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Hui Li Department of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, P. R. China.

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Peng Wu Department of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, P. R. China.

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Introduction Epigenetic regulation, which involves reversible and heritable changes in gene expression that occur in response to external stimuli without altering the DNA sequence ( 1 , 2 ), is fundamental to understanding the pathogenesis of

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K G Samsom Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands

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L M van Veenendaal Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands

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G D Valk Department of Endocrine Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands

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M R Vriens Department of Surgical Oncology and Endocrine Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands

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M E T Tesselaar Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands

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J G van den Berg Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands

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patients with sporadic SI-NETs, the determinant of genetic or epigenetic alterations and the outcomes of prognosis, survival or progression. Synonyms of SI-NETs and (epi)genetic alterations with the outcome described as prognosis, survival and progression

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Kristian Almstrup Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Hanne Frederiksen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Anna-Maria Andersson Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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epigenetic studies. We have previously published one of the first studies demonstrating changes in DNA methylation patterns with the onset of puberty in healthy children ( 12 ) and identified the promotor of the thyroid hormone receptor interactor 6 gene

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Jairo Arturo Pinzón-Cortés Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia
School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Angelina Perna-Chaux Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Nicolás Steven Rojas-Villamizar Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Angélica Díaz-Basabe Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Diana Carolina Polanía-Villanueva Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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María Fernanda Jácome Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia

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Carlos Olimpo Mendivil School of Medicine, Universidad de los Andes, Bogotá, Colombia
Endocrinology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia

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Helena Groot Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia
School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Valeriano López-Segura Biological Sciences Department, Laboratory of Human Genetics, Universidad de los Andes, Bogotá, Colombia
School of Medicine, Universidad de los Andes, Bogotá, Colombia

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at the population level. This environmental influence can also be explained from an epigenetic perspective. For example, the fetus and neonate development conditions have a significant influence on the onset of T2DM and obesity without inducing

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Christin Krause Epigenetics & Metabolism, Medical Department I, University of Lübeck, Lübeck, Germany

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Martina Grohs Epigenetics & Metabolism, Medical Department I, University of Lübeck, Lübeck, Germany

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Alexander T El Gammal Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Stefan Wolter Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Hendrik Lehnert Medical Department I, University of Lübeck, Lübeck, Germany

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Oliver Mann Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Jens Mittag Molecular Endocrinology, Medical Department I, University of Lübeck, Lübeck, Germany

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Henriette Kirchner Epigenetics & Metabolism, Medical Department I, University of Lübeck, Lübeck, Germany

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Hepatic thyroid hormone signaling has an important role in the development and progression of nonalcoholic steatohepatitis (NASH). While the systemic levels of thyroid hormone might remain stable, there is evidence that the intracellular signaling machinery consisting of transporters, deiodinases and receptors could be altered in NASH. However, clinical material from human liver biopsies of individuals with NASH has not been studied to date. In a cross-sectional study, we analyzed 85 liver biopsies from patients with different stages of NASH that underwent bariatric surgery. Using qPCR, we analyzed gene expression of thyroid hormone transporters NTCP (SLC10A1), MCT8 (SLC16A2) and OATP1C1 (SLCO1C1), thyroid hormone receptor α and β (THRA and THRB) and deiodinase type I, II and III (DIO1, DIO2, DIO3). The expression was correlated with serum TSH, triglyceride, HbA1c and NASH score and corrected for age or gender if required. While DIO2, DIO3 and SLCO1C1 were not expressed in human liver, we observed a significant negative correlation of THRB and DIO1 with age, and SLC16A2 with gender. THRB expression was also negatively associated with serum triglyceride levels and HbA1c. More importantly, its expression was inversely correlated with NASH score and further declined with age. Our data provide unique insight into the mRNA expression of thyroid hormone transporters, deiodinases and receptors in the human liver. The findings allow important conclusions on the intrahepatic mechanisms governing thyroid hormone action, indicating a possible tissue resistance to the circulating hormone in NASH, which becomes more prominent in advanced age.

