{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:42:30Z","timestamp":1790664150939,"version":"4.1.0"},"reference-count":71,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sleep problems like obstructive sleep apnea (OSA) are common in polycystic ovary syndrome (PCOS), although the underlying mechanisms are not well understood. We aimed to determine the prevalence of sleep problems, synthesise and appraise studies analysing the associations between serum sex hormones, sex hormone\u2010binding globulin (SHBG) and sleep problems in females with PCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search using MEDLINE, Embase, PsycInfo, CINAHL, Scopus, and Google Scholar was performed till 3 August 2024. Studies that examined serum sex hormones, SHBG or hyperandrogenism with sleep disorders and\/or sleep disturbances in PCOS were eligible. Random effects meta\u2010analyses of sex hormones and SHBG among females with PCOS with compared to without OSA were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 4487 screened studies, 24 were included, with nine suitable for meta\u2010analyses. Among females with PCOS, 46.0% had OSA and 56.0% had other sleep disturbances. SHBG levels were significantly lower in women with PCOS and OSA compared to those without OSA (standardised mean difference\u2009=\u2009\u22120.62; 95% CI\u2009=\u2009\u22120.82 to \u22120.42;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%; 179 participants;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001), but no differences were seen in total and free testosterone, dehydroepiandrosterone sulfate, androstenedione, and oestradiol. No significant associations between serum sex hormones, SHBG or hyperandrogenism with sleep disturbances in PCOS were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SHBG, rather than hyperandrogenism, may play a more important mechanistic role for OSA in PCOS, while other sleep disturbances exhibit a less severe SHBG profile. These findings enhance comprehension of underlying pathophysiology of sleep problems in PCOS. Further validation across PCOS populations is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.15219","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:53:49Z","timestamp":1741719229000},"page":"708-720","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Sex Hormones, Sex Hormone\u2010Binding Globulin and Sleep Problems in Females With Polycystic Ovary Syndrome: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1139-1086","authenticated-orcid":false,"given":"Nur K. Abdul","family":"Jafar","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences Monash University Clayton Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Fan","sequence":"additional","affiliation":[{"name":"Monash Lung and Sleep, Monash Health, Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J.","family":"Moran","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences Monash University Clayton Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren R.","family":"Mansfield","sequence":"additional","affiliation":[{"name":"Monash Lung and Sleep, Monash Health, Clayton Victoria Australia"},{"name":"Faculty of Medicine, Nursing and Health Sciences, School of Psychological Sciences Monash University, Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-2661","authenticated-orcid":false,"given":"Christie J.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Notting Hill Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew218"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.18502\/ijrm.v17i8.4818"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12762"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms030"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmy007"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.03.027"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh098"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvad096"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-41"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v13.i3.129"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2011-1034"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijt.ijt_93_16"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S344542"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(81)90746-8"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2015.06.005"},{"key":"e_1_2_9_17_1","first-page":"1004","article-title":"Sex Hormone Binding Globulin, but Not Testosterone, Is Associated With the Metabolic Syndrome in Overweight and Obese Women With Polycystic Ovary Syndrome","volume":"36","author":"Moran L. J.","year":"2013","journal-title":"Journal of Endocrinological Investigation"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21218191"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2019.09.010"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/19396368.2017.1410591"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1777724"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01178.2006"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.2.8306057"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2109080"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1530\/EC-17-0129"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsy085"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-019-01835-1"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23147983"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2024.06.017"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018820906689"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1084"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.04.027"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det013"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.18585\/inabj.v10i1.324"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.65.3.375"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-02385"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.4274\/haseki.galenos.2021.6584"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.4274\/jtsm.galenos.2021.85057"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.17517\/ksutfd.894115"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-022-00889-3"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114521002361"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1418933"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"issue":"3","key":"e_1_2_9_44_1","first-page":"163","article-title":"Conducting Systematic Reviews of Association (Etiology): The Joanna Briggs Institute's Approach","volume":"13","author":"Moola S.","year":"2015","journal-title":"JBI Evidence Implementation"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138237"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.3.1175"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.2.517"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0925"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.02.004"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2010.00902.x"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.12.024"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.06.023"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2016.02.014"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9372"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-021-02376-2"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.11012"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10780"},{"key":"e_1_2_9_58_1","unstructured":"National Heart Lung and Blood Institute. Study quality assessment tools. In: Health Topics. 2020. August 9 2024 https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools."},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.07.002"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP12366.OR"},{"key":"e_1_2_9_61_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.5. Cochrane","author":"Deeks J. J.","year":"2024"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2023.100226"},{"key":"e_1_2_9_63_1","volume-title":"Statistical Power Analysis in the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_9_64_1","volume-title":"Stata Statistical Software: Release 18","author":"StataCorp","year":"2023"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/0470870168"},{"key":"e_1_2_9_67_1","volume-title":"Methods Guide for Effectiveness and Comparative Effectiveness Reviews","author":"Viswanathan M.","year":"2017"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/25.5.497"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i34.424.3"},{"key":"e_1_2_9_70_1","first-page":"1","article-title":"Association of Sex Hormone\u2010Binding Globulin With Non\u2010Alcoholic Fatty Liver Disease in Chinese Adults","volume":"15","author":"Luo J.","year":"2018","journal-title":"Nutri & Metabol"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13922"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/1479164117714397"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.15219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:31:45Z","timestamp":1746174705000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.15219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":71,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/cen.15219"],"URL":"https:\/\/doi.org\/10.1111\/cen.15219","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,25]]},"assertion":[{"value":"2024-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}