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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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replacement therapy. Since then a growing body of clinical studies has been published describing the long-term effects of recombinant human parathyroid hormone rhPTH(1–84), other forms of parathyroid hormone-based therapies, and PTH receptor 1 (PTHR1) agonist

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Angelica Sharma Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Deborah Papadopoulou Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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Karim Meeran Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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mortality ( 2 ). Replacement with glucocorticoid therapy is the mainstay of treatment, with an objective to mimic the circadian cortisol profile ( 3 ). Current guidelines recommend the use of hydrocortisone in divided doses or low-dose (3–5 mg

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Johan Verhelst Department of Endocrinology, ZNA Middelheim Hospital, Antwerp, Belgium

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Anders F Mattsson Pfizer Endocrine Care, Pfizer Health AB, Sollentuna, Sweden

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Cecilia Camacho-Hübner Pfizer Endocrine Care, Pfizer, Inc., New York, New York, USA

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Anton Luger Division of Endocrinology and Metabolism, Medical University and General Hospital, Vienna, Austria

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Roger Abs Antwerp Centre for Endocrinology, Antwerp, Belgium

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particular relevance as an increased cardiovascular mortality has been found in patients with hypopituitarism receiving conventional hormonal replacement without GH ( 10 , 11 , 12 ). A recent KIMS study assessing GHD patients with MetS before GH replacement

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Charlotte Höybye Department of Endocrinology, Department of Molecular Medicine and Surgery, Metabolism and Diabetology, Karolinska University Hospital, 171 76 Stockholm, Sweden
Department of Endocrinology, Department of Molecular Medicine and Surgery, Metabolism and Diabetology, Karolinska University Hospital, 171 76 Stockholm, Sweden

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Erik Wahlström Department of Endocrinology, Department of Molecular Medicine and Surgery, Metabolism and Diabetology, Karolinska University Hospital, 171 76 Stockholm, Sweden

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Petra Tollet-Egnell Department of Endocrinology, Department of Molecular Medicine and Surgery, Metabolism and Diabetology, Karolinska University Hospital, 171 76 Stockholm, Sweden

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Gunnar Norstedt Department of Endocrinology, Department of Molecular Medicine and Surgery, Metabolism and Diabetology, Karolinska University Hospital, 171 76 Stockholm, Sweden

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with healthy controls, and changes in metabolic profile during GH treatment and after discontinuation of GH replacement was observed. The aims of this study were to detect the levels of serum metabolome in GHD patients and healthy subjects and to find

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David J F Smith Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

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Karim Meeran Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

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mineralocorticoid production in primary adrenal failure. The mainstay of treatment is glucocorticoid replacement, with either hydrocortisone or prednisolone ( 2 ). Both work by binding to the glucocorticoid receptor (GR) for which prednisolone has the greater

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

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Beverly M K Biller Neuroendocrine Unit, Massachusetts General Hospital, Massachusetts General Hospital, Boston, Massachusetts, USA

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Jean-Marc Ferran Qualiance ApS, Copenhagen, Denmark

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Murray B Gordon Allegheny Neuroendocrinology Center, Division of Endocrinology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA

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Nicky Kelepouris US Medical Affairs-Rare Endocrine Disorders, Novo Nordisk, Inc, Plainsboro, New Jersey, USA

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Navid Nedjatian Global Medical Affairs – Rare Endocrine Disorders, Novo Nordisk Health Care AG, Zurich, Switzerland

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Anne H Olsen Epidemiology, Novo Nordisk A/S, Soborg, Denmark

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Matthias M Weber Unit of Endocrinology, 1, Medical Department, University Hospital, Universitätsmedizin Mainz, der Johannes Gutenberg-Universität, Mainz, Germany

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quality of life, an adverse lipid profile and an increased risk for cardiovascular (CV)-associated disease, diabetes and metabolic syndrome vs healthy adults ( 4 , 5 , 6 , 7 ). The use of growth hormone (GH) replacement therapy in AGHD has been shown

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M Ahmid Developmental Endocrinology Research Group, Royal Hospital for Children, School of Medicine, University of Glasgow, Glasgow, UK

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C G Perry Department of Endocrinology, Queen Elizabeth University Hospitals, Glasgow, UK

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S F Ahmed Developmental Endocrinology Research Group, Royal Hospital for Children, School of Medicine, University of Glasgow, Glasgow, UK

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M G Shaikh Developmental Endocrinology Research Group, Royal Hospital for Children, School of Medicine, University of Glasgow, Glasgow, UK

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treatment during transition, especially with treatment costing up to £5000 per year in adulthood ( 7 ). The current guideline has approved continuation of GH replacement in those who were confirmed to have persistent GHD through the transition phase

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Guillem Cuatrecasas Endocrinology Department, Hospital Quiron-Teknon, CPEN S.L., Barcelona, Spain
Universitat Oberta Catalunya (UOC), Barcelona, Spain

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Hatice Kumru Institut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain
Univ Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain

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M Josep Coves Endocrinology Department, Hospital Quiron-Teknon, CPEN S.L., Barcelona, Spain

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Joan Vidal Institut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain
Univ Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain

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signaling pathway) both in animals and humans, as seen in vitro ( 13 ). In order to assess (1) frequency of GHD in chronic SCI patients and (2) the efficacy and safety of GH replacement therapy in SCI patients with GH deficiency, we designed a

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Mark R Postma Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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Pia Burman Department of Endocrinology, Skane University Hospital Malmö, University of Lund, Lund, Sweden

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André P van Beek Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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. It therefore usually occurs in the context of additional features of hypopituitarism, compounding the clinical picture attributable to AGHD ( 2 , 3 ). Available evidence shows benefit of GH replacement therapy (GHRT) on body composition, exercise

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Nathalie Ly Department of Endocrinology and Reproductive Medicine, Reference Center for Rare Endocrine Diseases of Growth and Development, Reference Center for Gynecological Rare Diseases, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
EndoERN, APHP Consortium Pitie Salpetriere Hospital, Necker Hospital, Paris, France

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Sophie Dubreuil Department of Endocrinology and Reproductive Medicine, Reference Center for Rare Endocrine Diseases of Growth and Development, Reference Center for Gynecological Rare Diseases, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
EndoERN, APHP Consortium Pitie Salpetriere Hospital, Necker Hospital, Paris, France

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Philippe Touraine Department of Endocrinology and Reproductive Medicine, Reference Center for Rare Endocrine Diseases of Growth and Development, Reference Center for Gynecological Rare Diseases, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
EndoERN, APHP Consortium Pitie Salpetriere Hospital, Necker Hospital, Paris, France
Sorbonne University, Paris, France

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( 1 ). IGF-1 concentration is routinely used to assess both treatment’s efficacy and patient’s adherence when treated with GH replacement therapy (GHRT). The paramount importance of the GH–IGF axis on bone growth during childhood is well documented, as

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