{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:43:23Z","timestamp":1781502203571,"version":"3.54.1"},"reference-count":41,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Los Angeles, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Ongoing research is needed to determine geo-epidemiologic differences of polycystic ovary syndrome (PCOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Determine hormonal and metabolic parameters of women with PCOS in 2 environments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary-care based specialty clinics in Alabama and California.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients or Other Participants<\/jats:title><jats:p>A total of 1610 women with PCOS by National Institutes of Health Criteria from 1987 to 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Interview, physical examination, laboratory studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes Measures<\/jats:title><jats:p>Demographic data, menstrual cycle history, and hormonal and metabolic parameters were collected. Hirsutism was defined as modified Ferriman-Gallwey scores \u22654. Androgen values greater than laboratory reference ranges or &amp;gt;95th percentile of all values were considered elevated (hyperandrogenemia). Metabolic parameters included body mass index (BMI), waist-hip-ratio (WHR), glucose tolerance test, and homeostatic model assessment for insulin resistance (HOMA-IR) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Alabama women with PCOS were younger with a higher BMI. After adjustment for age and BMI, Alabama women with PCOS were more likely hirsute (adjusted odds ratio [aOR], 1.8; 95% CI, 1.4-2.4; P &amp;lt; 0.001), with elevated HOMA-IR scores (adjusted beta coefficient 3.6; 95% CI, 1.61-5.5; P &amp;lt; 0.001). California women with PCOS were more likely to have hyperandrogenemia (free testosterone aOR, 0.14; 95% CI, 0.11-0.18; P &amp;lt; 0.001; total testosterone aOR, 0.41; 95% CI, 0.33-0.51). Results were similar when stratified by White race. In Black women with PCOS, BMI and WHR did not differ between locations, yet differences in androgen profiles and metabolic dysfunction remained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Alabama women with PCOS, regardless of Black or White race, were more likely hirsute with metabolic dysfunction, whereas California women with PCOS were more likely to demonstrate hyperandrogenemia, highlighting potential environmental impacts on PCOS.<\/jats:p><\/jats:sec>","DOI":"10.1210\/clinem\/dgac515","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T13:47:44Z","timestamp":1665496064000},"page":"706-712","source":"Crossref","is-referenced-by-count":6,"title":["Regional Variation in Hormonal and Metabolic Parameters of White and Black Women With PCOS in the United States"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6353-2803","authenticated-orcid":false,"given":"Katherine","family":"VanHise","sequence":"first","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L","family":"Chan","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Wertheimer","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8418-0288","authenticated-orcid":false,"given":"Roy G","family":"Handelsman","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Clark","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rae","family":"Buttle","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica T","family":"Wang","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3917-0483","authenticated-orcid":false,"given":"Ricardo","family":"Azziz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Alabama at Birmingham , Birmingham, AL 35233 , USA"},{"name":"Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Albany, SUNY , Albany, NY 12208 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1096-6506","authenticated-orcid":false,"given":"Margareta D","family":"Pisarska","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA 90048 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"issue":"3","key":"2023052512365426900_dgac515-B1","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.fertnstert.2018.05.004","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"110","author":"Teede","year":"2018","journal-title":"Fertil Steril"},{"issue":"3","key":"2023052512365426900_dgac515-B2","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1046\/j.1365-2265.2002.01603.x","article-title":"Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: is there a difference?","volume":"57","author":"Wijeyaratne","year":"2002","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"2023052512365426900_dgac515-B3","doi-asserted-by":"crossref","first-page":"189.e1","DOI":"10.1016\/j.ajog.2017.04.007","article-title":"Racial and ethnic differences in the prevalence of metabolic syndrome and its components of metabolic syndrome in women with polycystic ovary syndrome: a regional cross-sectional