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    Associations between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes.
    Minerva Endocrinol 2018 Apr 12. Epub 2018 Apr 12.
    Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
    Background: Studies comparing serum 25-hydroxyvitamin D concentrations in women with and without PCOS have produced inconsistent results. Additionally, no previous studies have evaluated associations between vitamin D and specific PCOS phenotypes.

    Methods: This case-control study was conducted among women undergoing intrauterine insemination. Read More

    [Maximal androgen deprivation with abiraterone acetate in hormone sensitive prostate cancer.]
    Arch Esp Urol 2018 03;71(3):267-275
    Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España.
    Objectives: The treatment of metastatic prostate cancer has remained unchanged for more than 70 years, based on androgen deprivation therapy (ADT). In 2015, following the CHAARTED and STAMPEDE trials, it was established that the addition of 6 cycles of docetaxel to ADT was associated with significantly increased survival. In June 2017, the LATITUDE trial and the G arm of the STAMPEDE trial showed that the addition of Abiraterone with Prednisone (5 mg/day) to ADT was also associated with a significant increase in survival in metastatic patients. Read More

    EXOGENOUS TESTOSTERONE DOES NOT INDUCE OR EXACERBATE THE METABOLIC FEATURES ASSOCIATED WITH PCOS AMONG TRANSGENDER MEN.
    Endocr Pract 2018 Apr 6. Epub 2018 Apr 6.
    Center for Transgender Medicine and Surgery, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, NY 10128 USA.
    Objectives: Polycystic ovarian syndrome (PCOS) is a complex condition which can include menstrual irregularity, metabolic derangement, and increased androgen levels. The mechanism of PCOS is unknown. Some suggest that excess production of androgens by the ovaries may cause or exacerbate the metabolic findings. Read More

    Contemporary approaches to the management of polycystic ovary syndrome.
    Ther Adv Endocrinol Metab 2018 Apr 7;9(4):123-134. Epub 2018 Feb 7.
    University Alma Mater Studiorum of Bologna, Via Santo Stefano 38, 40125 Bologna, Italy.
    Polycystic ovary syndrome (PCOS) is a common disorder in women in their reproductive years and is characterized by androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. It is also associated with several metabolic abnormalities, particularly insulin resistance and obesity, which play an important role in the pathophysiology of PCOS and, in particular, negatively influence ovarian function and fertility. This review article summarizes the available treatment for women with PCOS. Read More

    Ontogeny and reversal of brain circuit abnormalities in a preclinical model of PCOS.
    JCI Insight 2018 Apr 5;3(7). Epub 2018 Apr 5.
    Androgen excess is a hallmark of polycystic ovary syndrome (PCOS), a prevalent yet poorly understood endocrine disorder. Evidence from women and preclinical animal models suggests that elevated perinatal androgens can elicit PCOS onset in adulthood, implying androgen actions in both PCOS ontogeny and adult pathophysiology. Prenatally androgenized (PNA) mice exhibit a robust increase of progesterone-sensitive GABAergic inputs to gonadotropin-releasing hormone (GnRH) neurons implicated in the pathogenesis of PCOS. Read More

    A Klinefelter boy with congenital adrenal hyperplasia: too much or too little androgens?
    Ital J Pediatr 2018 Apr 3;44(1):43. Epub 2018 Apr 3.
    Department of Pediatrics, Institute for Maternal and Child Health IRCCS, "Burlo Garofolo", Via dell' Istria 65/1, Trieste, Italy.
    Background: The simultaneous occurrence of Klinefelter Syndrome (KS) and Congenital Adrenal Hyperplasia (CAH) is an exceptional event: there are just three case reports (two children and a 51 years old man) describing males affected by both KS and 21OHD (21-hydroxylase deficiency) CAH, the first causing androgen deficiency, the latter leading to androgen excess.

