Search Results (370)

Background: Central precocious puberty (CPP), defined as the onset of secondary sexual characteristics before age 8 in girls, is increasingly prevalent worldwide. CPP is often caused by early activation of the HPG axis, leading to accelerated growth and bone maturation. However, the diagnostic accuracy of standard bone age (BA) methods remains uncertain in this context. Objective: To compare the diagnostic accuracy of the Greulich–Pyle atlas (GPA) and Tanner–Whitehouse 3 (TW3) methods in estimating skeletal age in girls with CPP and to assess the predictive value of serum hormone levels for estimating chronological age (CA). Methods: An observational, cross-sectional diagnostic study was conducted, involving n = 109 girls aged 6–12 years with confirmed CPP (Ethics Committee approval: CHUC_2023_86; 13 July 2023). Left posteroanterior hand–wrist (PA–HW) radiographs were assessed using the GPA and TW3 methods. Anthropometric measurements were recorded, and serum concentrations of estradiol, LH, FSH, DHEA-S, cortisol, TSH, and free T4 were obtained. Comparisons between CA and BA estimates were conducted using repeated-measures ANOVA, and ANCOVA was applied to examine the hormonal predictors of CA. Results: Both GPA and TW3 overestimated CA between 7 and 12 years, with the GPA showing larger deviations (up to 4.8 months). The TW3 method provided more accurate estimations, particularly at advanced pubertal stages. Estradiol (η²_p = 0.188–0.197), LH (η²_p = 0.061–0.068), and FSH (η²_p = 0.008–0.023) emerged as the strongest endocrine predictors of CA, significantly enhancing the explanatory power of both radiological methods. Conclusions: The TW3 method demonstrated superior diagnostic accuracy over GPA in girls with CPP, especially between 7 and 12 years. Integrating estradiol, LH, and FSH into BA assessment significantly improved the accuracy, supporting a more individualized and physiologically grounded diagnostic approach. Full article

Effective transport strategies are critical for the survival and welfare of juvenile Ictalurus punctatus, but the effects of pre-transport salt bath treatments remain uncertain. In this study, we systematically evaluated the effects of pre-transport salt bath acclimation at 0‰ (S1), 1‰ (S2), 5‰ (S3), and 9‰ (S4) salinity for 30 min on stress resilience and recovery in fingerlings during 12 h of simulated transport and 24 h of recovery. All fish survived, but total ammonia nitrogen (TAN) increased, and pH decreased in all groups, except S3, which showed significantly lower TAN and higher pH (p < 0.05). The S3 and S4 groups showed attenuated increases in serum cortisol and glucose, with S3 exhibiting the fastest return to baseline levels and stable serum sodium and potassium levels. Liver antioxidant enzyme activities in group S3 remained stable, with the lowest malondialdehyde (MDA) accumulation. Integrated biomarker response (IBR) and histological analyses demonstrated that S3 had the lowest systemic stress and tissue damage, whereas S1 and S4 displayed marked cellular disruption. These results indicate that a 5‰ salt bath applied prior to transport may improve water quality, mitigate stress responses, and preserve tissue integrity in juvenile channel catfish. Further studies are needed to confirm these findings in other species and under commercial transport conditions. Full article

Background/Objective: One third of “non-functioning adrenal tumours” (NFAs) have mild autonomous cortisol secretion (MACS). An updated analysis of the hormonal biomarkers profile, including risk factors and the rate of post-surgery adrenal insufficiency (PSAI), the duration of restoring the normal adrenocortical function in MACS/NFA and potential impacts on clinical comorbidities. Methods: Comprehensive review based on PubMed search (January 2020–January 2025). Results: The studies (n = 14) included 2623 patients (N = 1158 underwent unilateral adrenalectomy), aged 18–93 (mean = 57.49 years), with a female-to-male ratio = 1.54. Post-adrenalectomy (n = 9, N = 753) analysis: the PSAI risk correlated with the severity of baseline hypercortisolism. PSAI incidence: 50% of MAC. The rate after 4–6 weeks follow-up was 71.9% (adrenal Cushing’s syndrome) vs. 50% (MACS) vs. 14.4% (NFA). PSAI duration was up to 35 months. Early PSAI diagnosis was reflected by post-operative cortisol assay on day 1 (cut-off ≤ 5 µg/dL) and an ACTH (Cosyntropin) stimulation test (CST) (cortisol cut-off ≤ 14 µg/dL). Pre-operatory PSAI predictors: higher serum cortisol-DST (1 mg dexamethasone testing) and lower baseline plasma ACTH (not all studies agreed). Conclusions: A stratified strategy is encouraged following a unilateral adrenalectomy in MACS; PSAI is expected in almost half of patients, with a potential improvement of hypertension. Serum cortisol assays serve as most useful biomarker as pre-operatory PSAI predictor (after DST) and, potentially, in addition with baseline ACTH. Post-surgery basal cortisol measurement (± CST) helps the decision of glucocorticoids replacement since first post-operative day and during follow-up, serial testing at 3 months is a useful tool. Full article