study","volume":"217","author":"Chan","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"6","key":"2023052512365426900_dgac515-B4","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1111\/j.1365-2265.2010.03873.x","article-title":"Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark","volume":"73","author":"Glintborg","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2023052512365426900_dgac515-B5","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.fertnstert.2011.09.024","article-title":"Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE\/ASRM-sponsored 3rd PCOS Consensus Workshop Group","volume":"97","author":"Fauser","year":"2012","journal-title":"Fertil Steril"},{"issue":"1","key":"2023052512365426900_dgac515-B6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.fertnstert.2016.05.011","article-title":"Environmental determinants of polycystic ovary syndrome","volume":"106","author":"Merkin","year":"2016","journal-title":"Fertil Steril"},{"issue":"2","key":"2023052512365426900_dgac515-B7","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1210\/jc.2003-031122","article-title":"Androgen excess in women: experience with over 1000 consecutive patients","volume":"89","author":"Azziz","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2023052512365426900_dgac515-B8","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/0002-9378(81)90746-8","article-title":"Hirsutism: implications, etiology, and management","volume":"140","author":"Hatch","year":"1981","journal-title":"Am J Obstet Gynecol"},{"issue":"7","key":"2023052512365426900_dgac515-B9","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1210\/jcem-27-7-1012","article-title":"Testosterone-binding levels in the serum of women during the normal menstrual cycle, pregnancy, and the post-partum period","volume":"27","author":"Pearlman","year":"1967","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2023052512365426900_dgac515-B10","first-page":"3078","article-title":"Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study","volume":"83","author":"Knochenhauer","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2023052512365426900_dgac515-B11","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/j.fertnstert.2013.12.056","article-title":"Specificity and predictive value of circulating testosterone assessed by tandem mass spectrometry for the diagnosis of polycystic ovary syndrome by the National Institutes of Health 1990 criteria","volume":"101","author":"Salameh","year":"2014","journal-title":"Fertil Steril"},{"key":"2023052512365426900_dgac515-B12","volume-title":"Diagnostic Criteria for Polycystic Ovary Syndrome: Towards a Rational Approach","author":"Zawadski JK","year":"1992"},{"issue":"7","key":"2023052512365426900_dgac515-B13","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"2023052512365426900_dgac515-B14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/1472-6823-13-47","article-title":"Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study","volume":"13","author":"Gayoso-Diz","year":"2013","journal-title":"BMC Endocr Disord"},{"issue":"1","key":"2023052512365426900_dgac515-B15","doi-asserted-by":"crossref","first-page":"R11","DOI":"10.1530\/REP-14-0499","article-title":"Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause","volume":"150","author":"de Melo","year":"2015","journal-title":"Reproduction"},{"issue":"3","key":"2023052512365426900_dgac515-B16","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1089\/jwh.2010.2303","article-title":"Socioeconomic status and polycystic ovary syndrome","volume":"20","author":"Merkin","year":"2011","journal-title":"J Womens Health (Larchmt)"},{"key":"2023052512365426900_dgac515-B17","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1146\/annurev-genom-083115-022331","article-title":"The genetic diversity of the Americas","volume":"18","author":"Adhikari","year":"2017","journal-title":"Annu Rev Genomics Hum Genet"},{"issue":"1","key":"2023052512365426900_dgac515-B18","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ajhg.2014.11.010","article-title":"The genetic ancestry of African Americans, Latinos, and European Americans across the United States","volume":"96","author":"Bryc","year":"2015","journal-title":"Am J Hum Genet"},{"issue":"3","key":"2023052512365426900_dgac515-B19","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ajhg.2020.02.002","article-title":"Population histories of the United States revealed through fine-scale migration and haplotype analysis","volume":"106","author":"Dai","year":"2020","journal-title":"Am J Hum Genet"},{"key":"2023052512365426900_dgac515-B20","doi-asserted-by":"crossref","first-page":"14238","DOI":"10.1038\/ncomms14238","article-title":"Clustering of 770,000 genomes reveals post-colonial population structure of North America","volume":"8","author":"Han","year":"2017","journal-title":"Nat Commun"},{"issue":"10","key":"2023052512365426900_dgac515-B21","doi-asserted-by":"crossref","first-page":"4085","DOI":"10.1210\/jc.2006-0227","article-title":"Variants in the 5alpha-reductase type 1 and type 2 genes are associated with polycystic ovary syndrome and the severity of hirsutism in affected