{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T23:43:54Z","timestamp":1749599034923},"reference-count":61,"publisher":"The Endocrine Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,7,1]]},"abstract":"<jats:p>Circulating concentrations of leptin are better correlated with absolute amounts of adipose tissue [fat mass (FM)] than with relative body fatness (body mass index or percent body fat). There is a clear sexual dimorphism in circulating concentrations of leptin (females&amp;gt; males) at birth and in adulthood. However, whether such dimorphism is present in the interval between these periods of development remains controversial. We examined body composition and clinical (Tanner stage) and endocrine (pituitary-gonadal axis hormones) aspects of sexual maturation in relationship to circulating concentrations of leptin in 102 children (53 males and 49 females, 6\u201319 yr of age) to evaluate the relationship between circulating leptin concentrations and body composition before and during puberty.<\/jats:p>\n               <jats:p>Pubertal stage was assigned by physical examination (Tanner staging) and also assessed by measurement of plasma estradiol, testosterone, and pituitary gonadotropins. Body composition was determined by dual-energy x-ray absorptiometry and by anthropometry. Circulating concentrations of leptin in the postabsorptive state were determined by a solid-phase sandwich enzyme immunoassay. The effect of gender on the relationship between circulating leptin concentrations and FM was determined by ANOVA at each Tanner stage. Stepwise multiple linear regression analyses, including circulating concentrations of pituitary-gonadal axis hormones, and FM were performed, by gender, to determine whether the relationship between circulating concentrations of leptin and FM changes during puberty.<\/jats:p>\n               <jats:p>Plasma leptin concentrations were significantly correlated with FM at all Tanner stages in males and females. Plasma leptin concentrations, normalized to FM, were significantly higher in females than males at Tanner stages IV and V but not at earlier stages of pubertal development. Plasma leptin concentrations, normalized to FM, were significantly greater in females at Tanner stage V compared with females at Tanner stage I and significantly lower in males at Tanner stage IV and V compared with males at Tanner stage I. These significant gender and maturational differences were confirmed by demonstrating that the regression equation relating circulating leptin concentrations to FM in females and males at Tanner stages IV and V were significantly different (predicted lower leptin concentrations in males than females with identical body composition) and that the regression equations relating circulating concentrations of leptin to FM in each gender before puberty (Tanner stage I) were significantly different (predicted higher plasma concentrations of leptin in prepubertal males and lower leptin concentrations in prepubertal females) than the same regression equations in later puberty. Circulating concentrations of testosterone were significant negative correlates of circulating concentrations of leptin normalized to FM in males when considered as a group over all pubertal stages. The inclusion in multivariate regression analyses of circulating concentrations of testosterone and estradiol, FM, fat-free mass, and gender did not eliminate a significant gender-effect (P &amp;lt; 0.05) on circulating concentrations of leptin at Tanner stages IV and V.<\/jats:p>\n               <jats:p>The circulating concentration of leptin, normalized to FM, declines significantly in males and rises significantly in females late in puberty to produce a late-pubertal\/adult sexual dimorphism. These studies confirm a potent role for gonadal steroids as mediators of this sexual dimorphism in circulating concentrations of leptin. The persistence of a significant gender-effect on circulating leptin concentrations at Tanner stages IV and V, even when the regression equation includes body composition and circulating concentrations of gonadal steroids, however, suggests that this sexual dimorphism also reflects the direct or interactive effects of either other sex-related metabolic variables (such as insulin, GH, or body fat distribution) or additional X or Y- chromosome-linked gene effects that produce an increasing sexual dimorphism of circulating leptin concentrations later in puberty.