{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:55:26Z","timestamp":1789617326981,"version":"build-2803163510"},"reference-count":142,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["636320005"],"award-info":[{"award-number":["636320005"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000268","name":"Biotechnology and Biological Sciences Research Council","doi-asserted-by":"publisher","award":["BB\/R007985\/1"],"award-info":[{"award-number":["BB\/R007985\/1"]}],"id":[{"id":"10.13039\/501100000268","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the National Institute of Environmental Health Sciences, USA","award":["1R01ES030374-01A1"],"award-info":[{"award-number":["1R01ES030374-01A1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Polycystic ovary syndrome (PCOS) is an endocrine condition associated with reproductive and psychiatric disorders, and with obesity. Eating disorders, such as bulimia and recurrent dieting, are also linked to PCOS. They can lead to the epigenetic dysregulation of the hypothalamic\u2013pituitary\u2013gonadal (HPG) axis, thereby impacting on ovarian folliculogenesis. We postulate that PCOS is induced by psychological distress and episodes of overeating and\/or dieting during puberty and adolescence, when body dissatisfaction and emotional distress are often present. We propose that upregulated activation of the central HPG axis during this period can be epigenetically altered by psychological stressors and by bulimia\/recurrent dieting, which are common during adolescence and which can lead to PCOS. This hypothesis is based on events that occur during a largely neglected stage of female reproductive development. To date, most research into the origins of PCOS has focused on the prenatal induction of this disorder, particularly in utero androgenization and the role of anti-M\u00fcllerian hormone. Establishing causality in our peripubertal model requires prospective cohort studies from infancy. Mechanistic studies should consider the role of the gut microbiota in addition to the epigenetic regulation of (neuro) hormones. Finally, clinicians should consider the importance of underlying chronic psychological distress and eating disorders in PCOS.<\/jats:p>","DOI":"10.3390\/ijms21218211","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T09:09:32Z","timestamp":1604394572000},"page":"8211","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence"],"prefix":"10.3390","volume":"21","author":[{"given":"R\u00e9gine P. M.","family":"Steegers-Theunissen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalieke E.","family":"Wiegel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline W.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus MC, University Medical Centre, 3000 CB Rotterdam, The Netherlands"},{"name":"Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joop S. E.","family":"Laven","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6375-215X","authenticated-orcid":false,"given":"Kevin D.","family":"Sinclair","sequence":"additional","affiliation":[{"name":"School of Biosciences, Sutton Bonnington Campus, University of Nottingham, Leicestershire LE12 6HD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.fertnstert.2007.09.041","article-title":"Consensus on infertility treatment related to polycystic ovary syndrome","volume":"89","author":"ESHRE","year":"2008","journal-title":"Fertil. Steril."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.2147\/NDT.S91700","article-title":"Polycystic ovary syndrome and mental disorders: A systematic review and exploratory meta-analysis","volume":"12","author":"Blay","year":"2016","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1071\/RD04092","article-title":"Early origins of polycystic ovary syndrome","volume":"17","author":"Dumesic","year":"2005","journal-title":"Reprod. Fertil. Dev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1038\/nrendo.2011.227","article-title":"Polycystic ovary syndrome in 2011: Genes, aging and sleep apnea in polycystic ovary syndrome","volume":"8","author":"Dunaif","year":"2011","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/nrendo.2015.230","article-title":"Pcos in 2015: New insights into the genetics of polycystic ovary syndrome","volume":"12","author":"Azziz","year":"2016","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1093\/humupd\/dmw025","article-title":"The management of anovulatory infertility in women with polycystic ovary syndrome: An analysis of the evidence to support the development of global who guidance","volume":"22","author":"Balen","year":"2016","journal-title":"Hum. Reprod. Update"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Teede, H., Deeks, A., and Moran, L. (2010). Polycystic ovary syndrome: A complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med., 8.","DOI":"10.1186\/1741-7015-8-41"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"ESHRE\/ASRM (2004). Rotterdam sponsored pcos consensus workshop group revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil. Steril., 81, 