{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:20:19Z","timestamp":1776133219312,"version":"3.50.1"},"reference-count":61,"publisher":"The Endocrine Society","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,6,1]]},"abstract":"<jats:p>Ovarian hyperandrogenism is a common disorder often presenting post menarche with anovulatory oligomenorrhea and signs of androgen excess. Associated hyperinsulinemic insulin resistance, dyslipidemia, and central fat excess herald long-term disease risk. Combined antiandrogen (flutamide 250 mg\/d) and insulin-sensitizing (metformin) therapy has beneficial effects, in particular on dyslipidemia and androgen excess in young women. We studied the effects of low-dose flutamide-metformin combination on metabolic variables and body composition in adolescent girls with ovarian hyperandrogenism. Thirty teenage girls (age range, 13.6\u201318.6 yr) with hyperinsulinemic hyperandrogenism participated in a 12-month pilot study with a 3-month off-treatment phase and a 9-month treatment phase (randomized sequence) on combined flutamide (125 mg\/d) and metformin (1275 mg\/d). Body composition was assessed by dual-energy x-ray absorptiometry; endocrine-metabolic state and ovulation rate were screened every 3 months. Insulin sensitivity was assessed by homeostasis model assessment (HOMA). Overnight GH and LH profiles were obtained pretreatment and after 6 months on treatment (n = 8). Over the 3-month pretreatment control phase (n = 14) all study indices were unchanged. Flutamide-metformin treatment (n = 30) was followed within 3 months by marked decreases in hirsutism score and serum androgens, by a more than 50% increase in insulin sensitivity and by a less atherogenic lipid profile (all P &amp;lt; 0.0001). After 9 months on flutamide-metformin, body fat decreased by 10%, with a preferential 20% loss of abdominal fat; conversely lean body mass increased, and total body weight remained unchanged; ovulation rate increased from 7\u201387% after 9 months. Baseline GH hypersecretion and elevated serum IGF-1 normalized after 6 months on flutamide-metformin. Within 3 months post treatment (n = 16), a rebound was observed for all assessed indices. In conclusion, in teenage girls with ovarian hyperandrogenism, low-dose combined flutamide-metformin therapy attenuated a spectrum of abnormalities, including insulin resistance and hyperlipidemia. Improved insulin sensitivity and reduced androgen activity led to a marked redistribution of body fat and lean mass, resulting in a more feminine body shape.<\/jats:p>","DOI":"10.1210\/jc.2002-022002","type":"journal-article","created":{"date-parts":[[2003,6,5]],"date-time":"2003-06-05T16:29:51Z","timestamp":1054830591000},"page":"2600-2606","source":"Crossref","is-referenced-by-count":74,"title":["Low-Dose Flutamide-Metformin Therapy Reverses Insulin Resistance and Reduces Fat Mass in Nonobese Adolescents with Ovarian Hyperandrogenism"],"prefix":"10.1210","volume":"88","author":[{"given":"Lourdes","family":"Iba\u0301n\u0303ez","sequence":"first","affiliation":[{"name":"Endocrinology Unit (L.I., A.F.), Hospital Sant Joan de De\u0301u, University of Barcelona, Barcelona 08950, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Ong","sequence":"additional","affiliation":[{"name":"Endocrinology Unit (L.I., A.F.), Hospital Sant Joan de De\u0301u, University of Barcelona, Barcelona 08950, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Endocrinology Unit (L.I., A.F.), Hospital Sant Joan de De\u0301u, University of Barcelona, Barcelona 08950, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rakesh","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (R.A., D.D.), University of Cambridge, Cambridge CB2 2QQ, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Dunger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (R.A., D.D.), University of Cambridge, Cambridge CB2 2QQ, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"de Zegher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (F.d.Z.), University of Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071616565821000_R1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/00019616-200207000-00011","article-title":"Polycystic ovary syndrome in adolescence.","volume":"12","author":"Baumann","year":"2002","journal-title":"The Endocrinologist"},{"key":"2020071616565821000_R2","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1146\/annurev.med.52.1.401","article-title":"Current concepts in the polycystic ovary syndrome.","volume":"52","author":"Dunaif","year":"2001","journal-title":"Annu Rev Med"},{"key":"2020071616565821000_R3","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJM199608293350902","article-title":"Decreases in ovarian cytochrome P450c17\u03b1 activity and serum free testosterone after reduction in insulin secretion in polycystic ovary syndrome.","volume":"335","author":"Nestler","year":"1996","journal-title":"N Engl J Med"},{"key":"2020071616565821000_R4","first-page":"4075","article-title":"Lean women with polycystic ovary syndrome respond to insulin reduction with decreases in ovarian P450c17\u03b1 activity and serum androgens.","volume":"82","author":"Nestler","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1210\/jcem.83.1.4500","article-title":"Hormonal effects of flutamide in young women with polycystic ovary syndrome.","volume":"83","author":"Leo,","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R6","first-page":"3251","article-title":"Treatment of hirsutism, hyperandrogenism, oligomenorrhea, dyslipidemia and hyperinsulinism in non-obese, adolescent