    Case Report: We report the 4th case of association of KS and CAH in a young man with CAH with good androgen control and with normal secondary sex characteristics, whose Klinefelter syndrome was diagnosed because of reduced testicular volume. He was the first reported case of association of KS and CAH who started androgen replacement therapy in the pubertal age and whose pubertal development was described and followed up step by step. Read More

    Improving Rural Nurse Practitioner Knowledge About Polycystic Ovary Syndrome Through Continuing Education.
    J Contin Educ Nurs 2018 Apr;49(4):164-170
    Background: Polycystic ovary syndrome (PCOS), a common androgen-excess disorder in reproductive-aged women, is often a missed diagnosis. Rural nurse practitioners (NPs) need to be able to diagnose and provide basic management for PCOS. This study's objective was to determine whether a continuing education program about PCOS would improve NPs' knowledge about PCOS. Read More

    Polycystic ovary syndrome, androgen excess, and the risk of nonalcoholic fatty liver disease in women: A longitudinal study based on a United Kingdom primary care database.
    PLoS Med 2018 Mar 28;15(3):e1002542. Epub 2018 Mar 28.
    Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
    Background: Androgen excess is a defining feature of polycystic ovary syndrome (PCOS), which affects 10% of women and represents a lifelong metabolic disorder, with increased risk of type 2 diabetes, hypertension, and cardiovascular events. Previous studies have suggested an increased risk of nonalcoholic fatty liver disease (NAFLD) in individuals with PCOS and implicated androgen excess as a potential driver.

    Methods And Findings: We carried out a retrospective longitudinal cohort study utilizing a large primary care database in the United Kingdom, evaluating NAFLD rates in 63,120 women with PCOS and 121,064 age-, body mass index (BMI)-, and location-matched control women registered from January 2000 to May 2016. Read More

    Estrogen: The necessary evil for human health, and ways to tame it.
    Biomed Pharmacother 2018 Mar 21;102:403-411. Epub 2018 Mar 21.
    Department of Botany, Berhampur University, Berhampur, Odisha, 760007, India.
    Estrogen is a pivotal enzyme for survival and health in both genders, though their quantum, tropism, tissue-specific distribution, and receptor affinity varies with different phases of life. Converted from androgen via aromatase enzyme, this hormone is indispensable to glucose homeostasis, immune robustness, bone health, cardiovascular health, fertility, and neural functions. However, estrogen is at the center of almost all human pathologies as well-infectious, autoimmune, metabolic to degenerative. Read More

    Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment.
    Nat Rev Endocrinol 2018 May 23;14(5):270-284. Epub 2018 Mar 23.
    Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain.
    Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in premenopausal women. Heterogeneous by nature, PCOS is defined by a combination of signs and symptoms of androgen excess and ovarian dysfunction in the absence of other specific diagnoses. The aetiology of this syndrome remains largely unknown, but mounting evidence suggests that PCOS might be a complex multigenic disorder with strong epigenetic and environmental influences, including diet and lifestyle factors. Read More

    A Major Population of Functional KLRG1 ILC2s in Female Lungs Contributes to a Sex Bias in ILC2 Numbers.
    Immunohorizons 2018 Feb;2(2):74-86
    Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104.
    Humans show significant sex differences in the incidence and severity of respiratory diseases, including asthma and virus infection. Sex hormones contribute to the female sex bias in type 2 inflammation associated with respiratory diseases, consistent with recent reports that female lungs harbor greater numbers of GATA-3-dependent group 2 innate lymphoid cells (ILC2s). In this study, we determined whether sex hormone levels govern sex differences in the numbers, phenotype, and function of ILC2s in the murine lung and bone marrow (BM). Read More

    Maternal androgen excess and obesity induce sexually dimorphic anxiety-like behavior in the offspring.
    FASEB J 2018 Mar 22:fj201701263RR. Epub 2018 Mar 22.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Maternal polycystic ovary syndrome (PCOS), a condition associated with hyperandrogenism, is suggested to increase anxiety-like behavior in the offspring. Because PCOS is closely linked to obesity, we investigated the impact of an adverse hormonal or metabolic maternal environment and offspring obesity on anxiety in the offspring. The obese PCOS phenotype was induced by chronic high-fat-high-sucrose (HFHS) consumption together with prenatal dihydrotestosterone exposure in mouse dams. Read More

