{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:17:28Z","timestamp":1788268648831,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To comprehensively reassess the clinical and metabolic significance of the luteinizing hormone (LH) to follicle\u2010stimulating hormone (FSH) ratio in women with polycystic ovary syndrome (PCOS), and to investigate whether it is associated with a clinical and hormonal pattern consistent with a possible neuroendocrine\u2010dominant subgroup, distinguishable from insulin\u2010related metabolic presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross\u2010sectional study included 316 women diagnosed with PCOS according to the Rotterdam criteria at a tertiary university hospital. Patients were categorised based on their LH:FSH ratio (using a cut\u2010off of 2) and their PCOS phenotypes (Phenotypes A, B, C, and D). Clinical, hormonal, and metabolic parameters, including anti\u2010M\u00fcllerian hormone (AMH) levels and ovarian volume, were compared across groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 316 patients, 18.35% had an LH:FSH ratio &gt;2. A strong positive correlation was found between LH:FSH ratio and AMH levels (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and a significant correlation was observed with ovarian volume (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and polycystic ovarian morphology (mean LH:FSH 1.59 vs. 1.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patients with phenotype D (OA\u2009+\u2009PCOM, non\u2010hyperandrogenic PCOS) exhibited the highest LH:FSH ratio (1.75\u2009\u00b1\u20090.87). Higher LH:FSH ratios were associated with oligo\/amenorrhea (1.59 vs. 1.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), anovulation (1.66 vs. 1.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and lower midluteal progesterone (\u03c1\u2009=\u2009\u22120.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), but not with serum androgens or Ferriman\u2010Gallwey scores. Weak positive correlations were observed with insulin levels (\u03c1\u2009=\u20090.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) and HOMA\u2010IR (\u03c1\u2009=\u20090.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), but no significant associations were found with BMI, glucose tolerance, or lipid profile.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high LH:FSH ratio is associated with a clinical and hormonal pattern\u2014including elevated AMH levels, prominent PCOM, and anovulation\u2014that may be consistent with a neuroendocrine\u2010dominant presentation of PCOS, rather than metabolic or androgenic disturbances. If confirmed by prospective studies, this association could inform more individualised therapeutic approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70179","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:15:38Z","timestamp":1784801738000},"page":"493-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reassessing the Luteinizing Hormone\/Follicle\u2010Stimulating Hormone Ratio in Polycystic Ovary Syndrome: Associations With a Possible Neuroendocrine and Anti\u2010M\u00fcllerian Hormone\u2010Related Phenotype"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8894-998X","authenticated-orcid":false,"given":"Mert","family":"Yesiladali","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecologist Yeditepe University, Faculty of Medicine, Reproductive Endocrinology Unit Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2327-9123","authenticated-orcid":false,"given":"Melis","family":"Yazici","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecologist Yeditepe University, Faculty of Medicine, Reproductive Endocrinology Unit Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-569X","authenticated-orcid":false,"given":"Zeynep Ece Utkan","family":"Korun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecologist Yeditepe University, Faculty of Medicine, Reproductive Endocrinology Unit Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukset","family":"Attar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecologist Yeditepe University, Faculty of Medicine, Reproductive Endocrinology Unit Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8459-2538","authenticated-orcid":false,"given":"Erkut","family":"Attar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecologist Yeditepe University, Faculty of Medicine, Reproductive Endocrinology Unit Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahrettin","family":"Kelestimur","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Yeditepe University, Faculty of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0253"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.05.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.5455\/medarh.2020.74.289-293"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3329\/taj.v35i1.61147"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1472-6483(10)60140-X"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/js.2019-00078"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"106","article-title":"Diagnosis and Treatment of Polycystic Ovary Syndrome","volume":"94","author":"Williams T.","year":"2016","journal-title":"American Family Physician"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.14740\/jem716"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygcen.2017.12.007"},{"issue":"1","key":"e_1_2_9_11_1","first-page":"131","article-title":"Incidence of Elevated LH\/FSH Ratio in Polycystic Ovary Syndrome Women With Normo\u2010and Hyperinsulinemia","volume":"48","author":"Banaszewska B.","year":"2003","journal-title":"Roczniki Akademii Medycznej w Bialymstoku (1995)"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1202"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa104"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-58064-0"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh098"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(81)90746-8"},{"key":"e_1_2_9_17_1","volume-title":"Hirsutism\u2014From Diagnosis to Use of Antiandrogens, in Polycystic Ovary Syndrome: Novel Insights into Causes and Therapy","author":"Unluhizarci K.","year":"2012"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.288.6410.7"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.04.019"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-015-0615-y"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-015-0494-2"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmw027"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms10055"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-020-03576-x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des460"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1582"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14704"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.09.005"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-01224-y"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.12.094"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199512000-00024"},{"key":"e_1_2_9_32_1","unstructured":"A. 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