girls: effect of flutamide.","volume":"85","author":"Iba\u0301n\u0303ez","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R7","first-page":"139","article-title":"Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation.","volume":"85","author":"Moghetti","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R8","first-page":"3526","article-title":"Sensitization to insulin in adolescent girls to normalize hirsutism, hyperandrogenism, oligomenorrhea, dyslipidemia, and hyperinsulinism after precocious pubarche.","volume":"85","author":"Iba\u0301n\u0303ez","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R9","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1056\/NEJM199806253382603","article-title":"Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome.","volume":"338","author":"Nestler","year":"1998","journal-title":"N Engl J Med"},{"key":"2020071616565821000_R10","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/S0015-0282(99)00208-3","article-title":"Effects of metformin on gonadotropin-induced ovulation in women with polycystic ovary syndrome.","volume":"72","author":"DeLeo","year":"1999","journal-title":"Fertil Steril"},{"key":"2020071616565821000_R11","doi-asserted-by":"crossref","first-page":"3595","DOI":"10.1210\/jcem.86.8.7756","article-title":"Sensitization to insulin induces ovulation in nonobese adolescents with anovulatory hyperandrogenism.","volume":"86","author":"Iba\u0301n\u0303ez","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R12","first-page":"1626","article-title":"Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial.","volume":"86","author":"Azziz","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R13","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/0303-7207(86)90132-2","article-title":"Characteristics of interaction of the antiandrogen flutamide with the androgen receptor in various target tissues.","volume":"44","author":"Simard","year":"1986","journal-title":"Mol Cell Endocrinol"},{"key":"2020071616565821000_R14","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1056\/NEJM199602293340906","article-title":"Drug therapy. Metformin.","volume":"334","author":"Bailey","year":"1996","journal-title":"N Engl J Med"},{"key":"2020071616565821000_R15","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/S0140-6736(00)90002-3","article-title":"Thiazolidinediones: an update.","volume":"355","author":"Schoonjans","year":"2000","journal-title":"Lancet"},{"key":"2020071616565821000_R16","doi-asserted-by":"crossref","first-page":"2870","DOI":"10.1210\/jcem.87.6.8568","article-title":"Additive effects of insulin-sensitizing and antiandrogen treatment in young, nonobese women with hyperinsulinism, hyperandrogenism, dyslipidemia and anovulation.","volume":"87","author":"Iba\u0301n\u0303ez","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R17","first-page":"2198","article-title":"Exogenous androgens influence body composition and regional body fat distribution in obese postmenopausal women\u2014a clinical research center study.","volume":"81","author":"Lovejoy","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R18","first-page":"2044","article-title":"Long-term testosterone administration increases visceral fat in female to male transsexuals.","volume":"82","author":"Elbers","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R19","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1172\/JCI1353","article-title":"Imprinting of female offspring with testosterone results in insulin resistance and changes in body fat distribution at adult age in rats.","volume":"101","author":"Nilsson","year":"1998","journal-title":"J Clin Invest"},{"key":"2020071616565821000_R20","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/0029-7844(95)00250-U","article-title":"Body fat distribution in women with polycystic ovary syndrome.","volume":"86","author":"Douchi","year":"1995","journal-title":"Obstet Gynecol"},{"key":"2020071616565821000_R21","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1093\/humrep\/16.6.1255","article-title":"Body composition characteristics and body fat distribution in lean women with polycystic ovary syndrome.","volume":"16","author":"Kirchengast","year":"2001","journal-title":"Hum Reprod"},{"key":"2020071616565821000_R22","first-page":"403","article-title":"Louvet J Functional adrenal and ovarian hyperandrogenism: body composition in patients with normal body mass index","volume-title":"Program of the 83rd Annual Meeting of The Endocrine Society","author":"Pech","year":"2001"},{"key":"2020071616565821000_R23","first-page":"713","article-title":"Insulin resistance and cardiovascular disease.","volume":"86","author":"McFarlane","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R24","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1038\/sj.ijo.0800597","article-title":"Obesity type and clustering of insulin-resistance-associated cardiovascular risk factors in middle-aged men and women.","volume":"22","author":"Vanhala","year":"1998","journal-title":"Int J Obes"},{"key":"2020071616565821000_R25","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1210\/jcem.85.8.6738","article-title":"Effect of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without the polycystic ovary syndrome.","volume":"85","author":"Pasquali","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R26","first-page":"2854","article-title":"Insulin, somatotropic and luteinizing hormone axes in lean and obese women with polycystic ovary syndrome.","volume":"81","author":"Morales","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R27","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1530\/eje.0.1390621","article-title":"Augmented