Hairloss Study Abstract: Evidence for a single gene effect causing polycystic ovaries and male pattern baldness
Title
Evidence for a single gene effect causing polycystic ovaries and male pattern baldness.
Author
Carey AH; Chan KL; Short F; White D; Williamson R; Franks S
Address
Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, Imperial
College of Science Technology and Medicine, London, UK.
Source
Clin Endocrinol (Oxf), 1993 Jun, 38:6, 653-8
Abstract
OBJECTIVE: Polycystic ovary syndrome is one of the most common endocrine disorders but
its aetiology remains unknown. It is highly prevalent within families, suggesting a
genetic basic for the syndrome, but the mode of inheritance is unclear. The purpose of
this study was to determine the mode of inheritance of polycystic ovary syndrome, within
the families of affected individuals, by classic segregation analysis. DESIGN: All first
degree relatives of affected individuals were screened for the presence or absence of
polycystic ovaries in post-menarchal-premenopausal women and early onset male pattern
baldness (MPB) in the males. In extended pedigrees, assignment of affected status in
post-menopausal women was made by consideration of the clinical history alone. PATIENTS:
Fourteen women (probands), presenting with a variety of clinical symptoms, were identified
sequentially as having polycystic ovaries (PCO) by ultrasound scan. They were examined in
detail to determine their family structure, clinical and endocrine status. Ten families
were found to have sufficient members for further study. MEASUREMENTS: All family members
had their body mass index calculated, their degree of hirsutism assessed using the
Ferriman and Gallwey score and serum levels of gonadotrophins (FSH and LH), testosterone,
prolactin and 17 alpha-hydroxyprogesterone measured by radioimmunoassay. A careful
reproductive history was taken for each woman and any menstrual disturbance was noted.
Obese probands had their glucose and insulin response to a standard 75-g oral glucose
tolerance test determined. Each male family member was also assessed for the degree and
time of onset of balding. RESULTS: First degree female relatives of affected individuals
had a 51% chance of being affected. Early onset male pattern baldness (MPB) was found to
be an accurate phenotype for obligate male carriers. Each family showed autosomal dominant
inheritance for PCO with greater than 90% penetrance. CONCLUSIONS: We postulate that PCO
and male pattern baldness are caused by alleles of the same gene which affect androgen
production or action. The different frequencies of PCO and male pattern baldness arise
from differing thresholds for phenotypic expression in females and males respectively. The
modifying effects of other genes is the most likely explanation of the somewhat variable
phenotype.