Evidence map›Paper›PMID 42199801›Full record

ArticleFrontiers in endocrinology2026

Characteristics of androgen metabolic pathways in patients with 21-hydroxylase deficiency and their association with disease control status.

Hemeng Chong, Yalei Pi, Yanan Zhang, Yuqian Li, Yutong Xing, Huifeng Zhang

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Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Hemeng ChongDepartment of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Yalei PiDepartment of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Yanan ZhangDepartment of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Yuqian LiDepartment of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Yutong XingDepartment of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Huifeng ZhangDepartment of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To investigate the activity characteristics of distinct androgen metabolic pathways in patients with 21-hydroxylase deficiency (21OHD) and their correlation with disease control status, and to elucidate the metabolic pathway features and underlying mechanisms in poorly controlled patients. Methods: A total of 111 patients with confirmed 21OHD were enrolled in this study. Clinical data and steroid hormone profiles were collected, and robust standardized Z-scores were calculated for each steroid hormone. K-means clustering analysis was performed using the robust standardized Z-scores of 7 signature steroid hormones to stratify patients into a well-controlled group and a poorly controlled group. Differences in clinical characteristics, pathway activities and key enzyme conversion efficiencies were compared between and within the two groups. Results: K-means clustering analysis classified 102 patients into the well-controlled group and 9 into the poorly controlled group. Multivariate analysis identified puberty as an independent risk factor for poor disease control (OR = 11.90, 95%CI:1.43-98.79, P = 0.02). Among pubertal patients, the poorly controlled group had a significantly higher relative weight of classical pathway androgen load than the well-controlled group (63.92% vs. 46.19%, P = 0.02), and the proportion of the classical pathway in the poorly controlled group was markedly higher than that of the 11-oxygenated and backdoor pathways (both P<0.05). Additionally, the conversion efficiency of the 21-deoxycortisol (21DOF) pathway was significantly decreased in the poorly controlled group (P = 0.004), suggesting relatively restricted CYP11B1 activity which drives the shift of androgen metabolism toward the classical pathway. Conclusion: In poorly controlled pubertal patients with 21OHD, the relative insufficiency of CYP11B1 activity and the dysregulation of the metabolic network jointly lead to the shift of androgen synthesis to the classical pathway, forming a "classical pathway dominance". This finding deepens the understanding of the pathological mechanism of 21OHD from the perspective of pathway dynamics and provides a novel theoretical basis for individualized clinical treatment of the disease.

Indexed as

Adrenal Hyperplasia, CongenitalAndrogensMetabolic Networks and PathwaysAdolescentChildChild, PreschoolFemaleHumansMalePubertySteroid 21-HydroxylaseAndrogensSteroid 21-Hydroxylase21-hydroxylase deficiencyandrogen metabolic pathwaysclassical pathway dominancedisease control statuspuberty

Identifiers

PMID42199801
PMCPMC13199108

What Socratic holds

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.