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Elevated circulating luteinizing hormone level

MedGen UID:
868698
Concept ID:
C4023101
Finding
Synonyms: Elevated LH levels; Elevated luteinizing hormone
 
HPO: HP:0011969

Definition

An elevated concentration of luteinizing hormone in the blood. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVElevated circulating luteinizing hormone level

Conditions with this feature

Androgen resistance syndrome
MedGen UID:
21102
Concept ID:
C0039585
Disease or Syndrome
Androgen insensitivity syndrome (AIS) is typically characterized by evidence of feminization (i.e., undermasculinization) of the external genitalia at birth, abnormal secondary sexual development in puberty, and infertility in individuals with a 46,XY karyotype. AIS represents a spectrum of defects in androgen action and can be subdivided into three broad phenotypes: Complete androgen insensitivity syndrome (CAIS), with typical female external genitalia. Partial androgen insensitivity syndrome (PAIS) with predominantly female, predominantly male, or ambiguous external genitalia. Mild androgen insensitivity syndrome (MAIS) with typical male external genitalia.
Aarskog syndrome
MedGen UID:
61234
Concept ID:
C0175701
Disease or Syndrome
Aarskog-Scott syndrome is a genetic disorder that affects the development of many parts of the body, most commonly the head and face, the hands and feet, and the genitals and urinary system (genitourinary tract). This condition mainly affects males, although females may have mild features of the syndrome.\n\nPeople with Aarskog-Scott syndrome often have distinctive facial features, such as widely spaced eyes (hypertelorism), a small nose, a long area between the nose and mouth (philtrum), and a widow's peak hairline. They frequently have mild to moderate short stature during childhood, but their growth usually catches up with that of their peers during puberty. Hand abnormalities are common in this syndrome and include short fingers (brachydactyly), curved pinky fingers (fifth finger clinodactyly), webbing of the skin between some fingers (cutaneous syndactyly), and a single crease across the palm. Affected individuals can also have wide, flat feet with broad, rounded toes. Other abnormalities in people with Aarskog-Scott syndrome include heart defects and a split in the upper lip (cleft lip) with or without an opening in the roof of the mouth (cleft palate).\n\nMost males with Aarskog-Scott syndrome have a shawl scrotum, in which the scrotum surrounds the penis instead of hanging below. Less often, they have undescended testes (cryptorchidism) or a soft out-pouching around the belly-button (umbilical hernia) or in the lower abdomen (inguinal hernia).\n\nThe intellectual development of people with Aarskog-Scott syndrome varies widely. Most individuals with Aarskog-Scott syndrome have normal intelligence; however, some may have mild learning and behavior problems, and in rare cases, severe intellectual disability has been reported.
Vanishing testis
MedGen UID:
78602
Concept ID:
C0266427
Disease or Syndrome
SRXY11 is characterized by a genital phenotype that may range from predominantly female to predominantly male, including marked sex ambiguity depending on the duration of normal testicular function prior to the loss of testicular tissue. Approximately half of patients present with micropenis and bilateral cryptorchidism, and half present with female-appearing or ambiguous external genitalia (da Silva et al., 2019; McElreavey et al., 2020). The testicular regression syndrome (TRS) was delineated by Sarto and Opitz (1973), who called it the XY gonadal dysgenesis syndrome. It is characterized primarily by the absence of gonads in an XY person. In most cases, uterus and fallopian tubes are absent but small tubular structures interpreted as mullerian or wolffian rudiments (or both) are present. The range of virilizing effects due to early testicular tissue extends from none in phenotypic females with only slightly hypoplastic normal external genitalia, well-formed but hypoplastic uterus, and well-formed tubes (De Marchi et al., 1981) to the anorchic phenotypic male (Edman et al., 1977). Most affected individuals lack a vagina but a urogenital sinus or pseudovaginal urethral outpouching is found. Partial labioscrotal fusion and clitoris enlargement are common, breast development is absent, and postpubertal eunuchoid habitus is the rule. Sometimes nongenital anomalies are present (summary by Rosenberg et al., 1984).
Premature ovarian failure 2A
MedGen UID:
336902
Concept ID:
C1845293
Disease or Syndrome
Any primary ovarian failure in which the cause of the disease is a mutation in the DIAPH2 gene.
Premature ovarian failure 6
MedGen UID:
394115
Concept ID:
C2676742
Disease or Syndrome
Any primary ovarian failure in which the cause of the disease is a mutation in the FIGLA gene.
46,XX sex reversal 1
MedGen UID:
411324
Concept ID:
C2748895