The climbing perch, Anabas testudineus, is one of the most widely distributed freshwater amphibious fishes in South and Southeast Asia, exhibiting terrestrial movements. Our experimental study aimed to investigate endocrinological and biochemical changes in the blood of climbing perch associated with their terrestrial movements. To achieve this, the fish were divided into two groups: one group was exposed to aquatic conditions for twenty minutes, while the other group was subjected to terrestrial conditions for the same duration through rapid water level decrease. In terrestrial conditions, the fish predominantly exhibit movements on land, whereas in aquatic environments, they primarily remain immobile or swim. Elevated levels of stress-induced cortisol and glucose after short-term exposure indicate a high-stress response involving both neuroendocrine and metabolic mechanisms. Changes in the activity of aspartate aminotransferase and increased concentrations of triglycerides in the blood serum suggest energy mobilization through aerobic metabolic pathways. Extreme environmental changes did not affect thyroid axis function, including deiodination, thereby maintaining essential physiological activities under new conditions. Additionally, the anaerobic metabolic pathway appears to be minimally utilized at the onset of terrestrial movement, as no significant changes in lactate dehydrogenase concentrations were observed. Overall, the terrestrial movements of the climbing perch are likely predominantly forced and associated with high stress. Full article

Neonatal calves possess an immature and naïve immune system and are reliant on the intake of maternal colostrum for the passive transfer of immunoglobulins. Maternal antibodies delivered to the calf via colostrum, are crucial to prevent calfhood diseases and death. Failure of transfer of passive immunity (FTPI) is a condition in which calves do not acquire enough maternal antibodies, mostly in the form of IgG, due to inadequate colostrum quality or delayed colostrum feeding. The diagnosis and risk factors for FTPI have been widely studied in dairy cattle; however, in beef calves, the research interest in the topic is relatively recent, and the most adequate diagnostic and preventative methods are still in development, making it difficult to define recommendations for the assessment and prevention of FTPI in cow–calf operations. The objective of this scoping review is to identify the published literature on best practices for colostrum management and transfer of passive immunity (TPI) in neonatal beef calves. The literature was searched using three electronic databases (CAB Direct, Scopus, and PubMed) for publications from 2003 to 2025. The search process was performed during the period from May to July 2023, and was repeated in January 2025. All screening processes were performed using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia). A total of 800 studies were initially identified through database searches. After removing duplicates, 346 studies were screened based on their titles and abstracts, leading to the exclusion of 260 studies. The remaining 86 studies underwent full-text screening, and 58 studies were considered eligible for data extraction. Hand-searching the references from published review papers on the subject yielded an additional five studies, bringing the total to 63 included articles. The prevalence of FTPI has been estimated to be between 5.8% and 34.5% in beef calves. Factors studied related to colostrum management include quality and quantity of colostrum intake, the timing and method of colostrum feeding, and the microbial content of the colostrum. Studies on risk factors related to the calf include the topics calf sex, twin status, calf vigor, weight, month of birth, cortisol and epinephrine concentrations, and the administration of nonsteroidal anti-inflammatory drugs to calves after difficult calving. The dam-related risk factors studied include dam body condition score and udder conformation, breed, parity, genetics, prepartum vaccinations and nutrition, calving area and difficulty, and the administration of nonsteroidal anti-inflammatory drugs at C-section. Most importantly for beef systems, calves with low vigor and a weak suckling reflex are at high risk for FTPI; therefore, these calves should be given extra attention to ensure an adequate consumption of colostrum. While serum IgG levels of < 8 g/L or < 10 g/L have been suggested as cutoffs for the diagnosis of FTPI, 16 g/L and 24 g/L have emerged as cutoffs for adequate and optimal serum IgG levels in beef calves. Several field-ready diagnostics have been compared in various studies to the reference standards for measuring indicators of TPI in beef calves, where results often differ between models or manufacturers. Therefore, care must be taken when interpreting these results. Full article

