{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T19:24:43Z","timestamp":1750533883499,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100853"],"award-info":[{"award-number":["82100853"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Natural Science Foundation of Shandong Province of China","award":["ZR2021QH028"],"award-info":[{"award-number":["ZR2021QH028"]}]},{"name":"Clinical Research Project of Shandong University","award":["2020SDUCRCC024"],"award-info":[{"award-number":["2020SDUCRCC024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>STUDY QUESTION<\/jats:title>\n                  <jats:p>Does the concurrent type 2 diabetes mellitus (T2DM) aggravate the features and prognosis of PCOS in patients undergoing sleeve gastrectomy (SG)?<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>SUMMARY ANSWER<\/jats:title>\n                  <jats:p>For patients undergoing SG with obesity, concurrent T2DM is associated with aggravated metabolic but milder reproductive features of PCOS and did not attenuate the resumption of regular menstruation for up to 1\u2009year after surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                  <jats:p>Women with T2DM have an increased risk of PCOS. However, whether concurrent T2DM further increases the disease burden and treatment difficulty of PCOS in patients with obesity requires further investigation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                  <jats:p>This was a single-center, two-arm, prospective, cohort study enrolling a total of 329 women with PCOS and scheduled for SG because of obesity at an university-affiliated hospital between January 2020 and August 2023, with a 1-year follow-up after surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                  <jats:p>Comparisons were made between patients with T2DM (PCOS+T2DM) and without (PCOS) to examine the impact of T2DM on the metabolic, reproductive, and psychological features of PCOS. The follow-up data of weight loss and menstruation were analyzed to determine the impact of T2DM on PCOS prognosis for up to 1\u2009year after SG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                  <jats:p>After controlling for confounders, patients in the PCOS+T2DM group (n\u2009=\u200998) showed more severe insulin resistance, glucose intolerance, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD) (NAFLD activity score 4.31\u2009\u00b1\u20091.15 versus 3.52\u2009\u00b1\u20091.42, P\u2009&amp;lt;\u20090.001) than those in the PCOS group (n\u2009=\u2009149). In addition, the PCOS+T2DM group had a lower level of total testosterone (1.63\u2009\u00b1\u20090.69 versus 1.82\u2009\u00b1\u20090.76, P\u2009=\u20090.045), a lower ratio between luteinizing hormone and follicle-stimulating hormone (median 1.48 versus 1.68, P\u2009=\u20090.030), and a lower proportion of patients with polycystic ovarian morphology (88% versus 96%, P\u2009=\u20090.022) than the PCOS group. As a result, the two groups differed significantly in terms of the Rotterdam classification of PCOS (P\u2009=\u20090.009). No significant difference was detected by group in the psychological features of PCOS except a lower degree of emotional eating in the PCOS+T2DM group (P\u2009=\u20090.001). Although the PCOS+T2DM group took longer to resume regular menstruation after SG (P\u2009=\u20090.037), the two groups had similar proportions of patients with regular menstruation (85% versus 87%, P\u2009=\u20090.758) 1\u2009year after SG, which was further confirmed by subgroup analyses by body mass index.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                  <jats:p>The prognosis of PCOS after SG mainly focused on the results of menstruation rather than a complete evaluation of the remission of the disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                  <jats:p>Our study showed that, for patients with obesity, concurrent T2DM is associated with aggravated metabolic but milder reproductive features of PCOS and did not attenuate the resumption of regular menstruation for up to 1\u2009year after surgery. Our study also highlights the need for high-quality studies with a more comprehensive evaluation of the impact of T2DM on the prognosis of patients with PCOS after SG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n                  <jats:p>This study was funded by the National Natural Science Foundation of China Grants (82100853), the Natural Science Foundation of Shandong Province of China (ZR2021QH028), and the Clinical Research Project of Shandong University (2020SDUCRCC024). The authors have no conflicts of interest.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>TRIAL REGISTRATION<\/jats:title>\n                  <jats:p>Chinese Clinical Trial Registry with No. ChiCTR1900026845.