Disease or Syndrome
Nonsyndromic 46,XX testicular disorders/differences of sex development (DSD) are characterized by: the presence of a 46,XX karyotype; external genitalia ranging from typical male to ambiguous; two testicles; azoospermia; absence of müllerian structures; and absence of other syndromic features, such as congenital anomalies outside of the genitourinary system, learning disorders / cognitive impairment, or behavioral issues. Approximately 85% of individuals with nonsyndromic 46,XX testicular DSD present after puberty with normal pubic hair and normal penile size but small testes, gynecomastia, and sterility resulting from azoospermia. Approximately 15% of individuals with nonsyndromic 46,XX testicular DSD present at birth with ambiguous genitalia. Gender role and gender identity are reported as male. If untreated, males with 46,XX testicular DSD experience the consequences of testosterone deficiency.
46,XY sex reversal 1
MedGen UID:
412662
Concept ID:
C2748896
Disease or Syndrome
Sex reversal in an individual with 46,XY karyotype caused by point mutations or deletions in the SRY gene, encoding sex-determining region Y protein.
46,XX sex reversal 2
MedGen UID:
411414
Concept ID:
C2749215
Disease or Syndrome
Nonsyndromic 46,XX testicular disorders/differences of sex development (DSD) are characterized by: the presence of a 46,XX karyotype; external genitalia ranging from typical male to ambiguous; two testicles; azoospermia; absence of müllerian structures; and absence of other syndromic features, such as congenital anomalies outside of the genitourinary system, learning disorders / cognitive impairment, or behavioral issues. Approximately 85% of individuals with nonsyndromic 46,XX testicular DSD present after puberty with normal pubic hair and normal penile size but small testes, gynecomastia, and sterility resulting from azoospermia. Approximately 15% of individuals with nonsyndromic 46,XX testicular DSD present at birth with ambiguous genitalia. Gender role and gender identity are reported as male. If untreated, males with 46,XX testicular DSD experience the consequences of testosterone deficiency.
Premature ovarian failure 7
MedGen UID:
414115
Concept ID:
C2751825
Disease or Syndrome
Any primary ovarian failure in which the cause of the disease is a mutation in the NR5A1 gene.
Moyamoya angiopathy-short stature-facial dysmorphism-hypergonadotropic hypogonadism syndrome
MedGen UID:
463207
Concept ID:
C3151857
Disease or Syndrome
This multisystem disorder is characterized by moyamoya disease, short stature, hypergonadotropic hypogonadism, and facial dysmorphism. Other variable features include dilated cardiomyopathy, premature graying of the hair, and early-onset cataracts. Moyamoya disease is a progressive cerebrovascular disorder characterized by stenosis or occlusion of the internal carotid arteries and the main branches, leading to the development of small collateral vessels (moyamoya vessels) at the base of the brain. Affected individuals can develop acute neurologic events due to stroke-like episodes (summary by Miskinyte et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of moyamoya disease, see MYMY1 (252350).
Ovarian dysgenesis 3
MedGen UID:
482101
Concept ID:
C3280471
Disease or Syndrome
Any 46 XX gonadal dysgenesis in which the cause of the disease is a mutation in the PSMC3IP gene.
46,XY sex reversal 3
MedGen UID:
483746
Concept ID:
C3489793
Congenital Abnormality
Centra precocious puberty 1
MedGen UID:
812209
Concept ID:
C3805879
Disease or Syndrome
Early activation of the hypothalamic-pituitary-gonadal axis results in gonadotropin-dependent precocious puberty, also known as central precocious puberty, which is clinically defined by the development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. Pubertal timing is influenced by complex interactions among genetic, nutritional, environmental, and socioeconomic factors. The timing of puberty is associated with risks of subsequent disease: earlier age of menarche in girls is associated with increased risk of breast cancer, endometrial cancer, obesity, type 2 diabetes, and cardiovascular disease. Central precocious puberty has also been associated with an increased incidence of conduct and behavior disorders during adolescence (summary by Abreu et al., 2013). Genetic Heterogeneity of Central Precocious Puberty Central precocious puberty-2 (CPPB2; 615346) is caused by mutation in the MKRN3 gene (603856) on chromosome 15q11.
Perrault syndrome 3
MedGen UID:
814744
Concept ID:
C3808414
Disease or Syndrome
