{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:55:30Z","timestamp":1789761330263,"version":"4.0.1"},"reference-count":51,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T00:00:00Z","timestamp":1626480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007557","name":"California Institute of Regenerative Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007557","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["1 R01 CA228399-02A1"],"award-info":[{"award-number":["1 R01 CA228399-02A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["1 R21 AG070721-01A1"],"award-info":[{"award-number":["1 R21 AG070721-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The biochemical basis for clinical variability in primary hyperparathyroidism (PHPT) is poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to define parathyroid tumor biochemical properties associated with calcium-sensing failure in PHPT patients, and to relate differences in these profiles to variations in clinical presentation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Preoperative clinical data from a sequential series of 39 patients undergoing surgery for PHPT at an endocrine surgery referral center in a large, public university hospital were evaluated for correlation to parathyroid tumor biochemical behavior. An intact tissue, ex vivo interrogative assay was employed to evaluate the calcium-sensing capacity of parathyroid adenomas relative to normal donor glands. Tumors were functionally classified based on calcium dose-response curve profiles, and clinical parameters were compared among the respective classes. Changes in the relative expression of 3 key components in the calcium\/parathyroid hormone (PTH) signaling axis\u2014CASR, RGS5, and RCAN1\u2014were evaluated as potential mechanisms for calcium-sensing failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Parathyroid adenomas grouped into 3 distinct functional classes. Tumors with diminished calcium sensitivity were the most common (18 of 39) and were strongly associated with reduced bone mineral density (P = 0.0009). Tumors with no calcium-sensing deficit (11 of 39) were associated with higher preoperative PTH (P = 0.036). A third group (6\/39) displayed a nonsigmoid calcium\/PTH response curve; 4 of these 6 tumors expressed elevated RCAN1.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Calcium-sensing capacity varies among parathyroid tumors but downregulation of the calcium-sensing receptor (CASR) is not an obligate underlying mechanism. Differences in tumor calcium responsiveness may contribute to variations in PHPT clinical presentation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab524","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T11:19:20Z","timestamp":1626520760000},"page":"3168-3183","source":"Crossref","is-referenced-by-count":7,"title":["<i>Ex Vivo<\/i> Intact Tissue Analysis Reveals Alternative Calcium-sensing Behaviors in Parathyroid Adenomas"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-8606","authenticated-orcid":false,"given":"James","family":"Koh","sequence":"first","affiliation":[{"name":"Endocrine Neoplasia Laboratory, Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"},{"name":"Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4876-810X","authenticated-orcid":false,"given":"Run","family":"Zhang","sequence":"additional","affiliation":[{"name":"Endocrine Neoplasia Laboratory, Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6911-2508","authenticated-orcid":false,"given":"Sanziana","family":"Roman","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7947-4393","authenticated-orcid":false,"given":"Quan-Yang","family":"Duh","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-5418","authenticated-orcid":false,"given":"Jessica","family":"Gosnell","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7531-1450","authenticated-orcid":false,"given":"Wen","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6911-2324","authenticated-orcid":false,"given":"Insoo","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Surgery, NYU Langone Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3356-7316","authenticated-orcid":false,"given":"Julie A","family":"Sosa","sequence":"additional","affiliation":[{"name":"Endocrine Neoplasia Laboratory, Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"},{"name":"Department of Surgery, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2021,7,17]]},"reference":[{"issue":"10","key":"2021120108544212100_CIT0001","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/jclinpath-2015-203186","article-title":"Clinicopathological correlates of hyperparathyroidism","volume":"68","author":"Duan","year":"2015","journal-title":"J Clin Pathol."},{"issue":"11","key":"2021120108544212100_CIT0002","doi-asserted-by":"crossref","first-page":"3993","DOI":"10.1210\/jc.2018-01225","article-title":"Primary hyperparathyroidism","volume":"103","author":"Bilezikian","year":"2018","journal-title":"J Clin Endocrinol Metab."