{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:18:43Z","timestamp":1791944323366,"version":"4.3.4"},"reference-count":42,"publisher":"The Endocrine Society","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Context: The diagnosis of the polycystic ovary syndrome requires the exclusion of nonclassical congenital adrenal hyperplasia (NCAH).<\/jats:p>\n               <jats:p>Objective: Our objective was to evaluate the actual prevalences of 21-hydroxylase and 11\u03b2-hydroxylase deficiencies among women presenting with hyperandrogenic complaints.<\/jats:p>\n               <jats:p>Settings: This study was performed at an academic hospital.<\/jats:p>\n               <jats:p>Patients: A total of 270 consecutive unselected women presenting with hyperandrogenic symptoms were prospectively recruited.<\/jats:p>\n               <jats:p>Interventions: Basal and ACTH-stimulated 11-deoxycortisol and 17-hydroxyprogesterone concentrations were measured.<\/jats:p>\n               <jats:p>Main Outcome Measures: The prevalences of 21-hydroxylase and 11\u03b2-hydroxylase deficiencies were calculated, and the diagnostic performance of basal serum 17-hydroxyprogesterone levels for the screening of NCAH was evaluated by receiver operating characteristic curve analysis.<\/jats:p>\n               <jats:p>Results: Six of the 270 patients had 21-hydroxylase-deficient NCAH that was confirmed by CYP21 genotyping, whereas no patient was diagnosed with 11\u03b2-hydroxylase deficiency, for an overall NCAH prevalence of 2.2% (95% confidence limits 0.5\u20133.9%). According to receiver operating characteristic analysis, a single basal serum 17-hydroxyprogesterone determination has a 0.97 (95% confidence interval: 0.934\u20131.008) chance of detecting NCAH in hyperandrogenic women. In our experience, the most appropriate cutoff value for the detection of NCAH is a 17-hydroxyprogesterone above 1.7 ng\/ml, showing a 100% sensitivity and a 88.6% specificity. Five of the six 21-hydroxylase-deficient NCAH patients carried a severe CYP21 allele requiring genetic counseling and highlighting the importance of excluding this disorder among hyperandrogenic patients.<\/jats:p>\n               <jats:p>Conclusions: The prevalence of NCAH among hyperandrogenic patients from Spain is 2.2%. Basal serum 17-hydroxyprogesterone measurements have an excellent diagnostic performance, yet the cutoff value should be established in each laboratory to avoid false-negative results.<\/jats:p>","DOI":"10.1210\/jc.2007-2053","type":"journal-article","created":{"date-parts":[[2007,11,14]],"date-time":"2007-11-14T02:05:31Z","timestamp":1195005931000},"page":"527-533","source":"Crossref","is-referenced-by-count":143,"title":["A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia among Women Presenting with Hyperandrogenic Symptoms and Signs"],"prefix":"10.1210","volume":"93","author":[{"given":"He\u0301ctor F.","family":"Escobar-Morreale","sequence":"first","affiliation":[{"name":"Departments of Endocrinology (H.F.E.-M., R.S.), Hospital Universitario Ramo\u0301n y Cajal & Universidad de Alcala\u0301, E-28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Sancho\u0301n","sequence":"first","affiliation":[{"name":"Departments of Endocrinology (H.F.E.-M., R.S.), Hospital Universitario Ramo\u0301n y Cajal & Universidad de Alcala\u0301, E-28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose\u0301 L.","family":"San Milla\u0301n","sequence":"first","affiliation":[{"name":"Departments of Molecular Genetics (J.L.S.M.), Hospital Universitario Ramo\u0301n y Cajal & Universidad de Alcala\u0301, E-28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071613162409000_R1","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1210\/jcem.84.6.5803","article-title":"Polycystic ovary syndrome (PCOS): arguably the most common endocrinopathy is associated with significant morbidity in women.","volume":"84","author":"Carmina","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071613162409000_R2","first-page":"2434","article-title":"A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain.","volume":"85","author":"Asuncio\u0301n","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"Suppl 1","key":"2020071613162409000_R3","first-page":"25","article-title":"Prevalence, definition and clinical manifestations of polycystic ovary syndrome","volume":"53","author":"Diamanti-Kandarakis","year":"2006","journal-title":"Endocrinol Nutr"},{"key":"2020071613162409000_R4","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1056\/NEJMra041536","article-title":"Polycystic ovary syndrome.","volume":"352","author":"Ehrmann","year":"2005","journal-title":"N Engl J Med"},{"key":"2020071613162409000_R5","first-page":"377","article-title":"Diagnostic criteria for polycystic ovary syndrome: towards a rational approach","author":"Zawadzki","year":"1992","journal-title":"In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, eds. 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