Perrault syndrome is characterized by sensorineural hearing loss (SNHL) in males and females and ovarian dysfunction in females. SNHL is bilateral and ranges from profound with prelingual (congenital) onset to moderate with early-childhood onset. When onset is in early childhood, hearing loss can be progressive. Ovarian dysfunction ranges from gonadal dysgenesis (absent or streak gonads) manifesting as primary amenorrhea to primary ovarian insufficiency (POI) defined as cessation of menses before age 40 years. Fertility in affected males is reported as normal (although the number of reported males is limited). Neurologic features described in some individuals with Perrault syndrome include learning difficulties and developmental delay, cerebellar ataxia, and motor and sensory peripheral neuropathy.
Premature ovarian failure 8
MedGen UID:
816697
Concept ID:
C3810367
Disease or Syndrome
Premature ovarian failure (POF), the endpoint of primary ovarian insufficiency, affects approximately 1% of women worldwide. Patients with POF present with at least a 6-month history of amenorrhea and elevated plasma levels of follicle-stimulating hormone (more than 40 mIU per milliliter). The disorder can result from premature depletion of the follicle pool, follicular atresia, follicle growth arrest, or ovarian dysgenesis (see 233300). In approximately 10 to 15% of patients with POF, a genetic cause has been determined (summary by Caburet et al., 2014). For a general phenotypic description and a discussion of genetic heterogeneity of premature ovarian failure, see POF1 (311360). Mutation in the STAG3 gene also causes male infertility; see spermatogenic failure-61 (SPGF61; 619672).
Premature ovarian failure 9
MedGen UID:
816706
Concept ID:
C3810376
Disease or Syndrome
Nonsyndromic primary ovarian insufficiency, which is characterized by amenorrhea with elevated gonadotropin levels, is observed in 1% of otherwise healthy women under the age of 40 years (summary by Wang et al., 2014). For a general phenotypic description and discussion of the genetic heterogeneity of premature ovarian failure, see POF1 (311360).
Premature ovarian failure 10
MedGen UID:
898849
Concept ID:
C4225402
Disease or Syndrome
Premature ovarian failure-10 (POF10) represents a syndrome characterized by primary amenorrhea, hypergonadotropic ovarian insufficiency, and genomic instability in somatic cells. For a general phenotypic description and discussion of genetic heterogeneity of premature ovarian failure, see POF1 (311360). For a discussion of genetic heterogeneity of age at natural menopause, see MENOQ1 (300488).
Acromesomelic dysplasia 3
MedGen UID:
904735
Concept ID:
C4225404
Disease or Syndrome
Methemoglobinemia type 4
MedGen UID:
925090
Concept ID:
C4285231
Disease or Syndrome
Methemoglobinemia and ambiguous genitalia (METAG) is due to isolated 17,20-lyase deficiency, defined by apparently normal 17-alpha-hydroxylase activity but severely reduced 17,20-lyase activity of the CYP17A1 enzyme (609300), which results in sex steroid deficiency but normal glucocorticoid and mineralocorticoid reserve. The clinical phenotype is characterized by male undermasculinization, with absent or disturbed pubertal development in both 46,XY and 46,XX individuals. Mild to severe methemoglobinemia has been reported in these patients (Idkowiak et al., 2012). Other autosomal recessive methemoglobinemias include types I and II (see 250800), caused by mutation in the CYB5R3 gene (613213). Isolated 17,20-lyase deficiency can also be caused by mutation in the CYP17A1 gene (609300), and mutation in the POR gene can manifest clinically as isolated 17,20-lyase deficiency (see 124015.0016).
Seckel syndrome 10
MedGen UID:
934614
Concept ID:
C4310647
Disease or Syndrome
Any Seckel syndrome in which the cause of the disease is a mutation in the NSMCE2 gene.
Ovarian dysgenesis 5
MedGen UID:
1627972
Concept ID:
C4540141
Disease or Syndrome
Premature ovarian failure 14
MedGen UID:
1646133
Concept ID:
C4693941
Disease or Syndrome
Premature ovarian failure-14 (POF14) is characterized by amenorrhea, hypoestrogenism, and elevated gonadotropin levels (Franca et al., 2018). For a general phenotypic description and discussion of genetic heterogeneity of premature ovarian failure, see POF1 (311360).
Spermatogenic failure 28
MedGen UID:
1648494
Concept ID:
C4748117
Disease or Syndrome
Spermatogenic failure-28 (SPGF28) is characterized by nonobstructive azoospermia, with a Sertoli cell-only phenotype observed in testicular tissue (Kasak et al., 2018). For a discussion of genetic heterogeneity of spermatogenic failure, see SPGF1 (258150).
Ovarian dysgenesis 7
MedGen UID:
1648458
Concept ID:
C4748263
Disease or Syndrome
Ovarian dysgenesis-7 (ODG7) is characterized by primary amenorrhea, delayed puberty, elevated gonadotropic hormones, and small uterus and ovaries. Ovarian histology shows fibrotic ovaries without follicles (Chen et al., 2018). For a discussion of genetic heterogeneity of ovarian dysgenesis, see ODG1 (233300).
Ovarian dysgenesis 8
MedGen UID:
1648455
Concept ID:
C4748626
Disease or Syndrome
Ovarian dysgenesis-8 (ODG8) is characterized by complete lack of estrogen action, resulting in absent breast development, primary amenorrhea, and osteoporosis (Lang-Muritano et al., 2018). For a discussion of genetic heterogeneity of ovarian dysgenesis, see ODG1 (233300).
