Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study
Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a compl...
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Published in | International Journal of Endocrinology Vol. 2014; no. 2014; pp. 218 - 225-023 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Cairo, Egypt
Hindawi Limiteds
01.01.2014
Hindawi Publishing Corporation John Wiley & Sons, Inc Wiley |
Subjects | |
Online Access | Get full text |
ISSN | 1687-8337 1687-8345 |
DOI | 10.1155/2014/191247 |
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Abstract | Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group ( P ≤ 0.001 ). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) ( P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations ( r = 0.78 ; P ≤ 0.001 , r = 0.74 ; P ≤ 0.001 , and r = 0.71 ; P ≤ 0.001 ), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels ( P = 0.001 ) and free T and DHEA-S declined significantly ( P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction. |
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AbstractList | Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group ( P ≤ 0.001 ). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) ( P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations ( r = 0.78 ; P ≤ 0.001 , r = 0.74 ; P ≤ 0.001 , and r = 0.71 ; P ≤ 0.001 ), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels ( P = 0.001 ) and free T and DHEA-S declined significantly ( P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction. Background . Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods . We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results . All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group ( P ≤ 0.001 ). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ /dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ /dL) ( P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations ( r = 0.78 ; P ≤ 0.001 , r = 0.74 ; P ≤ 0.001 , and r = 0.71 ; P ≤ 0.001 ), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels ( P = 0.001 ) and free T and DHEA-S declined significantly ( P = 0.0002 and 0.009). Conclusion . Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction. Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P [less than or equal to] 0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 [+ or -] 1.24 [micro]g/mL and 231.50 [+ or -] 12720 [micro]/dL) when compared to the control group (1.50 [+ or -] 0.75 [micro]g/mL and 133.59 [+ or -] 60.69 [micro]/dL) (P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r = 0.78; P [less than or equal to] 0.001, r = 0.74; P [less than or equal to] 0.001, and r = 0.71; P [less than or equal to] 0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P = 0.001) and free T and DHEA-S declined significantly (P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction. Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P=0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78; P≤0.001, r=0.74; P≤0.001, and r=0.71; P≤0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001) and free T and DHEA-S declined significantly (P=0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction. Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P ≤ 0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r = 0.78; P ≤ 0.001, r = 0.74; P ≤ 0.001, and r = 0.71; P ≤ 0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P = 0.001) and free T and DHEA-S declined significantly (P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P ≤ 0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r = 0.78; P ≤ 0.001, r = 0.74; P ≤ 0.001, and r = 0.71; P ≤ 0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P = 0.001) and free T and DHEA-S declined significantly (P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction. |
Audience | Academic |
Author | Rodríguez-Gutiérrez, René Alvarez-Villalobos, Neri Alejandro González-González, José Gerardo Rodríguez-Guajardo, René Lavalle-Gonzalez, Fernando Javier Mancillas-Adame, Leonardo G. Morales-Martinez, Felipe Arturo González-Saldivar, Gloria Villarreal-Pérez, Jesús Zacarías |
AuthorAffiliation | 3 Clinical Research Unit, University Hospital “Dr. José E. González”, School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico 1 Endocrinology Division, University Hospital “Dr. José E. González”, School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico 2 Obstetrics and Gynecology Department, University Hospital “Dr. José E. González”, School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico |
AuthorAffiliation_xml | – name: 3 Clinical Research Unit, University Hospital “Dr. José E. González”, School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico – name: 2 Obstetrics and Gynecology Department, University Hospital “Dr. José E. González”, School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico – name: 1 Endocrinology Division, University Hospital “Dr. José E. González”, School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico |
Author_xml | – sequence: 1 fullname: René Rodríguez-Gutiérrez – sequence: 2 fullname: Jesús Zacarías Villarreal-Pérez – sequence: 3 fullname: Felipe Arturo Morales-Martinez – sequence: 4 fullname: René Rodríguez-Guajardo – sequence: 5 fullname: Gloria González-Saldivar – sequence: 6 fullname: Leonardo G.Mancillas-Adame – sequence: 7 fullname: Neri Alejandro Alvarez-Villalobos – sequence: 8 fullname: Fernando Javier Lavalle-Gonzalez – sequence: 9 fullname: José Gerardo González-González |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25505909$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1016_j_jtbi_2016_03_020 crossref_primary_10_1016_j_ejogrb_2016_01_016 |
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Copyright | Copyright © 2014 René Rodríguez-Gutiérrez et al. COPYRIGHT 2014 John Wiley & Sons, Inc. Copyright © 2014 René Rodríguez-Gutiérrez et al. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2014 René Rodríguez-Gutiérrez et al. 2014 |
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References_xml | – volume: 4 start-page: 670 issue: 11 year: 2003 end-page: 678 ident: 1 article-title: Epidemiology and aetiology of gestational trophoblastic diseases – volume: 76 start-page: 108 issue: 1 year: 1993 end-page: 111 ident: 12 article-title: Low aromatase activity in microsomes from complete hydatidiform mole – volume: 353 start-page: 2578 issue: 24 year: 2005 end-page: 2588 ident: 19 article-title: Hirsutism – volume: 53 start-page: 698 issue: 4 year: 1981 end-page: 702 ident: 14 article-title: Evidence for the existence of an androgen binding protein in hydatidiform mole vesicles – volume: 67 start-page: 986 issue: 5 year: 1988 end-page: 991 ident: 20 article-title: Correlation of serum 3 -androstanediol glucuronide with acne and chest hair density in men – volume: 77 start-page: S3 year: 2002 end-page: S5 ident: 25 article-title: Androgen production in women – volume: 78 start-page: 103 issue: 1 year: 1991 end-page: 107 ident: 39 article-title: Effects of sex steroids on skin 5 -reductase activity in vitro – volume: 2 start-page: 461 year: 1998 end-page: 462 ident: 22 article-title: Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report – volume: 34 start-page: 558 issue: 3 year: 1972 end-page: 561 ident: 9 article-title: Plasma testosterone levels in trophoblastic disease and the effects of oophorectomy and chemotherapy – volume: 86 start-page: 37 issue: 1 year: 1979 end-page: 40 ident: 24 article-title: Testosterone production with hydatidiform mole—in vitro and in vivo studies – volume: 10 start-page: 95 issue: 2 year: 2004 end-page: 105 ident: 8 article-title: Abnormal stimulation of the thyrotrophin receptor during gestation – volume: 18 start-page: 649 issue: 6 year: 1983 end-page: 653 ident: 16 article-title: Further evidence for distinction between sex hormone-binding globulin and an androgen-binding protein in hydatidiform mole serum – volume: 17 start-page: 620 issue: 3 year: 2002 end-page: 624 ident: 35 article-title: Ovarian and adrenal steroid production: regulatory role of LH/HCG – volume: 89 start-page: 453 issue: 2 year: 2004 end-page: 462 ident: 42 article-title: Androgen excess in women: experience with over 1000 consecutive patients – volume: 7 start-page: 119 issue: 2 year: 1984 end-page: 122 ident: 32 article-title: Dehydroepiandrosterone sulfate: kinetics of metabolism in normal young men and women – volume: 6 start-page: 69 issue: 1 year: 2003 end-page: 77 ident: 18 article-title: Histopathological diagnosis of partial and complete hydatidiform mole in the first trimester of pregnancy – volume: 23 start-page: 20 issue: 1 year: 2002 end-page: 31 ident: 3 article-title: Current understandings of the molecular genetics of gestational trophoblastic diseases – volume: 81 start-page: 2397 issue: 6 year: 1996 end-page: 2400 ident: 38 article-title: Novel presence of luteinizing hormone/chorionic gonadotropin receptors in human adrenal glands – volume: 16 start-page: 131 issue: 1 year: 1996 end-page: 148 ident: 17 article-title: Gestational trophoblastic disease: radiologic-pathologic correlation – volume: 41 start-page: 795 issue: 6 year: 1994 end-page: 800 ident: 34 article-title: Dissociation of adrenal androgen and cortisol secretion in Cushing's syndrome – volume: 335 start-page: 1740 issue: 23 year: 1996 end-page: 1798 ident: 2 article-title: Chorionic tumors – volume: 84 start-page: 528 issue: 7 year: 1977 end-page: 530 ident: 11 article-title: Maternal plasma testosterone levels in molar pregnancy – volume: 97 start-page: 247 issue: 3 year: 1977 end-page: 254 ident: 21 article-title: Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex – volume: 28 issue: 1, article 34 year: 1968 ident: 29 article-title: Testosterone, androstenedione and dehydroepiandrosterone in plasma during pregnancy and at delivery: concentration and protein binding – volume: 118 start-page: 1029 issue: 5 year: 2011 end-page: 1036 ident: 27 article-title: Determinants of maternal sex steroids during the first half