{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:30:26Z","timestamp":1787031026776,"version":"build-2736575974"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med\ufffdInsights\ufffdReprod\ufffdHealth"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to assess the activity of cortisol-metabolizing enzymes in women with polycystic ovary syndrome (PCOS), using a fully quantitative gas chromatography\/mass spectrometry (GCMS) method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We investigated the glucocorticoid degradation pathways that include ll\u03b2-hydroxysteroid dehydrogenase (ll\u03b2-HSD) type 1, 5\u03b1-reductase (5\u03b1-R) and 5\u03b2-reductase (5\u03b2-R), 3\u03b1-hydroxysteroid dehydrogenase, and 20\u03b1- and 20\u03b2-hydroxysteroid dehydrogenase (20\u03b1-HSD and 20\u03b2-HSD, respectively) in young nonobese women with PCOS, using a fully quantitative GCMS method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study was conducted in a tertiary referral hospital in Israel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>\n                      This study group consisted of 13 young women, aged 20.1 \u00b12.8 years (mean \u00b1 SD), with the body mass index (BMI) of 22.6 \u00b1 3.7 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , diagnosed with PCOS according to the Rotterdam criteria. The control group consisted of 14 healthy young women matched for weight, height, and BMI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Urine samples were analyzed using GCMS. We measured urinary steroid metabolites that represent the products and substrates of the study enzymes and calculated the product\/substrate ratios to represent enzyme activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>The calculation of enzymatic activity, based on glucocorticoid degradation metabolites, was done by GCMS in PCOS vs. controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All glucocorticoid degradation metabolites were higher in the PCOS group than in controls. Of the adrenal enzymes, the activities of 21-hydroxylase and 17\u03b1-hydroxylase were reduced, whereas the activity of 17,20-lyase was enhanced in PCOS. Of the degradation enzymes, the activity of 11\u03b2-HSD type 1 was reduced in women with PCOS only when calculated from cortoles and cortolones ratios. The activities of 5\u03b1-R\/5\u03b2-R were increased only when calculating the 11-hydroxy metabolites of androgens. The activity of 20\u03b1-HSD was elevated in the patients with PCOS and its relation with the substrate levels was lost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We confirm PCOS association with low 21-hydroxylase activity. PCOS is associated with dysregulation in glucocorticoid degradation. The activity of 5\u03b1-R is enhanced only through the backdoor pathway. Marked increase in the activity of 20\u03b1-HSD suggests a hitherto unknown derangement in PCOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4137\/cmrh.s35567","type":"journal-article","created":{"date-parts":[[2016,5,5]],"date-time":"2016-05-05T18:12:53Z","timestamp":1462471973000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Cortisol-Metabolizing Enzymes in Polycystic Ovary Syndrome"],"prefix":"10.4137","volume":"10","author":[{"given":"Zeev","family":"Blumenfeld","sequence":"first","affiliation":[{"name":"Section of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Rambam Health Care Campus, Technion\u2013-Israel Institute of Technology, Haifa, Israel."},{"name":"Rappaport Family Faculty of Medicine, Technion\u2013-Israel Institute of Technology, Haifa, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabi","family":"Kaidar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Meyer Children's Hospital, Technion\u2013-Israel Institute of Technology, Haifa, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehama","family":"Zuckerman-Levin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Meyer Children's Hospital, Technion\u2013-Israel Institute of Technology, Haifa, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Dumin","sequence":"additional","affiliation":[{"name":"department of Clinical Biochemistry, Rambam Health Care Campus, Haifa, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Knopf","sequence":"additional","affiliation":[{"name":"department of Clinical Biochemistry, Rambam Health Care Campus, Haifa, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze'ev","family":"Hochberg","sequence":"additional","affiliation":[{"name":"Rappaport Family Faculty of Medicine, Technion\u2013-Israel Institute of Technology, Haifa, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,5,5]]},"reference":[{"key":"bibr1-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61345-2"},{"key":"bibr2-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.12.011"},{"key":"bibr3-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-007-9054-0"},{"key":"bibr4-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)58567-7"},{"key":"bibr5-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2222"},{"key":"bibr6-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030240"},{"key":"bibr7-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199402173300703"},{"key":"bibr8-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.00893.x"},{"key":"bibr9-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1515\/JPEM.2000.13.3.253"},{"key":"bibr10-CMRH.S35567","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021875"},{"key":"bibr11-CMRH.S35567","volume-title":"Current 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