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Sherwin Criseno Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, UK

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Helena Gleeson Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Andrew A Toogood Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Neil Gittoes Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Anne Topping School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, UK

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Niki Karavitaki Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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that in healthy individuals, GH and IGF-1 secretions decrease with advancing age ( 25 ). To date, the optimal duration of GH treatment in adults with GHD has not been established, as it remains unclear if its beneficial effects are sustained in the long

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Vita Birzniece School of Medicine, Western Sydney University, New South Wales, Australia
Department of Diabetes and Endocrinology, Blacktown Hospital, New South Wales, Australia
Garvan Institute of Medical Research, New South Wales, Australia
School of Medical Sciences, University of New South Wales, New South Wales, Australia

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Teresa Lam School of Medicine, Western Sydney University, New South Wales, Australia
Department of Diabetes and Endocrinology, Blacktown Hospital, New South Wales, Australia
Department of Diabetes and Endocrinology, Westmead Hospital, New South Wales, Australia

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Mark McLean School of Medicine, Western Sydney University, New South Wales, Australia
Department of Diabetes and Endocrinology, Blacktown Hospital, New South Wales, Australia

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Navneeta Reddy Department of Diabetes and Endocrinology, Blacktown Hospital, New South Wales, Australia

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Haleh Shahidipour School of Medicine, Western Sydney University, New South Wales, Australia
Department of Diabetes and Endocrinology, Blacktown Hospital, New South Wales, Australia

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Amy Hayden School of Medicine, Western Sydney University, New South Wales, Australia
Faculty of Medicine, Health and Human Sciences, Macquarie University, New South Wales, Australia
Crown Princess Mary Cancer Centre, Westmead Hospital, New South Wales, Australia

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Howard Gurney Crown Princess Mary Cancer Centre, Westmead Hospital, New South Wales, Australia

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Glenn Stone School of Computing, Engineering and Mathematics, Western Sydney University, New South Wales, Australia

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Rikke Hjortebjerg Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Endocrine Research Unit, Department of Endocrinology, Odense University Hospital & Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
Steno Diabetes Center Odense, Odense University Hospital & Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark

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Jan Frystyk Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Endocrine Research Unit, Department of Endocrinology, Odense University Hospital & Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark

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poorer cancer prognosis ( 1 , 2 ). Chronic hyperinsulinemia may stimulate carcinogenesis either directly through the insulin receptor or indirectly through insulin-like growth factor receptors (IGF-1Rs). Recent evidence indicates that the anti

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Sumana Chatterjee Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Emily Cottrell Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Stephen J Rose Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Talat Mushtaq The Leeds Teaching Hospital NHS Trust, Leeds, UK

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Avinaash V Maharaj Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Jack Williams Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Martin O Savage Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Louise A Metherell Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Helen L Storr Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK

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Introduction Growth hormone insensitivity (GHI) is characterised by growth failure, IGF1 deficiency and normal or elevated GH levels. GHI encompasses a spectrum of genetic, phenotypic and biochemical abnormalities associated with growth

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Charlotte Höybye Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden

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Andreas F H Pfeiffer Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Endokrinologie & Stoffwechselmedizin, Berlin, Germany

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Diego Ferone IRCCS AOU San Martino-IST, Università di Genova – Endocrinologia DiMI, Dipartimento di Medicina Interna e Specialità Mediche, & CEBR, Centro di Eccellenza per la Ricerca Biomedica, Genova, Italy

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Jens Sandahl Christiansen Medicinsk Endokrinologist Afd., MEA, NBG, Århus Sygehus, Århus, Denmark

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David Gilfoyle Ascendis Pharma A/S, Hellerup, Denmark

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Eva Dam Christoffersen Ascendis Pharma A/S, Hellerup, Denmark

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Eva Mortensen Ascendis Pharma Inc., Palo Alto, California, USA

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Jonathan A Leff Ascendis Pharma Inc., Palo Alto, California, USA

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Michael Beckert Ascendis Pharma A/S, Hellerup, Denmark

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with insulin-like growth factor 1 (IGF1), leads to abnormal body composition and metabolism as well as psychological impairment ( 1 , 2 ). Left untreated, AGHD is associated with decreased bone mineral density, increased risk of cardiovascular