<\/jats:p>","DOI":"10.1210\/jcem.85.7.6689","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T17:05:45Z","timestamp":1389200745000},"page":"2509-2518","source":"Crossref","is-referenced-by-count":11,"title":["Effect of Puberty on the Relationship between Circulating Leptin and Body Composition1"],"prefix":"10.1210","volume":"85","author":[{"given":"Mary B.","family":"HorlickK","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Columbia University College of Physicians and Surgeons (M.B.H., M.R., R.L.L., L.S.L.), New York, New York 10032"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University College of Physicians and Surgeons (M.B.H., M.R., R.L.L., L.S.L.), New York, New York 10032"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margery","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Amgen Inc. (M.N.), Thousand Oaks, California 91320-1789"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenore S.","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University College of Physicians and Surgeons (M.B.H., M.R., R.L.L., L.S.L.), New York, New York 10032"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Fedun","sequence":"additional","affiliation":[{"name":"Body Composition Unit, St. Luke\u2019s\/Roosevelt Hospital Center (J.W., B.F., R.N.P.) New York, New York 10019"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Wang","sequence":"additional","affiliation":[{"name":"Body Composition Unit, St. Luke\u2019s\/Roosevelt Hospital Center (J.W., B.F., R.N.P.) New York, New York 10019"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Richard N.","family":"Pierson","sequence":"additional","affiliation":[{"name":"Body Composition Unit, St. Luke\u2019s\/Roosevelt Hospital Center (J.W., B.F., R.N.P.) New York, New York 10019"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolph L.","family":"Leibel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University College of Physicians and Surgeons (M.B.H., M.R., R.L.L., L.S.L.), New York, New York 10032"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071619464266100_R1","first-page":"3647","article-title":"Effects of weight change on plasma leptin concentrations and energy expenditure.","volume":"82","author":"Rosenbaum","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R2","first-page":"3424","article-title":"Effects of gender, body composition, and menopause on plasma concentrations of leptin.","volume":"81","author":"Rosenbaum","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R3","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1038\/ng0797-218","article-title":"And finally, genes for human obesity.","volume":"16","year":"1997","journal-title":"Nat Genet"},{"key":"2020071619464266100_R4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1006\/bmme.1996.0056","article-title":"Gender differences in serum leptin levels in humans.","volume":"59","author":"Hickey","year":"1996","journal-title":"Biochem Mol Med"},{"key":"2020071619464266100_R5","first-page":"E562","article-title":"Gender-dependent effects of exercise training on serum leptin levels in humans","volume":"272","author":"Hickey","year":"1997","journal-title":"Am J Physiol."},{"key":"2020071619464266100_R6","first-page":"1293","article-title":"The metabolic significance of leptin in humans: gender-based differences in relationship to adiposity, insulin-sensitivity, and energy expenditure.","volume":"82","author":"Kennedy","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R7","first-page":"579","article-title":"Sexual dimorphism in plasma leptin concentration.","volume":"82","author":"Saad","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R8","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1002\/j.1550-8528.1998.tb00326.x","volume":"6","author":"Sumner","journal-title":"Obes Res"},{"key":"2020071619464266100_R9","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1677\/joe.0.1540285","article-title":"Estrogen increases in vivo leptin production in rats and human subjects.","volume":"154","author":"Shimizu","year":"1997","journal-title":"J Endocrinol"},{"key":"2020071619464266100_R10","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1046\/j.1365-2265.1997.2681067.x","article-title":"Strong associations between serum levels of leptin and testosterone in men.","volume":"37","author":"Behre","year":"1997","journal-title":"Clin Endocrinol"},{"key":"2020071619464266100_R11","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1530\/eje.0.1370068","article-title":"Leptin levels are strongly correlated with those of GH-binding protein in prepubertal children.","volume":"137","author":"Bjarnason","year":"1997","journal-title":"Eur J Endocrinol"},{"key":"2020071619464266100_R12","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1055\/s-2007-979888","article-title":"Serum