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    Confounder factors masking a Leydig-cell ovarian tumor in a post-menopausal woman treated for androgen-positive receptor breast cancer.
    Gynecol Endocrinol 2017 Apr 26:1-5. Epub 2017 Apr 26.
    a Endocrinology Division.
    Post-menopause hyperandrogenism is a condition that needs careful evaluation. Aromatase inhibitors (AI), which are important in the management of positive estrogen breast cancer, and chronic kidney disease (CKD) can puzzle the evaluation of this condition. A postmenopause female with type-2 diabetes and advanced CKD was attended due to progressive virilization, which has started after the introduction of an AI for breast cancer 5 years earlier. Read More

    Management of Childhood Congenital Adrenal Hyperplasia-An Integrative Review of the Literature.
    J Pediatr Health Care 2017 Apr 13. Epub 2017 Apr 13.
    Congenital adrenal hyperplasia (CAH) is an endocrine condition that requires parents to administer steroids up to three times daily, supplementing maintenance doses with oral or injectable doses during times of illness. The purpose of this integrative review was to explore the management, care, and associated health issues for children with CAH and the family response to the condition. Four literature indexes were searched, with 39 articles included. Read More

    A Case Report of Cushing's Disease Presenting as Hair Loss.
    Case Rep Dermatol 2017 Jan-Apr;9(1):45-50. Epub 2017 Feb 21.
    Department of Dermatology, Roger Williams Medical Center, Providence, RI, USA.
    Cushing's syndrome is a rare endocrine disorder that comprises a large group of signs and symptoms resulting from chronic exposure to excess corticosteroids. Most cases of Cushing's syndrome are due to increased adrenocorticotropic hormone production from a pituitary adenoma, which is referred to as Cushing's disease. Most of the signs and symptoms are nonspecific and common in the general population, making a diagnosis often challenging. Read More

    Maternal hirsutism and autism spectrum disorders in offspring.
    Autism Res 2017 Apr 6. Epub 2017 Apr 6.
    Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, 17129, Sweden.
    Because animal and human studies indicate that androgen exposure can influence neurodevelopment, it has been hypothesized that prenatal exposure to excess androgens may predispose to disorders with male-skewed ratio such as autism spectrum disorders (ASD). Therefore, maternal conditions characterized by hyperandrogenism such as polycystic ovary syndrome (PCOS) or hirsutism may be relevant to child ASD. We previously found in a large Swedish case-control study of 23,748 ASD cases and 208,796 matched controls that PCOS in mothers is associated with increased offspring risk of ASD. Read More

    Chinese Herbal Medicine for the Optimal Management of Polycystic Ovary Syndrome.
    Am J Chin Med 2017 Mar 30:1-18. Epub 2017 Mar 30.
    * School of Life Sciences, University of Technology Sydney, NSW, 2007, Australia.
    Polycystic ovary syndrome (PCOS) is a complex heterogeneous disorder characterized by androgen excess and ovulatory dysfunction; it is now known to be closely linked to metabolic syndrome. Recent research suggests that insulin resistance plays an important role in the pathogenesis of PCOS which may lead to the excessive production of androgens by ovarian theca cells. Currently there is no single drug that can treat both the reproductive and metabolic complications of the disorder. Read More

    Birth Weight in Different Etiologies of Disorders of Sex Development.
    J Clin Endocrinol Metab 2017 Mar;102(3):1044-1050
    Birmingham Children's Hospital, Birmingham B15 2TT, United Kingdom; and.
    Context: It is well established that boys are heavier than girls at birth. Although the cause of birth weight (BW) difference is unknown, it has been proposed that it could be generated from prenatal androgen action.

