{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:43:08Z","timestamp":1789587788976,"version":"build-2803163510"},"reference-count":40,"publisher":"The Endocrine Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3,1]]},"abstract":"\n Context:<\/jats:title>\n Adrenal hyperandrogenism affects approximately 25% of polycystic ovary syndrome (PCOS) patients but its relation to obesity is not totally understood.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n This study aimed to assess dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) levels in relation to body mass index (BMI) in PCOS.<\/jats:p>\n <\/jats:sec>\n \n Design and Setting:<\/jats:title>\n This was a prospective observational study at an institutional practice at an obstetrics\/gynecology hospital.<\/jats:p>\n <\/jats:sec>\n \n Participants:<\/jats:title>\n The study included 136 PCOS patients, 20\u201335 years old, and 42 age-matched control women. The participants were classified with the BMI cutoff value of 27 kg\/m2 as follows: 1) high-BMI PCOS patients; 2) low-BMI PCOS patients; 3) high-BMI control women; and 4) low-BMI control women. The data were reanalyzed with the BMI cutoff value of 30 kg\/m2 to corroborate the findings in obese and nonobese patients.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s):<\/jats:title>\n Blood samples were taken and LH, FSH, insulin, T, androstenedione (A4), DHEA, DHEAS, and glucose levels were determined. Homeostatic model assessment was calculated. Pelvic and abdominal ultrasound for ovarian morphology and adipose tissue, respectively, were performed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Obese PCOS patients presented significantly more insulin resistance than nonobese PCOS patients. The LH levels and LH\/FSH ratio were significantly higher in low-BMI than in high-BMI PCOS patients. The A4 and DHEAS levels were significantly higher in nonobese than in obese PCOS patients. A significant correlation between LH and A4 in nonobese PCOS patients was observed. The frequency of hyperandrogenism by increased A4, and DHEA along with DHEAS was significantly higher in low-BMI PCOS patients compared with high-BMI PCOS patients. Some findings observed with the BMI cutoff value of 27 kg\/m2 changed with the cutoff value of 30 kg\/m2.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Low BMI more so than high BMI is associated with increased LH, high A4, DHEA, and DHEAS levels in PCOS patients. The BMI cutoff value of 27 kg\/m2 classified better than 30 kg\/m2 for hormonal and metabolic characteristics.<\/jats:p>\n <\/jats:sec>","DOI":"10.1210\/jc.2014-2569","type":"journal-article","created":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T16:57:38Z","timestamp":1418749058000},"page":"942-950","source":"Crossref","is-referenced-by-count":54,"title":["Adrenal Androgen Excess and Body Mass Index in Polycystic Ovary Syndrome"],"prefix":"10.1210","volume":"100","author":[{"given":"Carlos","family":"Moran","sequence":"first","affiliation":[{"name":"Research Unit of Reproductive Medicine (C.M., F.A.-V.), Health Research Council, Mexican Institute of Social Security, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Arriaga","sequence":"additional","affiliation":[{"name":"Medical Unit of High Specialty (M.A.), Gynecology and Obstetrics Hospital No. 4 Luis Castelazo Ayala, Mexican Institute of Social Security, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Arechavaleta-Velasco","sequence":"additional","affiliation":[{"name":"Research Unit of Reproductive Medicine (C.M., F.A.-V.), Health Research Council, Mexican Institute of Social Security, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Segundo","family":"Moran","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Epidemiology (S.M.), Health Research Council, Mexican Institute of Social Security, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071700283573400_B1","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"},{"key":"2020071700283573400_B2","doi-asserted-by":"crossref","first-page":"4006","DOI":"10.1210\/jcem.84.11.6148","article-title":"A survey of the polycystic ovary syndrome in the Greek island of Lesbos: Hormonal and metabolic profile","volume":"84","author":"Diamanti-Kandarakis","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B3","first-page":"2434","article-title":"A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain","volume":"85","author":"Asunci\u00f3n","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B4","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1159\/000277640","article-title":"Prevalence of polycystic ovary syndrome and related disorders in Mexican women","volume":"69","author":"Moran","year":"2010","journal-title":"Gynecol Obstet Invest"},{"key":"2020071700283573400_B5","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"},{"key":"2020071700283573400_B6","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/978-1-59745-179-6_3","article-title":"Androgens throughout the life of women","volume-title":"Androgen excess disorders in women. Polycystic ovary syndrome and other