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/humrep\/deae159","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T20:36:35Z","timestamp":1721075795000},"page":"2079-2088","source":"Crossref","is-referenced-by-count":1,"title":["The impact of type 2 diabetes on polycystic ovary syndrome in patients undergoing sleeve gastrectomy"],"prefix":"10.1093","volume":"39","author":[{"given":"Tao","family":"Zhu","sequence":"first","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"The First Clinical College, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"The First Clinical College, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaocheng","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China"},{"name":"Shandong Key Laboratory of Oral Tissue Regeneration , Jinan, Shandong, China"},{"name":"Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration , Jinan, Shandong, China"},{"name":"Shandong Provincial Clinical Research Center for Oral Diseases , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peikai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"The First Clinical College, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"State Key University Laboratory of Diabetes and Obesity Surgery, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxuan","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"The First Clinical College, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shumin","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University , Jinan, Shandong, China"},{"name":"Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7407-9220","authenticated-orcid":false,"given":"Shigang","family":"Zhao","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2052-0516","authenticated-orcid":false,"given":"Shaozhuang","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"State Key University Laboratory of Diabetes and Obesity Surgery, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-4751","authenticated-orcid":false,"given":"Xin","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Bariatric and Metabolic Surgery, Department of General Surgery, Qilu Hospital of Shandong University , Jinan, Shandong, China"},{"name":"State Key University Laboratory of Diabetes and Obesity Surgery, Shandong University , Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"2024090414362897500_deae159-B1","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.fertnstert.2006.12.055","article-title":"Role of insulin in the hyperandrogenemia of lean women with polycystic ovary syndrome and normal insulin sensitivity","volume":"88","author":"Baillargeon","year":"2007","journal-title":"Fertil Steril"},{"key":"2024090414362897500_deae159-B2","doi-asserted-by":"crossref","first-page":"4226","DOI":"10.3390\/nu15194226","article-title":"Exploring the interrelationships between diabetes, nutrition, anxiety, and depression: implications for treatment and prevention strategies","volume":"15","author":"Basiri","year":"2023","journal-title":"Nutrients"},{"key":"2024090414362897500_deae159-B3","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1111\/cen.14900","article-title":"Self-reported sleep quality and exercise in polycystic ovary syndrome: a secondary analysis of a pilot randomized controlled trial","volume":"98","author":"Benham","year":"2023","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2024090414362897500_deae159-B4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1136\/bmj.305.6846.160","article-title":"Validating the SF-36 Health Survey Questionnaire: new outcome measure for primary care","volume":"305","author":"Brazier","year":"1992","journal-title":"BMJ"},{"key":"2024090414362897500_deae159-B5","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"2024090414362897500_deae159-B6","doi-asserted-by":"crossref","first-page":"594949","DOI":"10.3389\/fpsyg.2020.594949","article-title":"Validation of the weight bias internalization scale for Mainland Chinese children and adolescents","volume":"11","author":"Chen","year":"2020","journal-title":"Front Psychol"},{"key":"2024090414362897500_deae159-B7","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/humrep\/dex044","article-title":"High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis","volume":"32","author":"Cooney","year":"2017","journal-title":"Hum Reprod"},{"key":"2024090414362897500_deae159-B8","doi-asserted-by":"crossref","first-page":"e1003132","DOI":"10.1371\/journal.pmed.1003132","article-title":"Distinct subtypes of polycystic ovary syndrome with novel genetic associations: An unsupervised, phenotypic clustering analysis","volume":"17","author":"Dapas","year":"2020","journal-title":"PLoS Med"},{"key":"2024090414362897500_deae159-B9","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/nrendo.2018.24","article-title":"Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment","volume":"14","author":"Escobar-Morreale","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"2024090414362897500_deae159-B10","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.fertnstert.2020.12.015","article-title":"Menstrual