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Peiwen Wu Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

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Dongjie He Department of Radiation Oncology, Tangdu Hospital, the Second Affiliated Hospital of Air Force Medical University, Xi’an, China

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Hao Chang Department of Radiation Oncology, Tangdu Hospital, the Second Affiliated Hospital of Air Force Medical University, Xi’an, China

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Xiaozhi Zhang Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

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worse prognosis. This is consistent with the results of previous studies ( 1 , 13 , 44 ). Possible explanations for the poorer prognosis in men are that estrogen and progesterone receptor expression is associated with the prognosis of patients with

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Qiuli Liu Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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Lin-ang Wang Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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Jian Su Department of Urology, Affiliated Hospital of Nanjing University of Traditional Chinese Medical, Nanjing, People’s Republic of China

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Dali Tong Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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Weihua Lan Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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Luofu Wang Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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Gaolei Liu Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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Jun Zhang Department of Obstetrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China

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Victor Wei Zhang Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
AmCare Genomics Lab, Guangzhou, People’s Republic of China

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Dianzheng Zhang Department of Bio-Medical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA

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Rongrong Chen Geneplus-Beijing Institute, Beijing, People’s Republic of China

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Qingyi Zhu Department of Urology, Affiliated Hospital of Nanjing University of Traditional Chinese Medical, Nanjing, People’s Republic of China

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Jun Jiang Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

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-hydroxylase, which catalyzes the 17α-hydroxylation of pregnenolone and progesterone and the 17,20-cleavage of the corresponding hydroxylated steroids ( 5 ). CYP17A1 deficiency leads to the impaired synthesis of both glucocorticoids and androgen, resulting in

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Bledar Daka Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden
Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden

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Thord Rosen Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden

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Per Anders Jansson Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden

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Lennart Råstam Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden

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Charlotte A Larsson Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden
Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden

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Ulf Lindblad Department of Internal Medicine, Department of Clinical Sciences Malmö, Social Medicine and Global Health, University of Gothenburg, PO Box 454, SE-405 30 Gothenburg, Sweden

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as leisure time physical activity. Women on treatment with contraceptives and hormonal replacement therapy (progesterone alone, oestrogen alone or the combination) were excluded from analyses (remaining women=1002). Standard instruments were also used

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Jennifer K Y Ko Department of Women’s Health, University College London Hospital, London, UK

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Thomas F J King Department of Women’s Health, University College London Hospital, London, UK

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Louise Williams Department of Women’s Health, University College London Hospital, London, UK

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Sarah M Creighton Department of Women’s Health, University College London Hospital, London, UK

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Gerard S Conway Department of Women’s Health, University College London Hospital, London, UK

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use of testosterone, which in this situation is used as a prohormone providing oestradiol via aromatisation. As women with CAIS do not have a uterus, progesterone is not required. Based on our clinical experience, interest in the use of testosterone

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Lachlan Angus Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia

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Shalem Leemaqz Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia

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Olivia Ooi Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia

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Pauline Cundill Equinox Gender Diverse Clinic, Thorne Harbour Health, Fitzroy, Victoria, Australia

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Nicholas Silberstein Equinox Gender Diverse Clinic, Thorne Harbour Health, Fitzroy, Victoria, Australia

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Peter Locke Equinox Gender Diverse Clinic, Thorne Harbour Health, Fitzroy, Victoria, Australia

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Jeffrey D Zajac Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia

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Ada S Cheung Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia

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progesterone receptor which, similar to oestradiol treatment, causes further negative feedback to suppress GnRH and gonadotropins at the hypothalamus and pituitary respectively to lower testosterone production ( 16 , 17 ). As spironolactone may potentially

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Angelo Maria Patti Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy

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Kalliopi Pafili Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece

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Nikolaos Papanas Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece

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Manfredi Rizzo Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy

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Introduction There are several pregnancy indices of hormonal changes (such as oestrogens, progesterone, corticotropin-releasing hormone, cortisol, human placental growth hormone and human placental lactogen) that are implicated in the

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Timothy J Morris Directorate of Biochemistry, Manchester University NHS Foundation Trust, Manchester, UK
Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK

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Andrew Whatmore Division of Developmental Biology and Medicine, University of Manchester, Royal Manchester Children’s Hospital, Manchester, UK

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Laura Hamilton Pathology Department, Clinical Biochemistry, Huddersfield Royal Infirmary, Lindley, Huddersfield, UK

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Beverly Hird Directorate of Biochemistry, Manchester University NHS Foundation Trust, Manchester, UK

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Eric S Kilpatrick Directorate of Biochemistry, Manchester University NHS Foundation Trust, Manchester, UK

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Lesley Tetlow Directorate of Biochemistry, Manchester University NHS Foundation Trust, Manchester, UK

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Peter Clayton Division of Developmental Biology and Medicine, University of Manchester, Royal Manchester Children’s Hospital, Manchester, UK

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present for plasma sodium ( Table 3 ). Table 3 Correlations between renin MoU, electrolytes, 17α-OH-progesterone and fludrocortisone dose. Sodium Potassium 17α-OHP Fludrocortisone dose Post-clinic fludrocortisone dose

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Sophie Howarth Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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Luca Giovanelli Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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Catherine Napier Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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Simon H Pearce Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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reference range (0 min = 309 nmol/L, 30 min = 323 nmol/L, 60 min = 344 nmol/L, on a progesterone only contraceptive pill), and hydrocortisone 15 mg daily in a split dose was started ( Table 1 ). However, she quickly developed ankle swelling which resolved

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Dorte Glintborg Department of Endocrinology, Odense University Hospital, Odense, Denmark
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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Katrine Hass Rubin OPEN – Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark

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Mads Nybo Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark

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Bo Abrahamsen OPEN – Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark
Department of Medicine, Holbæk Hospital, Holbæk, Denmark

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Marianne Andersen Department of Endocrinology, Odense University Hospital, Odense, Denmark
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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-grade inflammation and unbalanced estrogen/progesterone secretion in PCOS could have adverse effects on autoimmune function ( 7 , 8 ). In accordance, women with PCOS had higher secretion of anti-thyroid, anti-nuclear (ANA), anti-ovarian, and anti-islet cell

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Robert I Menzies The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Xin Zhao The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Linda J Mullins The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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John J Mullins The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Carolynn Cairns The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Nicola Wrobel The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Donald R Dunbar The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Matthew A Bailey The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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Christopher J Kenyon The University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, UK

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cholesterol disposal and lipid biosynthesis form a separate larger cluster. It is notable that genes encoding enzymes that metabolise steroids were also affected. Akr1c18 , which encodes a progesterone 20α hydroxysteroid dehydrogenase enzyme was switched on

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