    Dehydroepiandrosterone-induced activation of mTORC1 and inhibition of autophagy contribute to skeletal muscle insulin resistance in a mouse model of polycystic ovary syndrome.
    Oncotarget 2018 Feb 12;9(15):11905-11921. Epub 2018 Jan 12.
    Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
    Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age and also an important metabolic disorder associated with insulin resistance (IR). Hyperandrogenism is a key feature of PCOS. However, whether hyperandrogenism can cause IR in PCOS remains largely unknown. Read More

    Congenital adrenal hyperplasia: clinical symptoms and diagnostic methods.
    Acta Biochim Pol 2018 15;65(1):25-33. Epub 2018 Mar 15.
    Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland.
    The aim of this paper is a straightforward presentation of the steroidogenesis process and the most common type of congenital adrenal hyperplasia (CAH) - 21-hydroxylase deficiency - as well as the analytical diagnostic methods that are used to recognize this disease. CAH is a family of common autosomal recessive disorders characterized by impaired adrenal cortisol biosynthesis with associated androgen excess due to a deficiency of one or more enzymes in the steroidogenesis process within the adrenal cortex. The most common and prototypical example of the CAH disorders group (90-95%) is caused by 21-hydroxylase deficiency. Read More

    Long-term urinary symptoms in adolescent and adult women with congenital adrenal hyperplasia.
    J Pediatr Urol 2018 Feb 7. Epub 2018 Feb 7.
    Gynaecology Department, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia. Electronic address:
    Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive condition resulting in excess androgen production. Females are typically born with ambiguous genitalia and often undergo feminising genitoplasty in infancy or childhood. Recently, there has been considerable international debate as to whether distressing urinary symptoms in CAH patients are truly present and, if so, whether these urinary problems are a consequence of the feminising genitoplasty. Read More

    An ovarian Leydig cell tumor of ultrasound negative in a postmenopausal woman with hirsutism and hyperandrogenism: A case report.
    Medicine (Baltimore) 2018 Mar;97(10):e0093
    Department of Endocrinology, the First Affiliated Hospital, College of Medicine, Zhejiang University.
    Rationale: The incidence of severe hyperandrogenism associated with masculinity in women is very low. While rare and difficult to diagnose, androgen secreting tumors should be suspected in women with hyperandrogenism and hirsutism, especially in the postmenopausal population. Herein we present one case of ovarian Leydig cell tumor (LCT) with markedly elevated serum testosterone levels and frank hirsutism. Read More

    Low digit ratio (2D:4D) and late pubertal onset indicate prenatal hyperandrogenziation in alcohol binge drinking.
    Prog Neuropsychopharmacol Biol Psychiatry 2018 Feb 27. Epub 2018 Feb 27.
    Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
    Background: Alcohol binge drinking behavior is an important public health issue. Causal rodent and human associational studies show that reinforcement of prenatal androgen signaling increases alcohol consumption in adulthood. However, the effects of prenatal androgen exposure on adult binge drinking patterns have not been investigated yet. Read More

    A high-throughput UPC-MS/MS method for the separation and quantification of C and C steroids and their C11-oxy steroid metabolites in the classical, alternative, backdoor and 11OHA4 steroid pathways.
    J Chromatogr B Analyt Technol Biomed Life Sci 2018 Mar 20;1080:71-81. Epub 2018 Feb 20.
    Department of Biochemistry, Stellenbosch University, Stellenbosch 7600, South Africa. Electronic address:
    In the present study an ultra-performance convergence chromatography tandem mass spectrometry (UPC-MS/MS) analytical method was developed and validated for the determination of 17 C and 14 C steroids, including C11-oxy C and C11-oxy C steroids. The limit of detection and limit of quantification ranged from 0.01 to 10 ng/mL and from 0. Read More

    Antiandrogen Treatment Ameliorates Reproductive and Metabolic Phenotypes in the Letrozole-Induced Mouse Model of PCOS.
    Endocrinology 2018 Apr;159(4):1734-1747
    Department of Reproductive Medicine, Center for Reproductive Science and Medicine, University of California, San Diego, La Jolla, California.
    Polycystic ovary syndrome (PCOS), the most common endocrinopathy in women of reproductive age, is characterized by hyperandrogenism, anovulation, and polycystic ovaries. Although its etiology is unknown, excess androgens are thought to be a critical factor driving the pathology of PCOS. We previously demonstrated that continuous exposure to the aromatase inhibitor letrozole (LET) in mice produces many hallmarks of PCOS, including elevated testosterone (T) and luteinizing hormone, anovulation, and obesity. Read More