disorders","author":"Parker","year":"2006","edition":"2nd ed"},{"key":"2020071700283573400_B7","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0300-595X(86)80021-4","article-title":"Adrenal and gonadal androgen secretion in normal females","volume":"15","author":"Longcope","year":"1986","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B8","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1210\/jcem-34-1-92","article-title":"Adrenal and ovarian contributions to the elevated free plasma androgen levels in hirsute women","volume":"34","author":"Rosenfield","year":"1972","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B9","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1210\/jcem-63-5-1204","article-title":"Determination of the source(s) of androgen overproduction in hirsutism associated with polycystic ovary syndrome by simultaneous adrenal and ovarian venous catheterization. Comparison with the dexamethasone suppression test","volume":"63","author":"Wajchenberg","year":"1986","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B10","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S0015-0282(98)00536-6","article-title":"Adrenal androgen excess in hyperandrogenism: Relation to age and body mass","volume":"71","author":"Mor\u00e1n","year":"1999","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B11","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/0002-9378(92)91779-A","article-title":"Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome?","volume":"167","author":"Carmina","year":"1992","journal-title":"Am J Obstet Gynecol"},{"key":"2020071700283573400_B12","first-page":"377","article-title":"Diagnostic criteria for polycystic ovary syndrome: Towards a rational approach","volume-title":"Polycystic ovary syndrome","author":"Zawadzki","year":"1992"},{"key":"2020071700283573400_B13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.fertnstert.2003.10.004","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome","volume":"81","author":"Rotterdam ESHRE\/ASRM\u2013Sponsored PCOS Consensus Workshop Group","year":"2004","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B14","doi-asserted-by":"crossref","first-page":"4237","DOI":"10.1210\/jc.2006-0178","article-title":"Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline","volume":"91","author":"Azziz","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B15","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0015-0282(16)55249-2","article-title":"Body weight, hyperinsulinemia, and gonadotropin levels in the polycystic ovarian syndrome: Evidence of two distinct populations","volume":"58","author":"Dale","year":"1992","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B16","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/humrep\/14.3.611","article-title":"Changes in luteinizing hormone and insulin secretion in polycystic ovarian syndrome","volume":"14","author":"Fulghesu","year":"1999","journal-title":"Hum Reprod"},{"key":"2020071700283573400_B17","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1016\/j.fertnstert.2003.05.010","article-title":"Relationship between insulin resistance and gonadotropin dissociation in obese and nonobese women with polycystic ovary syndrome","volume":"80","author":"Moran","year":"2003","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B18","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/j.1365-2265.1990.tb00857.x","article-title":"Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: An analysis of 263 consecutive cases","volume":"32","author":"Kiddy","year":"1990","journal-title":"Clin Endocrinol"},{"key":"2020071700283573400_B19","first-page":"805","article-title":"Effect of obesity on the clinical and hormonal characteristics of the polycystic ovary syndrome","volume":"39","author":"Singh","year":"1994","journal-title":"J Reprod Med"},{"key":"2020071700283573400_B20","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/j.1365-2265.1994.tb02577.x","article-title":"Serum lipoprotein lipid profile in women with the polycystic ovary syndrome: Relation to anthropometric, endocrine and metabolic variables","volume":"41","author":"Holte","year":"1994","journal-title":"Clin Endocrinol"},{"key":"2020071700283573400_B21","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/S0015-0282(99)00184-3","article-title":"Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: A heterogeneous group of disorders","volume":"72","author":"Aci\u00e9n","year":"1999","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B22","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1016\/j.fertnstert.2007.09.016","article-title":"Obesity differentially affects serum levels of androstenedione and testosterone in polycystic ovary syndrome","volume":"90","author":"Moran","year":"2008","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1210\/jcem-66-1-131","article-title":"The impact of obesity and chronic hyperinsulinemia on gonadotropin release and gonadal steroid secretion in the polycystic ovary syndrome","volume":"66","author":"Dunaif","year":"1988","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B24","first-page":"51S","article-title":"Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults. The