frequency and mass of LH discharged per burst are accompanied by marked disorderliness of LH secretion in adolescents with polycystic ovary syndrome.","volume":"139","author":"Garcia-Rudaz","year":"1998","journal-title":"Eur J Endocrinol"},{"key":"2020071616565821000_R28","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1530\/eje.0.1470207","article-title":"Amplified and orderly growth hormone secretion characterizes lean adolescents with polycystic ovary syndrome.","volume":"147","author":"Garcia-Rudaz","year":"2002","journal-title":"Eur J Endocrinol"},{"key":"2020071616565821000_R29","first-page":"227","article-title":"Insulin resistance: classification, prevalence, clinical manifestations, and diagnosis","author":"Vidal-Puig","year":"1997","journal-title":"In: Azziz R, Nestler JE, Dewailly D, eds. Androgen excess disorders in women. Philadelphia: Lippincott-Raven Publishers;"},{"key":"2020071616565821000_R30","first-page":"2283","article-title":"Hyperinsulinemia and decreased insulin-like growth factor binding protein-1 are common features in prepubertal and pubertal girls with a history of premature pubarche.","volume":"82","author":"Iba\u0301n\u0303ez","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R31","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1210\/jcem-21-11-1440","article-title":"Clinical assessment of body hair growth in women.","volume":"21","author":"Ferriman","year":"1961","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R32","first-page":"1778","article-title":"Source localization of androgen excess in adolescent girls.","volume":"79","author":"Iba\u0301n\u0303ez","year":"1994","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R33","first-page":"1599","article-title":"Postpubertal outcome in girls diagnosed of premature pubarche during childhood: increased frequency of functional ovarian hyperandrogenism.","volume":"76","author":"Iba\u0301n\u0303ez","year":"1993","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R34","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.2337\/diacare.20.7.1183","article-title":"Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.","volume":"20","year":"1997","journal-title":"Diabetes Care"},{"key":"2020071616565821000_R35","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1210\/jcem-57-2-320","article-title":"Genotyping steroid 21-hydroxylase deficiency: hormonal reference data.","volume":"56","author":"New","year":"1983","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R36","first-page":"3961","article-title":"Studies of 3\u03b2-hydroxysteroid dehydrogenase genes in infants and children manifesting premature pubarche and increased adrenocorticotropin-stimulated \u03945-steroid levels.","volume":"81","author":"Sakkal-Alkaddour","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R37","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: insulin resistance and \u03b2-cell function from fasting plasma glucose and insulin concentrations in man.","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"2020071616565821000_R38","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1464-5491.1994.tb00273.x","article-title":"Understanding oral glucose tolerance: comparison of glucose or insulin measurements during the oral glucose tolerance test with specific measurements of insulin resistance and insulin secretion.","volume":"11","author":"Phillips","year":"1994","journal-title":"Diabetes Med"},{"key":"2020071616565821000_R39","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1530\/eje.0.1410027","article-title":"Sexual dimorphism in the maturation of the pituitary-gonadal axis, assessed by GnRH agonist challenge.","volume":"141","author":"Potau","year":"1999","journal-title":"Eur J Endocrinol"},{"key":"2020071616565821000_R40","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1007\/s001250051030","article-title":"Hyperinsulinemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche.","volume":"41","author":"Iban\u0303ez","year":"1998","journal-title":"Diabetologia"},{"key":"2020071616565821000_R41","first-page":"192","article-title":"Increased bone mineral density and serum leptin in non-obese girls with precocious pubarche: relation to low birthweight and hyperinsulinism.","volume":"54","author":"Iba\u0301n\u0303ez","year":"2000","journal-title":"Horm Res"},{"key":"2020071616565821000_R42","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1093\/ajcn\/67.1.44","article-title":"Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves.","volume":"67","author":"Taylor","year":"1998","journal-title":"Am J Clin Nutr"},{"key":"2020071616565821000_R43","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1385\/JCD:3:1:035","article-title":"Measurement precission of body composition variables using the Lunar DPX-L densitometer.","volume":"3","author":"Kiebzak","year":"2000","journal-title":"J Clin Densitometry"},{"key":"2020071616565821000_R44","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1210\/jcem-71-5-1356","article-title":"Increased overnight growth hormone concentrations in diabetic compared with normal adolescents.","volume":"71","author":"Edge","year":"1990","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R45","first-page":"25","article-title":"Low-dose flutamide (125 mg\/day) as maintenance therapy in the treatment of hirsutism.","volume":"56","author":"Venturoli","year":"2001","journal-title":"Horm Res"},{"key":"2020071616565821000_R46","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0015-0282(01)02963-6","article-title":"Strategies