Endocrine Abstracts

Introduction: Hirsutism is described as excessive development of facial and body hair in women in androgen-dependent areas. Our aim was to determine the clinical and metabolic aspects of hirsutism and its relationship with the metabolic syndrome.

Methods: We conducted a retrospective descriptive study at the endocrinology department of Rabta Hospital in Tunis. We recruited 100 women who presented with hirsutism between January 2009 and December 2020 Clinical and paraclinical data were collected from medical records. The diagnosis of metabolic syndrome was made according to the IDF 2009 criteria.

Results: The mean age of our patients was 29.5 ± 10.7 years. Our patients were smokers in 8% of cases and diabetics in 19% of cases. The onset of hirsutism was post-pubertal in 56% with menstrual disorders in half cases. Associated clinical signs were skin acne (50%), Acanthosis Nigricans (20%) and signs of virilization (9%). Our population had an average weight of 83.9 ± 20.9 kg [38-150] with an average body mass index of 32.5 ± 7.7 kg/m² [16-57]. Obesity was noted in 58% and described as grade 1 in 44.2%, grade 2 in 25% and morbid in 30.8% of cases. Mean testosteronemia was 0.9 ± 0.76 ng/ml. Biological investigations showed mean values for blood fasting glucose = 1.08 ± 0.44 g/l, glycated haemoglobin = 7.37 ± 2.42%, total cholesterol = 1.8 ± 0.5 g/l, HDL-cholesterol = 0.45 ± 0.1 g/l and LDL-cholesterol = 1.11 ± 0.3 g/l. A metabolic syndrome was present in 54% of patients. Etiologies were dominated by polycystic ovary syndrome (51%), followed by idiopathic hirsutism (32%), adrenal pathology (15%) and ovarian tumors (3%).

Conclusion: Our results suggest that the increase of androgenic activity favors an android distribution of body fat, which is associated with an impairment of glucose and lipid metabolism.