{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:33:15Z","timestamp":1793035995695,"version":"4.5.0"},"reference-count":69,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, anovulation, infertility, obesity, and insulin resistance, which results in increased concentrations of testosterone (T), which disturbs follicular growth and ovulation. This study aimed to assess PCOS women\u2019s clinical, endocrinological, and metabolic parameters concerning hyperandrogenism severity. Results: 314 women (mean age 27.3 \u00b1 4.6; mean body mass index (BMI) 25.7 \u00b1 5.6) with PCOS, were divided into terciles according to T concentrations: &lt;0.64 ng\/mL (group 1), 0.64 to 0.84 ng\/mL (Group 2) and &gt;0.84 ng\/mL (group 3). The mean concentration of T in all women was 0.59 ng\/mL and correlated negatively with the number of menstrual cycles per year (MPY) (r = \u22120.36; p &lt; 0.0001) and positively with Ferriman-Gallway score (FG) (r = 0.33; p &lt; 0.0001), luteinizing hormone (LH) (r = 0.19; p &lt; 0.0001) and dehydroepiandrosterone sulfate (DHEAS) (r = 0.52; p &lt; 0.0001). Positive correlation between BMI and hirsutism (r = 0.16; p &lt; 0.0001), total cholesterol (TC) (r = 0.18; p &lt; 0.0001), low-density lipoprotein (LDL) (r = 0.29; p &lt; 0.0001), and triglycerides (TG) (r = 0.40; p &lt; 0.0001) was demonstrated. The division into subgroups confirmed the lowest MPY, highest LH, and hirsutism in group 3. BMI, insulin sensitivity indices, and lipid profile parameters were not different between the three T subgroups. Conclusions: We found no correlation between testosterone levels and insulin sensitivity or dyslipidemia in women with PCOS. Metabolic abnormalities may contribute more significantly than hyperandrogenemia to PCOS development.<\/jats:p>","DOI":"10.3390\/ijerph17249291","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T23:39:36Z","timestamp":1607902776000},"page":"9291","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Heterogeneity of Endocrinologic and Metabolic Parameters in Reproductive Age Polycystic Ovary Syndrome (PCOS) Women Concerning the Severity of Hyperandrogenemia\u2014A New Insight on Syndrome Pathogenesis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5988-4969","authenticated-orcid":false,"given":"Katarzyna","family":"Ozegowska","sequence":"first","affiliation":[{"name":"Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, 60-535 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Korman","sequence":"additional","affiliation":[{"name":"Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, 60-535 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0915-2783","authenticated-orcid":false,"given":"Agnieszka","family":"Szmyt","sequence":"additional","affiliation":[{"name":"Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, 60-535 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leszek","family":"Pawelczyk","sequence":"additional","affiliation":[{"name":"Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, 60-535 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1038\/nrendo.2010.217","article-title":"Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis","volume":"7","author":"Goodarzi","year":"2011","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_2","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":"Kouli","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1055\/s-2001-19087","article-title":"Unplanned pregnancies in a developed society--a study on a maternity ward in Berlin","volume":"123","author":"Mikolajczyk","year":"2001","journal-title":"Zentralbl. Gynakol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1093\/humrep\/dep399","article-title":"The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria","volume":"25","author":"March","year":"2010","journal-title":"Hum. Reprod."},{"key":"ref_5","unstructured":"Ma, Y.M., Li, R., Qiao, J., Zhang, X.W., Wang, S.Y., Zhang, Q.F., Li, L., Tu, B.B., and Zhang, X. (2010). Characteristics of abnormal menstrual cycle and polycystic ovary syndrome in community and hospital populations. Chin. Med. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"62","DOI":"10.5694\/mja11.10553","article-title":"Prevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia","volume":"196","author":"Boyle","year":"2011","journal-title":"Med. J. Aust."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.fertnstert.2008.06.035","article-title":"The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report","volume":"91","author":"Azziz","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_8","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":"Asuncion","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1210\/jc.2009-2724","article-title":"Assessment of Cardiovascular Risk and Prevention of Cardiovascular Disease in Women with the Polycystic Ovary Syndrome: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society","volume":"95","author":"Wild","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/humupd\/dmq001","article-title":"Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: A systematic review and meta-analysis","volume":"16","author":"Moran","year":"2010","journal-title":"Hum. Reprod. Update"},{"key":"ref_11","first-page":"774","article-title":"Insulin resistance and the polycystic ovary syndrome: Mechanism and implications for pathogenesis","volume":"18","author":"Dunaif","year":"1997","journal-title":"Endocr. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H.F., Futterweit, W., Janssen, O.E., Legro, R.S., Norman, R.J., and Taylor, A.E. (2006). Position statement: Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: An androgen excess society guideline. J. Clin. Endocrinol. Metab.","DOI":"10.1210\/jc.2006-0178"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum. Reprod., 19, 41\u201347.","DOI":"10.1093\/humrep\/deh098"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ozegowska, K., and Pawelczyk, L. (2015). Cardiometabolic risk in patients with polycystic ovary syndrome. Ginekol. Pol., 86.","DOI":"10.17772\/gp\/59131"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1093\/humupd\/dml036","article-title":"A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome","volume":"12","author":"Boomsma","year":"2006","journal-title":"Hum. Reprod. Update"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1016\/j.fertnstert.2009.10.043","article-title":"Pregnancy in women with polycystic ovary syndrome: The effect of different phenotypes and features on obstetric and neonatal outcomes","volume":"94","author":"Palomba","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1093\/humupd\/dmv029","article-title":"Pregnancy complications in women with polycystic ovary syndrome","volume":"21","author":"Palomba","year":"2015","journal-title":"Hum. Reprod. Update"},{"key":"ref_18","first-page":"415","article-title":"Insulin resistance and fertility in polycystic ovary syndrome","volume":"1","author":"Fica","year":"2008","journal-title":"J. Med. Life"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S0002-9343(01)00948-2","article-title":"Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome","volume":"111","author":"Legro","year":"2001","journal-title":"Am. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1530\/eje.1.01868","article-title":"Evidence for altered adipocyte function in polycystic ovary syndrome","volume":"152","author":"Carmina","year":"2005","journal-title":"Eur. J. Endocrinol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"745","DOI":"10.2147\/IJWH.S70314","article-title":"Complications and challenges associated with polycystic ovary syndrome: Current perspectives","volume":"7","author":"Palomba","year":"2015","journal-title":"Int. J. Womens Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/S0015-0282(02)03111-4","article-title":"Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus","volume":"77","author":"Ovalle","year":"2002","journal-title":"Fertil. Steril."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12958-020-00576-1","article-title":"Risk of hypertension in women with polycystic ovary syndrome: A systematic review, meta-analysis and meta-regression","volume":"18","author":"Amiri","year":"2020","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e0137609","DOI":"10.1371\/journal.pone.0137609","article-title":"Trend of Cardio-Metabolic Risk Factors in Polycystic Ovary Syndrome: A Population-Based Prospective Cohort Study","volume":"10","author":"Montazeri","year":"2015","journal-title":"PLoS ONE"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1159\/000058367","article-title":"The plasma homocysteine levels are increased in polycystic ovary syndrome","volume":"53","author":"Loverro","year":"2002","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1046\/j.1365-2265.2000.01000.x","article-title":"Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: A retrospective cohort study","volume":"52","author":"Wild","year":"2000","journal-title":"Clin. Endocrinol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Carmina, E., Koyama, T., Chang, L., Stanczyk, F.Z., and Lobo, R.A. (1993). Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome?. Int. J. Gynecol. Obstet.","DOI":"10.1016\/0020-7292(93)90673-K"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"DeUgarte, C.M., Bartolucci, A.A., and Azziz, R. (2005). Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil. Steril.","DOI":"10.1016\/j.fertnstert.2004.11.070"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Legro, R.S., Castracane, V.D., and Kauffman, R.P. (2004). Detecting Insulin Resistance in Polycystic Ovary Syndrome: Purposes and Pitfalls. Obstet. Gynecol. Surv.","DOI":"10.1097\/01.OGX.0000109523.25076.E2"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1055\/s-2007-1016294","article-title":"Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications","volume":"15","author":"Nestler","year":"1997","journal-title":"Semin. Reprod. Endocrinol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wood, J.R., Dumesic, D.A., Abbott, D.H., and Strauss, J.F. (2007). Molecular abnormalities in oocytes from