{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T19:30:57Z","timestamp":1786822257439,"version":"build-2736575974"},"reference-count":44,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100002661","name":"Fund for Scientific Research Flanders","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002661","id-type":"DOI","asserted-by":"publisher"}]},{"name":"FWOVlaanderen","award":["1146826N"],"award-info":[{"award-number":["1146826N"]}]},{"DOI":"10.13039\/501100007229","name":"BOF","doi-asserted-by":"publisher","award":["IOP003-18"],"award-info":[{"award-number":["IOP003-18"]}],"id":[{"id":"10.13039\/501100007229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sex is an important determinant for various immune system-related pathologies and sex steroids might possess immunomodulatory properties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study the effects of sex steroid exposure on the serum levels of immune-related biomarkers (irBMS), using a model of transgender individuals receiving gender-affirming hormone therapy (GAHT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>Serum samples were collected from hormone-na\u00efve trans women (TW) (n = 30) and trans men (TM) (n = 30) who initiated GAHT at baseline and after \u00b16 months of treatment. Cisgender men (n = 10) and cisgender women (n = 10) were included as controls. High-sensitivity C-reactive protein (hs-CRP) was measured using an immunoassay. Serum levels of several irBMs, including cytokines and chemokines were determined using a commercial multiplex assay (Olink\u00ae). Serum estradiol and testosterone were determined using liquid-chromatography tandem\u2013mass spectrometry (LC\u2013MS\/MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After \u00b16 months of GAHT in TW, serum levels of 10 cytokines (CCL2, CCL7, CCL11, CCL13, CCL19, CXCL9, CXCL10, CXCL11, IL15, and TNFSF10) significantly decreased, whereas IL7 increased. In TM, 8 factors significantly increased (CCL2, CCL7, CCL11, CCL13, CCL19, IL17C, MMP1, and TNFSF10). Other immune-related biomarkers were not significantly affected, and levels of hs-CRP did not show a clinically relevant change over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Six months of estrogen with antiandrogen treatment resulted in decreased serum levels of several cytokines and chemokines in TW, whereas cytokine and chemokine levels often increased in TM upon treatment with testosterone. These distinct and generally opposite changes suggest a sex steroid-dependent impact, which could contribute to sex-related disparities in (auto)inflammatory diseases. However, additional research should explore potential clinical consequences, as well as the mechanisms involved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag141","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:31:53Z","timestamp":1774956713000},"page":"2493-2501","source":"Crossref","is-referenced-by-count":2,"title":["Cytokine dynamics following initiation of gender-affirming hormone therapy in transgender subjects"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7682-2189","authenticated-orcid":false,"given":"Ya\u00ebl","family":"Sertons","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7591-8612","authenticated-orcid":false,"given":"Sarah","family":"Collet","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3909-892X","authenticated-orcid":false,"given":"Jeroen","family":"Vervalcke","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-2340","authenticated-orcid":false,"given":"Justine","family":"Defreyne","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]},{"name":"Department of Endocrinology, Center for Sexology and Gender, Ghent University Hospital , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1661-3840","authenticated-orcid":false,"given":"Sven C","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Experimental Clinical and Health Psychology, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2061-7617","authenticated-orcid":false,"given":"Mattias","family":"Hofmans","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ghent University Hospital , 9000 Ghent ,","place":["Belgium"]},{"name":"Department of Diagnostic Sciences, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9170-4200","authenticated-orcid":false,"given":"Carolien","family":"Bonroy","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ghent University Hospital , 9000 Ghent ,","place":["Belgium"]},{"name":"Department of Diagnostic Sciences, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3828-0442","authenticated-orcid":false,"given":"Valentino","family":"D\u2019Onofrio","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Sciences, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gido","family":"Snaterse","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0457-9673","authenticated-orcid":false,"given":"Guy","family":"T\u2019Sjoen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]},{"name":"Department