    Prenatal Androgen Exposure Causes Hypertension and Gut Microbiota Dysbiosis.
    Gut Microbes 2018 Feb 22:1-45. Epub 2018 Feb 22.
    a Department of Physiology and Pharmacology , The University of Toledo College of Medicine and Life Sciences , Toledo , OH.
    Background: Conditions of excess androgen in women, such as polycystic ovary syndrome (PCOS), often exhibit intergenerational transmission. One way in which the risk for PCOS may be increased in daughters of affected women is through exposure to elevated androgens in utero. Hyperandrogenemic conditions have serious health consequences, including increased risk for hypertension and cardiovascular disease. Read More

    Insulin resistance in an animal model of polycystic ovary disease is aggravated by vitamin D deficiency: Vascular consequences.
    Diab Vasc Dis Res 2018 Feb 1:1479164118758580. Epub 2018 Feb 1.
    3 Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
    Hyperandrogenic state in females is accompanied with metabolic syndrome, insulin resistance and vascular pathologies. A total of 67%-85% of hyperandrogenic women suffer also from vitamin D deficiency. We aimed to check a potential interplay between hyperandrogenism and vitamin D deficiency in producing insulin resistance and effects on coronary resistance arteries. Read More

    MANAGEMENT OF ENDOCRINE DISEASE Hyperandrogenic states in women: pitfalls in laboratory diagnosis.
    Eur J Endocrinol 2018 Apr 16;178(4):R141-R154. Epub 2018 Feb 16.
    Laboratoire d'Hormonologied'Endocrinologie Moléculaire et des Maladies Rares, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.
    Measuring total testosterone level is the first-line approach in assessing androgen excess in women. The main pitfalls in measuring testosterone relate to its low concentration and to the structural similarity between circulating androgens and testosterone, requiring accurate techniques with high specificity and sensitivity. These goals can be achieved by immunoassay using a specific anti-testosterone monoclonal antibody, ideally after an extraction step. Read More

    The impact of sex steroid agonists and antagonists on folliculogenesis in the neonatal porcine ovary via cell proliferation and apoptosis.
    Theriogenology 2018 Jun 10;113:19-26. Epub 2018 Feb 10.
    Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387, Krakow, Poland. Electronic address:
    The objective of the study was to examine the effects of androgen and estrogen agonists or antagonists on the follicle formation, ovarian cell proliferation and apoptosis as well as plasma steroid concentration in neonatal pigs. Piglets were injected with testosterone propionate (TP, 20 mg/kg bw), flutamide (FLU, 50 mg/kg bw), 4-tert-octylphenol (OP, 100 mg/kg bw), ICI 182,780 (ICI, 400 μg/kg bw), methoxychlor (MXC, 100 mg/kg bw) or corn oil (CTR, controls) between postnatal Days 1 and 10 (n = 4/group). Heart blood was collected and ovaries were excised from the 11-day-old piglets. Read More

    Metformin as an adjunct therapy for the treatment of moderate to severe acne vulgaris.
    Dermatol Online J 2017 Nov 15;23(11). Epub 2017 Nov 15.
    Lincoln Memorial University-DeBusk College of Osteopathic Medicine.
    The purpose of this literature review is to evaluate the use of metformin as an adjunct therapy in the treatment of moderate-to-severe acne in those not diagnosed with polycystic ovary syndrome (PCOS) or androgen excess. The authors conducted independent literature searches. Results were limited to clinical trials and randomized controlled trials. Read More