women with polycystic ovary syndrome revealed by microarray analysis. J. Clin. Endocrinol. Metab.","DOI":"10.1210\/jc.2006-2123"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Dumesic, D.A., and Abbott, D.H. (2008). Implications of polycystic ovary syndrome on oocyte development. Semin. Reprod. Med.","DOI":"10.1055\/s-2007-992925"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1530\/REP-09-0568","article-title":"The adverse effects of obesity on conception and implantation","volume":"140","author":"Brewer","year":"2010","journal-title":"Reproduction"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.beem.2006.03.005","article-title":"Endometrium in PCOS: Implantation and predisposition to endocrine CA","volume":"20","author":"Giudice","year":"2006","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Legro, R.S., Finegood, D., and Dunaif, A. (1998). A fasting glucose to insulin ratio is a useful measure of insulin sensitivity in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab.","DOI":"10.1210\/jc.83.8.2694"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1210\/jcem.85.7.6661","article-title":"Quantitative insulin sensitivity check index: A simple, accurate method for assessing insulin sensitivity in humans","volume":"85","author":"Katz","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0015-0282(03)00735-0","article-title":"Androgen excess is the key element in polycystic ovary syndrome","volume":"80","author":"Azziz","year":"2003","journal-title":"Fertil. Steril."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"R23","DOI":"10.1530\/JOE-19-0096","article-title":"Androgens and ovarian function: Translation from basic discovery research to clinical impact","volume":"242","author":"Walters","year":"2019","journal-title":"J. Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1017\/S0954422416000287","article-title":"Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: Diagnostic and methodological challenges","volume":"30","author":"Jeanes","year":"2017","journal-title":"Nutr. Res. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1210\/edrv.20.4.0374","article-title":"The insulin-related ovarian regulatory system in health and disease","volume":"20","author":"Poretsky","year":"1999","journal-title":"Endocr. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Wallace, I.R., McKinley, M.C., Bell, P.M., and Hunter, S.J. (2013). Sex hormone binding globulin and insulin resistance. Clin. Endocrinol.","DOI":"10.1111\/cen.12086"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1542\/peds.2015-1430","article-title":"The diagnosis of polycystic ovary syndrome in adolescents","volume":"136","author":"Rosenfield","year":"2015","journal-title":"Pediatrics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1067\/mpd.2001.109603","article-title":"Early metabolic abnormalities in adolescent girls with polycystic ovarian syndrome","volume":"138","author":"Lewy","year":"2001","journal-title":"J. Pediatr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jsbmb.2014.06.003","article-title":"DHEA, DHEAS and PCOS","volume":"145","author":"Goodarzi","year":"2015","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_46","first-page":"109","article-title":"The influence of combined oral contraceptives containing drospirenone on hypothalamic-pituitary-adrenocortical axis activity and glucocorticoid receptor expression and function in women with polycystic ovary syndrome","volume":"14","author":"Macut","year":"2015","journal-title":"Hormones"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1677\/joe.0.1560187","article-title":"Corticosteroid receptors in mononuclear leucocytes of obese subjects","volume":"156","author":"Vettor","year":"1998","journal-title":"J. Endocrinol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.psyneuen.2016.01.008","article-title":"Glucocorticoid mediated regulation of inflammation in human monocytes is associated with depressive mood and obesity","volume":"66","author":"Cheng","year":"2016","journal-title":"Psychoneuroendocrinology"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"O\u2019Shaughnessy, P.J., Antignac, J.P., Le Bizec, B., Morvan, M.L., Svechnikov, K., S\u00f6der, O., Savchuk, I., Monteiro, A., Soffientini, U., and Johnstonid, Z.C. (2019). Alternative (Backdoor) androgen production and masculinization in the human fetus. PLoS Biol., 17.","DOI":"10.1371\/journal.pbio.3000002"},{"key":"ref_50","first-page":"157","article-title":"Detection of functional ovarian hyperandrogenism in women with androgen excess","volume":"327","author":"Ehrmann","year":"1992","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1093\/hmg\/3.10.1873","article-title":"Polycystic ovaries and premature male pattern baldness are associated with one allele of the steroid metabolism gene CYP17","volume":"3","author":"Carey","year":"1994","journal-title":"Hum. Mol. Genet."