measured

Results: Of study participants, 63.5% had normal thyroid function. The prevalence of overt hypothyroidism and hyperthyroidism were 3.8%, and 0.8%, respectively and 29.8% of patients had subclinical hypothyroidism. Of pregnant women without thyroid dysfunction, 64.8% had one or more of the signs and symptoms of thyroid disorders. Most common symptoms were fatigue [30.3%], followed by lethargy and drowsiness [20.3%]

Conclusion: Normal physiological changes of pregnancy can mimic some of the signs and symptoms of thyroid disorders. The results indicated that over half of the healthy pregnant women experienced one or more of the signs and symptoms of thyroid disorders during pregnancy. Correct interpretation of signs and symptoms of thyroid dysfunction during normal pregnancy is critical to discriminate between physiologic and pathological changes

[Effect of interventions based on lifestyle modification on clinical, hormonal and metabolic findings in the patients with polycystic ovary syndrome: a systematic review]

Introduction: Polycystic ovary syndrome [PCOS] is often associated with clinical, metabolic and hormonal disorders. There are strong correlations between obesity, hyperandrogenism, impaired glucose tolerance and reproductive disorders emphasising the importance of lifestyle in patients with this syndrome

Materials and Methods: PubMed, Science Direct, Scopus, Cochrane and SID databases [2003-2014] were searched to identify publications on the effect of interventions based on Lifestyle modification on clinical, hormonal and metabolic findings in the patients with polycystic ovary syndrome

Results: Suitable nutrition and weight reduction can improve the results of patients with polycystic ovary syndrome. Data on enhanced benicial composition of diets in these patients is not available and studies have focused mainly on the restriction of energy instead of diet composition. Some researchers believe that a low glycemic load diet is effective on insulin resistance and other symptoms of disease but there is in sufficient evidence on the effectiveness of diets with high protein content. Regular physical activity also improves insulin resistance in patients with the PCOS

Conclusion: Lifestyle modification as the first-line treatment in patients with polycystic ovary syndrome can improve the clinical, hormonal and metabolic findings of patients. Although calorie restriction and weight loss can directly improve disease outcomes in these patients, yet the effect of diet composition is not well elucidated

[Effect of calligonum comosum on ovarian histology of polycystic ovary mouse model]

Background: Increased oxidative stress in women with polycystic ovary syndrome attracted attentions to antioxidant treatments. Calligonum Comosum is a planet with antioxidant propertis

Objective: This study aimed to investigating Calligonum effect on polycystic ovarian histology of polycystic ovary mouse model

Methods: Thity two female NMRI mice with 25-30 gr weight and 8 weeks age were investigated. A single dose of estradiol valerate [40 mg/kg; im] was used for induce polycystic ovarian morphology. Calligonum Comosom extract [20 mg/kg/ week; ip] was injected for 4 consequent weeks. In sham group, only DMSO was used. After 4 weeks, blood and histological samples were prepared to study

Results: There was no significant effect of 20 mg/kg Calligonum on polycystic ovarian morphology mouse model

Conclusion: The effect of other doses of Calligonum Comosum on fertility or adverse effect of this planet need to be more investigated

[ prevalence of various phenotypes of polycystic ovary syndrome: a community-based study in southwest of Iran]

There is very little information about the prevalence of polycystic ovary syndrome at the community level; heterogeneity in diagnostic criteria and lack of universal agreement on the definition of each criterion for population based studies complicate comparability of existing literature. This study aimed to assess the prevalence of different phenotypes of polycystic ovary syndrome in a large community-based study conducted in the southwest of Iran. A total of 646 reproductive-aged women were randomly selected using the stratified, multistage probability cluster sampling method. The prevalence of polycystic ovary syndrome according to the Rotterdam criteria and its various phenotypes were estimated using universal assessment of ultrasonographic parameters, hormonal profiles and clinical histories. The estimated prevalence of polycystic ovary syndrome in this population based study using the Rotterdam criteria was 14.1[n=85]. There were 279 [46.3%] women who had no symptoms of polycystic ovary syndrome and were completely normal. Among women with polycystic ovary syndrome, phenotypes A, B, C and D were observed in 11, 19, 42 and 13 women, respectively. The most common symptoms observed in this study in order of frequency were hyperandrogenism, polycystic ovary on sonography and menstrual disorders, indicating the need for more studies on the priority of paraclinical assessment, based on universal agreement on definitions for the diagnosis of polycystic ovary syndrome

[Determination and comparison of estimated menopausal age based on serum anti-mullerian hormone in women with and without polycystic ovarian syndrome]

Menopause is defined as 12 months of constant amenorrhea in the absence of any pathology. Right now there is no definite test to predict menopause age and the ovarian reserve evaluations are mainly implemented on the basis of sonographic and hormonal measurements. The present study was conducted to determine and compare the menopausal age in women with polycystic ovarian syndrome [PCOS] and non PCOS women based on anti-mullerian hormone [AMH]. The present study is an epidemiologic case- control research in which from among 1019 women aged 20-40 years, 208 PCOS women and 811 normo-ovulatory controls were selected as the case and control groups respectively. Data collection was done through completing questionnaire, clinical examination and lab test measurements. After age and body mass index [BMI] matching, AMH levels in relation to age were displayed in an interactive graph and SPSS software version 21 was used for statistical analysis. Findings showed the mean age and BMI for case and control groups were 29.75 years - 27.1 [kg/m[2]] and 31.62 years - 26.1 [Kg/m[2]] respectively. Our results indicated significantly higher AMH levels in PCOS cases than in normal controls [P<0.0001]. The estimated menopausal age for PCOS and non PCOS women was 51 and 49 years respectively. To conclude PCOS patients reach menopause two years later than healthy women. If the length of reproductive period in these patients is higher than that the healthy women, it may be possible to use this period for increasing the fertility likelihood