    C1QTNF3 in the murine ovary and its function in folliculogenesis.
    Reproduction 2018 Apr 1;155(4):333-346. Epub 2018 Feb 1.
    Key Laboratory for Regenerative Medicine (JNU-CUHK)Ministry of Education, Department of Developmental and Regenerative Biology, College of Life Science and Technologies, Jinan University, Guangzhou, China
    C1q/tumor necrosis factor-related protein 3 (C1QTNF3) is a novel adipokine with modulating effects on metabolism, inflammation and the cardiovascular system. C1QTNF3 expression levels in the sera and omental adipose tissues of women with PCOS are low compared to control subjects. However, the expression and function of C1QTNF3 in the ovary has not previously been examined. Read More

    Genes and Pathways Regulated by Androgens in Human Neural Cells, Potential Candidates for the Male Excess in Autism Spectrum Disorder.
    Biol Psychiatry 2018 Jan 9. Epub 2018 Jan 9.
    Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France; Centre National de la Recherche Scientifique, UMR 7104, Illkirch, France; Institut National de la Santé et de la Recherche Médicale, U964, Illkirch, France; Université de Strasbourg, Illkirch, France; Laboratory of Genetic Diagnostics, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. Electronic address:
    Background: Prenatal exposure to androgens during brain development in male individuals may participate to increase their susceptibility to develop neurodevelopmental disorders such as autism spectrum disorder (ASD) and intellectual disability. However, little is known about the action of androgens in human neural cells.

    Methods: We used human neural stem cells differentiated from embryonic stem cells to investigate targets of androgens. Read More

    Hidradenitis Suppurativa Is Associated with Polycystic Ovary Syndrome: A Population-Based Analysis in the United States.
    J Invest Dermatol 2018 Feb 19. Epub 2018 Feb 19.
    Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, USA.
    Polycystic ovary syndrome (PCOS) has been linked to hidradenitis suppurativa (HS). However, evidence establishing a relationship between the two conditions is limited. We sought to determine the prevalence of PCOS among patients with HS and the strength of the association. Read More

    Perimenarchal air pollution exposure and menstrual disorders.
    Hum Reprod 2018 Jan 25. Epub 2018 Jan 25.
    Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Landmark Center, 401 Park Drive, 3rd F West, Boston, MA 02115, USA.
    Study Question: What is the association between perimenarchal exposure to total suspended particulate (TSP) in air, menstrual irregularity phenotypes and time to menstrual cycle regularity?

    Summary Answer: Exposures to TSP during high school are associated with slightly increased odds of menstrual irregularity and longer time to regularity in high school and early adulthood.

    What Is Known Already: The menstrual cycle is responsive to hormonal regulation. Particulate matter air pollution has demonstrated hormonal activity. Read More

    Circadian blood pressure profiles and ambulatory arterial stiffness index in children and adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency in relation to their genotypes.
    Neuro Endocrinol Lett 2017 Dec;38(7):509-518
    Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
    Objective: Lifelong steroid therapy and exposure to adrenal androgen excess in 21-hydroxylase deficient (21-OHD) congenital adrenal hyperplasia (CAH) children and adolescents may modify circadian blood pressure profile and result in vascular complications. The objective of the study was to evaluate vascular abnormalities in 21-OHD children and adolescents in relation to their genotypes.

    Design: A cross-sectional study conducted at a tertiary referral center. Read More

    New perspectives on the definition and management of polycystic ovary syndrome.
    J Endocrinol Invest 2018 Jan 23. Epub 2018 Jan 23.
    Unit of Endocrinology, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy.
    Background: There is a growing debate on the opportunity of improving the understanding in the diagnosis and management of polycystic ovary syndrome (PCOS).

    Objective: This review article summarizes recent research related to the definition of polycystic ovary syndrome (PCOS).

    Methods: Review of the recent literature on the topic. Read More

    Testosterone a key factor in gender related metabolic syndrome.
    Obes Rev 2018 Apr 21;19(4):557-575. Epub 2018 Jan 21.
    Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
    Metabolic syndrome (MetS) is highly correlated with cardiovascular diseases. Although an excess of body fat is a determinant factor for MetS development, a reduced level of testosterone plays a fundamental role in its regulation. Low testosterone level is highly related to insulin resistance, visceral obesity and MetS. Read More