dysfunction in polycystic ovary syndrome: association with dynamic state insulin resistance rather than hyperandrogenism","volume":"115","author":"Ezeh","year":"2021","journal-title":"Fertil Steril"},{"key":"2024090414362897500_deae159-B11","doi-asserted-by":"crossref","first-page":"4595","DOI":"10.1210\/jc.2015-2546","article-title":"Endogenous androgens and sex hormone-binding globulin in women and risk of metabolic syndrome and type 2 diabetes","volume":"100","author":"Fenske","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"2024090414362897500_deae159-B12","doi-asserted-by":"crossref","first-page":"e3217","DOI":"10.1210\/clinem\/dgac294","article-title":"Efficacy of bariatric surgery in the treatment of women with obesity and polycystic ovary syndrome","volume":"107","author":"Hu","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2024090414362897500_deae159-B13","doi-asserted-by":"crossref","first-page":"572","DOI":"10.2337\/db22-1048","article-title":"\u03b2-cell function and insulin dynamics in obese patients with and without diabetes after sleeve gastrectomy","volume":"73","author":"Huang","year":"2024","journal-title":"Diabetes"},{"year":"2022","author":"International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)","key":"2024090414362897500_deae159-B14"},{"key":"2024090414362897500_deae159-B15","doi-asserted-by":"crossref","first-page":"1238090","DOI":"10.3389\/fendo.2023.1238090","article-title":"New evidence for the effect of type 2 diabetes and glycemic traits on testosterone levels: a two-sample Mendelian randomization study","volume":"14","author":"Jiang","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2024090414362897500_deae159-B16","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/S2213-8587(22)00163-2","article-title":"Polycystic ovary syndrome","volume":"10","author":"Joham","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2024090414362897500_deae159-B17","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/humupd\/dmy007","article-title":"Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression","volume":"24","author":"Kakoly","year":"2018","journal-title":"Hum Reprod Update"},{"key":"2024090414362897500_deae159-B18","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1210\/jc.2018-00132","article-title":"Menstrual dysfunction in girls from the treatment options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study","volume":"103","author":"Kelsey","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2024090414362897500_deae159-B19","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/hep.20701","article-title":"Design and validation of a histological scoring system for nonalcoholic fatty liver disease","volume":"41","author":"Kleiner","year":"2005","journal-title":"Hepatology"},{"key":"2024090414362897500_deae159-B20","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.psychres.2018.08.083","article-title":"Disordered eating behaviors as a potential obesogenic factor in schizophrenia","volume":"269","author":"Kouidrat","year":"2018","journal-title":"Psychiatry Res"},{"key":"2024090414362897500_deae159-B21","doi-asserted-by":"crossref","first-page":"e1002542","DOI":"10.1371\/journal.pmed.1002542","article-title":"Polycystic ovary syndrome, androgen excess, and the risk of nonalcoholic fatty liver disease in women: a longitudinal study based on a United Kingdom primary care database","volume":"15","author":"Kumarendran","year":"2018","journal-title":"PLoS Med"},{"key":"2024090414362897500_deae159-B22","doi-asserted-by":"crossref","first-page":"649","DOI":"10.3390\/healthcare10040649","article-title":"The association between menstrual irregularities and the risk of diabetes in premenopausal and postmenopausal women: a cross-sectional study of a nationally representative sample","volume":"10","author":"Kwan","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"2024090414362897500_deae159-B23","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/S0140-6736(17)33102-1","article-title":"Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial","volume":"391","author":"Lean","year":"2018","journal-title":"Lancet"},{"key":"2024090414362897500_deae159-B24","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4239\/wjd.v13.i1.5","article-title":"Polycystic ovary syndrome and type 2 diabetes mellitus: a state-of-the-art review","volume":"13","author":"Livadas","year":"2022","journal-title":"World J Diabetes"},{"key":"2024090414362897500_deae159-B25","doi-asserted-by":"crossref","first-page":"980405","DOI":"10.3389\/fendo.2022.980405","article-title":"Prevalence of polycystic ovary syndrome in patients with type 2 diabetes: a systematic review and