Rising water temperatures due to climate change pose a significant threat to Phoxinus lagowskii, a cold-water fish that is ecologically vital to the high-latitude regions of China. This study assessed heat stress effects on behavioral, hematological, histological, physiological, and molecular responses in P. lagowskii. The critical maximum temperature (CT_max) was determined using the loss of equilibrium (LOE) method, with the CT_max reaching 29 °C. Elevated temperatures lead to an increase in the OBR. Fish were subjected to acute heat stress at 28 °C (below CT_max) for 48 h, with samples collected during the 48 h period. RBC, WBC, HGB, and HCT significantly increased during heat stress but decreased 12 h after heat stress. The levels of serum cortisol and blood glucose after heat stress were significantly higher than those in the control group. After heat stress, the height of the ILCM in the gills increased significantly, and the liver exhibited vacuolar degeneration and hypopigmentation. The activities of Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase in the gills initially increased and then decreased over the duration of heat stress. Most enzyme activities (PK, LDH, PFK, and HK) decreased during heat stress, while LPL and HL levels increased, indicating that lipid metabolism was the primary utilization process under heat stress. There was an increase in SOD activity at 12 h, followed by a decrease at 24 h, and an increase in CAT activity under heat stress. Integrated biomarker response (IBR) and principal component analysis (PCA) were employed to synthesize multi-level responses. The IBR values reached their peak at 3 h and 48 h of heat stress. We observed an upregulation of heat shock proteins (Hsp70, Hsp90, and Hsc70) as well as interleukin-10 (IL-10) in response to heat stress. Our findings offer novel insights into the mechanisms underlying the heat stress response in P. lagowskii, thereby enhancing our understanding of the effects of heat stress on cold-water fish. Full article

The present study evaluated the effects of dietary rumen-protected taurine (RPT) supplementation on ruminal fermentation, hematological parameters, liver function, stress-related hormones, and immune responses in yaks. Eighteen yaks were randomly allocated to three groups: a control group receiving no RPT (CON), a low-dose group receiving 20 g/day (RPT20), and a high-dose group receiving 40 g/day (RPT40). Supplementation with RPT did not significantly affect ruminal pH, microbial protein concentration, ammonia nitrogen, total volatile fatty acids, or the individual volatile fatty acid profiles (p > 0.05). A decreasing trend in red blood cell count was observed (p = 0.050), while no significant changes were detected in white blood cell or platelet indices (p > 0.05). Liver function markers, including albumin, alanine transaminase, aspartate transaminase, and total protein, remained unchanged, although a trend toward altered alkaline phosphatase activity was noted (p = 0.074). No significant effects were observed on acute-phase proteins (serum amyloid A, C-reactive protein) or stress-related hormones (epinephrine, adrenocorticotropic hormone, cortisol) (p > 0.05). Importantly, serum immunoglobulin A and immunoglobulin G levels were significantly increased in response to RPT supplementation (p = 0.029 and p = 0.043, respectively), suggesting enhanced humoral immunity. These findings indicate that RPT may improve immune function in yaks without negatively affecting rumen fermentation or liver health. Full article