    Insulin signaling displayed a differential tissue-specific response to low-dose dihydrotestosterone in female mice.
    Am J Physiol Endocrinol Metab 2018 Apr 19;314(4):E353-E365. Epub 2017 Dec 19.
    Division of Pediatric Endocrinology, Johns Hopkins School of Medicine , Baltimore, Maryland.
    Hyperandrogenemia and hyperinsulinemia are believed to play prominent roles in polycystic ovarian syndrome (PCOS). We explored the effects of low-dose dihydrotestosterone (DHT), a model of PCOS, on insulin signaling in metabolic and reproductive tissues in a female mouse model. Insulin resistance in the energy storage tissues is associated with type 2 diabetes. Read More

    Causes, Patterns, and Severity of Androgen Excess in 1205 Consecutively Recruited Women.
    J Clin Endocrinol Metab 2018 Mar;103(3):1214-1223
    Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.
    Context: Androgen excess in women is predominantly due to underlying polycystic ovary syndrome (PCOS). However, there is a lack of clarity regarding patterns and severity of androgen excess that should be considered predictive of non-PCOS pathology.

    Objective: We examined the diagnostic utility of simultaneous measurement of serum dehydroepiandrosterone sulfate (DHEAS), androstenedione (A4), and testosterone (T) to delineate biochemical signatures and cutoffs predictive of non-PCOS disorders in women with androgen excess. Read More

    Children with premature pubarche: is an alterated neonatal 17-Ohp screening test a predictive factor?
    Ital J Pediatr 2018 Jan 16;44(1):10. Epub 2018 Jan 16.
    Pediatric Division, Department of Pediatrics, University Hospital of Verona, Verona, Italy.
    Background: Neonatal screening for 21 hydroxylase deficiency is designed to detect classical form of congenital adrenal hyperplasia (CAH). It is still unclear whether newborns who result false positives at neonatal screening might later develop signs of androgen excess. The aim of this study is to verify whether a slightly elevated 17-OHP at newborn screening is a predictive factor for premature pubarche. Read More

    Mitotane treatment in patients with metastatic testicular Leydig cell tumor associated with severe androgen excess.
    Eur J Endocrinol 2018 Mar 12;178(3):K21-K27. Epub 2018 Jan 12.
    Institute of Metabolism and Systems ResearchUniversity of Birmingham, Birmingham, UK
    Mitotane (o,p'DDD) is established in the adjuvant and advanced-stage treatment of adrenocortical carcinoma and counteracts both tumor growth and tumor-related steroid production. Both the adrenal glands and the gonads are steroidogenically active organs and share a common embryogenic origin. Here, we describe the effects of mitotane in two patients with metastatic Leydig cell tumor (LCT) of the testes and associated severe androgen excess (serum testosterone 93 and 88 nmol/L, respectively; male reference range 7-27 nmol/L). Read More

    Premature Adrenarche.
    Pediatr Ann 2018 Jan;47(1):e7-e11
    Adrenarche is when a child's adrenal cortex starts to secrete adrenal androgen precursors. Dehydroepiandrosterone (DHEA) is the most abundant product of the adrenal cortex, and is a weak androgen agonist thought to be responsible for the clinical signs of pubarche by conversion to more potent androgens, testosterone, and dihydrotestosterone. DHEA's extra-adrenal sulfation product, dehydroepiandrosterone sulfate, is a stable marker for adrenal androgenic activity. Read More

    Anogenital distance in newborn daughters of women with polycystic ovary syndrome indicates fetal testosterone exposure.
    J Dev Orig Health Dis 2018 Jan 9:1-8. Epub 2018 Jan 9.
    9Department of Preventive Medicine,Icahn School of Medicine at Mount Sinai,New York,NY,USA.
    Polycystic ovary syndrome (PCOS) affects ~7% of reproductive age women. Although its etiology is unknown, in animals, excess prenatal testosterone (T) exposure induces PCOS-like phenotypes. While measuring fetal T in humans is infeasible, demonstrating in utero androgen exposure using a reliable newborn biomarker, anogenital distance (AGD), would provide evidence for a fetal origin of PCOS and potentially identify girls at risk. Read More

    Suspected ontogeny of a recently described hypo-androgenic PCOS-like phenotype with advancing age.
    Endocrine 2018 Mar 6;59(3):661-676. Epub 2018 Jan 6.
    The Center for Human Reproduction, New York, NY, 10021, USA.
    Background: A recent report described a new PCOS-like phenotype in lean older infertile women, and was characterized by high age-specific anti-Müllerian hormone (AMH) but hypo- rather than the expected hyper-androgenism. The hypo-androgenism was, furthermore, characterized of, likely, adrenal origin and autoimmune etiology.

