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Alessandro Ciresi Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy

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Stefano Radellini Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy

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Valentina Guarnotta Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy

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Maria Grazia Mineo Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy

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Carla Giordano Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy

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estrogen receptors are expressed in the pituitary, regulating GH gene expression and reducing somatostatin receptor expression, leading to enhanced GH secretion ( 6 ). Lastly, the role of gender and sex steroids in modulating the clearance of GH must be

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Lisa Arnetz Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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Neda Rajamand Ekberg Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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Kerstin Brismar Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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Michael Alvarsson Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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found to be normal (7, 8) or decreased (9) . These inconsistent results may be explained by gender differences in HPA axis regulation. Many previous studies have only included patients of one gender, or have not factored in gender in the analyses (7

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Silvia Ciancia Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium

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Vanessa Dubois Basic and Translational Endocrinology (BaTE), Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

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Martine Cools Department of Internal Medicine and Pediatrics, Ghent University, Pediatric Endocrinology Service, Ghent University Hospital, Ghent, Belgium

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Introduction Transgender and gender diverse (TGD) adolescents experience a gender identity that is different from the gender assigned at birth and this often results in severe psychological distress, defined as gender dysphoria (GD). Although

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Shruti Khare Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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Anurag R Lila Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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Hiren Patt Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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Chaitanya Yerawar Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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Manjunath Goroshi Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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Tushar Bandgar Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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Nalini S Shah Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, India

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recognition and larger tumour size. Additionally it is proposed that macroprolactinoma in males have higher growth potential, as deducted from studying tumour proliferation markers (3, 4) . The aim of this retrospective analysis was to compare the gender

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Christos Tsatsanis Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece
Molecular Reproductive Research Group, Department of Translational Medicine, Lund University, Malmö, Sweden
Institute of Molecular Biology and Biotechnology, FORTH, Heraklion, Greece

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Angel Elenkov Molecular Reproductive Research Group, Department of Translational Medicine, Lund University, Malmö, Sweden
Reproductive Medicine Centre, Skåne University Hospital Malmö, Malmö, Sweden

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Irene Leijonhufvud Reproductive Medicine Centre, Skåne University Hospital Malmö, Malmö, Sweden

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Katerina Vaporidi Molecular Reproductive Research Group, Department of Translational Medicine, Lund University, Malmö, Sweden

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Åsa Tivesten Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

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Aleksander Giwercman Molecular Reproductive Research Group, Department of Translational Medicine, Lund University, Malmö, Sweden
Reproductive Medicine Centre, Skåne University Hospital Malmö, Malmö, Sweden

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, indicating gender dimorphism in its regulation ( 8 ). Nevertheless, both estrogens and testosterone directly suppress TNF production from immune cells ( 9 ), and testosterone deficiency has been associated with elevated serum TNF levels ( 10 , 11 ). Thus

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Sayaka Kawano Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Yukiko Kawagoe Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Kenji Kuwasako Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Satoshi Shimamoto Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Koji Igarashi Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Mariko Tokashiki Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Kazuo Kitamura Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Johji Kato Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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, low-grade inflammation in fat tissues associated with obesity is assumed to be involved in the increased expression of AM (6, 8, 11) . When evaluating plasma levels of endogenous bioactive substances, we sometimes need to take gender

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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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Miranda Scharff Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Chantal Maria Wiepjes Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Maartje Klaver Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Thomas Schreiner Department of Endocrinology, Oslo University Hospital, Oslo, Norway

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Guy T’Sjoen Department of Endocrinology & Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium

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Martin den Heijer Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Introduction According to the DSM criteria, gender dysphoria (GD) is defined as the incongruence between a person’s assigned sex at birth and the experienced gender ( 1 ). GD often has a strong impact on the person’s psychological wellbeing

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Lijuan Yuan Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China
Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Xihui Chen Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Ziyu Liu Department of Microbiology, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Dan Wu Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Jianguo Lu Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Guoqiang Bao Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Sijia Zhang Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Lifeng Wang Department of Biochemistry and Molecular Biology, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Yuanming Wu Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

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Family1, II.5 Family1, II.9 Family2, II.1 Family3, II.1 Family4, II.4 Gender Male Male Male Male Male Ages 43 37 25 33 38 Clubbing of fingers and toes ++ + ++ + ++ Thickened facial skin

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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 Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark

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Simon Bang Mohr Kristensen Open Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark

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Øjvind Lidegaard Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

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Guy T’Sjoen Department of Endocrinology and Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium

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Aisa Burgwal Department of Endocrinology and Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium

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Malene Hilden Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Centre for Gender Identity, Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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

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Introduction The term transgender is an umbrella term to group individuals whose gender identity differs from the assigned sex at birth. Transgender females are assigned male at birth (AMAB) but identified as females and transgender males are

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