The following is a summary of “Idiopathic Hirsutism and Metabolic Status: A Population-based Prospective Cohort Study,” published in the January 2023 issue of Endocrinology & Metabolism by Mahmoudieh, et al.

Idiopathic hirsutism (IH) has been the subject of a small number of research, with conflicting and ambiguous findings on its effects on cardiometabolic parameters. For a study, researchers sought to explore IH’s impact on metabolic outcomes.

From the Tehran Lipid and Glucose Study, 334 women with IH and 1,226 women serving as healthy controls were chosen for this population-based prospective study. The secular longitudinal trends of metabolic indices, including fasting blood sugar (FBS), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL), non-HDL, triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and waist circumference (WC) in both groups, were investigated using the generalized estimating equations method. The link between IH and metabolic diseases was evaluated using unadjusted and adjusted Cox regression models to calculate hazard ratios (HR) and 95% CIs. The modified model considered potential confounding variables such as as age, body mass index, smoking, physical activity, history of hypertension (HTN), and familial history of diabetes.

The study revealed that women with IH had lower SHBG and higher total testosterone compared to healthy controls (median [interquartile ratio; IQR]: 0.37 [0.16-0.70] vs. 0.33 [0.14-0.58]; P = 0.01), free androgen index (median [IQR]: 0.85 [0.38-1.54] vs. 0.54 [0.26-0.97]; P = 0.001), androstenedione (median [IQR]: 1.60 [1.00-2.25] vs. 1.10 [0.90-1.70]; P = 0.001), and dehydroepiandrosterone sulfate (median [IQR]: 168.5 [91.1-227.8] vs. 125.2 [66.3-181]; P = 0.001). When compared to women without IH, the mean changes in FBS, HDL-C, LDL-C, non-HDL-C, TG, SBP, DBP, and WC over time were not statistically different. According to the unadjusted Cox regression model, there was no statistically significant difference in the risk of metabolic disorders (i.e., HTN, pre-HTN, pre-T2DM, and metabolic syndrome) in IH, compared with healthy controls, with the exception of type 2 diabetes mellitus (T2DM) (HR [95% CI]: 1.45 [1.00-2.11]), P = 0.05). Additionally, there were no discernible variations in the hazard of these events in the adjusted Cox regression model.

Except for a marginally significant difference in T2DM, which vanished after further adjustment for potential confounders, the study showed no significant difference in the overtime mean changes of metabolic risk factors and cardiometabolic outcomes in women with IH, compared with the healthy control group. Therefore, it was not advised to evaluate women for metabolic outcomes routinely.