Gonadal dysgenesis, dysmorphic facies, retinal dystrophy, and myopathy
MedGen UID:
1679397
Concept ID:
C5193085
Disease or Syndrome
Myoectodermal gonadal dysgenesis syndrome (MEGD) is characterized by 46,XY complete or partial gonadal dysgenesis, or 46,XX gonadal dysgenesis, in association with extragonadal anomalies, including low birth weight, typical facies, rod and cone dystrophy, sensorineural hearing loss, omphalocele, anal atresia, renal agenesis, skeletal abnormalities, dry and scaly skin, severe myopathy, and neuromotor delay. Dysmorphic facial features along with muscular habitus are the hallmarks of the syndrome. Abnormal hair patterning with frontal upsweep and additional whorls, eyebrow abnormalities comprising broad, arched, and sparse or thick eyebrows, underdeveloped alae nasi, smooth philtrum, and low-set ears with overfolded helices facilitate a gestalt diagnosis. (Guran et al., 2019; Altunoglu et al., 2022).
Premature ovarian failure 17
MedGen UID:
1748767
Concept ID:
C5436889
Disease or Syndrome
Premature ovarian failure-17 (POF17) is characterized by early cessation of menses after initial menarche, with small ovaries and uterus (Zhang et al., 2019). For a discussion of genetic heterogeneity of premature ovarian failure, see POF1 (311360).
Premature ovarian failure 18
MedGen UID:
1785989
Concept ID:
C5543095
Disease or Syndrome
Premature ovarian failure-18 (POF18) is characterized by irregular menstrual cycles and cessation of menstruation in the third decade of life. The uterus is small; ovaries may be small or rudimentary, and do not show follicular activity (Fan et al., 2021). For a general phenotypic description and discussion of genetic heterogeneity of premature ovarian failure, see POF1 (311360).
Ovarian dysgenesis 9
MedGen UID:
1794256
Concept ID:
C5562046
Disease or Syndrome
Ovarian dysgenesis-9 (ODG9) is characterized by severe nonsyndromic primary ovarian insufficiency with primary amenorrhea, hypoplastic or absent ovaries, and delayed bone age. Patient cells show evidence of chromosomal instability (Smirin-Yosef et al., 2017; Heddar et al., 2022). For a general phenotypic description and discussion of genetic heterogeneity of ovarian dysgenesis, see ODG1 (233300).
Hypogonadotropic hypogonadism 24 without anosmia
MedGen UID:
1806136
Concept ID:
C5574957
Disease or Syndrome
Congenital idiopathic hypogonadotropic hypogonadism (IHH) is a disorder characterized by absent or incomplete sexual maturation by the age of 18 years, in conjunction with low levels of circulating gonadotropins and testosterone and no other abnormalities of the hypothalamic-pituitary axis. Idiopathic hypogonadotropic hypogonadism can be caused by an isolated defect in gonadotropin-releasing hormone (GNRH; 152760) release, action, or both. Other associated nonreproductive phenotypes, such as anosmia, cleft palate, and sensorineural hearing loss, occur with variable frequency. In the presence of anosmia, idiopathic hypogonadotropic hypogonadism has been called 'Kallmann syndrome (KS),' whereas in the presence of a normal sense of smell, it has been termed 'normosmic idiopathic hypogonadotropic hypogonadism (nIHH)' (summary by Raivio et al., 2007). Because families have been found to segregate both KS and nIHH, the disorder is here referred to as 'hypogonadotropic hypogonadism with or without anosmia (HH).' For a general phenotypic description and a discussion of genetic heterogeneity of hypogonadotropic hypogonadism with or without anosmia, see 147950.
Spermatogenic failure, X-linked, 4
MedGen UID:
1804024
Concept ID:
C5676882
Disease or Syndrome
X-linked spermatogenic failure-4 (SPGFX4) is characterized by male infertility due to azoospermia or oligoasthenoteratozoospermia. Some patients show maturation arrest, and Sertoli cell-only phenotype has been observed (Hardy et al., 2021; Arafat et al., 2021; Kherraf et al., 2022). For a discussion of genetic heterogeneity of spermatogenic failure, see SPGF1 (258150).
Ovarian dysgenesis 10
MedGen UID:
1801078
Concept ID:
C5676966
Disease or Syndrome
Ovarian dysgenesis-10 (ODG10) is characterized by primary amenorrhea and absent puberty. The uterus is small and prepubertal, and ovaries are streak or not visualized on ultrasound (McGlacken-Byrne et al., 2022). Mutation in the ZSWIM7 gene also causes male infertility due to spermatogenic failure (SPGF71; 619831). For a general phenotypic description and discussion of genetic heterogeneity of ovarian dysgenesis, see ODG1 (233300).
Premature ovarian failure 20
MedGen UID:
1808256
Concept ID:
C5677011
Disease or Syndrome
Premature ovarian failure-20 (POF20) is characterized by female infertility due to secondary amenorrhea. Some patients exhibit atrophic ovaries lacking follicles (Carlosama et al., 2017; Akbari et al., 2021; Wyrwoll et al., 2022). For a general phenotypic description and a discussion of genetic heterogeneity of POF, see POF1 (311360).