19\u201325.","DOI":"10.1016\/j.fertnstert.2003.10.004"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.ecl.2016.01.004","article-title":"Polycystic ovary syndrome in adolescents","volume":"45","author":"Witchel","year":"2016","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3558","DOI":"10.1210\/jcem.83.10.5205","article-title":"Precocious pubarche, hyperinsulinism, and ovarian hyperandrogenism in girls: Relation to reduced fetal growth","volume":"83","author":"Potau","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.tem.2018.08.005","article-title":"New perspectives on the pathogenesis of pcos: Neuroendocrine origins","volume":"29","author":"Walters","year":"2018","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1210\/jc.2003-030932","article-title":"Anti-m\u00fcllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age","volume":"89","author":"Laven","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Steegers, E.A., Fauser, B.C., Hilders, C.G., Jaddoe, V.W., Massuger, L.F., Schoenmakers, S., and van der Post, J.A. (2019). Textbook of Obstetrics and Gynaecology: A Life Course Approach, Bohn Stafleu van Loghum.","DOI":"10.1007\/978-90-368-2131-5"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/cen.14153","article-title":"Eating, sleeping and sexual function disorders in women with polycystic ovary syndrome (pcos): A systematic review and meta-analysis","volume":"92","author":"Thannickal","year":"2020","journal-title":"Clin. Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1007\/s12020-018-1692-3","article-title":"Psychiatric disorders in women with polycystic ovary syndrome: A systematic review and meta-analysis","volume":"62","author":"Brutocao","year":"2018","journal-title":"Endocrine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1017\/S0033291718002076","article-title":"Depression, anxiety and perceived stress in women with and without pcos: A community-based study","volume":"49","author":"Damone","year":"2019","journal-title":"Psychol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.fertnstert.2007.11.022","article-title":"Risk of depression and other mental health disorders in women with polycystic ovary syndrome: A longitudinal study","volume":"91","author":"Kerchner","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1097\/01.ogx.0000243772.33357.84","article-title":"Polycystic ovary syndrome and mental health: A review","volume":"61","author":"Himelein","year":"2006","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.adolescence.2010.05.004","article-title":"Investigating adolescent stress and body image","volume":"34","author":"Murray","year":"2011","journal-title":"J. Adolesc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1176\/appi.ajp.2008.08050721","article-title":"The evolution of the cognitive model of depression and its neurobiological correlates","volume":"165","author":"Beck","year":"2008","journal-title":"Am. J. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1586\/eog.12.54","article-title":"The role of reproductive hormones in the development and maintenance of eating disorders","volume":"7","author":"Baker","year":"2012","journal-title":"Expert Rev. Obstet. Gynecol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s12958-017-0271-4","article-title":"Psychological stress is related to a decrease of serum anti-m\u00fcllerian hormone level in infertile women","volume":"15","author":"Dong","year":"2017","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_23","first-page":"2001","article-title":"Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system","volume":"83","author":"Nestler","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jpsychores.2013.11.011","article-title":"Binge eating and menstrual dysfunction","volume":"76","author":"Algars","year":"2014","journal-title":"J. Psychosom. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.tem.2009.10.004","article-title":"Stress-induced obesity and the emotional nervous system","volume":"21","author":"Dallman","year":"2010","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.tem.2007.07.003","article-title":"Abdominal adiposity and the polycystic ovary syndrome","volume":"18","year":"2007","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s12529-009-9036-6","article-title":"Salivary cortisol and binge eating disorder in obese women after surgery for morbid obesity","volume":"16","author":"Larsen","year":"2009","journal-title":"Int. J. Behav. Med."},{"key":"ref_28","first-page":"517","article-title":"Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: Role of insulin resistance","volume":"86","author":"Vgontzas","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1172\/JCI9842","article-title":"Two defects contribute to hypothalamic leptin resistance in mice with diet-induced obesity","volume":"105","author":"Pierroz","year":"2000","journal-title":"J. Clin. Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1093\/humupd\/5.2.166","article-title":"Leptin, polycystic ovaries and polycystic ovary syndrome","volume":"5","author":"Jacobs","year":"1999","journal-title":"Hum. Reprod. Update"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1530\/EJE-12-0456","article-title":"Mechanisms in endocrinology: Ghrelin: The differences between acyl- and des-acyl ghrelin","volume":"167","author":"Delhanty","year":"2012","journal-title":"Eur. J. Endocrinol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1159\/000346058","article-title":"Ghrelin, reward and motivation","volume":"25","author":"Menzies","year":"2013","journal-title":"Endocr. Dev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1111\/jne.12236","article-title":"Ghrelin signalling on food reward: A salient link between the gut and the mesolimbic system","volume":"27","author":"Perello","year":"2015","journal-title":"J. Neuroendocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.psyneuen.2015.06.018","article-title":"Escalation in high fat intake in a binge eating model differentially engages dopamine neurons of the ventral tegmental area and requires ghrelin signaling","volume":"60","author":"Valdivia","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.neuroscience.2016.01.004","article-title":"Investigation of a role for ghrelin signaling in binge-like feeding in mice under limited access to high-fat diet","volume":"319","author":"King","year":"2016","journal-title":"Neuroscience"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1007\/s12020-015-0614-x","article-title":"Elevated ratio of acylated to unacylated ghrelin in children and young adults with prader-willi syndrome","volume":"50","author":"Kuppens","year":"2015","journal-title":"Endocrine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1159\/000346059","article-title":"Des-acyl ghrelin: A metabolically active peptide","volume":"25","author":"Delhanty","year":"2013","journal-title":"Endocr. Dev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00404-011-1947-1","article-title":"Co-involvement of psychological and neurological abnormalities in infertility with polycystic ovarian syndrome","volume":"284","author":"Shi","year":"2011","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12958-018-0354-x","article-title":"Gnrh dysregulation in polycystic ovarian syndrome (pcos) is a manifestation of an altered neurotransmitter profile","volume":"16","author":"Chaudhari","year":"2018","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.physbeh.2005.04.013","article-title":"Serotonin alterations in anorexia and bulimia nervosa: New insights from imaging studies","volume":"85","author":"Kaye","year":"2005","journal-title":"Physiol. Behav."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Lam, Y.Y., Maguire, S., Palacios, T., and Caterson, I.D. (2017). Are the gut bacteria telling us to eat or not to eat? Reviewing the role of gut microbiota in the etiology, disease progression and treatment of eating disorders. Nutrients, 9.","DOI":"10.3390\/nu9060602"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.psyneuen.2018.05.020","article-title":"Emerging literature in the microbiota-brain axis and perinatal mood and anxiety disorders","volume":"95","author":"Rackers","year":"2018","journal-title":"Psychoneuroendocrinology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13048-020-00670-3","article-title":"Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: A review","volume":"13","author":"He","year":"2020","journal-title":"J. Ovarian Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1038\/s41591-019-0509-0","article-title":"Gut microbiota\u2013bile acid\u2013interleukin-22 axis orchestrates polycystic ovary syndrome","volume":"25","author":"Qi","year":"2019","journal-title":"Nat. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1055\/a-1081-2036","article-title":"Exploration of the relationship between gut microbiota and polycystic ovary syndrome (pcos): A review","volume":"80","author":"Zhao","year":"2020","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1098\/rstb.2006.1860","article-title":"Modulation of appetite by gonadal steroid hormones","volume":"361","author":"Asarian","year":"2006","journal-title":"Philos. Trans. R. Soc. Lond B Biol. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/j.1600-0447.1994.tb01613.x","article-title":"High levels of free testosterone in women with bulimia nervosa","volume":"90","author":"Sundblad","year":"1994","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Huijgen, N.A., Laven, J.S., Labee, C.T., Louwers, Y.V., Willemsen, S.P., and Steegers-Theunissen, R.P. (2015). Are dieting and dietary inadequacy a second hit in the association with polycystic ovary syndrome severity?. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0142772"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.rbmo.2017.02.014","article-title":"Dietary patterns and the phenotype of polycystic ovary syndrome: The chance of ongoing pregnancy","volume":"34","author":"Huijgen","year":"2017","journal-title":"Reprod. Biomed. Online"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1038\/ejcn.2011.81","article-title":"Habitual dietary intake, eating pattern and physical activity of women with polycystic ovary syndrome","volume":"65","author":"Barr","year":"2011","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.fertnstert.2005.08.045","article-title":"Role of diet in the treatment of polycystic ovary syndrome","volume":"85","author":"Douglas","year":"2006","journal-title":"Fertil. Steril."