    Objective: The aim of the current study was to determine the BW of children with disorders of sex development (DSD) of different etiologies and to evaluate the effects of androgen action on BW. Read More

    Modulation of steroidogenesis by vitamin D3 in granulosa cells of the mouse model of polycystic ovarian syndrome.
    Syst Biol Reprod Med 2017 Jun 27;63(3):150-161. Epub 2017 Mar 27.
    a Department of Anatomy, School of medicine , Tehran University of Medical Sciences , Tehran , Iran.
    Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder of women of reproductive age characterized by polycystic ovarian morphology, anovulation or oligomenorrhea, and hyperandrogenism. It is shown that disruption in the steroidogenesis pathway caused by excess androgen in PCOS is a critical element of abnormal folliculogenesis and failure in dominant follicle selection. Vitamin D plays an important role in the regulation of ovulatory dysfunction and can influence genes involved in steroidogenesis in granulosa cells. Read More

    Effects of Chronic ACTH Excess on Human Adrenal Cortex.
    Front Endocrinol (Lausanne) 2017 8;8:43. Epub 2017 Mar 8.
    Service des Maladies Endocriniennes et Métaboliques, Centre de Référence des Maladies Rares de la Surrénale, Faculté de Médecine Paris Descartes, Université Paris 5, Hôpital Cochin , Paris , France.
    Chronic ACTH excess leads to chronic cortisol excess, without escape phenomenon, resulting in Cushing's syndrome. Excess adrenal androgens also occur: in females, they will overcompensate the gonadotrophic loss, inducing high testosterone; in males, they will not compensate it, inducing low testosterone. Chronic ACTH excess leads to chronic adrenal mineralocorticoid excess and low aldosterone levels: after an acute rise, aldosterone plasma levels resume low values after a few days when ACTH is prolonged. Read More

    Androgen Stimulates Growth of Mouse Preantral Follicles In Vitro: Interaction With Follicle-Stimulating Hormone and With Growth Factors of the TGFβ Superfamily.
    Endocrinology 2017 Apr;158(4):920-935
    Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom.
    Androgens are essential for the normal function of mature antral follicles but also have a role in the early stages of follicle development. Polycystic ovary syndrome (PCOS), the most common cause of anovulatory infertility, is characterized by androgen excess and aberrant follicle development that includes accelerated early follicle growth. We have examined the effects of testosterone and dihydrotestosterone (DHT) on development of isolated mouse preantral follicles in culture with the specific aim of investigating interaction with follicle-stimulating hormone (FSH), the steroidogenic pathway, and growth factors of the TGFβ superfamily that are known to have a role in early follicle development. Read More

    Neuroendocrine androgen action is a key extraovarian mediator in the development of polycystic ovary syndrome.
    Proc Natl Acad Sci U S A 2017 Apr 20;114(16):E3334-E3343. Epub 2017 Mar 20.
    Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, NSW 2139, Australia;
    Polycystic ovary syndrome (PCOS) is a complex hormonal disorder characterized by reproductive, endocrine, and metabolic abnormalities. As the origins of PCOS remain unknown, mechanism-based treatments are not feasible and current management relies on treatment of symptoms. Hyperandrogenism is the most consistent PCOS characteristic; however, it is unclear whether androgen excess, which is treatable, is a cause or a consequence of PCOS. Read More

    Developmental Programming: Gestational Exposure to Excess Testosterone Alters Expression of Ovarian Matrix Metalloproteases and Their Target Proteins
    Reprod Sci 2017 01 1:1933719117697127. Epub 2017 Jan 1.
    1 Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
    Prenatal testosterone (T)-treated sheep, similar to women with polycystic ovary syndrome (PCOS), manifests reproductive defects that include multifollicular ovarian phenotype. Women with PCOS manifest increased ovarian matrix metalloproteinases (MMPs) activity. We tested the hypothesis that gestational T excess in sheep would alter ovarian expression of MMPs, tissue inhibitors of MMP (TIMP) and their target proteins laminin B (LAMB), collagen, tumor necrosis factor alpha (TNF), and connexin 43 (GJA1) consistent with increased MMP activity and that these changes are developmentally regulated. Read More