Professional guidelines

PubMed

Yeap BB, Grossmann M, McLachlan RI, Handelsman DJ, Wittert GA, Conway AJ, Stuckey BG, Lording DW, Allan CA, Zajac JD, Burger HG
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Recent clinical studies

Etiology

Xu X, Li C, Diao H, Guo Y, Zhao Y, Zhao W, Dong B
Diabetes Metab Res Rev 2024 Jan;40(1):e3718. Epub 2023 Aug 29 doi: 10.1002/dmrr.3718. PMID: 37644801
Wang H, Wang Y, Zhang H, Liang Z, Hu W, Qiu S, Li K, Zhang L, Dai H, Yang M, Yang G, Li L
Ann Med 2023 Dec;55(1):2206162. doi: 10.1080/07853890.2023.2206162. PMID: 37166403Free PMC Article
Krysiak R, Kowalcze K, Okopień B
J Clin Pharmacol 2022 Nov;62(11):1364-1371. Epub 2022 Jun 20 doi: 10.1002/jcph.2088. PMID: 35603693
Yildirim E, Gorkem U
Gynecol Endocrinol 2021 Dec;37(12):1128-1131. Epub 2021 Jul 9 doi: 10.1080/09513590.2021.1950683. PMID: 34241554
Tata B, Mimouni NEH, Barbotin AL, Malone SA, Loyens A, Pigny P, Dewailly D, Catteau-Jonard S, Sundström-Poromaa I, Piltonen TT, Dal Bello F, Medana C, Prevot V, Clasadonte J, Giacobini P
Nat Med 2018 Jun;24(6):834-846. Epub 2018 May 14 doi: 10.1038/s41591-018-0035-5. PMID: 29760445Free PMC Article