of pregnancy – volume: 154 start-page: 875 issue: 6 year: 2006 end-page: 881 ident: 37 article-title: The adrenal gland may be a target of LH action in postmenopausal women – volume: 19 start-page: 1280 issue: 11 year: 2012 end-page: 1283 ident: 36 article-title: Luteinizing hormone correlates with adrenal function in postmenopausal women – volume: 170 start-page: 1508 issue: 5 year: 1994 end-page: 1513 ident: 40 article-title: Sex hormone receptor binding, progestin selectivity, and the new oral contraceptives – reference: Dancey C. Reidy J. Statistics without Maths for Psychology: Using SPSS for Windows 2004 London, UK Prentice Hall – volume: 85 start-page: 218 issue: 3 year: 1978 end-page: 220 ident: 13 article-title: Testosterone in the molar vesicle fluid and theca-lutein cyst fluid – volume: 73 start-page: 824 issue: 4 year: 1991 end-page: 831 ident: 6 article-title: Pregnancy-induced changes in thyroid function: role of human chorionic gonadotropin as putative regulator of maternal thyroid – volume: 80 start-page: 473 issue: 2 year: 1995 end-page: 479 ident: 7 article-title: Potent thyrotropic activity of human chorionic gonadotropin variants in terms of 125I incorporation and de novo synthesized thyroid hormone release in human thyroid follicles – reference: Hancock B. W. Seckl M. J. Berkowitz R. S. Cole L. A. 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Andriesse R. Agema A. Donker G. H. Schwarz F. Thijssen J. H. H. Genazzani A. R. Thijssen J. H. H. Siiteri P. K. Adrenal androgen secretion and metabolism in postmenopausal women Adrenal Androgens 1980 New York, NY, USA Raven Press 219 240 – ident: 1 doi: 10.1016/S1470-2045(03)01245-2 – ident: 2 doi: 10.1056/NEJM199612053352306 – ident: 5 doi: 10.1097/01.AOG.0000224697.31138.a1 – volume: 11 start-page: 561 issue: 4 year: 1982 ident: 31 publication-title: Annals of the Academy of Medicine Singapore – ident: 26 doi: 10.1016/S0300-595X(86)80021-4 – ident: 27 doi: 10.1097/AOG.0b013e3182342b7f – ident: 40 doi: 10.1016/S0002-9378(94)05012-X – ident: 20 doi: 10.1210/jcem-67-5-986 – ident: 13 doi: 10.1111/j.1471-0528.1978.tb10485.x – volume: 7 start-page: 119 issue: 2 year: 1984 ident: 32 publication-title: Clinical and Investigative Medicine – ident: 38 doi: 10.1210/jc.81.6.2397 – volume: 47 start-page: 684 issue: 6 year: 1976 ident: 10 publication-title: Obstetrics and Gynecology – ident: 42 doi: 10.1210/jc.2003-031122 – year: 2009 ident: 4 – ident: 37 doi: 10.1530/eje.1.02165 – ident: 17 doi: 10.1148/radiographics.16.1.131 – volume: 78 start-page: 103 issue: 1 year: 1991 ident: 39 publication-title: Obstetrics and Gynecology – ident: 14 doi: 10.1210/jcem-53-4-698 – volume: 18 start-page: 649 issue: 6 year: 1983 ident: 15 publication-title: Journal of Steroid Biochemistry doi: 10.1016/0022-4731(83)90242-X – volume: 2 start-page: 461 year: 1998 ident: 22 publication-title: Obesity Research – year: 2004 ident: 23 – ident: 9 doi: 10.1210/jcem-34-3-558 – ident: 34 doi: 10.1111/j.1365-2265.1994.tb02795.x – ident: 6 doi: 10.1210/jcem-73-4-824 – ident: 19 doi: 10.1056/NEJMcp033496 – ident: 21 doi: 10.1111/j.1365-2133.1977.tb15179.x – volume: 137 start-page: 293 issue: 3 year: 1980 ident: 28 publication-title: American Journal of Obstetrics and Gynecology doi: 10.1016/0002-9378(80)90912-6 – ident: 36 doi: 10.1097/gme.0b013e31825540c4 – ident: 8 doi: 10.1093/humupd/dmh008 – volume: 141 start-page: 1029 issue: 8 year: 1981 ident: 41 publication-title: American Journal of Obstetrics and Gynecology doi: 10.1016/S0002-9378(16)32694-1 – volume: 80 start-page: 473 issue: 2 year: 1995 ident: 7 publication-title: Journal of Clinical Endocrinology and Metabolism – ident: 29 doi: 10.1210/jcem-28-1-34 – ident: 12 doi: 10.1210/jc.76.1.108 – ident: 24 doi: 10.1111/j.1471-0528.1979.tb10681.x – volume: 77 start-page: S3 year: 2002 ident: 25 publication-title: Fertility and Sterility – ident: 3 doi: 10.1053/plac.2001.0744 – ident: 11 doi: 10.1111/j.1471-0528.1977.tb12639.x – ident: 35 doi: 10.1093/humrep/17.3.620 – ident: 30 doi: 10.3109/09513598709082695 – start-page: 219 volume-title: Adrenal androgen secretion and metabolism in postmenopausal women year: 1980 ident: 33 – ident: 18 doi: 10.1007/s10024-002-0079-9 – ident: 16 doi: 10.1016/0022-4731(83)90242-X |
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Snippet | Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions... Background . Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions... |
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SubjectTerms | Acne Alopecia Androgens Baldness Body mass index Chorionic gonadotropin Development and progression Endocrinology Genetic aspects Gestational age Glycoproteins Gonadal disorders Gynecology Hormones Obstetrics Physiological aspects Risk factors Standard deviation Statistical analysis Studies Thyroid gland Uterus |
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Title | Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study |
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