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Kjersti S Bakken Women’s Clinic, Innlandet Hospital Trust, Lillehammer, Norway
Center for International Health, University of Bergen, Bergen, Norway

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Kristina Randjelovic Nermo Center for International Health, University of Bergen, Bergen, Norway
Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway

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Bjørn Gunnar Nedrebø Department of Medicine, Haugesund Hospital, Haugesund, Norway
Department of Clinical Science, University of Bergen, Bergen, Norway

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Tim I M Korevaar Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands

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Tor A Strand Center for International Health, University of Bergen, Bergen, Norway
Department of Research, Innlandet Hospital Trust, Lillehammer, Norway

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caused overdiagnosis of (subclinical) hypothyroidism and subsequent overtreatment ( 4 , 5 , 6 ). However, there is a lack of data that quantify this potential increase in thyroid hormone therapy from a national perspective. Interestingly, the diagnostic

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Brendan J Nolan Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Aviva S Frydman Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia

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Shalem Y Leemaqz College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

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Meg Carroll Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Mathis Grossmann Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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

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

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Introduction Transgender (trans) individuals, including those who are binary and/or non-binary identified, undergoing feminising hormone therapy are often treated with oestradiol with or without anti-androgen therapy. Treatment allows the

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Lauren R Cirrincione Department of Pharmacy, University of Washington, Seattle, Washington, USA

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Bridgit O Crews Department of Pathology and Laboratory Medicine, University of California Irvine, Orange, California, USA

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Jane A Dickerson Department of Laboratories, Seattle Children's Hospital, Seattle, Washington, USA

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Matthew D Krasowski Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA

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Jessica Rongitsch Internal Medicine, Capitol Hill Medical, Seattle, Washington, USA

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Katherine L Imborek Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA

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Zil Goldstein Department of Medicine, Callen-Lorde Community Health Center, New York, New York, USA
CUNY Graduate School of Public Health and Health Policy, New York, New York, USA

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Dina N Greene Washington Kaiser Permanente, Renton, Washington, USA
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA

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Introduction Estradiol (17β-estradiol) is a natural sex steroid available in several exogenous preparations. The Endocrine Society recommended high-dose exogenous estradiol treatment as one part of feminizing hormone therapy for transgender

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Robert Rapaport Ichan School of Medicine, New York, New York, USA

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Peter A Lee Penn State College of Medicine, Hershey, Pennsylvania, USA

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Judith L Ross Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Nemours/DuPont Hospital for Children, Wilmington, Delaware, USA

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Paul Saenger Winthrop University Hospital, Mineola, New York, USA

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Vlady Ostrow Novo Nordisk Inc., Plainsboro, New Jersey, USA

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Giuseppe Piccoli Novo Nordisk Inc., Plainsboro, New Jersey, USA

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346 – 351 . ( https://doi.org/10.1007/BF03346369 ) 18475054 10.1007/BF03346369 9 Ross JL Lee PA Gut R Germak J. Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed

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María Dolores Rodríguez Arnao Pediatric Endocrinology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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Amparo Rodríguez Sánchez Pediatric Endocrinology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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Ignacio Díez López Hospital Universitario Araba, Araba/Alava, Spain

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Joaquín Ramírez Fernández Hospital Universitario Príncipe de Asturias, Oviedo, Spain

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Jose Antonio Bermúdez de la Vega Centro Nuevas Tecnologias, Sevilla, Spain

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Diego Yeste Fernández Hospital Vall d’Hebrón, Barcelona, Spain

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María Chueca Guindulain Complejo Hospitalario de Navarra, Pamplona, Spain

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Raquel Corripio Collado Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain

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Jacobo Pérez Sánchez Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain

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Ana Fernández González Merck S.L.U., Madrid, Spain

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ECOS Spain Study Collaborative Investigator Group
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-2265.2009.03775.x ) 2 Richmond E Rogol AD . Current indications for growth hormone therapy for children and adolescents . Endocrine Development 2010 92 – 108 . ( https://doi.org/10.1159/000316130 ) 3 Loche S Carta L Ibba A Guzzetti C . Growth

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Urszula Smyczyńska Department of Automatics and Biomedical Engineering, AGH University of Science and Technology, Krakow, Poland

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Joanna Smyczyńska Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland

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Maciej Hilczer Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
Department of Paediatric Endocrinology, Medical University of Lodz, Lodz, Poland

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Renata Stawerska Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland

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Ryszard Tadeusiewicz Department of Automatics and Biomedical Engineering, AGH University of Science and Technology, Krakow, Poland

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Andrzej Lewiński Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland

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.1203/00006450-200010000-00010 11004238 10 Salah N Abd El Dayem SM El Mogy F Amin M Ibrahim M . Egyptian growth hormone deficient patients: demographic, auxological characterization and response to growth hormone therapy . Journal of Pediatric Endocrinology and Metabolism 2013 26

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Patrizia Bruzzi Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy

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Silvia Vannelli Pediatric Endocrinologic Unit, Regina Margherita Children’s Hospital, Turin, Italy

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Emanuela Scarano Unit of Pediatrics, Department of Medical and Surgical Sciences, Policlinico St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

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Natascia Di Iorgi Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, Genova, Italy

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Maria Parpagnoli Anna Meyer Children's University Hospital, Florence, Italy

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MariaCarolina Salerno Department of Translational Medicine, University Federico II, Naples, Italy

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Marco Pitea Pediatric Unit, Ospedale San Raffaele, Milano, Italy

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Maria Elisabeth Street Division of Paediatric Endocrinology and Diabetology, Paediatrics, Department of Mother and Child-AUSL of Reggio Emilia-IRCCS, Reggio Emilia, Italy

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Andrea Secco Pediatric Unit, Azienda ospedaliero Nazionale SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

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Adolfo Andrea Trettene Pediatric Unit, ASST Sette Laghi, Varese, Italy

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Malgorzata Wasniewska Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, Italy

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Nicola Corciulo Pediatric Unit, P.O. Gallipoli, ASL Lecce, Italy

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Gianluca Tornese Institute for maternal and child health IRCCS Burlo Garofalo, Trieste, Italy

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Maria Felicia Faienza DAI Scienze Chirurgiche e Pediatriche, Ospedale Pediatrico Giovanni XXIII, Bari, Italy

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Maurizio Delvecchio U.O. Malattie Metaboliche e Genetiche e Diabetologia, Ospedale Pediatrico Giovanni XXIII, Bari, Italy

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Simona Filomena Madeo Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy

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Lorenzo Iughetti Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy

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Savage MO . The changing face of paediatric human growth hormone therapy . Endocrines 3 419 – 427 . ( https://doi.org/10.3390/endocrines3030033 ) 10 Blum WF Ross JL Zimmermann AG Quigley CA Child CJ Kalifa G Deal C Drop SLS Rappold

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Mette Bøgehave Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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Dorte Glintborg Department of Endocrinology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark
OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, Odense, Denmark

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Jørgen Brodersen Gram Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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Else-Marie Bladbjerg Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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

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Johannes Jakobsen Sidelmann Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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Introduction

Hypogonadism is prevalent during opioid treatment, and low testosterone concentrations are associated with cardiovascular disease. The effect of testosterone replacement therapy (TRT) on the coagulation system in men with hypogonadism is not clarified. We investigate the effects of TRT on the tissue factor (TF) and contact activation pathways of coagulation in opioid-treated men.

Materials and methods

This was a double-blinded, placebo-controlled study in 37 men with total testosterone < 12 nmol/L randomized to 24 weeks of testosterone injections (n = 17) or placebo (n = 20). Variables of the coagulation system were analysed at baseline and after 24 weeks. Measurements included the TF pathway (endogenous thrombin potential (ETP) and peak thrombin), the contact activation pathway (endogenous kallikrein potential (EKP) and peak kallikrein), coagulation factors (FVII, FX, prothrombin, and FXII), and inhibitors (tissue factor pathway inhibitor (TFPI), protein C, protein S, antithrombin, and C1 esterase inhibitor (C1inh)). Between-group differences at 24 weeks were determined with analysis of covariance. Within-group changes in TRT and placebo were analysed with paired t-test.

Results

Between-group differences at 24 weeks were observed for ETP (P = 0.036), FVII (P = 0.044), FX (P = 0.015), prothrombin (P = 0.003), protein C (P = 0.004), and protein S (P = 0.038). Within the TRT group, ETP, peak thrombin, FVII, FX, prothrombin, TFPI, protein C, FXII, and C1inh decreased and protein S increased (all P < 0.05). Within the placebo group, coagulation outcomes were unchanged.

Conclusion

TRT affects the coagulation system in an anticoagulant direction through suppressed TF pathway in men with opioid-induced hypogonadism.

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Guido Zavatta Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

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Bart L Clarke Mayo Clinic, Rochester, Minnesota, USA

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-term data on the impact of hormone therapy on chronic complications has limited use of rhPTH(1–84) as a new therapeutic option. In addition, the FDA withdrawal of rhPTH(1–84) from the market on September 5, 2019, has limited use of intact PTH in the USA over

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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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oestradiol as feminising gender-affirming hormone therapy ( 3 ). Goals of therapy are generally to increase serum oestradiol concentrations and lower serum total testosterone concentrations to achieve sex steroid concentrations in the female reference range

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