leptin levels following hypothalamic surgery.","volume":"28","author":"Brabant","year":"1996","journal-title":"Horm Metab Res"},{"key":"2020071619464266100_R13","doi-asserted-by":"crossref","first-page":"2203","DOI":"10.1210\/endo.138.5.5238","article-title":"Regulation of in vivo growth hormone secretion by leptin.","volume":"138","author":"Carro","year":"1997","journal-title":"Endocrinology"},{"key":"2020071619464266100_R14","first-page":"2149","article-title":"Gender differences in both spontaneous and stimulated leptin secretion by human omental adipose tissue in vitro: dexamethasone and estradiol stimulated leptin release in women, but not men.","volume":"83","author":"Casebielli","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R15","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1038\/sj.ijo.0800902","article-title":"Serum leptin concentration, body composition, and gonadal hormones during puberty.","volume":"23","author":"Demerath","year":"1999","journal-title":"Int J Obes"},{"key":"2020071619464266100_R16","first-page":"4139","article-title":"Isoproterenol and somatostatin decrease plasma leptin in humans: a novel mechanism regulating leptin secretion.","volume":"82","author":"Donahoo","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R17","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S0026-0495(97)90128-1","article-title":"Serum leptin is increased in growth hormone-deficient adults: relationship to body composition and affects of placebo-controlled growth hormone therapy for 1 year.","volume":"46","author":"Fisker","year":"1997","journal-title":"Metabolism"},{"key":"2020071619464266100_R18","doi-asserted-by":"crossref","first-page":"913","DOI":"10.2337\/diabetes.47.6.913","article-title":"Leptin secretion from subcutaneous and visceral adipose tissue in women.","volume":"47","author":"Harmelen","year":"1998","journal-title":"Diabetes"},{"key":"2020071619464266100_R19","first-page":"4406","article-title":"Relationship of plasma leptin to plasma insulin and adiposity in normal weight and overweight women\u2014effects of dietary fat content and sustained weight loss.","volume":"81","author":"Havel","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R20","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1161\/01.HYP.30.3.619","article-title":"Sympathetic and cardiorenal actions of leptin.","volume":"30","author":"Haynes","year":"1997","journal-title":"Hypertension"},{"key":"2020071619464266100_R21","doi-asserted-by":"crossref","first-page":"699","DOI":"10.2337\/diab.45.5.699","article-title":"Acute and chronic effects of insulin on leptin production in humans: studies in vitro and in vivo.","volume":"45","author":"Kolaczynski","year":"1996","journal-title":"Diabetes"},{"key":"2020071619464266100_R22","first-page":"E1031","article-title":"\u03b2 3-Adrenergic-mediated suppression of leptin gene expression in rats","volume":"272","author":"Li","year":"1997","journal-title":"Am J Physiol."},{"key":"2020071619464266100_R23","doi-asserted-by":"crossref","first-page":"342","DOI":"10.2337\/diab.46.3.342","article-title":"Depot- and sex-specific differences in human leptin mRNA expression: implications for the control of regional fat distribution.","volume":"46","author":"Montague","year":"1997","journal-title":"Diabetes"},{"key":"2020071619464266100_R24","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S1043-2760(98)00028-9","article-title":"Leptin: a molecule integrating somatic energy stores, energy expenditure, and fertility.","volume":"9","author":"Rosenbaum","year":"1998","journal-title":"Trends Endocrinol Metab"},{"key":"2020071619464266100_R25","first-page":"1784","article-title":"Role of gonadal steroids in the sexual dimorphisms in body composition and circulating concentrations of leptin.","volume":"84","author":"Rosenbaum","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R26","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1210\/jcem.83.4.4731","article-title":"Ontogeny of leptin in human fetuses and newborns: effect of intrauterine growth retardation on serum leptin concentrations.","volume":"83","author":"Jaquet","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R27","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1210\/jcem.82.5.4063","article-title":"Serum leptin concentrations in cord blood: relationship to birth weight and gender.","volume":"82","author":"Matsuda","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R28","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1530\/eje.0.1370655","article-title":"Sex-based differences in serum leptin concentrations from