    Patients And Methods: We extracted data on 708 consecutive infertility patients, and separated them into three age-strata, <35, 36-42, and >42 years. Read More

    Combined oral contraceptives and/or antiandrogens versus insulin sensitizers for polycystic ovary syndrome: a systematic review and meta-analysis.
    Hum Reprod Update 2017 Dec 27. Epub 2017 Dec 27.
    Department of Endocrinology & Metabolism, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, E-28034 Madrid, Spain.
    Background: Androgen excess is a key pathogenetic mechanism in polycystic ovary syndrome (PCOS), although hyperinsulinism also contributes to androgen secretion. Therapeutic approaches for adult patients not seeking fertility include combined oral contraceptives (COC), antiandrogens (AA) and/or insulin sensitizers, although these practices are supported by limited high-quality evidence.

    Objective And Rationale: We aimed to assess the efficacy and safety of these common treatments for PCOS by conducting a meta-analysis of RCTs with the following review questions: Which is the more appropriate therapeutic approach for hyperandrogenic symptoms, hyperandrogenemia, and ovulatory dysfunction in adult women with PCOS not seeking fertility; What is the impact on classic cardiometabolic risk factors of the more common treatments used in those women; Does the combination of the antiandrogenic therapy plus metformin have any impact on efficacy or cardiometabolic profile?

    Search Methods: We searched PubMed and EMBASE for articles published up to 16 September 2017. Read More

    Androgen excess is due to elevated 11-oxygenated androgens in treated children with congenital adrenal hyperplasia.
    J Steroid Biochem Mol Biol 2018 Apr 23;178:221-228. Epub 2017 Dec 23.
    Steroid Research & Mass Spectrometry Unit, Laboratory for Translational Hormone Analytics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany. Electronic address:
    Adrenal androgen excess is the hallmark of classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. Recently, 11-oxygenated C19 steroids, a class of highly active adrenal-derived androgens, have been described in patients with CAH. The aim of our study was to elucidate the significance of 11-oxygenated androgens in children with CAH. Read More

    Enlarged adipocytes in subcutaneous adipose tissue associated to hyperandrogenism and visceral adipose tissue volume in women with polycystic ovary syndrome.
    Steroids 2018 Feb 20;130:15-21. Epub 2017 Dec 20.
    Endocrinology and Metabolism Laboratory, West Division, School of Medicine, University of Chile, Santiago, Chile.
    Context: Polycystic ovary syndrome (PCOS) is an androgen excess disorder associated with obesity and adipose tissue disturbances. Our aim was to evaluate gene expression of adipocytokines and adipocyte characteristics in abdominal subcutaneous adipose tissue (SAT) of PCOS women.

    Design: Twelve PCOS (PCOSw) and 12 control (Cw) premenopausal women (BMI 20-35 kg/m) were included, with measurements of whole-body composition assessed by dual-energy X-ray absorptiometry, and abdominal subcutaneous and visceral adipose tissue (VAT) volume, by magnetic resonance imaging. Read More

    Alterations in Hydrocortisone Pharmacokinetics in a Patient With Congenital Adrenal Hyperplasia Following Bariatric Surgery.
    J Endocr Soc 2017 Jul 21;1(7):994-1001. Epub 2017 Jun 21.
    National Institutes of Health Clinical Center, Bethesda, Maryland 20892.
    Management of adult patients with classic congenital adrenal hyperplasia (CAH) is challenging and often complicated by obesity, metabolic syndrome, and adverse cardiovascular risk. Alterations in weight can influence cortisol kinetics. A 19-year-old woman with classic CAH and morbid obesity experienced persistent elevations of androgen levels while receiving oral glucocorticoid therapy. Read More