    Testosterone Levels in Pre-Menopausal Women are Associated With Nonalcoholic Fatty Liver Disease in Midlife.
    Am J Gastroenterol 2017 Mar 14. Epub 2017 Mar 14.
    Division of Gastroenterology and Hepatology, University of California, San Francisco, California, USA.
    Objectives: Young women with hyperandrogenism have high risk of metabolic co-morbidities, including increased risk of nonalcoholic fatty liver disease (NAFLD). Whether testosterone (the predominant androgen) is associated with NAFLD independent of metabolic co-factors is unclear. Additionally, whether testosterone confers increased risk of NAFLD in women without hyperandrogenism is unknown. Read More

    Alteration in follistatin gene expression detected in prenatally androgenized rats.
    Gynecol Endocrinol 2017 Feb 26:1-5. Epub 2017 Feb 26.
    a Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences , Tehran , Iran.
    Impaired ovarian follicle development, the hallmark of polycystic ovarian syndrome (PCOS), is believed to be due to the changes in expression of related genes such as follistatin (FST). Expression of FST gene and methylation level of its promoter in theca cells from adult female rats, prenatally exposed to androgen excess, during different phases of the estrus cycle was determined and compared with controls. Eight pregnant Wistar rats (experimental group) were treated by subcutaneous injection of 5 mg free testosterone on day 20 of pregnancy, while controls (n = 8) received 500 ml solvent. Read More

    GLP-1 receptor agonists in the treatment of polycystic ovary syndrome.
    Expert Rev Clin Pharmacol 2017 Apr 13;10(4):401-408. Epub 2017 Feb 13.
    b Department of Medicine , University of Maryland Medical Center , Baltimore , MD , USA.
    Introduction: Polycystic ovarian syndrome (PCOS) affects many women of child-bearing age and is characterized by hyperandrogenism, ovulatory and metabolic dysfunction. A primary treatment goal is weight reduction. The weight loss effects of glucagon-like peptide-1 receptor agonists (GLP-1RA), previously demonstrated in diabetic and obese non-diabetic patients, offer a unique opportunity to expand the medical options available to PCOS patients. Read More

    MECHANISMS IN ENDOCRINOLOGY: Aging and anti-aging: a Combo-Endocrinology overview.
    Eur J Endocrinol 2017 Jun 6;176(6):R283-R308. Epub 2017 Mar 6.
    Department of EndocrinologyDiabetes and Metabolism, 'Red Cross Hospital', Athens, Greece.
    Aging and its underlying pathophysiological background has always attracted the attention of the scientific society. Defined as the gradual, time-dependent, heterogeneous decline of physiological functions, aging is orchestrated by a plethora of molecular mechanisms, which vividly interact to alter body homeostasis. The ability of an organism to adjust to these alterations, in conjunction with the dynamic effect of various environmental stimuli across lifespan, promotes longevity, frailty or disease. Read More

    Prevalence and Predicting Factors for Commonly Neglected Sexual Side Effects to External-Beam Radiation Therapy for Prostate Cancer.
    J Sex Med 2017 Apr 1;14(4):558-565. Epub 2017 Mar 1.
    Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark; Department of Urology, Zealand University Hospital, Roskilde, Denmark.
    Introduction: Changes in sexual function other than erectile dysfunction are sparsely investigated after radiation therapy for prostate cancer.

    Aim: To investigate orgasmic dysfunction, urinary incontinence during sexual activity, changes in penile morphology, and sensory disturbances in the penis in patients with prostate cancer treated with external-beam radiation therapy (EBRT).

    Methods: In February 2015, men treated with EBRT at our center 3 months to 5 years previously (N = 519) received a study-specific questionnaire. Read More

    Clinical significance of 11-oxygenated androgens.
    Curr Opin Endocrinol Diabetes Obes 2017 Feb 23. Epub 2017 Feb 23.
    aDivision of Metabolism, Endocrinology and Diabetes bDepartment of Pharmacology, University of Michigan, Ann Arbor, Michigan, USA.
    Purpose Of Review: The adrenal gland is considered a source of weak androgens, such as dehydroepiandrosterone, dehydroepiandrosterone sulfate, and androstenedione. Emerging evidence proposes a set of 11-oxygenated 19-carbon (11oxC19) adrenal-derived steroids as clinically important androgens. Such steroids include 11β-hydroxyandrostenedione, 11-ketoandrostenedione, 11β-hydroxytestosterone, and 11-ketotestosterone. Read More

