PDF(Pubmed)
Abstract：
Hyperandrogenism is a condition in which the levels of androgen hormones in the blood are significantly increased and could be of an adrenal or ovarian origin. The adrenal androgens, normally secreted by the zona reticularis, are steroid hormones with weak androgen activity. The causes of hyperandrogenism are diverse and could be endogenous and exogenous. Androgen excess affecting different tissues and organs results in clinical features such as acne, hirsutism, virilization, and reproductive dysfunction such as oligomenorrhoea/amenorrhoea. Although androgen excess is rarely associated with adrenal tumours, it is important as it could be predictive of malignancy. A careful evaluation of the androgen pattern, also in patients with clear signs of hyperandrogenism, could be useful. Laboratory evaluation should focus on measuring total testosterone levels, followed by the estimation of other androgens such as dehydroepiandrosterone and androstenedione, and using visualisation procedures in the further management. The treatment of adrenal hyperandrogenism is eminently surgical, in consideration of the frequent malignant origin. The aim of this review is to elaborate and summarize the prevalence and clinical management of hyperandrogenism of an adrenal origin by describing the physiological mechanisms of adrenal androgen steroidogenesis, the clinical manifestations of hyperandrogenism with a special reference to hyperandrogenism in adrenal adenomas and carcinomas, and the diagnostic methods that will lead us to establishing the correct diagnosis and different treatment options to manage this condition according to the clinical presentation of the patient.
摘要：
雄激素过多症是一种情况，其中血液中的雄激素激素水平显着增加，并且可能是肾上腺或卵巢起源。肾上腺雄激素,通常由网状带分泌，是具有弱雄激素活性的类固醇激素。高雄激素血症的原因是多种多样的，可能是内源性和外源性的。雄激素过量影响不同的组织和器官导致临床特征，如痤疮，多毛症,男性化,和生殖功能障碍，如少月症/闭经。尽管雄激素过量很少与肾上腺肿瘤相关，这很重要，因为它可以预测恶性肿瘤。仔细评估雄激素模式，也有明显的高雄激素血症症状的患者，可能是有用的。实验室评估应侧重于测量总睾酮水平，其次是其他雄激素的估计，如脱氢表雄酮和雄烯二酮，并在进一步的管理中使用可视化程序。肾上腺高雄激素血症的治疗主要是手术治疗，考虑到频繁的恶性起源。这篇综述的目的是通过描述肾上腺雄激素类固醇生成的生理机制来阐述和总结肾上腺起源的高雄激素血症的患病率和临床管理。高雄激素血症的临床表现，特别是肾上腺腺瘤和癌中的高雄激素血症，以及将导致我们根据患者的临床表现建立正确的诊断和不同的治疗方案来管理这种情况的诊断方法。