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1093\/humupd\/dmt015","article-title":"Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines","volume":"19","author":"Moran","year":"2013","journal-title":"Hum. Reprod. Update"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"8553","DOI":"10.3390\/nu7105419","article-title":"The association of a mediterranean-style diet pattern with polycystic ovary syndrome status in a community cohort study","volume":"7","author":"Moran","year":"2015","journal-title":"Nutrients"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mehy.2017.06.013","article-title":"Fasting as possible complementary approach for polycystic ovary syndrome: Hope or hype?","volume":"105","author":"Chiofalo","year":"2017","journal-title":"Med. Hypotheses"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.tem.2020.02.002","article-title":"Inositols in polycystic ovary syndrome: An overview on the advances","volume":"31","author":"Facchinetti","year":"2020","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"R107","DOI":"10.1530\/JME-16-0212","article-title":"Neuroendocrine integration of nutritional signals on reproduction","volume":"58","author":"Evans","year":"2017","journal-title":"J. Mol. Endocrinol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1016\/j.metabol.2014.07.007","article-title":"Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with pcos","volume":"63","author":"Goss","year":"2014","journal-title":"Metabolism"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/cen.12175","article-title":"Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with pcos","volume":"79","author":"Gower","year":"2013","journal-title":"Clin. Endocrinol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1080\/07315724.2012.10720017","article-title":"Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: A randomized controlled intervention study","volume":"31","author":"Mehrabani","year":"2012","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"39","DOI":"10.3945\/ajcn.111.020693","article-title":"Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome","volume":"95","author":"Sorensen","year":"2012","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.fertnstert.2003.08.023","article-title":"A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome","volume":"81","author":"Stamets","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"925","DOI":"10.3109\/09513590.2011.564686","article-title":"Effect of high-protein or normal-protein diet on weight loss, body composition, hormone, and metabolic profile in southern brazilian women with polycystic ovary syndrome: A randomized study","volume":"27","author":"Toscani","year":"2011","journal-title":"Gynecol. Endocrinol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1016\/j.metabol.2011.04.007","article-title":"Metabolic and endocrine effects of long-chain versus essential omega-3 polyunsaturated fatty acids in polycystic ovary syndrome","volume":"60","author":"Vargas","year":"2011","journal-title":"Metabolism"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1002\/erv.2553","article-title":"The science behind the academy for eating disorders\u2019 nine truths about eating disorders","volume":"25","author":"Schaumberg","year":"2017","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1017\/S0033291705006653","article-title":"Preliminary evidence that gonadal hormones organize and activate disordered eating","volume":"36","author":"Klump","year":"2006","journal-title":"Psychol. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1017\/S0033291709992236","article-title":"Preliminary evidence that estradiol moderates genetic influences on disordered eating attitudes and behaviors during puberty","volume":"40","author":"Klump","year":"2010","journal-title":"Psychol. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S1054-139X(01)00195-1","article-title":"Early puberty and early sexual activity are associated with bulimic-type eating pathology in middle adolescence","volume":"28","author":"Rissanen","year":"2001","journal-title":"J. Adolesc. Health"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1136\/archdischild-2016-310475","article-title":"Early puberty in 11-year-old girls: Millennium cohort study findings","volume":"102","author":"Kelly","year":"2017","journal-title":"Arch. Dis. Child."