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

ABSTRACT

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