    High serum progesterone associated with infertility in a woman with nonclassic congenital adrenal hyperplasia.
    J Obstet Gynaecol Res 2017 Feb 11. Epub 2017 Feb 11.
    Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
    Nonclassic congenital adrenal hyperplasia (NCAH) is an autosomal-recessive disorder caused by 21-hydroxylase deficiency and manifests as hirsutism and oligomenorrhea due to excess adrenal androgen and progesterone. We report a case of a woman with NCAH who showed continuous high serum progesterone levels in the follicular phase associated with impaired folliculogenesis. NCAH was diagnosed based on high 17-hydroxyprogesterone levels after rapid adrenocorticotropic hormone loading, and three heterozygous missense mutations in CYP21A2, encoding 21-hydroxylase, were identified. Read More

    Sex differences in the effects of androgens acting in the central nervous system on metabolism.
    Dialogues Clin Neurosci 2016 Dec;18(4):415-424
    Department of Medicine, Section of Endocrinology and Metabolism, Tulane University Health Sciences Center, School of Medicine, New Orleans, Louisiana, USA.
    One of the most sexually dimorphic aspects of metabolic regulation is the bidirectional modulation of glucose and energy homeostasis by testosterone in males and females. Testosterone deficiency predisposes men to metabolic dysfunction, with excess adiposity, insulin resistance, and type 2 diabetes, whereas androgen excess predisposes women to insulin resistance, adiposity, and type 2 diabetes. This review discusses how testosterone acts in the central nervous system, and especially the hypothalamus, to promote metabolic homeostasis or dysfunction in a sexually dimorphic manner. Read More

    Is acne a sign of androgen excess disorder or not?
    Eur J Obstet Gynecol Reprod Biol 2017 Apr 23;211:21-25. Epub 2017 Jan 23.
    Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey.
    Objective: Acne is not solely a cosmetic problem. The clinical importance of acne in the estimation of androgen excess disorders is controversial. Recently, the Amsterdam ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group suggested that acne is not commonly associated with hyperandrogenemia and therefore should not be regarded as evidence of hyperandrogenemia. Read More

    Adrenocortical neoplasms in adulthood and childhood: distinct presentation. Review of the clinical, pathological and imaging characteristics.
    J Pediatr Endocrinol Metab 2017 Mar;30(3):253-276
    Adrenocortical tumors (ACT) in adulthood and childhood vary in clinical, histopathological, molecular, prognostic, and imaging aspects. ACT are relatively common in adults, as adenomas are often found incidentally on imaging. ACT are rare in children, though they have a significantly higher prevalence in the south and southeast regions of Brazil. Read More

    Cryptotanshinone Regulates Androgen Synthesis through the ERK/c-Fos/CYP17 Pathway in Porcine Granulosa Cells.
    Evid Based Complement Alternat Med 2017 12;2017:5985703. Epub 2017 Jan 12.
    Research Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou 510120, China; Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
    The aim of the study is to investigate the molecular mechanism behind androgen reduction in porcine granulosa cells (pGCs) with Salvia miltiorrhiza Bunge extract cryptotanshinone. PGCs were isolated from porcine ovaries and identified. Androgen excess model of the pGCs was induced with the MAPK inhibitor PD98059 and then treated with cryptotanshinone. Read More

    Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review.
    Am J Clin Dermatol 2017 Apr;18(2):169-191
    Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
    Background: The management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required.