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Lian, Q., Mao, Y., Luo, S., Zhang, S., Tu, X., Zuo, X., Lou, C., and Zhou, W. (2019). Puberty timing associated with obesity and central obesity in chinese han girls. BMC Pediatr., 19.","DOI":"10.1186\/s12887-018-1376-4"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Nguyen, N.T.K., Fan, H.Y., Tsai, M.C., Tung, T.H., Huynh, Q.T.V., Huang, S.Y., and Chen, Y.C. (2020). Nutrient intake through childhood and early menarche onset in girls: Systematic review and meta-analysis. Nutrients, 12.","DOI":"10.3390\/nu12092544"},{"key":"ref_71","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_72","doi-asserted-by":"crossref","unstructured":"Mizgier, M., Jarz\u0105bek-Bielecka, G., Opydo-Szymaczek, J., Wendland, N., Wi\u0119ckowska, B., and K\u0119dzia, W. (2020). Risk factors of overweight and obesity related to diet and disordered eating attitudes in adolescent girls with clinical features of polycystic ovary syndrome. J. Clin. Med., 9.","DOI":"10.3390\/jcm9093041"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"495","DOI":"10.29252\/ijrm.14.8.495","article-title":"Pcos women show significantly higher homocysteine level, independent to glucose and e2 level","volume":"14","author":"Eskandari","year":"2016","journal-title":"Int. J. Reprod. Biomed."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Meng, Y., Chen, X., Peng, Z., Liu, X., Sun, Y., and Dai, S. (2016). Association between high serum homocysteine levels and biochemical characteristics in women with polycystic ovarian syndrome: A systematic review and meta-analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157389"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1093\/jn\/133.8.2643","article-title":"Serum total homocysteine concentrations in children and adolescents: Results from the third national health and nutrition examination survey (nhanes iii)","volume":"133","author":"Must","year":"2003","journal-title":"J. Nutr."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"8330","DOI":"10.1038\/s41598-017-08568-9","article-title":"Associations between serum homocysteine levels and anxiety and depression among children and adolescents in taiwan","volume":"7","author":"Chung","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Esnafoglu, E., and Ozturan, D.D. (2020). The relationship of severity of depression with homocysteine, folate, vitamin b12, and vitamin d levels in children and adolescents. Child Adolesc. Ment. Health.","DOI":"10.1111\/camh.12387"},{"key":"ref_78","first-page":"807","article-title":"A pilot study of folic acid supplementation for improving homocysteine levels, cognitive and depressive status in eating disorders","volume":"28","author":"Hernanz","year":"2013","journal-title":"Nutr. Hosp."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s40618-019-01163-x","article-title":"Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in pcos women","volume":"43","author":"Schiuma","year":"2020","journal-title":"J. Endocrinol. Investig."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.cmet.2017.02.003","article-title":"Metabolic inputs into the epigenome","volume":"25","author":"Sharma","year":"2017","journal-title":"Cell Metab."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"100942","DOI":"10.1016\/j.molmet.2020.01.006","article-title":"Two genomes, one cell: Mitochondrial-nuclear coordination via epigenetic pathways","volume":"38","author":"Wiese","year":"2020","journal-title":"Mol. Metab."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1038\/cr.2011.22","article-title":"Regulation of chromatin by histone modifications","volume":"21","author":"Bannister","year":"2011","journal-title":"Cell Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"a018754","DOI":"10.1101\/cshperspect.a018754","article-title":"A structural perspective on readout of epigenetic histone and DNA methylation marks","volume":"8","author":"Patel","year":"2016","journal-title":"Cold Spring Harb. Perspect. Biol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"14348","DOI":"10.1073\/pnas.1507514112","article-title":"Maternal testosterone exposure increases anxiety-like behavior and impacts the limbic system in the offspring","volume":"112","author":"Hu","year":"2015","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_85","first-page":"538","article-title":"Animal models to understand the etiology and pathophysiology of polycystic ovary syndrome","volume":"41","author":"Padmanabhan","year":"2020","journal-title":"Endocr. Rev."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1093\/humrep\/dei009","article-title":"Birth weight in offspring of mothers with polycystic ovarian syndrome","volume":"20","author":"Hitchsfeld","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/MED.0b013e32835a1a03","article-title":"Diagnosis and treatment of polycystic ovarian syndrome in adolescents","volume":"19","author":"Nicandri","year":"2012","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1038\/ijosup.2015.23","article-title":"Birth weight and childhood obesity: A 12-country study","volume":"5","author":"Qiao","year":"2015","journal-title":"Int. J. Obes. Suppl."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.fertnstert.2019.09.034","article-title":"The associations of maternal polycystic ovary syndrome and hirsutism with behavioral problems in offspring","volume":"113","author":"Robinson","year":"2020","journal-title":"Fertil. Steril."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1093\/humrep\/deaa192","article-title":"Association of polycystic ovary syndrome or anovulatory infertility with offspring psychiatric and mild neurodevelopmental disorders: A finnish population-based cohort study","volume":"35","author":"Chen","year":"2020","journal-title":"Hum. Reprod."