meta-analysis","volume":"13","author":"Long","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"volume-title":"IDF Diabetes Atlas [Internet]","year":"2021","author":"Magliano","key":"2024090414362897500_deae159-B26"},{"key":"2024090414362897500_deae159-B27","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0140-6736(20)32649-0","article-title":"Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial","volume":"397","author":"Mingrone","year":"2021","journal-title":"Lancet"},{"key":"2024090414362897500_deae159-B28","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12902-022-00980-1","article-title":"Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss","volume":"22","author":"Pouwels","year":"2022","journal-title":"BMC Endocr Disord"},{"key":"2024090414362897500_deae159-B29","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.fertnstert.2003.10.004","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome","volume":"81","author":"Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group","year":"2004","journal-title":"Fertil Steril"},{"key":"2024090414362897500_deae159-B30","doi-asserted-by":"crossref","first-page":"1333051","DOI":"10.3389\/fendo.2023.1333051","article-title":"Sex dimorphism in the effect and predictors of weight loss after sleeve gastrectomy","volume":"14","author":"Shu","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2024090414362897500_deae159-B31","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/S0015-0282(16)57979-5","article-title":"Ovarian volume: a novel outcome predictor for assisted reproduction","volume":"64","author":"Syrop","year":"1995","journal-title":"Fertil Steril"},{"key":"2024090414362897500_deae159-B32","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1016\/j.cgh.2022.03.044","article-title":"Development and validation of a score for fibrotic nonalcoholic steatohepatitis","volume":"21","author":"Tavaglione","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2024090414362897500_deae159-B33","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"108","author":"Teede","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2024090414362897500_deae159-B34","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/cen.14153","article-title":"Eating, sleeping and sexual function disorders in women with polycystic ovary syndrome (PCOS): a systematic review and meta-analysis","volume":"92","author":"Thannickal","year":"2020","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2024090414362897500_deae159-B35","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/j.soard.2021.04.009","article-title":"Effects of bariatric surgery on patients with obesity and polycystic ovary syndrome: a meta-analysis","volume":"17","author":"Tian","year":"2021","journal-title":"Surg Obes Relat Dis"},{"key":"2024090414362897500_deae159-B36","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/nrgastro.2016.147","article-title":"NAFLD and diabetes mellitus","volume":"14","author":"Tilg","year":"2017","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2024090414362897500_deae159-B37","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0303-7207(98)00171-3","article-title":"Developmental and endocrine aspects of normal ovarian aging","volume":"145","author":"Velde","year":"1998","journal-title":"Mol Cell Endocrinol"},{"key":"2024090414362897500_deae159-B38","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.2337\/dc10-2339","article-title":"Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes","volume":"34","author":"Wang","year":"2011","journal-title":"Diabetes Care"},{"key":"2024090414362897500_deae159-B39","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12933-022-01531-7","article-title":"Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China","volume":"21","author":"Yang","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"2024090414362897500_deae159-B40","doi-asserted-by":"crossref","first-page":"848947","DOI":"10.3389\/fendo.2022.848947","article-title":"Metabolic surgery on patients with polycystic ovary syndrome: a systematic review and meta-analysis","volume":"13","author":"Yue","year":"2022","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/39\/9\/2079\/59018353\/deae159.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/39\/9\/2079\/59018353\/deae159.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T08:37:44Z","timestamp":1725525464000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/39\/9\/2079\/7713889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":40,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,7,15]]},"published-print":{"date-parts":[[2024,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deae159","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"type":"print","value":"0268-1161"},{"type":"electronic","value":"1460-2350"}],"subject":[],"published-other":{"date-parts":[[2024,9]]},"published":{"date-parts":[[2024,7,15]]}}}