ArticleThe Journal of clinical endocrinology and metabolism2021
Ovarian Hyperandrogenism and Response to Gonadotropin-releasing Hormone Analogues in Primary Severe Insulin Resistance.
Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women.Clinical endocrinology · 2025Guideline
- Association of ADAMTS proteoglycanases downregulation with IVF-ET outcomes in patients with polycystic ovary syndrome: a systematic review and meta-analysis.Reproductive biology and endocrinology : RB&E · 2022Pooled it
- [False positives in female testosterone testing and the diagnostic value of mass spectrometry].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
- Unraveling the Complexity of Polycystic Ovary Syndrome: Biomarkers for Diagnosis, Prognosis, and Treatment.Current pharmaceutical design · 2026Review
- Metabolic Mediation of the Association Between Hyperandrogenism and Paratubal Cysts in Polycystic Ovary Syndrome: A Structural Equation Modeling Approach.Journal of clinical medicine · 2025Article
- Investigation of associations between polycystic ovary syndrome and INSR gene polymorphisms rs2059806 and rs2252673.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Integrated single-cell and spatial transcriptomics reveal microenvironment disruptions by androgen in mouse ovary.iScience · 2024Article
- Juvenile Granulosa Cell Tumor Mimicking HAIR-AN in a 4-year-old: A Case ReportJournal of clinical research in pediatric endocrinology · 2024Article
- Diagnostic and referral pathways in patients with rare lipodystrophy and insulin-resistance syndromes: key milestones assessed from a national reference center.Orphanet journal of rare diseases · 2024Article
- Effect of oral glucose tolerance test-based insulin resistance on embryo quality in women with/without polycystic ovary syndrome.Frontiers in endocrinology · 2024Article
- Association Between Triglyceride Glucose Index and Infertility in Reproductive-Aged Women: A Cross-Sectional Study.International journal of women's health · 2024Article
- A promising treatment for spontaneous ovarian hyperstimulation syndrome due to familial partial lipodystrophy: GnRH analogs combined with cyst aspiration.Hormones (Athens, Greece) · 2023Review
- Clinical Utility of GnRH Analogues in Female Androgen Excess: Highlighting Diagnostic and Therapeutic Applications.JCEM case reports · 2023Article
- PPT1 regulation of HSP90α depalmitoylation participates in the pathogenesis of hyperandrogenism.iScience · 2023Article
- Insulin Resistance and Adrenal Androgen Synthesis Viewed Through a Monogenic Lens.The Journal of clinical endocrinology and metabolism · 2022Article
- Achievements, prospects and challenges in precision care for monogenic insulin-deficient and insulin-resistant diabetes.Diabetologia · 2022Review
- Excess 11-Oxygenated Androgens in Women With Severe Insulin Resistance Are Mediated by Adrenal Insulin Receptor Signaling.The Journal of clinical endocrinology and metabolism · 2022Article
- Chronic androgen excess in female mice does not impact luteinizing hormone pulse frequency or putative GABAergic inputs to GnRH neurons.Journal of neuroendocrinology · 2022Article
- Pituitary tumors and the risk of other malignancies: is the relationship coincidental or causal?Endocrine oncology (Bristol, England) · 2022Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
contextInsulin resistance (IR) is associated with polycystic ovaries and hyperandrogenism, but underpinning mechanisms are poorly understood and therapeutic options are limited.
objectiveTo characterize hyperandrogenemia and ovarian pathology in primary severe IR (SIR), using IR of defined molecular etiology to interrogate disease mechanism. To extend evaluation of gonadotropin-releasing hormone (GnRH) analogue therapy in SIR.
methodsRetrospective case note review in 2 SIR national referral centers. Female patients with SIR with documented serum total testosterone (TT) concentration.
resultsAmong 185 patients with lipodystrophy, 65 with primary insulin signaling disorders, and 29 with idiopathic SIR, serum TT ranged from undetectable to 1562 ng/dL (54.2 nmol/L; median 40.3 ng/dL [1.40 nmol/L]; n = 279) and free testosterone (FT) from undetectable to 18.0 ng/dL (0.625 nmol/L; median 0.705 ng/dL [0.0244 nmol/L]; n = 233). Higher TT but not FT in the insulin signaling subgroup was attributable to higher serum sex hormone-binding globulin (SHBG) concentration. Insulin correlated positively with SHBG in the insulin signaling subgroup, but negatively in lipodystrophy. In 8/9 patients with available ovarian tissue, histology was consistent with polycystic ovary syndrome (PCOS). In 6/6 patients treated with GnRH analogue therapy, gonadotropin suppression improved hyperandrogenic symptoms and reduced serum TT irrespective of SIR etiology.
conclusionSIR causes severe hyperandrogenemia and PCOS-like ovarian changes whether due to proximal insulin signaling or adipose development defects. A distinct relationship between IR and FT between the groups is mediated by SHBG. GnRH analogues are beneficial in a range of SIR subphenotypes.
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Registered trials
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