{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:44:49Z","timestamp":1792111489521,"version":"4.4.0"},"reference-count":48,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n The binary sex classification protects elite female athletes from the male physical advantages arising from puberty; however, mutations causing XY disorders of sex development (DSD) challenge the binary sex classification. Hormonal features of the most frequent XY DSDs in sports, androgen insensitivity syndrome (AIS) and 5\u03b1-reductase type 2 deficiency (5ARD) are not well described.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n To define serum androgen profiles in elite athletics (track and field) events<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Serum samples from elite athletes (n = 1689; male 889, female 800; n = 5516 samples, median 3 per person) were analyzed by liquid chromatography\u2013mass spectrometry (LCMS) for serum testosterone (T), dihydrotestosterone (DHT), and androstenedione in 19 World Anti-Doping Agency (WADA)-accredited laboratories. Serum steroids and ratios were analyzed by linear mixed model for repeated measures with adjustment for multiple comparisons and imputation for left-censored (dihydrotestosterone [DHT]) data. Among females, XY DSD identified by adult male serum T concentrations, had clinical diagnosis of 5ARD, AIS, or unclassified (UNCL).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n XY DSD comprised 12 individuals with 5ARD with 2 with AIS (1 complete). Excluding pregnancy or androgen doping samples, men had higher serum T (n = 2671, 19.7 \u00b1 0.1 nmol\/L) and T\/DHT ratio (n = 1903, 14.4 \u00b1 0.2) than women (n = 2793, 1.1 \u00b1 0.1 nmol\/L; n = 1809, 3.7 \u00b1 0.12, respectively) with XY DSD featuring male-like results (n = 52, 28.9 \u00b1 0.8 nmol\/L; n = 39; 32.0 \u00b1 1.3).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The prevalence of XY DSD in elite female athletes greatly exceeds that of the community with a high proportion of androgen-sensitive 5ARD. Serum T\/DHT ratio by LCMS to characterize 5ARD can be extended to elite athletes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1210\/clinem\/dgag196","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:44:45Z","timestamp":1778067885000},"page":"3262-3268","source":"Crossref","is-referenced-by-count":2,"title":["Serum androgen profile of elite athletes"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4200-7476","authenticated-orcid":false,"given":"David J","family":"Handelsman","sequence":"first","affiliation":[{"name":"ANZAC Research Institute, University of Sydney , Sydney, NSW 2139 ,","place":["Australia"]},{"name":"Andrology Department, Concord Hospital , Sydney, NSW 2139 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Bermon","sequence":"additional","affiliation":[{"name":"Health and Science Department, World Athletics , 6-8 quai Antoine 1er, 98000 Monaco 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