Lipopolysaccharide (LPS) endotoxin is a well-characterized microbe-associated molecular pattern (MAMP) that forms the outer membrane of both pathogenic and commensal Gram-negative bacteria. It plays a crucial role in triggering inflammatory disorders such as mastitis, acidosis, and septicemia. In heifers, an LPS challenge induces a dynamic stress response, marked by elevated cortisol levels, increased body temperature, and altered immune function. Research indicates that LPS administration leads to a significant rise in cortisol post-challenge. Building on this understanding, the present study aimed to estimate genetic parameters for serum cortisol response to LPS challenge in Holstein heifers and its linear associations with production, health, reproduction, and conformation traits. Additionally, a genome-wide association study (GWAS) was conducted to identify genetic regions associated with cortisol response. A total of 252 animals were evaluated for cortisol response, with correlations estimated between cortisol levels and 55 genomic breeding values for key traits. Genetic parameters and heritability for cortisol response were estimated using Residual Maximum Likelihood (REML) in the Blupf90+ v 2.57 software. Single-Step GWAS (ssGWAS) employing a 10-SNP window approach and 42,123 SNP markers was performed to identify genomic regions that explained at least 0.5% of additive genetic variance. Finally, candidate genes and QTLs located 50 kb up and downstream of those windows were identified. The cortisol response showed significant but weak linear associations with cystic ovaries, body maintenance requirements, lactation persistency, milk yield, and protein yield (p-value ≤ 0.05) and showed suggestive weak linear associations with udder texture, clinical ketosis, heel horn erosion, and milking speed (p-value ≤ 0.15). Cortisol response showed significant additive genetic variance, along with moderate heritability of 0.26 (±0.19). A total of 34 windows explained at least 0.5% of additive genetic variance, and 75 QTLs and 11 candidate genes, comprising the genes CCL20, DAW1, CSMD2, HMGB4, B3GAT2, PARD3, bta-mir-2285aw, CFH, CDH2, ENSBTAG00000052242, and ENSBTAG00000050498, were identified. The functional enrichment analysis allowed us to infer two instances where these gene products could interfere with cortisol production: the first instance is related to the complement system, and the second one is related to the EMT (Epithelium–Mesenchymal Transition) and pituitary gland formation. Among the QTLs, 13 were enriched in the dataset, corresponding to traits related to milk (potassium content), the exterior (udder traits, teat placement, foot angle, rear leg placement, and feet and leg conformation), production (length of productive life, net merit, and type), and reproduction (stillbirth and calving ease). In summary, the cortisol response to LPS challenge in Holstein heifers seems to be moderately heritable and has weak but significant linear associations with important production and health traits. Several candidate genes identified could perform important roles, in at least two ways, for cortisol production, and QTLs were identified close to regions of the genome that explained a significant amount of additive genetic variance for cortisol response. Therefore, further investigations are warranted to validate these findings with a larger dataset. Full article

Understanding hormone patterns in free-ranging African elephants can provide critical insights for the management of elephants in human care, particularly in addressing reproductive anomalies and the rising prevalence of obesity in zoo populations. This study is the first to establish baseline values for glucose, insulin, and leptin, and their potential relationships with reproductive and stress hormones. We measured the hormones in serum samples collected opportunistically in Kruger National Park between 2000 and 2016. Endocrine profiles were compared across age groups in both male and female elephants and between the wet and dry seasons. In females, progestogen and prolactin levels were highest in adults, and were not significantly correlated with the glucose-to-insulin (G/I) ratio or leptin. In males, testosterone levels were higher in adults, and the G/I ratio was a significant predictor of testosterone concentrations. Seasonal variations revealed that, in males, testosterone levels were higher, and cortisol concentrations were lower during the rainy season. In females, cortisol concentrations were negatively associated with progestogen levels during the dry season. These benchmarks offer zoos a reference point to assess whether current management approaches are effective, and how natural variation with the season may impact hormone levels. Full article

Staphylococcus aureus is a significant bacterial pathogen responsible for a wide range of diseases in both humans and animals. This study aimed to investigate nucleotide sequence variations, gene expression patterns, and serum biomarkers, including acute phase proteins (APPs), hormonal fluctuations, and iron profile parameters in sheep affected by pneumonia. Additionally, the study focused on the isolation and characterization of S. aureus from pneumonic sheep, with particular emphasis on the prevalence of methicillin-resistant S. aureus (MRSA) strains. Blood samples were collected from both healthy and pneumonic sheep for gene expression and biochemical analyses, while nasal swabs from pneumonic sheep were used for bacterial isolation and identification. Out of 100 nasal swabs analyzed, 44% tested positive for Staphylococcus spp., and 61.4% of these were confirmed as S. aureus by PCR. The mecA gene, a key marker of methicillin resistance, was identified in 17 isolates (38.6% of the S. aureus-positive samples). MRSA isolates showed complete resistance to amoxicillin, cloxacillin, and erythromycin, and high resistance to penicillin, amoxicillin, and tetracycline; however, all MRSA strains remained fully susceptible to vancomycin. Gene expression analysis revealed that TLR2, CLEC4E, PTX3, CXCL8, and IL15RA were significantly upregulated (p < 0.05) in pneumonic ewes, while SOCS3 expression was markedly downregulated. Sequence analysis of immune-related genes revealed notable nucleotide differences between healthy and affected animals. Furthermore, the pneumonic group exhibited significantly elevated levels of APPs, cortisol, and growth hormone, along with reduced levels of insulin, T3, and T4. These findings underscore the zoonotic risk posed by MRSA and emphasize the need for robust surveillance and antibiotic stewardship to control its spread. The study also highlights the importance of molecular diagnostics in accurately identifying MRSA and elucidating resistance mechanisms, thereby facilitating targeted treatment and informed management strategies. Full article