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.gene.2011.12.048","article-title":"Polymorphism T\u2192C of gene CYP17 promoter and polycystic ovary syndrome risk: A meta-analysis","volume":"495","author":"Li","year":"2012","journal-title":"Gene"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ajmal, N., Khan, S.Z., and Shaikh, R. (2019). Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. Eur. J. Obstet. Gynecol. Reprod. Biol. X, 3.","DOI":"10.1016\/j.eurox.2019.100060"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.tem.2007.07.004","article-title":"Pathophysiology and types of dyslipidemia in PCOS","volume":"18","author":"Papavassiliou","year":"2007","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1365-2265.2011.04015.x","article-title":"Polycystic ovary syndrome is associated with atherogenic changes in lipoprotein particle number and size independent of body weight","volume":"75","author":"Sidhwani","year":"2011","journal-title":"Clin. Endocrinol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1530\/JME-17-0023","article-title":"The association of the lipidomic profile with features of polycystic ovary syndrome","volume":"59","author":"Moran","year":"2017","journal-title":"J. Mol. Endocrinol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"11056","DOI":"10.1016\/j.mce.2019.110561","article-title":"Pathological pulses in PCOS","volume":"498","author":"Coyle","year":"2019","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1093\/humupd\/dml017","article-title":"The origins and sequelae of abnormal neuroendocrine function in polycystic ovary syndrome","volume":"12","author":"Blank","year":"2006","journal-title":"Hum. Reprod. Update"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2810","DOI":"10.1210\/jc.2004-2359","article-title":"Progesterone inhibition of the hypothalamic gonadotropin-releasing hormone pulse generator: Evidence for varied effects in hyperandrogenemic adolescent girls","volume":"90","author":"Chhabra","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"E1292","DOI":"10.1152\/ajpendo.00310.2013","article-title":"Elevated androgens during puberty in female rhesus monkeys lead to increased neuronal drive to the reproductive axis: A possible component of polycystic ovary syndrome","volume":"306","author":"McGee","year":"2014","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1093\/humrep\/dex338","article-title":"Chronic hyperandrogenemia in the presence and absence of a western-style diet impairs ovarian and uterine structure\/function in young adult rhesus monkeys","volume":"33","author":"Bishop","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/j.1365-2605.2005.00623.x","article-title":"Development of polycystic ovary syndrome: Involvement of genetic and environmental factors","volume":"29","author":"Franks","year":"2006","journal-title":"Int. J. Androl."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.bpobgyn.2017.08.008","article-title":"Polycystic ovary syndrome in adolescents","volume":"48","author":"Rothenberg","year":"2018","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1056\/NEJM198311173092002","article-title":"A Chronobiologic Abnormality in Luteinizing Hormone Secretion in Teenage Girls with the Polycystic-Ovary Syndrome","volume":"309","author":"Zumoff","year":"1983","journal-title":"N. Engl. J. Med."},{"key":"ref_65","first-page":"1328","article-title":"Ovarian hyperandrogynism as a result of congenital adrenal virilizing disorders: Evidence for perinatal masculinization of neuroendocrine function in women","volume":"79","author":"Barnes","year":"1994","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.gene.2011.11.054","article-title":"Role of luteinizing hormone \u03b2-subunit gene variants among South Indian women with polycystic ovary syndrome","volume":"494","author":"Dasgupta","year":"2012","journal-title":"Gene"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"845","DOI":"10.2337\/dc12-0840","article-title":"Limitations in the use of indices using glucose and insulin levels to predict insulin sensitivity: Impact of race and gender and superiority of the indices derived from oral glucose tolerance test in African Americans","volume":"36","author":"Pisprasert","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"246","DOI":"10.17772\/gp\/61751","article-title":"Is there an association between the development of metabolic syndrome in PCOS patients and the C677T MTHFR gene polymorphism?","volume":"87","author":"Ozegowska","year":"2016","journal-title":"Ginekol. Pol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Ozegowska, K.E., and Pawelczyk, L.A. (2015). The role of insulin and selected adipocytokines in patients with polycystic ovary syndrome (PCOS)\u2014A literature review. Ginekol. Pol., 86.","DOI":"10.17772\/gp\/59131"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9291\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:44:06Z","timestamp":1760179446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,11]]},"references-count":69,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["ijerph17249291"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17249291","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,11]]}}}