    Developmental Programming: Impact of Prenatal Testosterone Excess on Steroidal Machinery and Cell Differentiation Markers in Visceral Adipocytes of Female Sheep.
    Reprod Sci 2017 Jan 1:1933719117746767. Epub 2017 Jan 1.
    1 Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
    Prenatal testosterone (T)-treated female sheep manifest reduced adipocyte size and peripheral insulin resistance. The small adipocyte phenotype may reflect defects in adipogenesis and its steroidal machinery. To test whether prenatal T treatment from gestational days 30 to 90 alters the visceral adipose tissue (VAT) steroidal machinery and reduces adipocyte differentiation, we examined expression of the steroidogenic enzymes, steroid receptors, and adipocyte differentiation markers at fetal day 90 and postnatal ages 10 and 21 months. Read More

    Do Different Diagnostic Criteria Impact Polycystic Ovary Syndrome Diagnosis for Adolescents?
    J Pediatr Adolesc Gynecol 2017 Dec 9. Epub 2017 Dec 9.
    Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
    Study Objective: Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. Read More

    The Role of Androgen Excess in Metabolic Dysfunction in Women : Androgen Excess and Female Metabolic Dysfunction.
    Adv Exp Med Biol 2017 ;1043:597-608
    Diabetes Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramon y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain.
    Polycystic ovary syndrome (PCOS) is characterized by the association of androgen excess with chronic oligoovulation and/or polycystic ovarian morphology, yet metabolic disorders and classic and nonclassic cardiovascular risk factors cluster in these women from very early in life. This chapter focuses on the mechanisms underlying the association of PCOS with metabolic dysfunction, focusing on the role of androgen excess on the development of visceral adiposity and adipose tissue dysfunction. Read More

    Sex Differences in Androgen Regulation of Metabolism in Nonhuman Primates.
    Adv Exp Med Biol 2017 ;1043:559-574
    Division of Cardiometabolic Health, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA.
    The in-depth characterization of sex differences relevant to human physiology requires the judicious use of a variety of animal models and human clinical data. Nonhuman primates (NHPs) represent an important experimental system that bridges rodent studies and clinical investigations. NHP studies have been especially useful in understanding the role of sex hormones in development and metabolism and also allow the elucidation of the effects of pertinent dietary influences on physiology pertinent to disease states such as obesity and diabetes. Read More

    Molecular Modifiers of Hormone Receptor Action: Decreased Androgen Receptor Expression in Mismatch Repair Deficient Endometrial Endometrioid Adenocarcinoma.
    Int J Gynecol Pathol 2017 Nov 28. Epub 2017 Nov 28.
    Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
    Endometrial endometrioid carcinoma is related to estrogen excess and expression of estrogen and progesterone receptors. Epidemiological evidence suggests that exposure to elevated androgens, as in polycystic ovarian syndrome, increases the risk of endometrial cancer. Factors impacting androgen receptor (AR) expression are not well studied. Read More

    Effects of vitamin D on ovary in DHEA-treated PCOS rat model: A light and electron microscopic study.
    Ultrastruct Pathol 2018 Jan-Feb;42(1):55-64. Epub 2017 Dec 1.
    a Department of Histology and Embryology, Faculty of Medicine , Cukurova University , Adana , Turkey.
    Aim: The aim of this study was to investigate the effects of vitamin D treatment on ovary in experimentally designed polycystic ovary syndrome of female rats using light and electron microscopic techniques.

    Methods: Twenty-four female pre-pubertal rats were divided into control, DHEA and DHEA+Vit.D groups. Read More

    Dermatologic manifestations of endocrine disorders.
    Transl Pediatr 2017 Oct;6(4):300-312
    The Ohio State University College of Medicine, Columbus, OH, USA.
    The skin serves as a window for clinicians to understand, diagnose, and monitor endocrine disease. Dermatologic manifestations of endocrinopathies contribute significantly to an individual's health and quality of life. In this review, we outline various disorders of the hypothalamic-pituitary axis, thyroid gland, pancreas, adrenal gland, and androgen axis as well as hereditary endocrine syndromes. Read More

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