In this study, thirty female dogs, aged one to five years and varying in weight, in the last week of gestation were evaluated. The animals were divided into two groups: GC, which comprised twenty-two bitches undergoing elective cesarean section, and GD, which consisted of eight dogs requiring therapeutic cesarean section as a treatment to dystocia. We found that cortisol levels in the amniotic fluid were significantly higher in pups delivered via elective cesareans (mean: 9.86 ng/mL) compared to those from therapeutic c-sections (mean: 4.11 ng/mL). This observation contrasted with previous studies that reported lower cortisol levels in elective procedures, suggesting complexities in the physiological responses to different delivery methods that warrant further investigation. Notably, our study observed no significant association between amniotic fluid meconium presence and other distress markers, indicating that meconium may be more closely associated with fetal maturation rather than distress (p > 0.05). Neonatal viability (Apgar score) revealed that 92.86% of the neonates from elective procedures demonstrated no distress shortly after delivery, contrasting with 56.25% in therapeutic c-section. Fetal distress can be a direct consequence of dystocia caused by various stressors, such as pain and hypoxia. These factors can impair the fetus’ ability to adapt to extrauterine life, often leading to lower Apgar scores. Notably, neonatal weight was directly related to fetal cortisol levels, while no significant associations were noted between the litter size or birth order and cortisol concentrations, irrespective of the delivery type. These findings underscore the need for ongoing investigation into the relationships between cesarean delivery types, maternal and neonatal stress markers, and resultant health outcomes, aiming to enhance care strategies for expectant canine mothers and their puppies. Full article

This study investigates the biochemical and physiological responses of the economically important fish Barbonymus gonionotus to acute temperature fluctuations. Focusing on malondialdehyde (MDA) levels in serum and visceral organs, serum biochemical indices, hematological parameters, cortisol levels, and operculum movement, this research assessed the impacts of thermal stress. Experimental conditions involved two thermal regimes: heat shock at 25–29 °C and 25–37 °C; as well as cold shock at 25–21 °C and 25–13 °C sustained over 24 (D1), 48 (D2), and 72 (D3) h. Serum MDA levels increased significantly. Notably, MDA in the gills, brain, and liver fluctuated under cold stress, particularly at 13 °C. Serum parameters showed significant alterations except for AST, total protein, and cholesterol, which remained unaffected by heat shock. Red blood cell (RBC) counts dropped to their lowest at 13 °C, while white blood cell (WBC) counts diminished significantly when temperatures dropped to 21 °C and then stabilized. Cortisol surged with temperature changes, peaking at 13 °C and 29 °C for cold and heat shock, respectively. Operculum movement was inversely affected by thermal changes, decreasing with cold and increasing with heat. These findings underscore the sensitivity of silver barb to thermal extremes, providing insights for optimized aquaculture management and enhanced resilience to environmental stressors. Full article