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A H Ludwig-Slomczynska Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland

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S Borys Department of Metabolic Diseases, Jagiellonian University Medical College
University Hospital, Krakow, Poland

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M T Seweryn Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland

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J Hohendorff Department of Metabolic Diseases, Jagiellonian University Medical College
University Hospital, Krakow, Poland

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P Kapusta Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland

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B Kiec-Wilk Department of Metabolic Diseases, Jagiellonian University Medical College
University Hospital, Krakow, Poland

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E Pitera Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland

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P P Wolkow Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland

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M T Malecki Department of Metabolic Diseases, Jagiellonian University Medical College
University Hospital, Krakow, Poland

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standard therapy ( 9 ). In light of this prior evidence of differential expression of several genes between the two treatment methods ( 9 ), it seemed strongly justified to test whether these can also be seen at the epigenetic level of gene methylation, a

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Huguette S Brink Department of Endocrinology, Maasstad Hospital, Rotterdam, The Netherlands

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Aart Jan van der Lely Department of Endocrinology, Erasmus University MC, Rotterdam, The Netherlands

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Joke van der Linden Department of Endocrinology, Maasstad Hospital, Rotterdam, The Netherlands

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obesity and T2DM ( 7 , 8 ). Long-term maternal risks include T2DM and cardiovascular disease ( 9 ). Currently, the GD diagnosis is made during the late second trimester, possibly exposing the infant to intrauterine metabolic alterations and epigenetic

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Roberto Cosimo Melcangi Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy

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Livio Casarini Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy

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Marco Marino Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy

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Daniele Santi Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Department of Medical Specialties, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

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Samantha Sperduti Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy

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Silvia Giatti Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy

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Silvia Diviccaro Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy

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Maria Grimoldi Neurology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy

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Donatella Caruso Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy

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Guido Cavaletti Experimental Neurology Unit and Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy

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Manuela Simoni Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy
Department of Medical Specialties, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

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and gut microbiota composition ( 28 ). A possible hypothesis for the persistent side effects may be epigenetic modifications occurring in PFS patients. Indeed, downregulation and hypermethylation of 5α-R were observed in the rodent nervous system and

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Magnolia Ariza-Nieto Cornell University, Meinig School of Biomedical Engineering, Ithaca, New York, USA
epiWELL, LLC, Ithaca, New York, USA

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Joshua B Alley Donald Guthrie Foundation for Education and Research, Guthrie Clinic, Sayre, Pennsylvania, USA

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Sanjay Samy Donald Guthrie Foundation for Education and Research, Guthrie Clinic, Sayre, Pennsylvania, USA

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Laura Fitzgerald Donald Guthrie Foundation for Education and Research, Guthrie Clinic, Sayre, Pennsylvania, USA

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Francoise Vermeylen Cornell University, Cornell Statistical Consulting Unit, Ithaca, New York, USA

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Michael L Shuler Cornell University, Meinig School of Biomedical Engineering, Ithaca, New York, USA

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José O Alemán New York University Langone Medical Center, New York, New York, USA

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physiologically active and the concept of adiponectin insensitivity is well accepted ( 3 ). Adiponectin secretion has been suggested to be regulated by epigenetic mechanisms ( 4 ), and interventions that activate its physiological secretion levels hold promise for

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E T Aristizabal Prada Department of Internal Medicine IV, Campus Grosshadern, University-Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany

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C J Auernhammer Department of Internal Medicine IV, Campus Grosshadern, University-Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany

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over the last few years. Hallmarks of gastrointestinal NET development have been defined ( 9 , 10 ) and our understanding of genetics ( 11 , 12 , 13 ), epigenetics ( 14 , 15 ), tumourigenesis ( 9 ), angiogenesis ( 9 ), novel biomarkers ( 10 ) and

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