    Objective: Our aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females. Read More

    Selective deletion of Pten in theca-interstitial cells leads to androgen excess and ovarian dysfunction in mice.
    Mol Cell Endocrinol 2017 Mar 28;444:26-37. Epub 2017 Jan 28.
    Department of OB/GYN & Women's Health, University of Louisville School of Medicine, Louisville, KY 40202, USA. Electronic address:
    Theca cell-selective Pten mutation (tPtenMT) in mice resulted in increases in PDK1 and Akt phosphorylation, indicating an over-activation of PI3K signaling in the ovaries. These mice displayed elevated androgen levels, ovary enlargement, antral follicle accumulation, early fertility loss and increased expression of Lhcgr and genes that are crucial to androgenesis. These abnormalities were partially reversed by treatments of PI3K or Akt inhibitor. Read More

    MANAGEMENT OF ENDOCRINE DISEASE: Congenital adrenal hyperplasia due to 21-hydroxylase deficiency: update on the management of adult patients and prenatal treatment.
    Eur J Endocrinol 2017 Apr 23;176(4):R167-R181. Epub 2017 Jan 23.
    AP-HPIE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, ICAN, Paris, France
    Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is characterized by cortisol and in some cases aldosterone deficiency associated with androgen excess. Goals of treatment are to replace deficient hormones and control androgen excess, while avoiding the adverse effects of exogenous glucocorticoid. Over the last 5 years, cohorts of adults with CAH due to 21-hydroxylase deficiency from Europe and the United States have been described, allowing us to have a better knowledge of long-term complications of the disease and its treatment. Read More

    Premature pubarche in a child with abnormal 3β-hydroxysteroid dehydrogenase function and Klinefelter syndrome: the intriguing relationship between androgen deficiency and excess.
    Clin Case Rep 2017 Jan 20;5(1):57-60. Epub 2016 Dec 20.
    Department of Pediatrics Division of Pediatric Endocrinology Baystate Medical Center Springfield Massachusetts USA.
    Disorders of androgen excess may coexist with disorders of androgen deficiency, such as Klinefelter syndrome, and can create diagnostic and therapeutic challenges. Read More

    Prevalence of hormonal and endocrine dysfunction in patients with lichen planopilaris (LPP): A retrospective data analysis of 168 patients.
    J Am Acad Dermatol 2017 Feb;76(2):314-320
    Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address:
    Background: Studies on the pathophysiology and comorbidities associated with lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are limited.

    Objective: The purpose of this study was to determine the prevalence of androgen excess in the postmenopausal LPP population, in relation to demographics and comorbidities.

    Methods: A retrospective data analysis of 413 patients with LPP, FFA, and LPP/FFA seen in the Department of Dermatology at the Cleveland Clinic Foundation in Ohio between 2005 and 2015 was conducted. Read More

    A Comparison of Sexual Function in Women with Polycystic Ovary Syndrome (PCOS) Whose Mothers Had PCOS During Their Pregnancy Period with Those Without PCOS.
    Arch Sex Behav 2017 Jan 9. Epub 2017 Jan 9.
    Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during reproductive ages. Clinical symptoms associated with PCOS, such as hirsutism, acne, alopecia, obesity, and infertility, may lead to emotional morbidity and then impaired sexual function in those affected. During intrauterine development, the fetus may program the development of diseases during adulthood. Read More

    Effect of Exercise on Ovulation: A Systematic Review.
    Sports Med 2016 Dec 29. Epub 2016 Dec 29.
    Laboratory of Protein Biochemistry, Federal University of State of Rio de Janeiro, Rio de Janeiro, Brazil.
    Background: Infertility has been described as a devastating life crisis for couples, and has a particularly severe effect on women, in terms of anxiety and depression. Anovulation accounts for around 30% of female infertility, and while lifestyle factors such as physical activity are known to be important, the relationship between exercise and ovulation is multi-factorial and complex, and to date there are no clear recommendations concerning exercise regimes.

    Objectives: The objective of this review was to systematically assess the effect of physical activity on ovulation and to discuss the possible mechanisms by which exercise acts to modulate ovulation in reproductive-age women. Read More

    Metabolic and carbohydrate characteristics of different phenotypes of polycystic ovary syndrome.
    J Turk Ger Gynecol Assoc 2016 1;17(4):201-208. Epub 2016 Dec 1.
    Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey.
    Objective: To compare the prevalence of various metabolic and cardiovascular risk factors and insulin resistance between polycystic ovary syndrome (PCOS) patients with or without hyperandrogenism.