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.fertnstert.2018.11.028","article-title":"Circulating antim\u00fcllerian hormone and steroid hormone levels remain high in pregnant women with polycystic ovary syndrome at term","volume":"111","author":"Piltonen","year":"2019","journal-title":"Fertil. Steril."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"4891","DOI":"10.1210\/endo.142.11.8486","article-title":"Anti-m\u00fcllerian hormone attenuates the effects of fsh on follicle development in the mouse ovary","volume":"142","author":"Durlinger","year":"2001","journal-title":"Endocrinology"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.fertnstert.2008.04.047","article-title":"Intrafollicular antim\u00fcllerian hormone levels predict follicle responsiveness to follicle-stimulating hormone (fsh) in normoandrogenic ovulatory women undergoing gonadotropin releasing-hormone analog\/recombinant human fsh therapy for in vitro fertilization and embryo transfer","volume":"92","author":"Dumesic","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1210\/er.2017-00235","article-title":"The versatile tanycyte: A hypothalamic integrator of reproduction and energy metabolism","volume":"39","author":"Prevot","year":"2018","journal-title":"Endocr. Rev."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"10055","DOI":"10.1038\/ncomms10055","article-title":"Novel role for anti-m\u00fcllerian hormone in the regulation of gnrh neuron excitability and hormone secretion","volume":"7","author":"Cimino","year":"2016","journal-title":"Nat. Commun."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"e47198","DOI":"10.7554\/eLife.47198","article-title":"Defective amh signaling disrupts gnrh neuron development and function and contributes to hypogonadotropic hypogonadism","volume":"8","author":"Malone","year":"2019","journal-title":"eLife"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1038\/s41591-018-0035-5","article-title":"Elevated prenatal anti-m\u00fcllerian hormone reprograms the fetus and induces polycystic ovary syndrome in adulthood","volume":"24","author":"Tata","year":"2018","journal-title":"Nat. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0015-0282(01)02944-2","article-title":"Relationship between serum m\u00fcllerian-inhibiting substance and other reproductive hormones in untreated women with polycystic ovary syndrome and normal women","volume":"77","author":"Cook","year":"2002","journal-title":"Fertil. Steril."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1159\/000500689","article-title":"Emerging roles of anti-m\u00fcllerian hormone in hypothalamic-pituitary function","volume":"109","author":"Barbotin","year":"2019","journal-title":"Neuroendocrinology"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Silva, M.S.B., and Giacobini, P. (2020). New insights into anti-m\u00fcllerian hormone role in the hypothalamic-pituitary-gonadal axis and neuroendocrine development. Cell Mol. Life Sci., 1\u201316.","DOI":"10.1007\/s00018-020-03576-x"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/14767050701209560","article-title":"Depression and anxiety during pregnancy: A risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature","volume":"20","author":"Alder","year":"2007","journal-title":"J. Matern Fetal Neonatal Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.1016\/S0049-3848(15)50446-5","article-title":"Adverse obstetric and neonatal outcomes in women with mental disorders","volume":"135","author":"Brenner","year":"2015","journal-title":"Thromb. Res."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"R1","DOI":"10.1530\/REP-19-0197","article-title":"Mechanisms of intergenerational transmission of polycystic ovary syndrome","volume":"159","author":"Dumesic","year":"2020","journal-title":"Reproduction"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1210\/jc.2016-3907","article-title":"Fetal hyperglycemia changes human preadipocyte function in adult life","volume":"102","author":"Hansen","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1093\/humupd\/dmx013","article-title":"Is foetal hyperexposure to androgens a cause of pcos?","volume":"23","author":"Filippou","year":"2017","journal-title":"Hum. Reprod. Update"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"111042","DOI":"10.1016\/j.mce.2020.111042","article-title":"Aberrant subcutaneous adipogenesis precedes adult metabolic dysfunction in an ovine model of polycystic ovary syndrome (pcos)","volume":"519","author":"Siemienowicz","year":"2020","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Chakraborty, P., Goswami, S.K., Rajani, S., Sharma, S., Kabir, S.N., Chakravarty, B., and Jana, K. (2013). Recurrent pregnancy loss in polycystic ovary syndrome: Role of hyperhomocysteinemia and insulin resistance. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0064446"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.jcma.2013.01.009","article-title":"Correlation between thrombophilia and recurrent pregnancy loss in patients with polycystic ovary syndrome: A comparative study","volume":"76","author":"Kazerooni","year":"2013","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_109","first-page":"141","article-title":"Methylenotetrahydrololate reductase a1298c and c677t polymorphisms and adverse pregnancy outcome in women with pcos","volume":"37","author":"Szafarowska","year":"2016","journal-title":"Neuro Endocrinol. Lett."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"6447","DOI":"10.1038\/s41598-019-42061-9","article-title":"The serum level of irisin, but not asprosin, is abnormal in polycystic ovary syndrome patients","volume":"9","author":"Chang","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Mesa, M.D., Loureiro, B., Iglesia, I., Fernandez Gonzalez, S., Llurba Oliv\u00e9, E., Garc\u00eda Algar, O., Solana, M.J., Cabero Perez, M.J., Sainz, T., and Martinez, L. (2020). The evolving microbiome from pregnancy to early infancy: A comprehensive review. Nutrients, 12.","DOI":"10.3390\/nu12010133"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1203\/PDR.0b013e318217638a","article-title":"The role of microbes in developmental immunologic programming","volume":"69","author":"Kaplan","year":"2011","journal-title":"Pediatr. Res."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/nature10213","article-title":"Human nutrition, the gut microbiome and the immune system","volume":"474","author":"Kau","year":"2011","journal-title":"Nature"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.psyneuen.2015.01.006","article-title":"Maternal prenatal stress is associated with the infant intestinal microbiota","volume":"53","author":"Zijlmans","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1002\/dev.21837","article-title":"Microbiota of newborn meconium is associated with maternal anxiety experienced during pregnancy","volume":"61","author":"Hu","year":"2019","journal-title":"Dev. Psychobiol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"e00036-17","DOI":"10.1128\/MMBR.00036-17","article-title":"The first microbial colonizers of the human gut: Composition, activities, and health implications of the infant gut microbiota","volume":"81","author":"Milani","year":"2017","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s40291-020-00463-w","article-title":"Deciphering the DNA methylome of polycystic ovary syndrome","volume":"24","author":"Tan","year":"2020","journal-title":"Mol. Diagn. Ther."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.mito.2020.02.006","article-title":"Mitochondrial dysfunction: An emerging link in the pathophysiology of polycystic ovary syndrome","volume":"52","author":"Shukla","year":"2020","journal-title":"Mitochondrion"},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Mao, Z., Li, T., Zhao, H., Qin, Y., Wang, X., and Kang, Y. (2020). Identification of epigenetic interactions between microrna and DNA methylation associated with polycystic ovarian syndrome. J. Hum. Genet.","DOI":"10.20944\/preprints201910.0191.v1"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2042018820938305","DOI":"10.1177\/2042018820938305","article-title":"A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome","volume":"11","author":"Abdalla","year":"2020","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.gene.2019.04.082","article-title":"The role of mirna in polycystic ovary syndrome (pcos)","volume":"706","author":"Chen","year":"2019","journal-title":"Gene"},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Stueve, T.R., Wolff, M.S., Pajak, A., Teitelbaum, S.L., and Chen, J. (2014). Cyp19a1 promoter methylation in saliva associated with milestones of pubertal timing in urban girls. BMC Pediatr., 14.","DOI":"10.1186\/1471-2431-14-78"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1080\/15592294.2018.1556198","article-title":"Association of blood leukocyte DNA methylation at line-1 and growth-related candidate genes with pubertal onset and progression","volume":"13","author":"Wu","year":"2018","journal-title":"Epigenetics"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"R107","DOI":"10.1530\/EJE-20-0103","article-title":"Genetics in endocrinology: Genetic etiologies of central precocious puberty and the role of imprinted genes","volume":"183","author":"Roberts","year":"2020","journal-title":"Eur. J. Endocrinol."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Vazquez, A., Sanchez-Rodriguez, E., Vargas, F., Montoro-Molina, S., Romero, M., Espejo-Calvo, J.A., Vilchez, P., Jaramillo, S., Olmo-Garc\u00eda, L., and Carrasco-Pancorbo, A. (2019). Cardioprotective effect of a virgin olive oil enriched with bioactive compounds in spontaneously hypertensive rats. Nutrients, 11.","DOI":"10.3390\/nu11081728"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/gbb.12207","article-title":"Methyl-donor deficiency in adolescence affects memory and epigenetic status in the mouse hippocampus","volume":"14","author":"Tomizawa","year":"2015","journal-title":"Genes Brain Behav."