evidence report","volume":"2","author":"National Institutes of Health","year":"1998","journal-title":"Obes Res Suppl"},{"key":"2020071700283573400_B25","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1097\/AOG.0b013e3181da9423","article-title":"Accuracy of current body mass index obesity classification for white, black, and Hispanic reproductive-age women","volume":"115","author":"Rahman","year":"2010","journal-title":"Obstet Gynecol"},{"key":"2020071700283573400_B26","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":"2020071700283573400_B27","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"},{"key":"2020071700283573400_B28","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/01.OGX.0000109523.25076.E2","article-title":"Detecting insulin resistance in polycystic ovary syndrome: Purposes and pitfalls","volume":"59","author":"Legro","year":"2004","journal-title":"Obstet Gynecol Surv"},{"key":"2020071700283573400_B29","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1007\/s00404-010-1816-3","article-title":"Ovarian morphology and endocrine function in polycystic ovary syndrome","volume":"284","author":"Tena","year":"2011","journal-title":"Arch Gynecol Obstet"},{"key":"2020071700283573400_B30","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.fertnstert.2007.03.085","article-title":"Subcutaneous and omental fat expression of adiponectin and leptin in women with polycystic ovary syndrome","volume":"89","author":"Carmina","year":"2008","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B31","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/BF03347408","article-title":"Prevalence and metabolic characteristics of adrenal androgen excess in hyperandrogenic women with different phenotypes","volume":"30","author":"Carmina","year":"2007","journal-title":"J Endocrinol Invest"},{"key":"2020071700283573400_B32","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1016\/j.fertnstert.2008.02.101","article-title":"Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome","volume":"91","author":"Brennan","year":"2009","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B33","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0889-8545(05)70185-6","article-title":"The role of the adrenal cortex in polycystic ovary syndrome","volume":"28","author":"Moran","year":"2001","journal-title":"Obstet Gynecol Clin North Am"},{"key":"2020071700283573400_B34","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/0002-9378(91)90280-5","article-title":"Adrenal and ovarian steroid hormone responses to gonadotropin-releasing hormone agonist treatment in polycystic ovary syndrome","volume":"165","author":"Gonzalez","year":"1991","journal-title":"Am J Obstet Gynecol"},{"key":"2020071700283573400_B35","first-page":"603","article-title":"The impact of estrogen on adrenal androgen sensitivity and secretion in polycystic ovary syndrome","volume":"80","author":"Ditkoff","year":"1995","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B36","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.fertnstert.2003.07.008","article-title":"Adrenocortical hyperresponsiveness to corticotropin in polycystic ovary syndrome patients with adrenal androgen excess","volume":"81","author":"Moran","year":"2004","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B37","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1210\/jcem-72-5-1025","article-title":"The effects of prolonged hypertestosteronemia on adrenocortical biosynthesis in oophorectomized women","volume":"72","author":"Azziz","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B38","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1210\/jcem-54-5-1069","article-title":"Evidence for an influence of the ovary on circulating dehydroepiandrosterone sulfate levels","volume":"54","author":"Cumming","year":"1982","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071700283573400_B39","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/S0015-0282(16)56219-0","article-title":"Determination of the steroidogenic capacity in premature ovarian failure","volume":"60","author":"Berm\u00fadez","year":"1993","journal-title":"Fertil Steril"},{"key":"2020071700283573400_B40","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/j.fertnstert.2010.02.014","article-title":"Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes","volume":"94","author":"Guastella","year":"2010","journal-title":"Fertil Steril"}],"container-title":["The Journal of Clinical Endocrinology & Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/100\/3\/942\/10434694\/jcem0942.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/100\/3\/942\/10434694\/jcem0942.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T14:18:42Z","timestamp":1594995522000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/100\/3\/942\/2839480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,1]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2014-2569","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,1]]}}}