women","volume":"91","author":"Goodarzi","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"2023052512365426900_dgac515-B22","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.foodchem.2014.02.153","article-title":"Estrogenic endocrine disruptors present in sports supplements. A risk assessment for human health","volume":"159","author":"Plotan","year":"2014","journal-title":"Food Chem"},{"issue":"2","key":"2023052512365426900_dgac515-B23","first-page":"259","article-title":"Low starch\/low dairy diet results in successful treatment of obesity and co-morbidities linked to polycystic ovary syndrome (PCOS)","volume":"5","author":"Phy","year":"2015","journal-title":"J Obes Weight Loss Ther"},{"key":"2023052512365426900_dgac515-B24","first-page":"15","article-title":"Where do U.S. households purchase healthy foods? An analysis of food-at-home purchases across different types of retailers in a nationally representative dataset","volume-title":"Prev Med","author":"Chrisinger","year":"2018"},{"issue":"6","key":"2023052512365426900_dgac515-B25","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.3390\/nu11061233","article-title":"Geographic differences in the dietary quality of food purchases among participants in the Nationally Representative Food Acquisition and Purchase Survey (FoodAPS)","volume":"11","author":"Vadiveloo","year":"2019","journal-title":"Nutrients"},{"key":"2023052512365426900_dgac515-B26","author":"U.S. Department of Agriculture Economic Research Service"},{"key":"2023052512365426900_dgac515-B27","author":"USDA Food and Nutrition Service"},{"key":"2023052512365426900_dgac515-B28","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1017\/jns.2018.18","article-title":"Assessment of the nutrition environment in rural counties in the deep south","volume":"7","author":"Shikany","year":"2018","journal-title":"J Nutr Sci"},{"issue":"6","key":"2023052512365426900_dgac515-B29","doi-asserted-by":"crossref","first-page":"w1088","DOI":"10.1377\/hlthaff.28.6.w1088","article-title":"Zoning for health? The year-old ban on new fast-food restaurants in South LA","volume":"28","author":"Sturm","year":"2009","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"2023052512365426900_dgac515-B30","first-page":"A27","article-title":"Food access, availability, and affordability in 3 Los Angeles communities, Project CAFE, 2004-2006","volume":"7","author":"Azuma","year":"2010","journal-title":"Prev Chronic Dis"},{"issue":"3","key":"2023052512365426900_dgac515-B31","doi-asserted-by":"crossref","first-page":"554","DOI":"10.3934\/publichealth.2015.3.554","article-title":"A mixed methods comparison of urban and rural retail corner stores","volume":"2","author":"McGuirt","year":"2015","journal-title":"AIMS Public Health"},{"key":"2023052512365426900_dgac515-B32","author":"United States Census Bureau"},{"key":"2023052512365426900_dgac515-B33","author":"U.S. Census Bureau"},{"key":"2023052512365426900_dgac515-B34","author":"World Population Review"},{"key":"2023052512365426900_dgac515-B35","author":"AirNow"},{"key":"2023052512365426900_dgac515-B36","author":"U.S. Environmental Protection Agency"},{"issue":"6","key":"2023052512365426900_dgac515-B37","doi-asserted-by":"crossref","first-page":"4555","DOI":"10.3390\/nu7064555","article-title":"Serum vitamin D levels and polycystic ovary syndrome: a systematic review and meta-analysis","volume":"7","author":"He","year":"2015","journal-title":"Nutrients"},{"issue":"3","key":"2023052512365426900_dgac515-B38","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1515\/hmbci-2014-0003","article-title":"Endocrine disruptors and polycystic ovary syndrome: a focus on bisphenol A and its potential pathophysiological aspects","volume":"17","author":"Palioura","year":"2014","journal-title":"Horm Mol Biol Clin Investig"},{"issue":"3","key":"2023052512365426900_dgac515-B39","doi-asserted-by":"crossref","first-page":"E480","DOI":"10.1210\/jc.2010-1658","article-title":"Endocrine disruptors and polycystic ovary syndrome (PCOS): elevated serum levels of bisphenol A in women with PCOS","volume":"96","author":"Kandaraki","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2023052512365426900_dgac515-B40","author":"Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention"},{"key":"2023052512365426900_dgac515-B41","author":"Centers for Disease Control and Prevention, United States Diabetes Surveillance System"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgac515\/46359447\/dgac515.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/3\/706\/50451552\/dgac515.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/3\/706\/50451552\/dgac515.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T19:04:45Z","timestamp":1701198285000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/108\/3\/706\/6750997"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,10,11]]},"published-print":{"date-parts":[[2023,2,15]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgac515","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,3,1]]},"published":{"date-parts":[[2022,10,11]]}}}