{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:49:31Z","timestamp":1777499371883,"version":"3.51.4"},"reference-count":16,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T00:00:00Z","timestamp":1584144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI18\/00109"],"award-info":[{"award-number":["PI18\/00109"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Adolescent polycystic ovary syndrome (PCOS) is characterized by androgen excess and oligomenorrhea, and commonly driven by hepato-visceral fat excess (\u201ccentral obesity\u201d) ensuing from a mismatch between prenatal and postnatal nutrition, on a background of genetic susceptibility. There is no approved treatment for adolescent PCOS.<\/jats:p>\n               <jats:p>We report the pooled results of 2 pilot studies in nonobese girls with PCOS (N = 62, age 15.8 years) that compared the effects of randomized treatment for 1 year, either with an oral estro-progestogen contraceptive (OC), or with a low-dose combination of spironolactone-pioglitazone-metformin (SPIOMET, targeting the excess of ectopic fat).<\/jats:p>\n               <jats:p>Auxological and endocrine-metabolic variables (including fasting insulin, androgens, high-molecular-weight adiponectin [HMW-adiponectin], and microRNA [miR]-451a), body composition (dual x-ray absorptiometry) and hepato-visceral fat (magnetic resonance imaging) were assessed on- and posttreatment. Data from menstrual diaries were combined with weekly salivary progesterone measurements to infer ovulation rates during the second and fourth quarter of the posttreatment year.<\/jats:p>\n               <jats:p>OC and SPIOMET treatment reduced the androgen excess comparably, and had no differential effects on total-body lean or fat mass. However, SPIOMET was accompanied by more broadly normalizing effects, including on hepato-visceral fat and on circulating insulin, HMW-adiponectin, and miR-451a. On average, there were 3-fold more ovulations post-SPIOMET than post-OC; normovulation was only observed after SPIOMET; anovulation was &amp;gt;10-fold more prevalent post-OC.<\/jats:p>\n               <jats:p>Pooled results of randomized studies in nonobese adolescent girls with PCOS indicate that SPIOMET treatment leads to an overall healthier, more insulin-sensitive condition\u2014with less ectopic fat\u2014than OC treatment, and to a more normal posttreatment ovulation rate.<\/jats:p>","DOI":"10.1210\/jendso\/bvaa032","type":"journal-article","created":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T03:57:30Z","timestamp":1584158250000},"source":"Crossref","is-referenced-by-count":35,"title":["Toward a Treatment Normalizing Ovulation Rate in Adolescent Girls With Polycystic Ovary Syndrome"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4595-7191","authenticated-orcid":false,"given":"Lourdes","family":"Ib\u00e1\u00f1ez","sequence":"first","affiliation":[{"name":"Institut de Recerca Pedi\u00e0tric Hospital Sant Joan de D\u00e9u, University of Barcelona , Esplugues, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) , ISCIII, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Institut de Recerca Pedi\u00e0tric Hospital Sant Joan de D\u00e9u, University of Barcelona , Esplugues, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) , ISCIII, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Garc\u00eda-Beltr\u00e1n","sequence":"additional","affiliation":[{"name":"Institut de Recerca Pedi\u00e0tric Hospital Sant Joan de D\u00e9u, University of Barcelona , Esplugues, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) , ISCIII, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Malpique","sequence":"additional","affiliation":[{"name":"Institut de Recerca Pedi\u00e0tric Hospital Sant Joan de D\u00e9u, University of Barcelona , Esplugues, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) , ISCIII, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edurne","family":"Garde","sequence":"additional","affiliation":[{"name":"Institut de Recerca Pedi\u00e0tric Hospital Sant Joan de D\u00e9u, University of Barcelona , Esplugues, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) , ISCIII, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-8911","authenticated-orcid":false,"given":"Abel","family":"L\u00f3pez-Bermejo","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI) and Dr. Josep Trueta Hospital , Girona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2491-5884","authenticated-orcid":false,"given":"Francis","family":"de Zegher","sequence":"additional","affiliation":[{"name":"Department of Development & Regeneration, University of Leuven , Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2020,3,14]]},"reference":[{"issue":"8","key":"2023020302404181700_CIT0001","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1210\/js.2019-00078","article-title":"Polycystic ovary syndrome: pathophysiology, presentation, and treatment with emphasis on adolescent girls","volume":"3","author":"Witchel","year":"2019","journal-title":"J Endocr Soc"},{"issue":"6","key":"2023020302404181700_CIT0002","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1159\/000479371","article-title":"An International Consortium Update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence","volume":"88","author":"Ib\u00e1\u00f1ez","year":"2017","journal-title":"Horm Res Paediatr"},{"issue":"9","key":"2023020302404181700_CIT0003","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1002\/oby.21935","article-title":"Reduced prenatal weight gain 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