{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:55:21Z","timestamp":1789617321105,"version":"build-2803163510"},"reference-count":37,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2025-0151_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examines the roles of hyperandrogenism (HA) and insulin resistance (IR) in eating behaviors among adolescents with polycystic ovary syndrome (PCOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0151_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty adolescents with PCOS (mean age 16.04\u00a0\u00b1\u00a01.46 years, BMI 27.55\u00a0\u00b1\u00a06.34) were assessed. IR was evaluated using HOMA-IR, and eating behaviors were measured with the Eating Attitudes Test (EAT) and the Eating Disorders Examination Questionnaire (EDE-Q).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0151_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>IR was present in 46\u202f% of participants, with obesity affecting 71\u202f% of those with IR. While EAT scores showed no significant association with BMI, HA, or IR, the IR group had higher EDE-Q Total scores (p=0.05), particularly in Shape Concern (SC, p=0.003) and Weight Concern (WC, p=0.03). HA primarily influenced WC (p=0.04). BMI correlated more strongly with WC (r=0.579, p&lt;0.001) than IR. ROC analysis indicated BMI&gt;27.5 (AUC=0.967) and HOMA-IR&gt;3.1 (AUC=0.961) as strong predictors of disordered eating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0151_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BMI and HOMA-IR are more reliable than HA for identifying disordered eating behaviors in PCOS adolescents. The EDE-Q is recommended for effective screening, emphasizing the need to monitor BMI and HOMA-IR in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2025-0151","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T21:15:06Z","timestamp":1762809306000},"page":"37-45","source":"Crossref","is-referenced-by-count":2,"title":["Role of hyperandrogenism on disordered eating behaviors in adolescents with PCOS and interplay with insulin resistance"],"prefix":"10.1515","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3962-4799","authenticated-orcid":false,"given":"Nazan","family":"Kaymaz","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Istinye University Liv Hospital , Istanbul , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0915-5546","authenticated-orcid":false,"given":"\u00d6zlem","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2159-523X","authenticated-orcid":false,"given":"Hande","family":"\u015eirin","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry , University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1046-7638","authenticated-orcid":false,"given":"Tolga","family":"Kasap","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , \u00c7anakkale Onsekiz Mart University , \u00c7anakkale , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4311-2670","authenticated-orcid":false,"given":"Mehmet Erdem","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry , University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"2026010809595748894_j_jpem-2025-0151_ref_001","unstructured":"World Health Organization. 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Clin Obstet Gynecol 2021;64:3\u201311. https:\/\/doi.org\/10.1097\/grf.0000000000000563.","DOI":"10.1097\/GRF.0000000000000563"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_004","doi-asserted-by":"crossref","unstructured":"Brutocao, C, Zaiem, F, Alsawas, M, Morrow, AS, Murad, MH, Javed, A. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine 2018;62:318\u201325. https:\/\/doi.org\/10.1007\/s12020-018-1692-3.","DOI":"10.1007\/s12020-018-1692-3"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_005","doi-asserted-by":"crossref","unstructured":"Salvador, J, Gutierrez, G, Llavero, M, Gargallo, J, Escalada, J, L\u00f3pez, J. Endocrine disorders and psychiatric manifestations. In: Portincasa, P, Fr\u00fchbeck, G, Nathoe, HM, editors. Endocrinology and systemic diseases. 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Gynecol Endocrinol 2006;22:388\u201394. https:\/\/doi.org\/10.1080\/09513590600847421.","DOI":"10.1080\/09513590600847421"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_016","doi-asserted-by":"crossref","unstructured":"Hollinrake, E, Abreu, A, Maifeld, M, Van Voorhis, BJ, Dokras, A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril 2007;87:1369\u201376. https:\/\/doi.org\/10.1016\/j.fertnstert.2006.11.039.","DOI":"10.1016\/j.fertnstert.2006.11.039"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_017","doi-asserted-by":"crossref","unstructured":"Saei Ghare Naz, M, Ozgoli, G, Mousavi, M, Ramezani Tehrani, F. Polycystic ovary syndrome and body image concerns during adolescence. J\u00a0Pediatr Nurs 2023;72:e1\u20139. https:\/\/doi.org\/10.1016\/j.pedn.2023.05.009.","DOI":"10.1016\/j.pedn.2023.05.009"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_018","unstructured":"World Health Organization. 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Endocrine 2023;82:201\u20138. https:\/\/doi.org\/10.1007\/s12020-023-03436-1.","DOI":"10.1007\/s12020-023-03436-1"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_029","doi-asserted-by":"crossref","unstructured":"Ozturk, A, Mazicioglu, MM, Hatipoglu, N, Budak, N, Keskin, G, Yazlak, Z, et al.. Reference body mass index curves for Turkish children 6 to 18\u00a0years of age. J\u00a0Pediatr Endocrinol Metab 2008;21:827\u201336. https:\/\/doi.org\/10.1515\/jpem.2008.21.9.827.","DOI":"10.1515\/JPEM.2008.21.9.827"},{"key":"2026010809595748894_j_jpem-2025-0151_ref_030","doi-asserted-by":"crossref","unstructured":"Eyupoglu, ND, Aksun, S, Ozturk, M, Yildiz, BO. Impact of social isolation during COVID-19 pandemic on health behaviors and weight management in women with polycystic ovary syndrome. 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