Background/Objectives: The endoscopic transsphenoidal approach constitutes an excellent technique for adrenocorticotropin hormone (ACTH)-producing pituitary tumours. It is associated with subnormal postoperative serum cortisol levels, which may guide decisions regarding immediate re-operation. Methods: The authors retrospectively reviewed patients with Cushing’s disease who had undergone endoscopic transsphenoidal surgery between 2013 and 2023. All operations were performed by neurosurgeons and skull-base otolaryngologists. Surgical outcomes were evaluated in combination with prognostic factors such as cortisol and ACTH levels in terms of long-term remission and late recurrence rates of Cushing’s disease. Results: Fifty patients aged between 15 and 69 (average 37.8) years were evaluated, having undergone 50 operations. The median follow-up was 76.5 months (range: 23–122 months). Major complications with a transient CSF leak resulting from the surgical approach occurred in three patients. Two patients in the series experienced minor complications, developing a deep vein thrombosis, and thirteen patients developed transient diabetes insipidus. The initial remission rate was 84% (n = 42/50). Initial non-remission occurred in eight (8) patients (16%), with three macro- and five microadenomas. A total of 3 of the 42 patients with initial remission had a late recurrence after 50 months follow-up and required repeat transsphenoidal surgery. Seven patients (16.6%) who did not exhibit early postoperative cortisol reduction subsequently achieved remission. Male gender was the only factor that was significantly associated with lower remission rates in either short- or long-term follow-up (p = 0.003 and 0.038, respectively). An immediate postoperative ACTH nadir of ≤5 pg/mL was significantly related to long-term remission (p = 0.004). In our study, a significant correlation was confirmed between remission of the disease and 24 h urinary cortisol values, both early and late (p = 0.019), and serum cortisol <138 nmol/L. In this retrospective study from a single institution specialising in pituitary tumour management, the endoscopic transsphenoidal approach was shown to be both safe and effective. Additionally, we found that the risk of relapse in patients with Cushing’s disease persisting for more than 5 years after surgery is real but low. Moreover, failure to achieve an early postoperative cortisol reduction does not preclude a subsequent remission. Conclusions: Our findings demonstrate that ACTH, postoperative serum cortisol, and urinary free cortisol are valuable predictors of relapse over a five-year period and are closely correlated to each other. Full article

Anesthesia is commonly used in sturgeon aquaculture to reduce stress and pain during handling and procedures. This study compared the effects of clove oil (rich in eugenol) and propofol—an anesthetic widely used in human and veterinary medicine—on Persian sturgeon (Acipenser persicus) fingerlings. A total of 405 fish (6.88 ± 0.90 g) were exposed to varying concentrations of clove oil (25, 50, 75, 100 mg L⁻¹), propofol (10.0, 12.5, 25.0, 50 mg L⁻¹), or no anesthetic (control) in triplicate. Hematocrit and monocyte levels remained unchanged across treatments, but the highest doses of both anesthetics significantly reduced leukocyte percentages (p = 0.049 and p = 0.043, respectively). While serum enzymes were stable, cortisol levels increased significantly at the highest concentrations of both clove oil (38.92 ± 5.1 ng mL⁻¹; p = 0.001) and propofol (36.48 ± 3.4 ng mL⁻¹; p = 0.035), indicating secondary stress responses. Propofol at 25 mg L⁻¹ showed fast induction and recovery times and induced milder stress compared to clove oil. Overall, short-term anesthesia with both agents triggered physiological stress, but propofol at 25 mg L⁻¹ appeared more suitable for minimizing adverse effects in Persian sturgeon fingerlings. Full article

Background: The objective of this study was to evaluate the influence of polycystic ovary syndrome (PCOS) on various laboratory measurements, especially hormonal and metabolic parameters, as well as clinical measurements including hirsutism and acne assessment, with consideration of different PCOS phenotypes. This study was focused mainly on the correlation between anti-Müllerian hormone (AMH) levels and other hormonal measurements. Methods: This single-center retrospective study included 296 patients with diagnosed PCOS according to the Rotterdam criteria. All participants of this study underwent blood tests between the 2nd and the 6th day of their menstrual cycle. Results: In statistical analysis, a strong significant correlation of AMH with androstenedione (r = 0.48, p < 0.0001), luteinizing hormone (LH) (r = 0.45, p < 0.0001), total testosterone (r = 0.34, p < 0.0001), 17-hydroxyprogesterone (r = 0.31, p < 0.0001), and cortisol after dexamethasone (r = 0.15, p = 0.011) was observed. In addition, significant negative correlations were found with follicle-stimulating hormone (FSH) (r = −0.21, p < 0.0001), weight (r = −0.15, p = 0.010), glucose 0′ (r = −0.14, p = 0.014), hip circumference (r = −0.14, p = 0.017), and body mass index (BMI) (r = −0.14, p = 0.018). A weak correlation with waist circumference of p = 0.06 was also observed. Conclusions: AMH serum levels showed a positive correlation with hyperandrogenism and a negative correlation with metabolic factors, although its relationship with BMI is more complex. There were no significant differences in AMH levels across the four PCOS phenotypes or when categorized into hyperandrogenic and normoandrogenic subtypes. Full article