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"19436","DOI":"10.1038\/srep19436","article-title":"Abnormally activated one-carbon metabolic pathway is associated with mtdna hypermethylation and mitochondrial malfunction in the oocytes of polycystic gilt ovaries","volume":"6","author":"Jia","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1146\/annurev-animal-020518-115206","article-title":"One-carbon metabolism: Linking nutritional biochemistry to epigenetic programming of long-term development","volume":"7","author":"Clare","year":"2019","journal-title":"Annu. Rev. Anim. Biosci."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"e12586","DOI":"10.1111\/ijpo.12586","article-title":"Polycystic ovary syndrome in adolescent girls","volume":"15","year":"2020","journal-title":"Pediatr. Obes."},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"Xu, N., Kwon, S., Abbott, D.H., Geller, D.H., Dumesic, D.A., Azziz, R., Guo, X., and Goodarzi, M.O. (2011). Epigenetic mechanism underlying the development of polycystic ovary syndrome (pcos)-like phenotypes in prenatally androgenized rhesus monkeys. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0027286"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"dvy016","DOI":"10.1093\/eep\/dvy016","article-title":"Environmentally induced epigenetic transgenerational inheritance of disease","volume":"4","author":"Nilsson","year":"2018","journal-title":"Environ. Epigenet."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1080\/17446651.2019.1576522","article-title":"Hyperandrogenic origins of polycystic ovary syndrome\u2014Implications for pathophysiology and therapy","volume":"14","author":"Abbott","year":"2019","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/j.fertnstert.2014.07.1203","article-title":"Genome-wide identification of aberrantly methylated promoters in ovarian tissue of prenatally androgenized rats","volume":"102","author":"Zhang","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1093\/biolre\/ioaa007","article-title":"Developmental programming: Prenatal testosterone-induced epigenetic modulation and its effect on gene expression in sheep ovary\u2020","volume":"102","author":"Sinha","year":"2020","journal-title":"Biol. Reprod."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Lei, L., Ding, L., Su, J., Liu, M., Shi, Q., Zhou, J., Sun, H., and Yan, G. (2017). Attenuated expression of mtr in both prenatally androgenized mice and women with the hyperandrogenic phenotype of pcos. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0187427"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"352","DOI":"10.3389\/fendo.2017.00352","article-title":"Intrauterine reprogramming of the polycystic ovary syndrome: Evidence from a pilot study of cord blood global methylation analysis","volume":"8","author":"Lambertini","year":"2017","journal-title":"Front. Endocrinol."},{"key":"ref_137","doi-asserted-by":"crossref","unstructured":"Echibur\u00fa, B., Milagro, F., Crisosto, N., P\u00e9rez-Bravo, F., Flores, C., Arp\u00f3n, A., Salas-P\u00e9rez, F., Recabarren, S.E., Sir-Petermann, T., and Maliqueo, M. (2020). DNA methylation in promoter regions of genes involved in the reproductive and metabolic function of children born to women with pcos. Epigenetics, 1\u201317.","DOI":"10.1080\/15592294.2020.1754674"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1038\/s41591-019-0666-1","article-title":"Prenatal androgen exposure and transgenerational susceptibility to polycystic ovary syndrome","volume":"25","author":"Risal","year":"2019","journal-title":"Nat. Med."},{"key":"ref_139","doi-asserted-by":"crossref","unstructured":"Oostingh, E.C., Koster, M.P.H., van Dijk, M.R., Willemsen, S.P., Broekmans, F.J.M., Hoek, A., Goddijn, M., Klijn, N.F., van Santbrink, E.J.P., and Steegers, E.A.P. (2020). First effective mhealth nutrition and lifestyle coaching program for subfertile couples undergoing in vitro fertilization treatment: A single-blinded multicenter randomized controlled trial. Fertil. Steril.","DOI":"10.1016\/j.fertnstert.2020.04.051"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.rbmo.2018.09.015","article-title":"The impact of maternal lifestyle factors on periconception outcomes: A systematic review of observational studies","volume":"38","author":"Oostingh","year":"2019","journal-title":"Reprod. Biomed. Online"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"e19378","DOI":"10.2196\/19378","article-title":"Impact of a blended periconception lifestyle care approach on lifestyle behaviors: Before-and-after study","volume":"22","author":"Snoek","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.fertnstert.2016.12.014","article-title":"Increased risk of disordered eating in polycystic ovary syndrome","volume":"107","author":"Lee","year":"2017","journal-title":"Fertil. Steril."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/21\/21\/8211\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:28:25Z","timestamp":1760178505000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/21\/21\/8211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,3]]},"references-count":142,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["ijms21218211"],"URL":"https:\/\/doi.org\/10.3390\/ijms21218211","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,3]]}}}