Investigation of body mass index, insulin resistance and diabetes in patients with hirsutism

Introduction
Obese woman with hirsutism have increased risk for developing insulin resistance and diabetes mellitus.

Aim
To evaluate patients with hirsutism, report the hormone levels, body mass index (BMI), insulin resistance and diabetes in our study population and compare our results with those of similar research conducted in other countries.

Material and methods
Hormones were measured with radioimmunoassay/immunoradiometric assay methods. Oral glucose tolerance test was done only in a selected group of women (with positive anamnesis for diabetes, women with polycystic ovary syndrome (PCOS) and overweight/obese women). The level of blood glucose was measured after drinking the liquid containing 75 g glucose. Blood was taken to measure glucose, insulin and C-peptide levels after 30 min, 60 min and 3 h.

Results
Women with PCOS (27.4%) had higher BMI than women with other causes of hirsutism. Among 135 of the women with hirsutism, 9.6% were underweight, 60% were with normal weight, 20.7% were overweight and 9.6% were obese. Obesity was more frequent in PCOS and hyperandrogenism groups. Women with hirsutism had higher levels of androstenedione, dehydroepiandrosterone sulfate (DHEAS), total testosterone, free testosterone, lower levels of sex hormone-binding globulin (SHBG). Insulin resistance was present in 20 (14.8%) women and diabetes in 2 (1.4%) women.

Conclusions
Obesity was associated with increased hirsutism. In our study we found that insulin resistance should be assessed in hirsute women with PCOS regardless of their BMI as insulin resistance was found in hirsute women irrespective of whether they were overweight, obese, of normal weight or underweight. Groups at risk (hirsute, obese, diabetes) should be identified and treated.