},{"key":"2021120108544212100_CIT0003","first-page":"139","article-title":"Clinical detection and treatment of parathyroid diseases. In: Hunt J, eds. Molecular Pathology of Endocrine Diseases. Molecular Pathology Library. Vol 3. Springer;","author":"Stang","year":"2010"},{"issue":"8","key":"2021120108544212100_CIT0004","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.5858\/2008-132-1251-PHACP","article-title":"Primary hyperparathyroidism: a current perspective","volume":"132","author":"DeLellis","year":"2008","journal-title":"Arch Pathol Lab Med."},{"issue":"9","key":"2021120108544212100_CIT0005","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1111\/jgs.12968","article-title":"Surgical management of primary hyperparathyroidism in older adults","volume":"62","author":"Denizot","year":"2014","journal-title":"J Am Geriatr Soc."},{"issue":"1","key":"2021120108544212100_CIT0006","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s41574-018-0115-0","article-title":"The calcium-sensing receptor in physiology and in calcitropic and noncalcitropic diseases","volume":"15","author":"Hannan","year":"2018","journal-title":"Nat Rev Endocrinol."},{"issue":"1-2","key":"2021120108544212100_CIT0007","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.mce.2013.09.005","article-title":"Genetic and epigenetic changes in sporadic endocrine tumors: parathyroid tumors","volume":"386","author":"Costa-Guda","year":"2014","journal-title":"Mol Cell Endocrinol."},{"key":"2021120108544212100_CIT0008","doi-asserted-by":"crossref","first-page":"563","DOI":"10.3389\/fphys.2016.00563","article-title":"The calcium-sensing receptor and the parathyroid: past, present, future","volume":"7","author":"Conigrave","year":"2016","journal-title":"Front Physiol."},{"issue":"4","key":"2021120108544212100_CIT0009","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1530\/ERC-17-0470","article-title":"Transcriptional profiling reveals distinct classes of parathyroid tumors in PHPT","volume":"25","author":"Koh","year":"2018","journal-title":"Endocr Relat Cancer."},{"issue":"2","key":"2021120108544212100_CIT0010","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/jcmm.12732","article-title":"Single-cell functional analysis of parathyroid adenomas reveals distinct classes of calcium sensing behaviour in primary hyperparathyroidism","volume":"20","author":"Koh","year":"2016","journal-title":"J Cell Mol Med."},{"issue":"8","key":"2021120108544212100_CIT0011","doi-asserted-by":"crossref","first-page":"3092","DOI":"10.1073\/pnas.1319742111","article-title":"Functional and genetic studies of isolated cells from parathyroid tumors reveal the complex pathogenesis of parathyroid neoplasia","volume":"111","author":"Shi","year":"2014","journal-title":"Proc Natl Acad Sci U S A."},{"issue":"3","key":"2021120108544212100_CIT0012","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.beem.2013.05.010","article-title":"Calcium-sensing receptor (CaSR): pharmacological properties and signaling pathways","volume":"27","author":"Conigrave","year":"2013","journal-title":"Best Pract Res Clin Endocrinol Metab."},{"issue":"1","key":"2021120108544212100_CIT0013","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1210\/jc.2004-0842","article-title":"Cinacalcet hydrochloride maintains long-term normocalcemia in patients with primary hyperparathyroidism","volume":"90","author":"Peacock","year":"2005","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2021120108544212100_CIT0014","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1002\/jbmr.3674","article-title":"Parathyroid-targeted overexpression of regulator of G-protein signaling 5 (RGS5) causes hyperparathyroidism in transgenic mice","volume":"34","author":"Balenga","year":"2019","journal-title":"J Bone Miner Res."},{"issue":"5","key":"2021120108544212100_CIT0015","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1210\/me.2010-0277","article-title":"Regulator of G-protein signaling 5 is highly expressed in parathyroid tumors and inhibits signaling by the calcium-sensing receptor","volume":"25","author":"Koh","year":"2011","journal-title":"Molecular Endo."},{"issue":"12","key":"2021120108544212100_CIT0016","doi-asserted-by":"crossref","first-page":"e1003975","DOI":"10.1371\/journal.pgen.1003975","article-title":"Parathyroid-specific deletion of Klotho unravels a novel calcineurin-dependent FGF23 signaling pathway that regulates PTH secretion","volume":"9","author":"Olauson","year":"2013","journal-title":"PLoS Genet."},{"issue":"8","key":"2021120108544212100_CIT0017","doi-asserted-by":"crossref","first-page":"E1499","DOI":"10.1210\/jc.2011-3366","article-title":"Differential gene expression by oxyphil and chief cells of human parathyroid glands","volume":"97","author":"Ritter","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"key":"2021120108544212100_CIT0018","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.metabol.2017.06.004","article-title":"Impaired calcium sensing distinguishes primary hyperparathyroidism (PHPT) patients with low bone mineral density","volume":"74","author":"Weber","year":"2017","journal-title":"Metabolism."},{"issue":"2","key":"2021120108544212100_CIT0019","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00007890-199002000-00004","article-title":"Important components of the UW solution","volume":"49","author":"Southard","year":"1990","journal-title":"Transplantation."