of Endocrinology, Center for Sexology and Gender, Ghent University Hospital , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1584-4965","authenticated-orcid":false,"given":"Bruno","family":"Lapauw","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University , 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"issue":"10","key":"2026081219563904200_dgag141-B1","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein","year":"2016","journal-title":"Nat Rev Immunol"},{"issue":"2","key":"2026081219563904200_dgag141-B2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1005374","article-title":"SeXX matters in infectious disease pathogenesis","volume":"12","author":"vom Steeg","year":"2016","journal-title":"PLoS Pathog"},{"issue":"8","key":"2026081219563904200_dgag141-B3","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1158\/1055-9965.EPI-11-0246","article-title":"Sex disparities in cancer mortality and survival","volume":"20","author":"Cook","year":"2011","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"3","key":"2026081219563904200_dgag141-B4","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1006\/clin.1997.4412","article-title":"Epidemiology and estimated population burden of selected autoimmune diseases in the United States","volume":"84","author":"Jacobson","year":"1997","journal-title":"Clin Immunol Immunopathol"},{"issue":"5","key":"2026081219563904200_dgag141-B5","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/S1473-3099(10)70049-9","article-title":"The Xs and Y of immune responses to viral vaccines","volume":"10","author":"Klein","year":"2010","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"2026081219563904200_dgag141-B6","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/acel.12326","article-title":"How sex and age affect immune responses, susceptibility to infections, and response to vaccination","volume":"14","author":"Giefing-Kr\u00f6ll","year":"2015","journal-title":"Aging Cell"},{"issue":"1","key":"2026081219563904200_dgag141-B7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13293-015-0037-7","article-title":"Sex differences in Sj\u00f6gren's syndrome: a comprehensive review of immune mechanisms","volume":"6","author":"Brandt","year":"2015","journal-title":"Biol Sex Differ"},{"issue":"2","key":"2026081219563904200_dgag141-B8","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.mayocp.2019.09.012","article-title":"Sex differences in systemic lupus erythematosus: epidemiology, clinical considerations, and disease pathogenesis","volume":"95","author":"Nusbaum","year":"2020","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"2026081219563904200_dgag141-B9","doi-asserted-by":"crossref","DOI":"10.1186\/1741-7015-7-12","article-title":"Sex differences in rheumatoid arthritis: more than meets the eye","volume":"7","author":"van Vollenhoven","year":"2009","journal-title":"BMC Med"},{"issue":"12","key":"2026081219563904200_dgag141-B10","doi-asserted-by":"crossref","first-page":"2983","DOI":"10.1007\/s10067-016-3330-x","article-title":"Hypogonadism and the risk of rheumatic autoimmune disease","volume":"35","author":"Baillargeon","year":"2016","journal-title":"Clin Rheumatol"},{"issue":"5-6","key":"2026081219563904200_dgag141-B11","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1080\/08820130802205886","article-title":"Autoimmune disease during pregnancy and the microchimerism legacy of pregnancy","volume":"37","author":"Adams Waldorf","year":"2008","journal-title":"Immunol Invest"},{"issue":"5","key":"2026081219563904200_dgag141-B12","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1111\/joim.13441","article-title":"Gender-affirming hormone therapy: an updated literature review with an eye on the future","volume":"291","author":"D'Hoore","year":"2022","journal-title":"J Intern Med"},{"issue":"4","key":"2026081219563904200_dgag141-B13","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/ejendo\/lvaf051","article-title":"Autoimmune diseases in 3812 Danish transgender persons and 38 120 cisgender controls before and after transgender care: a register-based cohort study","volume":"192","author":"Glintborg","year":"2025","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026081219563904200_dgag141-B14","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1016\/j.jsxm.2016.03.371","article-title":"A European network for the investigation of gender incongruence: endocrine part","volume":"13","author":"Dekker","year":"2016","journal-title":"J Sex Med"},{"issue":"7","key":"2026081219563904200_dgag141-B15","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11071784","article-title":"The ENIGI (European Network for the Investigation of Gender Incongruence) study: overview of acquired endocrine knowledge and future