    Material And Methods: This is a retrospective cross-sectional study involving women with PCOS as diagnosed according to the Androgen Excess (AE) Society definition (n=504) and women with normoandrogenemic PCOS (n=183). Anthropometrics, lipid profile, glucose, insulin, oral glucose tolerance test (OGTT), and reproductive hormone levels were evaluated. Read More

    Adrenal disorders and non-alcoholic fatty liver disease.
    Minerva Endocrinol 2017 Jun 14;42(2):151-163. Epub 2016 Dec 14.
    Unit of Translation and Clinical Research in Endocrinology, University of Athens Medical School, Athens, Greece.
    Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the developed world and its pathogenesis is complex and multifactorial. It is considered the hepatic manifestation of the metabolic syndrome and is the leading cause of hepatic cirrhosis. This review aims to present current knowledge on the involvement of the adrenal glands in the development of NAFLD. Read More

    Low-Dose Dihydrotestosterone Drives Metabolic Dysfunction via Cytosolic and Nuclear Hepatic Androgen Receptor Mechanisms.
    Endocrinology 2017 Mar;158(3):531-544
    Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland 21283.
    Androgen excess in women is associated with metabolic dysfunction (e.g., obesity, hyperinsulinemia, insulin resistance, and increased risk of type 2 diabetes) and reproductive dysfunction (e. Read More

    Gestational Hyperandrogenism in Developmental Programming.
    Endocrinology 2017 Feb;158(2):199-212
    College of Human Medicine, Michigan State University, East Lansing, Michigan 48824.
    Androgen excess (hyperandrogenism) is a common endocrine disorder affecting women of reproductive age. The potential causes of androgen excess in women include polycystic ovary syndrome, congenital adrenal hyperplasia (CAH), adrenal tumors, and racial disparity among many others. During pregnancy, luteoma, placental aromatase deficiency, and fetal CAH are additional causes of gestational hyperandrogenism. Read More

    Growth of a progesterone receptor-positive meningioma in a female patient with congenital adrenal hyperplasia.
    Endocrinol Diabetes Metab Case Rep 2016 21;2016. Epub 2016 Nov 21.
    Department of Endocrinology , Adelaide and Meath Hospitals, incorporating the National Children's Hospital, Tallaght, Dublin , Ireland.
    Meningioma growth has been previously described in patients receiving oestrogen/progestogen therapy. We describe the clinical, radiological, biochemical and pathologic findings in a 45-year-old woman with congenital adrenal hyperplasia secondary to a defect in the 21-hydroxylase enzyme who had chronic poor adherence to glucocorticoid therapy with consequent virilisation. The patient presented with a frontal headache and marked right-sided proptosis. Read More

    Clinical perspectives in congenital adrenal hyperplasia due to 11β-hydroxylase deficiency.
    Endocrine 2017 Jan 7;55(1):19-36. Epub 2016 Dec 7.
    Department of Endocrinology, Royal Darwin Hospital, Darwin, NT, Australia.
    Congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency is a rare autosomal recessive genetic disorder. It is caused by reduced or absent activity of 11β-hydroxylase (CYP11B1) enzyme and the resultant defects in adrenal steroidogenesis. The most common clinical features of 11 beta-hydroxylase deficiency are ambiguous genitalia, accelerated skeletal maturation and resultant short stature, peripheral precocious puberty and hyporeninemic hypokalemic hypertension. Read More

    Polycystic ovary syndrome in adolescent girls.
    Curr Opin Endocrinol Diabetes Obes 2017 Feb;24(1):56-66
    Division of Pediatric Endocrinology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
    Purpose Of Review: Polycystic ovary syndrome (PCOS) is a common heterogeneous disorder that appears to have its origins during the peripubertal years. The diagnostic conundrum is that the typical clinical features, irregular menses and acne, occur during normal female puberty. Understanding the physiologic origins and molecular basis of the dysregulated hypothalamic-pituitary-gonadal axis in PCOS is fundamental to interrupting the distinctive vicious cycle of hyperandrogenism and chronic anovulation. Read More

    Bilateral Testicular Tumors Resulting in Recurrent Cushing Disease After Bilateral Adrenalectomy.
    J Clin Endocrinol Metab 2017 Feb;102(2):339-344
    Departments of Medicine.
    Context: Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing disease is extremely rare.

