A 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% (R²= 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.