perspectives","volume":"11","author":"Cocchetti","year":"2022","journal-title":"J Clin Med"},{"issue":"1","key":"2026081219563904200_dgag141-B16","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/jalm\/jfaa192","article-title":"Dynamic impact of hormone therapy on laboratory values in transgender patients over time","volume":"6","author":"Allen","year":"2021","journal-title":"J Appl Lab Med"},{"key":"2026081219563904200_dgag141-B17","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.steroids.2014.04.013","article-title":"A critical evaluation of salivary testosterone as a method for the assessment of serum testosterone","volume":"86","author":"Fiers","year":"2014","journal-title":"Steroids"},{"issue":"3","key":"2026081219563904200_dgag141-B18","doi-asserted-by":"crossref","first-page":"249","DOI":"10.30574\/gscbps.2025.30.3.0112","article-title":"Verification of the analytical performance of the serum C-reactive Protein (CRP) assay on the Abbott\u00ae ARCHITECT ci8200 in the Biochemistry Laboratory of the Mohammed VI University Hospital, Oujda","volume":"30","author":"Kharkhach","year":"2025","journal-title":"GSC Biol Pharm Sci"},{"key":"2026081219563904200_dgag141-B19","doi-asserted-by":"crossref","unstructured":"Sertons Y, Collet S, Vervalcke J, et al \u00a02026. Supplementary material for the paper \u201cCytokine Dynamics Following Initiation of Gender-Affirming Hormone Therapy in Transgender Subjects\u201d. Figshare. doi:10.6084\/m9.figshare.31746463.v1","DOI":"10.1210\/clinem\/dgag141"},{"key":"2026081219563904200_dgag141-B20","author":"Olink-group"},{"issue":"5","key":"2026081219563904200_dgag141-B21","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1172\/JCI71951","article-title":"CXCL11-dependent induction of FOXP3-negative regulatory T cells suppresses autoimmune encephalomyelitis","volume":"124","author":"Zohar","year":"2014","journal-title":"J Clin Invest"},{"issue":"4","key":"2026081219563904200_dgag141-B22","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1210\/clinem\/dgz289","article-title":"Th1 chemokines in autoimmune endocrine disorders","volume":"105","author":"Fallahi","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2026081219563904200_dgag141-B23","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2015.00568","article-title":"Estrogen signaling modulates allergic inflammation and contributes to sex differences in asthma","volume":"6","author":"Keselman","year":"2015","journal-title":"Front Immunol"},{"key":"2026081219563904200_dgag141-B24","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2019.02759","article-title":"More than just attractive: how CCL2 influences myeloid cell behavior beyond chemotaxis","volume":"10","author":"Gschwandtner","year":"2019","journal-title":"Front Immunol"},{"issue":"6","key":"2026081219563904200_dgag141-B25","doi-asserted-by":"crossref","first-page":"4716","DOI":"10.3892\/mmr.2020.11543","article-title":"Cytokines CCL2 and CXCL1 may be potential novel predictors of early bone loss","volume":"22","author":"Hu","year":"2020","journal-title":"Mol Med Rep"},{"key":"2026081219563904200_dgag141-B26","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.mce.2017.01.051","article-title":"Testosterone increases CCL-2 expression in visceral adipose tissue from obese women of reproductive age","volume":"444","author":"Crisosto","year":"2017","journal-title":"Mol Cell Endocrinol"},{"issue":"8028","key":"2026081219563904200_dgag141-B27","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/s41586-024-07789-z","article-title":"Immune system adaptation during gender-affirming testosterone treatment","volume":"633","author":"Lakshmikanth","year":"2024","journal-title":"Nature"},{"issue":"8","key":"2026081219563904200_dgag141-B28","doi-asserted-by":"crossref","DOI":"10.1172\/jci.insight.184544","article-title":"Testosterone affects female CD4+ T cells in healthy individuals and autoimmune liver diseases","volume":"10","author":"Henze","year":"2025","journal-title":"JCI Insight"},{"issue":"2","key":"2026081219563904200_dgag141-B29","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2174\/1871530315666150316120920","article-title":"CCL2-CCR2 signaling in disease pathogenesis","volume":"15","author":"O'Connor","year":"2015","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"issue":"6","key":"2026081219563904200_dgag141-B30","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s10787-013-0177-5","article-title":"The multiple faces of CCL13 in immunity and inflammation","volume":"21","author":"Mendez-Enriquez","year":"2013","journal-title":"Inflammopharmacology"},{"key":"2026081219563904200_dgag141-B31","article-title":"CCL13 and human diseases","volume":"14","author":"Li","year":"2023","journal-title":"Front Immunol"},{"issue":"4","key":"2026081219563904200_dgag141-B32","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1172\/JCI29919","article-title":"Critical