{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:33:35Z","timestamp":1785411215667,"version":"3.56.0"},"reference-count":40,"publisher":"The Endocrine Society","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context:<\/jats:title>\n                  <jats:p>Polycystic ovarian syndrome (PCOS) is associated with cardiovascular risk factors (CRF). Lifestyle intervention is regarded as therapy of choice even if studies in adolescent girls with PCOS are scarce.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>Our objective was to analyze the impact of lifestyle intervention on menses irregularities, hyperandrogenemia, CRF, and intima-media thickness (IMT) in adolescent girls with PCOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients:<\/jats:title>\n                  <jats:p>Patients included 59 obese girls with PCOS aged 12\u201318 yr.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention:<\/jats:title>\n                  <jats:p>Intervention was a 1-yr lifestyle intervention based on nutrition education, exercise training, and behavior therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures:<\/jats:title>\n                  <jats:p>Menses cycles, IMT, waist circumference, blood pressure, fasting lipids, insulin, glucose, testosterone, dehydroepiandrosterone sulfate, androstenedione, and SHBG were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>In contrast to the 33 girls without weight loss, the 26 girls reducing their body mass index during the lifestyle intervention (by a mean of \u22123.9 kg\/m2) improved most CRF and decreased their IMT (by a mean of \u22120.01 cm). Testosterone concentrations decreased (by a mean of \u22120.3 nmol\/liter) and SHBG concentrations increased (by a mean of +8 ng\/ml) significantly in girls with weight loss in contrast to girls with increasing weight. The prevalence of amenorrhea (\u221242%) and oligoamenorrhea (\u221219%) decreased in the girls with weight loss. The changes in insulin in the 1-yr follow-up were significantly correlated to changes in testosterone (r = 0.38; P = 0.002) and SHBG (r = \u22120.35; P = 0.048). A linear regression model with changes in IMT as dependent variable demonstrated a significant association with changes in blood pressure and weight status but not with changes in testosterone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Weight loss due to lifestyle intervention is effective to treat menses irregularities, normalize androgens, and improve CRF and IMT in obese adolescent girls with PCOS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2011-1609","type":"journal-article","created":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T11:19:20Z","timestamp":1314875960000},"page":"3533-3540","source":"Crossref","is-referenced-by-count":129,"title":["Effect of Lifestyle Intervention on Features of Polycystic Ovarian Syndrome, Metabolic Syndrome, and Intima-Media Thickness in Obese Adolescent Girls"],"prefix":"10.1210","volume":"96","author":[{"given":"Nina","family":"Lass","sequence":"first","affiliation":[{"name":"Departments of Pediatric Endocrinology, Diabetes, and Nutrition Medicine (N.L., M.K., K.W., T.R.), Vestische Hospital for Children and Adolescents, University of Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Kleber","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Endocrinology, Diabetes, and Nutrition Medicine (N.L., M.K., K.W., T.R.), Vestische Hospital for Children and Adolescents, University of Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Winkel","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Endocrinology, Diabetes, and Nutrition Medicine (N.L., M.K., K.W., T.R.), Vestische Hospital for Children and Adolescents, University of Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Wunsch","sequence":"additional","affiliation":[{"name":"Pediatric Radiology and Sonography (R.W.), Vestische Hospital for Children and Adolescents, University of Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reinehr","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Endocrinology, Diabetes, and Nutrition Medicine (N.L., M.K., K.W., T.R.), Vestische Hospital for Children and Adolescents, University of Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071618253290600_B1","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1056\/NEJMra041536","article-title":"Polycystic ovary syndrome.","volume":"352","author":"Ehrmann","year":"2005","journal-title":"N Engl J Med"},{"key":"2020071618253290600_B2","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1038\/ijo.2008.61","article-title":"Polycystic ovary syndrome in adolescents.","volume":"32","author":"Franks","year":"2008","journal-title":"Int J Obes (Lond)"},{"key":"2020071618253290600_B3","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/humrep\/deh098","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS).","volume":"19","author":"Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group","year":"2004","journal-title":"Hum Reprod"},{"key":"2020071618253290600_B4","first-page":"377","article-title":"Diagnostic criteria for polycystic ovary syndrome: towards a rational