Diagnosis

Wang H, Wang Y, Zhang H, Liang Z, Hu W, Qiu S, Li K, Zhang L, Dai H, Yang M, Yang G, Li L
Ann Med 2023 Dec;55(1):2206162. doi: 10.1080/07853890.2023.2206162. PMID: 37166403Free PMC Article
Krysiak R, Kowalcze K, Okopień B
J Clin Pharmacol 2022 Nov;62(11):1364-1371. Epub 2022 Jun 20 doi: 10.1002/jcph.2088. PMID: 35603693
Clay CM, Cherrington BD, Navratil AM
Front Endocrinol (Lausanne) 2020;11:616053. Epub 2021 Feb 4 doi: 10.3389/fendo.2020.616053. PMID: 33613451Free PMC Article
Bicer M, Alan M, Alarslan P, Guler A, Kocabas GU, Imamoglu C, Aksit M, Bozkaya G, Isil AM, Baloglu A, Aslanipoiur B, Calan M
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Pearson JC
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Therapy

Wang H, Wang Y, Zhang H, Liang Z, Hu W, Qiu S, Li K, Zhang L, Dai H, Yang M, Yang G, Li L
Ann Med 2023 Dec;55(1):2206162. doi: 10.1080/07853890.2023.2206162. PMID: 37166403Free PMC Article
Krysiak R, Kowalcze K, Okopień B
J Clin Pharmacol 2022 Nov;62(11):1364-1371. Epub 2022 Jun 20 doi: 10.1002/jcph.2088. PMID: 35603693
Krysiak R, Szkróbka W, Bednarska-Czerwińska A, Okopień B
Fundam Clin Pharmacol 2021 Apr;35(2):466-472. Epub 2020 Sep 10 doi: 10.1111/fcp.12600. PMID: 32813271
Tata B, Mimouni NEH, Barbotin AL, Malone SA, Loyens A, Pigny P, Dewailly D, Catteau-Jonard S, Sundström-Poromaa I, Piltonen TT, Dal Bello F, Medana C, Prevot V, Clasadonte J, Giacobini P
Nat Med 2018 Jun;24(6):834-846. Epub 2018 May 14 doi: 10.1038/s41591-018-0035-5. PMID: 29760445Free PMC Article
Whirledge S, Cidlowski JA
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Prognosis

Boga A, Stapleton F, Chapman M, Golebiowski B
Ocul Surf 2023 Jul;29:511-520. Epub 2023 Jul 6 doi: 10.1016/j.jtos.2023.06.015. PMID: 37422153
Wang H, Wang Y, Zhang H, Liang Z, Hu W, Qiu S, Li K, Zhang L, Dai H, Yang M, Yang G, Li L
Ann Med 2023 Dec;55(1):2206162. doi: 10.1080/07853890.2023.2206162. PMID: 37166403Free PMC Article
Pozzi E, Boeri L, Capogrosso P, Palmisano F, Preto M, Sibona M, Franceschelli A, Ruiz-Castañé E, Sarquella-Geli J, Bassas-Arnau L, Scroppo FI, Gentile G, Falcone M, Timpano M, Ceruti C, Gadda F, Colombo F, Rolle L, Gontero P, Montorsi F, Sánchez-Curbelo J, Montanari E, Salonia A
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Bicer M, Alan M, Alarslan P, Guler A, Kocabas GU, Imamoglu C, Aksit M, Bozkaya G, Isil AM, Baloglu A, Aslanipoiur B, Calan M
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Clinical prediction guides

Xu X, Li C, Diao H, Guo Y, Zhao Y, Zhao W, Dong B
Diabetes Metab Res Rev 2024 Jan;40(1):e3718. Epub 2023 Aug 29 doi: 10.1002/dmrr.3718. PMID: 37644801
Wang H, Wang Y, Zhang H, Liang Z, Hu W, Qiu S, Li K, Zhang L, Dai H, Yang M, Yang G, Li L
Ann Med 2023 Dec;55(1):2206162. doi: 10.1080/07853890.2023.2206162. PMID: 37166403Free PMC Article
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Cunningham RL, Singh M, O'Bryant SE, Hall JR, Barber RC
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Recent systematic reviews

Del Giudice F, Busetto GM, De Berardinis E, Sperduti I, Ferro M, Maggi M, Gross MS, Sciarra A, Eisenberg ML
Asian J Androl 2020 Jul-Aug;22(4):360-367. doi: 10.4103/aja.aja_101_19. PMID: 31621654Free PMC Article

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