{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:08:53Z","timestamp":1791994133995,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,8,2]],"date-time":"2018-08-02T00:00:00Z","timestamp":1533168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1022793"],"award-info":[{"award-number":["APP1022793"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Summary<\/jats:title>\n \n Objective<\/jats:title>\n \n Insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic low\u2010grade inflammation may act together in a vicious cycle in the pathophysiology of\n PCOS<\/jats:styled-content>\n . However, the inter\u2010relationships of these components are not fully understood. We aimed to study these mechanisms in the pathophysiology of\n PCOS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Participants and methods<\/jats:title>\n \n Premenopausal women with\n PCOS<\/jats:styled-content>\n (Rotterdam diagnostic criteria) and without\n PCOS<\/jats:styled-content>\n were recruited from a community setting into a cross\u2010sectional substudy within a randomized control trial. Insulin resistance (fasting insulin and glucose), hyperandrogenism (testosterone, sex hormone\u2010binding globulin [\n SHBG<\/jats:styled-content>\n ] and Free Androgen Index [\n FAI<\/jats:styled-content>\n ]), muscle sympathetic nerve activity (\n MSNA<\/jats:styled-content>\n ) and markers of chronic low\u2010grade inflammation (high sensitivity C\u2010reactive protein [hs\u2010\n CRP<\/jats:styled-content>\n ] and high molecular weight adiponectin [\n HMW<\/jats:styled-content>\n \u2010adiponectin]) were measured.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty\u2010nine women with\n PCOS<\/jats:styled-content>\n (mean age 30\u00a0\u00b1\u00a06 mean\n BMI<\/jats:styled-content>\n 29\u00a0\u00b1\u00a05) and 23 controls (mean age 29\u00a0\u00b1\u00a08 mean\n BMI<\/jats:styled-content>\n 33\u00a0\u00b1\u00a07) with included in this analysis.\n MSNA<\/jats:styled-content>\n and testosterone level were most significantly associated with\n PCOS<\/jats:styled-content>\n status, after adjustment for age and\n BMI<\/jats:styled-content>\n . In women with\n PCOS<\/jats:styled-content>\n , markers of sympathetic activity correlated inversely with\n HMW<\/jats:styled-content>\n \u2010adiponectin and\n HMW<\/jats:styled-content>\n \u2010adiponectin correlated inversely with\n FAI<\/jats:styled-content>\n . Testosterone and\n FAI<\/jats:styled-content>\n both correlated positively with insulin resistance in women\n PCOS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Sympathetic dysfunction and hyperandrogenism are significantly associated with\n PCOS<\/jats:styled-content>\n . Chronic low\u2010grade inflammation potentially mediates the effect of sympathetic dysfunction on hyperandrogenism and insulin resistance.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cen.13808","type":"journal-article","created":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T23:19:36Z","timestamp":1531264776000},"page":"628-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":156,"title":["Inter\u2010related effects of insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic inflammation in\n PCOS<\/scp>"],"prefix":"10.1111","volume":"89","author":[{"given":"Soulmaz","family":"Shorakae","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Diabetes and Vascular Medicine Unit Monash Health Melbourne Victoria 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