},{"key":"2021120108544212100_CIT0020","doi-asserted-by":"crossref","DOI":"10.1210\/jendso\/bvaa046.526","article-title":"A Novel Ex Vivo Live-Cell Interrogative Assay of Human Parathyroid Tissue Reveals Distinct Mechanisms of Calcium Sensing Failure in Primary, Secondary, and Tertiary Hyperparathyroidism","volume":"4","author":"Zhang","year":"2020","journal-title":"J Endocr Soc."},{"issue":"3","key":"2021120108544212100_CIT0021","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1038\/s42255-020-0175-z","article-title":"PTH hypersecretion triggered by a GABAB1 and Ca2+-sensing receptor heterocomplex in hyperparathyroidism","volume":"2","author":"Chang","year":"2020","journal-title":"Nat Metab."},{"issue":"3","key":"2021120108544212100_CIT0022","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/j.1365-2818.1993.tb03313.x","article-title":"Measurement of co-localization of objects in dual-colour confocal images","volume":"169","author":"Manders","year":"1993","journal-title":"J Microsc."},{"issue":"18","key":"2021120108544212100_CIT0023","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1001\/jama.294.18.2336","article-title":"Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake","volume":"294","author":"Steingrimsdottir","year":"2005","journal-title":"JAMA."},{"key":"2021120108544212100_CIT0024","article-title":"Supplemental Figures: calcium response behaviors and biomarker expression in human parathyroid tumors","volume-title":"Dryad","author":"Koh"},{"issue":"5","key":"2021120108544212100_CIT0025","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.beem.2018.09.004","article-title":"Primary hyperparathyroidism","volume":"32","author":"Silva","year":"2018","journal-title":"Best Pract Res Clin Endocrinol Metab."},{"issue":"3","key":"2021120108544212100_CIT0026","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.beem.2013.02.006","article-title":"Role of the calcium-sensing receptor in extracellular calcium homeostasis","volume":"27","author":"Brown","year":"2013","journal-title":"Best Pract Res Clin Endocrinol Metab."},{"issue":"3","key":"2021120108544212100_CIT0027","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1210\/jcem-56-3-572","article-title":"Four-parameter model of the sigmoidal relationship between parathyroid hormone release and extracellular calcium concentration in normal and abnormal parathyroid tissue","volume":"56","author":"Brown","year":"1983","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2021120108544212100_CIT0028","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1111\/j.1476-5381.2011.01403.x","article-title":"Behind the curtain: cellular mechanisms for allosteric modulation of calcium-sensing receptors","volume":"165","author":"Cavanaugh","year":"2012","journal-title":"Br J Pharmacol."},{"key":"2021120108544212100_CIT0029","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.13662","article-title":"Structural mechanism of ligand activation in human calcium-sensing receptor","volume":"5","author":"Geng","year":"2016","journal-title":"Elife."},{"issue":"3","key":"2021120108544212100_CIT0030","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1007\/s12022-015-9378-3","article-title":"Oxyphil cell parathyroid adenomas causing primary hyperparathyroidism: a clinico-pathological correlation","volume":"26","author":"Howson","year":"2015","journal-title":"Endocr Pathol."},{"issue":"6","key":"2021120108544212100_CIT0031","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.surg.2005.09.015","article-title":"Surgery for hyperparathyroidism: does morphology or function matter most?","volume":"138","author":"Mun","year":"2005","journal-title":"Surgery."},{"issue":"10","key":"2021120108544212100_CIT0032","doi-asserted-by":"crossref","first-page":"3561","DOI":"10.1210\/jc.2014-1413","article-title":"Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop","volume":"99","author":"Bilezikian","year":"2014","journal-title":"J Clin Endocrinol Metab."},{"issue":"3-4","key":"2021120108544212100_CIT0033","first-page":"130","article-title":"PTH secretion in vivo and in vitro. Regulation by calcium and other secretagogues","volume":"8","author":"Brown","year":"1982","journal-title":"Miner Electrolyte Metab."},{"issue":"2","key":"2021120108544212100_CIT0034","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1152\/physrev.1991.71.2.371","article-title":"Extracellular Ca2+ sensing, regulation of parathyroid cell function, and role of Ca2+ and other ions as extracellular (first) messengers","volume":"71","author":"Brown","year":"1991","journal-title":"Physiol Rev."},{"issue":"6","key":"2021120108544212100_CIT0035","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/0002-9343(79)90446-7","article-title":"Calcium-regulated parathyroid hormone release in primary hyperparathyroidism: studies in vitro with dispersed parathyroid cells","volume":"66","author":"Brown","year":"1979","journal-title":"Am J Med."},{"issue":"4","key":"2021120108544212100_CIT0036","first-page":"1309","article-title":"Calcium-sensing receptor mutations: insights into a structurally and functionally novel receptor","volume":"81","author":"Pearce","year":"1996","journal-title":"J Clin Endocrinol Metab."