for the use of insulin-sensitizing drugs to treat infertility in women with polycystic ovary syndrome.","volume":"77","author":"Nestler","year":"2002","journal-title":"Fertil Steril"},{"key":"2020071616565821000_R47","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/S0015-0282(00)01675-7","article-title":"Metformin increases the ovulatory rate and pregnancy rate in patients with polycystic ovary syndrome who are resistant to clomiphene citrate alone.","volume":"75","author":"Vandermolen","year":"2001","journal-title":"Fertil Steril"},{"key":"2020071616565821000_R48","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0015-0282(01)01975-6","article-title":"Metformin directly inhibits androgen production in human thecal cells.","volume":"76","author":"Attia","year":"2001","journal-title":"Fertil Steril"},{"key":"2020071616565821000_R49","first-page":"72","article-title":"Disruption of the joint synchrony of luteinizing hormone, testosterone, and androstenedione secretion in adolescents with polycystic ovarian syndrome.","volume":"86","author":"Veldhuis","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R50","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1210\/jcem.87.3.8342","article-title":"Circulating IGF-I levels in childhood are related to both current body composition and early postnatal growth rate.","volume":"87","author":"Ong","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R51","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1046\/j.1365-2265.2001.01399.x","article-title":"Polycystic ovary syndrome after precocious pubarche: ontogeny of the low-birthweight effect.","volume":"55","author":"Iba\u0301n\u0303ez","year":"2001","journal-title":"Clin Endocrinol"},{"key":"2020071616565821000_R52","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/S0015-0282(98)00098-3","article-title":"Pituitary desensitization to gonadotropin-releasing hormone increases abdominal adiposity in hyperandrogenic anovulatory women.","volume":"70","author":"Dumesic","year":"1998","journal-title":"Fertil Steril"},{"key":"2020071616565821000_R53","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1210\/jcem.87.1.8139","article-title":"Cross-sectional and prospective associations between abdominal obesity and proinsulin concentration.","volume":"87","author":"Hanley","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R54","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1203\/00006450-200202000-00019","article-title":"Plasminogen activator inhibitor-1 in girls with precocious pubarche: a premenarcheal marker for polycystic ovary syndrome?","volume":"51","author":"Iba\u0301n\u0303ez","year":"2002","journal-title":"Pediatr Res"},{"key":"2020071616565821000_R55","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1056\/NEJMoa012512","article-title":"Reduction in the indicence of type 2 diabetes with lifestyle intervention or metformin.","volume":"346","year":"2002","journal-title":"N Engl J Med"},{"key":"2020071616565821000_R56","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1038\/sj.ijo.0800866","article-title":"Distribution of waist-to-hip ratio, other indices of body fat distribution and obesity and associations with HDL cholesterol in children and young adults aged 4\u201319 years: The Third National Health and Nutrition Examination Survey.","volume":"23","author":"Gillum","year":"1999","journal-title":"Int J Obes"},{"key":"2020071616565821000_R57","first-page":"1021","article-title":"Rapid maturation of the reproductive axis during perimenarche independent of body composition.","volume":"85","author":"Legro","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R58","doi-asserted-by":"crossref","first-page":"5702","DOI":"10.1210\/jc.2002-020926","article-title":"Anovulation in eumenorheic, non-obese adolescent girls born small for gestational age: insulin sensitization induces ovulation, increases lean body mass, and reduces abdominal fat excess, dyslipidemia and subclinical hyperandrogenism.","volume":"87","author":"Iba\u0301n\u0303ez","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616565821000_R59","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1542\/peds.102.5.e60","article-title":"Muscularity and fatness of infants and young children born small- or large-for-gestational age","volume":"102","author":"Hediger","year":"1998","journal-title":"Pediatrics"},{"key":"2020071616565821000_R60","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1038\/sj.ijo.0801821","article-title":"Abdominal fat and birth size in healthy prepubertal children.","volume":"25","author":"Garnett","year":"2001","journal-title":"Int J Obes Relat Metab Dis"},{"key":"2020071616565821000_R61","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1139\/h97-020","article-title":"Human skeletal muscle fiber types: delineation, development, and distribution.","volume":"22","author":"Staron","year":"1997","journal-title":"Can J Appl Physiol"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/88\/6\/2600\/9150107\/jcem2600.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/88\/6\/2600\/9150107\/jcem2600.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T03:28:29Z","timestamp":1594956509000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/88\/6\/2600\/2845406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,6,1]]},"references-count":61,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2003,6,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2002-022002","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,6,1]]}}}