approach","volume-title":"Polycystic ovary syndrome","author":"Zawadski","year":"1992"},{"key":"2020071618253290600_B5","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.tem.2003.08.002","article-title":"Polycystic ovary syndrome: syndrome XX?","volume":"14","author":"Sam","year":"2003","journal-title":"Trends Endocrinol Metab"},{"key":"2020071618253290600_B6","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1210\/jc.2004-1045","article-title":"Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome.","volume":"90","author":"Apridonidze","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618253290600_B7","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.metabol.2005.11.003","article-title":"Obesity, free testosterone, and cardiovascular risk factors in adolescents with polycystic ovary syndrome and regularly cycling adolescents.","volume":"55","author":"Glueck","year":"2006","journal-title":"Metabolism"},{"key":"2020071618253290600_B8","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1210\/jc.2005-1666","article-title":"Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance.","volume":"91","author":"Coviello","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618253290600_B9","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1111\/j.1365-2265.2009.03710.x","article-title":"Association between androgens, intima-media thickness and the metabolic syndrome in obese adolescent girls.","volume":"72","author":"de Sousa","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071618253290600_B10","first-page":"118","article-title":"The intima media thickness and coronary risk factors.","volume":"20","author":"Hurwitz Eller","year":"2001","journal-title":"Int Angiol"},{"key":"2020071618253290600_B11","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.atherosclerosis.2009.03.041","article-title":"Lifestyle intervention in obese children is associated with a decrease of the metabolic syndrome prevalence.","volume":"207","author":"Reinehr","year":"2009","journal-title":"Atherosclerosis"},{"key":"2020071618253290600_B12","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2147\/IJWH.S11304","article-title":"Treatment options for polycystic ovary syndrome.","volume":"3","author":"Badawy","year":"2011","journal-title":"Int J Womens Health"},{"key":"2020071618253290600_B13","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2217\/WHE.09.89","article-title":"Polycystic ovary syndrome and weight management.","volume":"6","author":"Moran","year":"2010","journal-title":"Womens Health (Lond Engl)"},{"key":"2020071618253290600_B14","doi-asserted-by":"crossref","first-page":"4299","DOI":"10.1210\/jc.2008-0461","article-title":"The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials.","volume":"93","author":"Hoeger","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618253290600_B15","first-page":"CD007506","article-title":"Lifestyle changes in women with polycystic ovary syndrome.","volume":"2","author":"Moran","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2020071618253290600_B16","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1542\/peds.2006-0302","article-title":"Intima-media thickness in obese children before and after weight loss.","volume":"118","author":"Wunsch","year":"2006","journal-title":"Pediatrics"},{"key":"2020071618253290600_B17","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.beem.2006.02.002","article-title":"Treatment of PCOS in adolescence.","volume":"20","author":"Warren-Ulanch","year":"2006","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2020071618253290600_B18","first-page":"208","article-title":"Treatment options of polycystic ovary syndrome in adolescence.","volume":"3","author":"Zapanti","year":"2006","journal-title":"Pediatr Endocrinol Rev"},{"key":"2020071618253290600_B19","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jpag.2011.01.002","article-title":"Effect of weight loss on menstrual function in adolescents with polycystic ovary syndrome.","volume":"24","author":"Ornstein","year":"2011","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2020071618253290600_B20","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jpag.2009.04.004","article-title":"Characteristics of adolescents presenting to a multidisciplinary clinic for polycystic ovarian syndrome.","volume":"23","author":"Bekx","year":"2010","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2020071618253290600_B21","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.3945\/ajcn.2009.28705","article-title":"Body mass index patterns over 5 y in obese children motivated to participate in a 1-y lifestyle intervention: age as a predictor of long-term success.","volume":"91","author":"Reinehr","year":"2010","journal-title":"Am J Clin Nutr"},{"key":"2020071618253290600_B22","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":"2020071618253290600_B23","unstructured":"2011\n          Guidelines of the German working group on obese children and adolescents. http:www.a-g-a.de\/Leitlinie.pdf"},{"key":"2020071618253290600_B24","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a standard definition for child overweight and obesity worldwide: international survey.","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"key":"2020071618253290600_B25","article-title":"Therapie der Adipositas im Kindes und Jugendalter: Schulung Obeldicks und Obeldicks Light. 