},{"issue":"15","key":"2021120108544212100_CIT0037","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1056\/NEJM199610103351505","article-title":"A familial syndrome of hypocalcemia with hypercalciuria due to mutations in the calcium-sensing receptor","volume":"335","author":"Pearce","year":"1996","journal-title":"N Engl J Med."},{"issue":"4","key":"2021120108544212100_CIT0038","first-page":"1598","article-title":"Reduced immunostaining for the extracellular Ca2+-sensing receptor in primary and uremic secondary hyperparathyroidism","volume":"81","author":"Kifor","year":"1996","journal-title":"J Clin Endocrinol Metab."},{"issue":"12","key":"2021120108544212100_CIT0039","first-page":"4789","article-title":"Parathyroid expression of calcium-sensing receptor protein and in vivo parathyroid hormone-Ca(2+) set-point in patients with primary hyperparathyroidism","volume":"85","author":"Cetani","year":"2000","journal-title":"J Clin Endocrinol Metab."},{"key":"2021120108544212100_CIT0040","volume-title":"Human Protein Atlas","year":"2021"},{"key":"2021120108544212100_CIT0041","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3389\/fendo.2018.00333","article-title":"Impact of altered mineral metabolism on pathological cardiac remodeling in elevated fibroblast growth factor 23","volume":"9","author":"Leifheit-Nestler","year":"2018","journal-title":"Front Endocrinol (Lausanne)."},{"issue":"4","key":"2021120108544212100_CIT0042","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/1440-1681.12884","article-title":"The neuronal and endocrine roles of RCAN1 in health and disease","volume":"45","author":"Peiris","year":"2018","journal-title":"Clin Exp Pharmacol Physiol."},{"issue":"5","key":"2021120108544212100_CIT0043","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1038\/s12276-020-0441-x","article-title":"The RCAN1.4-calcineurin\/NFAT signaling pathway is essential for hypoxic adaption of intervertebral discs","volume":"52","author":"Huang","year":"2020","journal-title":"Exp Mol Med."},{"issue":"11","key":"2021120108544212100_CIT0044","doi-asserted-by":"crossref","first-page":"5212","DOI":"10.1210\/en.2011-2149","article-title":"Increased expression of the glucose-responsive gene, RCAN1, causes hypoinsulinemia, \u03b2-cell dysfunction, and diabetes","volume":"153","author":"Peiris","year":"2012","journal-title":"Endocrinology."},{"key":"2021120108544212100_CIT0045","doi-asserted-by":"crossref","first-page":"520316","DOI":"10.1155\/2014\/520316","article-title":"RCAN1 regulates mitochondrial function and increases susceptibility to oxidative stress in mammalian cells","volume":"2014","author":"Peiris","year":"2014","journal-title":"Oxid Med Cell Longev."},{"issue":"2-4","key":"2021120108544212100_CIT0046","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/biof.5520150208","article-title":"The essential role of calcium in induction of the DSCR1 (ADAPT78) gene","volume":"15","author":"Davies","year":"2001","journal-title":"Biofactors."},{"issue":"42","key":"2021120108544212100_CIT0047","doi-asserted-by":"crossref","first-page":"38787","DOI":"10.1074\/jbc.M102829200","article-title":"Chronic overexpression of the calcineurin inhibitory gene DSCR1 (Adapt78) is associated with Alzheimer\u2019s disease","volume":"276","author":"Ermak","year":"2001","journal-title":"J Biol Chem."},{"issue":"1","key":"2021120108544212100_CIT0048","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3233\/JAD-2005-8108","article-title":"Expression of calcipressin1, an inhibitor of the phosphatase calcineurin, is altered with aging and Alzheimer\u2019s disease","volume":"8","author":"Cook","year":"2005","journal-title":"J Alzheimers Dis."},{"issue":"2","key":"2021120108544212100_CIT0049","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s12022-018-9527-6","article-title":"Immunohistochemistry in diagnostic parathyroid pathology","volume":"29","author":"Erickson","year":"2018","journal-title":"Endocr Pathol."},{"issue":"6","key":"2021120108544212100_CIT0050","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1210\/jc.2018-02517","article-title":"Analysis of activating GCM2 sequence variants in sporadic parathyroid adenomas","volume":"104","author":"Riccardi","year":"2019","journal-title":"J Clin Endocrinol Metab."},{"key":"2021120108544212100_CIT0051","doi-asserted-by":"crossref","first-page":"105695","DOI":"10.1016\/j.jsbmb.2020.105695","article-title":"Effect of vitamin D nutrition on disease indices in patients with primary hyperparathyroidism","volume":"201","author":"Rao","year":"2020","journal-title":"J Steroid Biochem Mol Biol."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgab524\/40482371\/dgab524.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/11\/3168\/41378695\/dgab524.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/11\/3168\/41378695\/dgab524.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T13:46:09Z","timestamp":1638366369000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/106\/11\/3168\/6323246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,17]]},"references-count":51,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,7,17]]},"published-print":{"date-parts":[[2021,10,21]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgab524","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,7,17]]}}}