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Data collected included pre-and-during therapy alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), gamma-glutamyl-transferase (GGT), and alkaline phosphatase (ALP) mean concentration values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The prevalence of BLD in 14 studies on 1698 subjects was 1% (95% CI 0.00\u20133.00; I<jats:sup>2<\/jats:sup>\u2009=\u200914.1%; p\u2009=\u20090.82). In 17 studies on 2758 subjects, GAHT was associated with a statistically (but not clinically) significant increase in AST, GGT and ALP at 12\u00a0months and ALT at 3\u20137 (MD: 1.19\u00a0IU\/l; 95% CI 0.31, 2.08; I<jats:sup>2<\/jats:sup>: 0%), at 12 (MD: 2.31\u00a0IU\/l; 95% CI 1.41, 3.21; I<jats:sup>2<\/jats:sup>: 29%), but with no more significant increase at 24\u00a0months (MD: 1.71\u00a0IU\/l; 95% CI \u22120.02, 3.44; I<jats:sup>2<\/jats:sup>: 0%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Analysis of aggregate estimates confirms a low risk of BLD and abnormalities in LBTs, transient in most cases, during T-based GAHT, thus suggesting a limited need for careful liver monitoring in AFAB people.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40618-024-02418-y","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T18:01:36Z","timestamp":1719079296000},"page":"161-171","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Biochemical liver damage\u00a0during\u00a0gender affirming\u00a0therapy in trans\u00a0adults assigned female at birth: a meta-analysis"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-7955","authenticated-orcid":false,"given":"D.","family":"Tienforti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Savignano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Spagnolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Di Giulio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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