{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:58:56Z","timestamp":1788238736864,"version":"build-2803163510"},"reference-count":34,"publisher":"The Endocrine Society","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"NICHD","doi-asserted-by":"publisher","award":["HD108484"],"award-info":[{"award-number":["HD108484"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Androgen excess in polycystic ovary syndrome (PCOS)\/polyendocrine metabolic ovarian syndrome (PMOS) is classically attributed to ovarian steroids, yet adrenal-derived 11-oxygenated androgens are potent contributors whose regulation and treatment responsiveness in PMOS remains poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify classic and 11-oxygenated androgens across PMOS phenotypes vs controls and to evaluate their responses to oral contraceptive pills (OCPs), metformin, or lifestyle modification (LSM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of residual serum samples from 3 trials: oral contraceptives versus weight loss (OWL)\u2013PCOS trial (16-week OCP vs LSM), combined OCPs versus metformin (COMET)\u2013PCOS trial (24-week OCP vs metformin), and assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial (controls).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two academic medical centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>Two hundred and seventy-six with Rotterdam-defined PMOS and 97 controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s)<\/jats:title>\n                    <jats:p>Low-dose OCPs (4-6 months), metformin (2000\u2005mg\/day for 6 months), or LSM (4 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Serum concentrations of 11\u03b2-hydroxytestosterone (11-OHT), 11-ketotestosterone (11-KT), 11-ketoandrostenedione (11-KA4), and 11\u03b2-hydroxyandrostenedione (11-OHA4) measured by liquid chromatography\u2013tandem mass spectrometry, and total testosterone (TT), at baseline and end of study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adjusting for age and body mass index, women with PCOS\/PMOS had higher median 11-OHT (11.0 vs 7.8\u2005ng\/dL; P = .01) and 11-KT (31.9 vs 25.6\u2005ng\/dL; P = .03) than controls. Elevations were phenotype specific: biochemical hyperandrogenism showed broad increases, whereas clinical hyperandrogenism with normal TT found no significant differences compared with controls. Oral contraceptive pills suppressed 11-KT, 11-KA4, and 11-OHT (all P &amp;lt; .001), comparable to TT reductions. Metformin produced modest reductions in 11-OHT and 11-KT (P &amp;lt; .05), while LSM had no effect. Changes were independent of body mass index, glycemia, and homeostatic model assessment for insulin resistance (HOMA-IR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>11-Oxygenated androgens are elevated in PMOS in a phenotype-specific manner and are strongly suppressed by OCPs, with modest response to metformin and no short-term effect from LSM, supporting their utility in phenotyping and treatment monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag329","type":"journal-article","created":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T11:34:36Z","timestamp":1786275276000},"source":"Crossref","is-referenced-by-count":1,"title":["11-Oxygenated androgens in PCOS: impact of PCOS phenotypes and first-line 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