umbilical cord blood at delivery.","volume":"137","author":"Tome","year":"1997","journal-title":"Eur J Endocrinol"},{"key":"2020071619464266100_R29","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000014093","article-title":"Postnatal changes of leptin levels in full-term and preterm neonates: their relation to intrauterine growth, gender, and testosterone.","volume":"75","author":"Ertl","year":"1999","journal-title":"Biol Neonate"},{"key":"2020071619464266100_R30","first-page":"2148","article-title":"Effects of gender, ethnicity, body composition, and fat distribution on serum leptin levels in children.","volume":"82","author":"Nagy","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R31","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1046\/j.1365-2265.1997.2081026.x","article-title":"Serum leptin through childhood and adolescence.","volume":"46","author":"Clayton","year":"1997","journal-title":"Clin Endocrinol"},{"key":"2020071619464266100_R32","first-page":"2904","article-title":"Plasma leptin levels in healthy children and adolescents: dependence on body mass index, body fat mass, gender, pubertal stage, and testosterone.","volume":"82","author":"Blum","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R33","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1136\/adc.77.5.396","article-title":"Serum leptin concentrations in relation to pubertal development.","volume":"77","author":"Carlsson","year":"1997","journal-title":"Arch Dis Child"},{"key":"2020071619464266100_R34","first-page":"E543","article-title":"Gender differences in leptin levels during puberty are related to the subcutaneous fat depot and sex steroids","volume":"275","author":"Roemmich","year":"1998","journal-title":"Am J Physiol."},{"key":"2020071619464266100_R35","first-page":"2849","article-title":"Serum leptin levels in normal children: relationship to age, gender, body mass index, pituitary-gonadal hormones, and pubertal stage.","volume":"82","author":"Garcia-Mayor","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R36","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/S0022-3476(97)70029-5","article-title":"Leptin levels in healthy Spanish children and adolescents, children with obesity, and adolescents with anorexia nervosa and bulimia nervosa.","volume":"131","author":"Argente","year":"1997","journal-title":"J Pediatr"},{"key":"2020071619464266100_R37"},{"key":"2020071619464266100_R38","article-title":"The ovary. In: Felig P, Baxter J, Broadus A, Frohman L, eds","author":"Speroff","year":"1981"},{"key":"2020071619464266100_R39","article-title":"The testis. In: Felig P, Baxter J, Broadus A, Frohman L, eds","author":"Troen","year":"1981"},{"key":"2020071619464266100_R40","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/0021-9681(65)90161-X","article-title":"Measures of body fat and related factors in normal adults.","volume":"18","author":"Steinkamp","year":"1965","journal-title":"J Chron Dis"},{"key":"2020071619464266100_R41","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/ajcn\/51.6.1106","article-title":"Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition.","volume":"51","author":"Mazess","year":"1990","journal-title":"Am J Clin Nutr"},{"key":"2020071619464266100_R42","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1093\/ajcn\/60.5.660","article-title":"Accuracy of dual-energy x-ray absorptiometry for body-composition measurement in children.","volume":"60","author":"Ellis","year":"1994","journal-title":"Am J Clin Nutr"},{"key":"2020071619464266100_R43","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/jbmr.5650060413","article-title":"Comparison of dual-photon absorptiometry systems for total-body bone and soft tissue measurements: dual-energy x-rays versus gadolinium 153.","volume":"6","author":"Russel-Aulet","year":"1991","journal-title":"J Bone Min Res"},{"key":"2020071619464266100_R44","article-title":"edition","year":"1997"},{"key":"2020071619464266100_R45","first-page":"899","article-title":"Longitudinal study of leptin concentrations during puberty: sex differences and relationship to changes in body composition.","volume":"84","author":"Ahmed","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R46","first-page":"10","article-title":"Leptin values in placental cord blood of human newborns with normal intrauterine growth after 30\u201342 weeks of gestation.","volume":"51","author":"Gomez","year":"1999","journal-title":"Horm Res"},{"key":"2020071619464266100_R47","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1530\/eje.0.1370655","article-title":"Sex-based differences in serum leptin concentrations from umbilical