    Patient: We present a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing disease with complete clinical resolution. Cushingoid features recurred 12 years later, with bilateral testicular enlargement. Read More

    11-Oxygenated C19 Steroids Are the Predominant Androgens in Polycystic Ovary Syndrome.
    J Clin Endocrinol Metab 2017 Mar;102(3):840-848
    Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
    Context: Androgen excess is a defining feature of polycystic ovary syndrome (PCOS), but the exact origin of hyperandrogenemia remains a matter of debate. Recent studies have highlighted the importance of the 11-oxygenated C19 steroid pathway to androgen metabolism in humans. In this study, we analyzed the contribution of 11-oxygenated androgens to androgen excess in women with PCOS. Read More

    Maternal Polycystic Ovary Syndrome and Risk for Attention-Deficit/Hyperactivity Disorder in the Offspring.
    Biol Psychiatry 2016 Oct 6. Epub 2016 Oct 6.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Electronic address:
    Background: Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder, and boys are two to three times more likely to develop ADHD. Maternal polycystic ovary syndrome (PCOS), a common metabolic disorder associated with excess circulating androgens, has been associated with increased risk for autism spectrum disorder in the offspring. In this study, we aimed to investigate whether maternal PCOS increases the risk for ADHD in the offspring. Read More

    Polycystic ovarian syndrome: clinical and biological diagnosis.
    Ann Biol Clin (Paris) 2016 Dec;74(6):661-667
    Service d'endocrinologie et médecine de la reproduction et Centre de référence des maladies endocriniennes rares de la croissance, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France ; UPMC Université Paris 6, Paris, France.
    Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. This syndrome leads to clinical hyperandrogenism and/or a biological dysovulation and infertility. Its diagnosis is based on consensual diagnostic criteria, but which are likely to change in the near future with the rise of the interest of new markers such as AMH. Read More

    Modified release and conventional glucocorticoids and diurnal androgen excretion in congenital adrenal hyperplasia.
    J Clin Endocrinol Metab 2016 Nov 15:jc20162855. Epub 2016 Nov 15.
    1 Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK.
    Context: The classic androgen synthesis pathway proceeds via DHEA, androstenedione and testosterone to 5α-dihydrotestosterone (DHT). However, DHT synthesis can also be achieved by an alternative pathway originating from 17α-hydroxyprogesterone (17OHP), which accumulates in congenital adrenal hyperplasia (CAH). Similarly, recent work has highlighted androstenedione-derived 11-oxygenated 19-carbon steroids as active androgens and, in CAH, androstenedione is generated directly from 17OHP. Read More

    Association between the angiotensin converting enzyme gene insertion/deletion polymorphism and metabolic disturbances in women with polycystic ovary syndrome.
    Mol Med Rep 2016 Dec 31;14(6):5401-5407. Epub 2016 Oct 31.
    Department of Infertility and Reproductive Endocrinology, Poznań University of Medical Sciences, 60‑535 Poznań, Poland.
    Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. A number of PCOS complications may be associated with the elevated level of angiotensin II and low bradykinin concentrations. The aim of the present study was to investigate the frequencies of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms in women with PCOS and to determine the association between ACE genetic variants and the risk of metabolic and cardiovascular complications in such women. Read More