[Infertility, the most adverse outcome among sexual function outcome affecting of Iranian women with polycystic ovarian syndrome]

The physical and apparent changes caused by PCOS such as hirsutism, obesity, acnea, hair loss and outcomes like infertility can cause decreased sexual function in the women affected. In the present study we aimed to evaluate the impact of PCOS clinical signs on the sexual function of married Iranian women. This cross-sectional study was carried out on 600 reproductive aged married women with PCOS selected using simple sampling from among women referring to gynecologists at private clinics. Clinical examinations and antropomethric measurements were done and a questionnaire including demographic, reproductive history, diseases and Persian version of Female Sexual Function Index were completed for all participants. Analysis was done using SPSS version 15. Approximately two third of participants had sexual dysfunction. Infertility is was found to be the most influential clinical sign of PCOS on sexual function of affected women. Subgroup analysis demonstrated that PCOS women with infertility had significantly more sexual dysfunction compared to fertile PCOS women [71 vs 61%]. Seventy-two percent of infertile women had sexual dysfunction in lubrication and arousal, while these values for fertile women were 54 and 52% respectively. Among Iranian women with PCOS, infertility affects their sexual function more than any other clinical sign, and these women experience orgasm and sexual satisfaction less than their fertile counterparts. It seems that infertility should be carefully considered during sexual consultation visits for PCOS women

[Concerns of women with polycystic ovary syndrome: a qualitative study]

Polycystic ovary syndrome [PCOS] is one of the most common chronic endocrine disorders with a prevalence estimated to range between 4-25%, depending on the diagnostic criteria used. It has significant and diverse clinical consequences associated with reproductive, metabolic, psychological morbidity and some cancers. It is not clear how PCOS symptoms influences women's physical experiences and concerns. This qualitative study aimed to explain study the effects that life experiences and concerns women with polycystic ovary syndrome have. Twenty women, aged 18 to 39 years, diagnosed with PCOS were interviewed using semi-structured open interviews to reach data saturation. All the interviews were recorded and transcribed, and data were analysed using content analysis, with deductive and inductive methods. Four closely intertwined themes were disclosed: Physical consequences of PCOS, fear of the future, economic burden of disease and coming to terms with a chronic condition. The results of our study suggest that healthcare professionals working with PCOS patients should consider providing peer support groups as a means to alleviate patients concern and to promote self management activities like lifestyle modification. Ideally, support groups should be designed to meet the patients support needs and expectations, and should be evaluated regularly

[Correlation between menarcheal age and certain demographic characteristics]

The first occurrence of menstruation [or periods] is called menarche and it is a vital event during puberty in girls. Various studies show a downward trend in menarcheal age over the last hundred years. Many factors can influence age at menarche. The aim of this study was to determine the correlation between menarcheal age and certain demographic characteristics, in female residents of district 13, Tehran Lipid and Glucose Study. In this longitudinal descriptive, conducted within the framework of the Tehran lipid and glucose study, subjects were 402 girls, aged 12 and 18 years, whose menarche had not begun at the initiation of the study, but it did during their follow-up. In order to collect data, questionnaires previously completed in the TLGS were used. Validity and reliability of the questionnaire confirmed in previous studies. Various factors including maternal age at menarche, maternal education, maternal occupation, body mass index, physical activity, energy expenditure and exposure to tobacco smoke were examined. Findings showed that the mean age at menarche was 13.06 +/- 1.24 years in this study. There were significant statistical associations between body mass index [P=0.002, r=-0.04], mother's age at menarche [P<0.001, r=0.66] and maternal education [P=0.027, r=0.25] and the subjects age at menarche. However there was no significant association between age at menarche, with mother's occupation, passive smoking, physical activity and energy expenditure. It seems that BMI, mother's menarcheal age and maternal education are factors that influence the age at menarche

[ simpler diagnostic method to assess Hirsutism in the Iranian population: based on modified Ferriman-Gallwey scoring system [Tehran lipid and glucose study]]

Hirsutism is a common endocrine disorder among reproductive women. There is no clear definition and criterion for the clinical evaluation and diagnosis of hirsutism. The aim of present study is to introduce a simpler diagnostic method on the basis of modified Ferriman-Gallwey [mF-G] system, which examines fewer body areas, but with the same sensitivity, specificity and positive predictive value [PPV]. A one thousand women, aged 18-45 years, participants of the Tehran Lipid and Glucose Study, were recruited by random systematic sampling. Data were collected by a questionnaire and clinical examination. The total mF-G score was calculated and ROC curve was drawn for subsets of areas. The new cut-off points were calculated for those subsets with optimal sensitivity, specificity, positive and negative predictive value and concordance percentage. The subset of 5 areas of the lips, chin, thighs, upper and lower abdomen [cut-off point 5], had sensitivity and specificity of 97/5% and 89/9% [R[2]= 0/92%, P<0.0001] respectively, and was the nearest subset to mF-G method. The subset of lip, abdomen and thighs [cut-off point 4] was 91/5% sensitive and 92% specific, with the highest PPV [72/2%] and concordance percentage [91/9%] with the golden standard [mF-G score >/= 8]. Using the 3 area subset of lip + lower abdomen + thighs serves as a simple and more accepted method for hirsutism assessment and can be used in wide epidemiologic studies