cord blood at delivery.","volume":"137","author":"Tome","year":"1997","journal-title":"Eur J Endocrinol"},{"key":"2020071619464266100_R48","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1203\/00006450-199902000-00007","article-title":"Changes in leptin concentration during the early postnatal period: adjustment to extrauterine life.","volume":"45","author":"Hytinantti","year":"1999","journal-title":"Pediatr Res"},{"key":"2020071619464266100_R49","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1203\/00006450-199803000-00005","article-title":"Neonatal cord blood leptin: its relationship to birth weight, body mass index, maternal diabetes, and steroids.","volume":"43","author":"Shekawat","year":"1998","journal-title":"Pediatr Res"},{"key":"2020071619464266100_R50","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000014093","article-title":"Postnatal changes of leptin levels in full-term and pre-term neonates: their relationship to intrauterine growth, gender and testosterone.","volume":"75","author":"Ertl","year":"1999","journal-title":"Biol Neonate"},{"key":"2020071619464266100_R51"},{"key":"2020071619464266100_R52","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1038\/nm0997-1029","article-title":"Nonadipose tissue production of leptin\u2014leptin as a novel placenta-derived hormone in humans.","volume":"3","author":"Masuzaki","year":"1997","journal-title":"Nat Med"},{"key":"2020071619464266100_R53","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1542\/peds.100.1.e1","article-title":"Placental leptin\u2014an important new growth factor in intrauterine and fetal development.","volume":"100","author":"Hassink","year":"1997","journal-title":"Pediatrics"},{"key":"2020071619464266100_R54","first-page":"1066","article-title":"A longitudinal assessment of hormonal and physical alterations during normal puberty in boys. V. Rising leptin levels may signal the onset of puberty.","volume":"82","author":"Mantzoros","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R55","doi-asserted-by":"crossref","first-page":"989","DOI":"10.2337\/diab.46.6.989","article-title":"Circulating leptin in normal children and during the dynamic phase of juvenile obesity: relation to body fatness, energy metabolism, caloric intake, and sexual dimorphism.","volume":"35","author":"Lahlou","year":"1997","journal-title":"Diabetes"},{"key":"2020071619464266100_R56","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1172\/JCI119595","article-title":"Contribution of androgens to the gender difference in leptin production in obese children and adolescents.","volume":"100","author":"Wabitsch","year":"1997","journal-title":"J Clin Invest"},{"key":"2020071619464266100_R57","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0026-0495(98)90262-1","article-title":"Plasma leptin in children: relationship to puberty, gender, body composition, insulin sensitivity, and energy expenditure.","volume":"47","author":"Arslanian","year":"1998","journal-title":"Metabolism"},{"key":"2020071619464266100_R58","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1203\/00006450-199710000-00010","article-title":"Leptin levels and body fatness in children: effects of gender, ethnicity, and sexual development.","volume":"42","author":"Ellis","year":"1997","journal-title":"Pediatr Res"},{"key":"2020071619464266100_R59","first-page":"4140","article-title":"Sex differences in circulating human leptin pulse amplitude: clinical implications.","volume":"83","author":"Licinio","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R60","first-page":"453","article-title":"Diurnal and ultradian rhythmicity of plasma leptin: effects of gender and adiposity.","volume":"83","author":"Saad","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071619464266100_R61","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1210\/jcem-69-4-821","article-title":"Metabolic clearance rates of synthetic human growth hormone in children, adult women and adult men.","volume":"69","author":"Rosenbaum","year":"1989","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\/85\/7\/2509\/9178610\/jcem2509.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/85\/7\/2509\/9178610\/jcem2509.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T04:48:42Z","timestamp":1594961322000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/85\/7\/2509\/2852633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,7,1]]},"references-count":61,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2000,7,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jcem.85.7.6689","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,7,1]]}}}