    Spatiotemporal dynamics of androgen signaling underlie sexual differentiation and congenital malformations of the urethra and vagina.
    Proc Natl Acad Sci U S A 2016 Nov 7;113(47):E7510-E7517. Epub 2016 Nov 7.
    Department of Molecular Genetics and Microbiology, University of Florida Genetics Institute, University of Florida, Gainesville, FL 32610.
    Disorders of sex development (DSDs) are congenital anomalies that affect sexual differentiation of genitourinary organs and secondary sex characters. A common cause of female genital virilization is congenital adrenal hyperplasia (CAH), in which excess androgen production during development of 46XX females can result in vaginal atresia, masculinization of the urethra, a single urogenital sinus, and clitoral hypertrophy or ambiguous external genitalia. Development of the vagina depends on sexual differentiation of the urogenital sinus ridge, an epithelial thickening that forms where the sex ducts attach to the anterior urethra. Read More

    Plexiform schwannoma: an unusual clitoral mass.
    Am J Obstet Gynecol 2017 Mar 3;216(3):319.e1-319.e2. Epub 2016 Nov 3.
    Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
    Acquired clitoral enlargement is a rare condition resulting from a variety of etiologies, including tumors and excess androgens. Few cases of nonmalignant schwannoma, a benign tumor of the peripheral nerve sheath, have been reported in the literature as causes of clitoral enlargement in patients without known neurofibromatosis. These painless, slow-growing tumors rarely recur once excised. Read More

    Hepatic Steatosis is Common in Adolescents with Obesity and PCOS and Relates to De Novo Lipogenesis but not Insulin Resistance.
    Obesity (Silver Spring) 2016 Nov;24(11):2399-2406
    Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
    Objective: Increased liver fat and type 2 diabetes are prevalent in women with polycystic ovarian syndrome (PCOS) and cause excess mortality, yet little is known about their development during adolescence. The objective of this study was to measure hepatic steatosis and related metabolic contributors in girls with obesity, with and without PCOS.

    Methods: Nondiabetic adolescents with obesity, 41 with PCOS (PCOS; age 15. Read More

    Hypogonadism alters cecal and fecal microbiota in male mice.
    Gut Microbes 2016 Nov 22;7(6):533-539. Epub 2016 Sep 22.
    a Division of Applied Life Sciences , Graduate School of Life and Environmental Sciences, Osaka Prefecture University , Sakai , Osaka , Japan.
    Low testosterone levels increase the risk for cardiovascular disease in men and lead to shorter life spans. Our recent study showed that androgen deprivation via castration altered fecal microbiota and exacerbated risk factors for cardiovascular disease, including obesity, impaired fasting glucose, excess hepatic triglyceride accumulation, and thigh muscle weight loss only in high-fat diet (HFD)-fed male mice. However, when mice were administered antibiotics that disrupted the gut microbiota, castration did not increase cardiovascular risks or decrease the ratio of dried feces to food intake. Read More

    Does Fluoride Affect Serum Testosterone and Androgen Binding Protein with Age-Specificity? A Population-Based Cross-Sectional Study in Chinese Male Farmers.
    Biol Trace Elem Res 2016 Dec 6;174(2):294-299. Epub 2016 May 6.
    Department of Occupational and Environmental Health, Institute of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China.
    Many studies have demonstrated that exposure to excess fluoride was associated with a variety of diseases. Little is known about the variation of testosterone (T) levels caused by fluoride exposure. The aim of this study is to explore the association of fluoride exposure and age with serum T and androgen-binding protein (ABP) levels in male farmers. Read More

    Excess Testosterone Exposure Alters Hypothalamic-Pituitary-Testicular Axis Dynamics and Gene Expression in Sheep Fetuses.
    Endocrinology 2016 Nov 27;157(11):4234-4245. Epub 2016 Sep 27.
    Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501.
    Prenatal exposure to excess androgen may result in impaired adult fertility in a variety of mammalian species. However, little is known about what feedback mechanisms regulate gonadotropin secretion during early gestation and how they respond to excess T exposure. The objective of this study was to determine the effect of exogenous exposure to T on key genes that regulate gonadotropin and GnRH secretion in fetal male lambs as compared with female cohorts. Read More

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