roles for CCR2 and MCP-3 in monocyte mobilization from bone marrow and recruitment to inflammatory sites","volume":"117","author":"Tsou","year":"2007","journal-title":"J Clin Invest"},{"issue":"1","key":"2026081219563904200_dgag141-B33","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s12933-022-01626-1","article-title":"CCL7 as a novel inflammatory mediator in cardiovascular disease, diabetes mellitus, and kidney disease","volume":"21","author":"Chang","year":"2022","journal-title":"Cardiovasc Diabetol"},{"issue":"3","key":"2026081219563904200_dgag141-B34","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1084\/jem.179.3.881","article-title":"Eotaxin: a potent eosinophil chemoattractant cytokine detected in a Guinea pig model of allergic airways inflammation","volume":"179","author":"Jose","year":"1994","journal-title":"J Exp Med"},{"issue":"26","key":"2026081219563904200_dgag141-B35","doi-asserted-by":"crossref","first-page":"10924","DOI":"10.1523\/JNEUROSCI.0886-13.2013","article-title":"Estrogen mediates neuroprotection and anti-inflammatory effects during EAE through ER\u03b1 signaling on astrocytes but not through ER\u03b2 signaling on astrocytes or neurons","volume":"33","author":"Spence","year":"2013","journal-title":"J Neurosci"},{"key":"2026081219563904200_dgag141-B36","doi-asserted-by":"crossref","DOI":"10.3389\/fcell.2019.00212","article-title":"CCL19 and CCR7 expression, signaling pathways, and adjuvant functions in viral infection and prevention","volume":"7","author":"Yan","year":"2019","journal-title":"Front Cell Dev Biol"},{"issue":"1","key":"2026081219563904200_dgag141-B37","doi-asserted-by":"crossref","DOI":"10.1186\/1476-4598-10-34","article-title":"Targeted expression of tumor necrosis factor-related apoptosis-inducing ligand TRAIL in skin protects mice against chemical carcinogenesis","volume":"10","author":"Kedinger","year":"2011","journal-title":"Mol Cancer"},{"issue":"1","key":"2026081219563904200_dgag141-B38","doi-asserted-by":"crossref","first-page":"675","DOI":"10.3892\/etm.2021.10107","article-title":"Therapeutic potential of interleukin-15 in cancer (review)","volume":"22","author":"Isvoranu","year":"2021","journal-title":"Exp Ther Med"},{"key":"2026081219563904200_dgag141-B39","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2020.00341","article-title":"IL-17C\/IL-17RE: emergence of a unique axis in T(H)17 biology","volume":"11","author":"Nies","year":"2020","journal-title":"Front Immunol"},{"issue":"9","key":"2026081219563904200_dgag141-B40","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1097\/QAD.0000000000003265","article-title":"Sex differences in cytokine profiles during suppressive antiretroviral therapy","volume":"36","author":"Vanpouille","year":"2022","journal-title":"Aids"},{"issue":"7","key":"2026081219563904200_dgag141-B41","doi-asserted-by":"crossref","first-page":"4415","DOI":"10.4049\/jimmunol.179.7.4415","article-title":"IL-27 suppresses Th2 cell development and Th2 cytokines production from polarized Th2 cells: a novel therapeutic way for Th2-mediated allergic inflammation","volume":"179","author":"Yoshimoto","year":"2007","journal-title":"J Immunol"},{"issue":"9","key":"2026081219563904200_dgag141-B42","doi-asserted-by":"crossref","first-page":"5748","DOI":"10.4049\/jimmunol.0801162","article-title":"IL-27 blocks RORc expression to inhibit lineage commitment of Th17 cells","volume":"182","author":"Diveu","year":"2009","journal-title":"J Immunol"},{"issue":"1","key":"2026081219563904200_dgag141-B43","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/s41591-020-01202-8","article-title":"Immune determinants of COVID-19 disease presentation and severity","volume":"27","author":"Brodin","year":"2021","journal-title":"Nat Med"},{"issue":"2","key":"2026081219563904200_dgag141-B44","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1089\/lgbt.2019.0260","article-title":"Lower serum estradiol levels in assigned female at birth transgender people with initiation of testosterone therapy: results from the European network for the investigation of gender incongruence","volume":"7","author":"Defreyne","year":"2020","journal-title":"LGBT Health"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgag141\/67715143\/dgag141.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/9\/2493\/67715143\/dgag141.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/9\/2493\/67715143\/dgag141.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T23:56:48Z","timestamp":1786579008000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/111\/9\/2493\/8571382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":44,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,4,1]]},"published-print":{"date-parts":[[2026,8,13]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgag141","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,4,1]]}}}