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Kevin C J Yuen Departments of Neuroendocrinology and Neurosurgery, Barrow Neurological Institute, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, Arizona, United States

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Gudmundur Johannsson Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Ken K Y Ho The Garvan Institute of Medical Research and the Faculty of Medicine, University of New South Wales, Sydney, Australia

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Bradley S Miller Pediatric Endocrinology, University of Minnesota Medical School, M Health Fairview Masonic Children’s Hospital, Minneapolis, Minnesota, United States

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Ignacio Bergada Centro de Investigaciones Endocrinológicas "Dr César Bergadá" (CEDIE), CONICET-FEI-División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina

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Alan D Rogol Pediatric Diabetes and Endocrinology, University of Virginia, Charlottesville, Virginia, United States

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). The exceptions when re-testing is generally not required are in patients with genetic/congenital defects, irreversible hypothalamic–pituitary lesions, and in those with panhypopituitarism and low serum insulin-like growth factor 1 (IGF1) levels ( 4

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Cecilia Follin Department of Endocrinology, Skåne University Hospital, Lund, Sweden

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Sven Karlsson Department of Endocrinology, Skåne University Hospital, Lund, Sweden

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diabetes and hypertension ( 3 , 4 ). The aims of treatment for acromegaly are to control/reduce tumour size, normalise GH and insulin-like growth factor 1 (IGF-1) levels and to improve comorbidities. Current treatments consist of surgery, medical therapy

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Marie Reeberg Sass Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Nicolai Jacob Wewer Albrechtsen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark

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Jens Pedersen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Endocrinology and Nephrology, Nordsjællands University Hospital, Hillerød, Denmark

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Kristine Juul Hare Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Nis Borbye-Lorenzen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark

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Katalin Kiss Department of Pathology, Rigshospitalet, Copenhagen, Denmark

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Tina Vilsbøll Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Filip Krag Knop Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Steen Seier Poulsen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Niklas Rye Jørgensen Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens Juul Holst Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Cathrine Ørskov Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Bolette Hartmann Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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resorption ( 6 ). Finally, we studied the expression of insulin receptors ( INSR ), insulin-like growth factor 1 receptors ( IGF1R ), and insulin-like growth factor 2 receptors ( IGF2R ) in the parathyroid gland on formalin fixed, paraffin embedded (FFPE

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B Shahida Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
Department of Diabetes and Endocrinology, Skåne University Hospital, Malmö, Sweden

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P Sahlstrand Johnson Department of Oto-Rhino-Laryngology, Skåne University Hospital, Malmö, Sweden
Department of Clinical Sciences, Lund University, Malmö, Sweden

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R Jain Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden

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H Brorson Department of Clinical Sciences, Lund University, Malmö, Sweden
Department of Plastic Surgery, Skåne University Hospital, Malmö, Sweden

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P Åsman Department of Clinical Sciences Malmö, Ophthalmology, Lund University, Malmö, Sweden
Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden

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M Lantz Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
Department of Diabetes and Endocrinology, Skåne University Hospital, Malmö, Sweden

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T Planck Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
Department of Diabetes and Endocrinology, Skåne University Hospital, Malmö, Sweden

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as an autoantigen and is expressed by both preadipocytes and adipocytes in orbital tissue ( 1 , 2 ) as well as in the thyroid. Other autoantigens, such as the insulin-like growth factor 1 (IGF-1) receptor have been suggested to be involved in the

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Robert Rapaport Division of Pediatric Endocrinology & Diabetes, Mount Sinai Kravis Children’s Hospital and Icahn School of Medicine at Mount Sinai, New York, New York, USA

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Jan M Wit Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands

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Martin O Savage Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, UK

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a sensitive marker of illness ( 2 ). Understanding the physiology of linear growth initially focused on the growth hormone (GH)-insulin-like growth factor (IGF)-1 axis as the key regulatory process ( 3 ). However, the development of genetic studies

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Jin Kyu Oh Department of Urology, College of Medicine, Gachon University, Incheon, Republic of Korea

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Young Jae Im Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea

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Kwanjin Park Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea

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Jae-Seung Paick Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea

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underlying molecular mechanisms have not been described, the GH–insulin-like growth factor 1 (IGF1) axis is a proactive mediator of the actions of testosterone and its potent derivative dihydrotestosterone. Accordingly, stimulation of IGF1 signalling

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