2. Auflage ed","author":"Reinehr","year":"2010"},{"key":"2020071618253290600_B26","first-page":"45","article-title":"The LMS method for constructing normalized growth standards.","volume":"44","author":"Cole","year":"1990","journal-title":"Eur J Clin Nutr"},{"key":"2020071618253290600_B27","first-page":"116","article-title":"Waist circumference percentile in Jena children (Germany) 6 to 18 years of age.","volume":"33","author":"Kromeyer-Hausschild","year":"2008","journal-title":"Aktuel Ernaehr Med"},{"key":"2020071618253290600_B28","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1542\/peds.114.2.S2.555","article-title":"The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents.","volume":"114","author":"National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents","year":"2004","journal-title":"Pediatrics"},{"key":"2020071618253290600_B29","doi-asserted-by":"crossref","first-page":"3666","DOI":"10.1210\/jcem.84.10.6079","article-title":"A critical evaluation of simple methods for the estimation of free testosterone in serum.","volume":"84","author":"Vermeulen","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618253290600_B30","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":"2020071618253290600_B31","doi-asserted-by":"crossref","first-page":"3160","DOI":"10.2337\/diacare.26.11.3160","article-title":"Follow-up report on the diagnosis of diabetes mellitus.","volume":"26","author":"Genuth","year":"2003","journal-title":"Diabetes Care"},{"key":"2020071618253290600_B32","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.2337\/diacare.27.2007.S5","article-title":"Diagnosis and classification of diabetes mellitus.","volume":"27","author":"American Diabetes Association","year":"2004","journal-title":"Diabetes Care"},{"key":"2020071618253290600_B33","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1399-5448.2007.00271.x","article-title":"The metabolic syndrome in children and adolescents: an IDF consensus report.","volume":"8","author":"Zimmet","year":"2007","journal-title":"Pediatr Diabetes"},{"key":"2020071618253290600_B34","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1038\/sj.ijo.0803777","article-title":"Effect of hypocaloric diet plus sibutramine treatment on hormonal and metabolic features in overweight and obese women with polycystic ovary syndrome: a randomized, 24-week study.","volume":"32","author":"Florakis","year":"2008","journal-title":"Int J Obes (Lond)"},{"key":"2020071618253290600_B35","doi-asserted-by":"crossref","first-page":"R1","DOI":"10.1677\/joe.0.124R001","article-title":"Effect of insulin-like growth factor-type I (IGF-I) and insulin on the secretion of sex hormone binding globulin and IGF-I binding protein (IBP-I) by human hepatoma cells.","volume":"124","author":"Singh","year":"1990","journal-title":"J Endocrinol"},{"key":"2020071618253290600_B36","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1055\/s-2007-976539","article-title":"Endocrinology of adipose tissue: an update.","volume":"39","author":"Fischer-Posovszky","year":"2007","journal-title":"Horm Metab Res"},{"key":"2020071618253290600_B37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-2004-816246","article-title":"[Evaluation of the training program \u201cOBELDICKS\u201d for obese children and adolescents].","volume":"217","author":"Reinehr","year":"2005","journal-title":"Klin Padiatr"},{"key":"2020071618253290600_B38","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s00103-010-1193-x","article-title":"[Overweight and obesity in childhood and adolescence. Evaluation of inpatient and outpatient care in Germany: the EvAKuJ study].","volume":"54","author":"Hoffmeister","year":"2011","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"2020071618253290600_B39","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1001\/archpedi.162.8.764","article-title":"Insulin resistance status: predicting weight response in overweight children.","volume":"162","author":"Cummings","year":"2008","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2020071618253290600_B40","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1210\/jc.2006-2012","article-title":"Clinical review: Identifying children at risk for polycystic ovary syndrome.","volume":"92","author":"Rosenfield","year":"2007","journal-title":"J Clin Endocrinol Metab"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/96\/11\/3533\/9088796\/jcem3533.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/96\/11\/3533\/9088796\/jcem3533.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T03:53:36Z","timestamp":1594958016000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/96\/11\/3533\/2834697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,11,1]]},"references-count":40,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2011,11,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2011-1609","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,11,1]]}}}