{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:45:49Z","timestamp":1782798349906,"version":"3.54.5"},"reference-count":44,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T00:00:00Z","timestamp":1617580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Health Research Foundation of Central Denmark Region"},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF13OC0003234"],"award-info":[{"award-number":["NNF13OC0003234"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF15OC0016474"],"award-info":[{"award-number":["NNF15OC0016474"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF20OC0060610"],"award-info":[{"award-number":["NNF20OC0060610"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Familien Hede Nielsen Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Klinefelter Syndrome (KS) is the most frequent sex chromosome disorder in males. Due to hypergonadotropic hypogonadism, treatment with testosterone replacement therapy (TRT) is commonly indicated. There are no international guidelines for the most appropriate TRT in KS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to evaluate how different routes of testosterone administration impact testosterone-responsive variables, as well as the development of later metabolic diseases and other complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study covering 5 years from 2015 to 2020. Data on TRT, biochemical parameters, bone mineral density (BMD), medications, comorbidity, and karyotyping were derived from electronic patient records and The Danish Cytogenetic Register.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 147 KS males were included: 81 received injection TRT, 61 received transdermal TRT, and 5 did not receive TRT. Testosterone levels were similar in the 2 TRT groups (P\u2005=\u20050.9), while luteinizing hormone and follicle-stimulating hormone levels were higher in the group receiving transdermal TRT (P\u2005=\u20050.002). Levels of cholesterol, blood glucose, hemoglobin A1c, hemoglobin, hematocrit, liver parameters, prostate-specific antigen, and spine and hip BMD were similar in the 2 treatment groups (Ps\u2005&amp;gt;\u20050.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TRT, irrespective of route of administration, affects androgen-responsive variables similarly in males with KS. Neither long-acting injection nor transdermal gel seem to reduce the risk of metabolic diseases significantly. These results should encourage clinicians in seeking the route of administration resulting in the highest degree of adhesion to treatment based on individual patient preferences. Implementation of shared decision-making with patients may be important when choosing TRT.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jendso\/bvab062","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T20:39:02Z","timestamp":1617741542000},"source":"Crossref","is-referenced-by-count":17,"title":["Evaluation of the Efficacy of Transdermal and Injection Testosterone Therapy in Klinefelter Syndrome: A Real-Life Study"],"prefix":"10.1210","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6797-0077","authenticated-orcid":false,"given":"Apiraa","family":"Kabilan","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus, Denmark"},{"name":"Department of Internal Medicine, Lillebaelt Hospital, 6000 Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9178-4901","authenticated-orcid":false,"given":"Anne","family":"Skakkeb\u00e6k","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Aarhus University Hospital, 8200 Aarhus, Denmark"},{"name":"Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1130-3659","authenticated-orcid":false,"given":"Simon","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus, Denmark"},{"name":"Department of Internal Medicine, Lillebaelt Hospital, 6000 Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5924-1720","authenticated-orcid":false,"given":"Claus H","family":"Gravholt","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus, Denmark"},{"name":"Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2021,4,5]]},"reference":[{"issue":"2","key":"2021121114455000700_CIT0001","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1210\/jc.2002-021491","article-title":"Prenatal and postnatal prevalence of Klinefelter syndrome: a national registry study","volume":"88","author":"Bojesen","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2021121114455000700_CIT0002","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1210\/er.2017-00212","article-title":"Klinefelter syndrome: integrating genetics, neuropsychology, and endocrinology","volume":"39","author":"Gravholt","year":"2018","journal-title":"Endocr Rev."},{"issue":"3","key":"2021121114455000700_CIT0003","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/andr.12208","article-title":"The Klinefelter syndrome: current management and research challenges","volume":"4","author":"Nieschlag","year":"2016","journal-title":"Andrology."},{"issue":"1","key":"2021121114455000700_CIT0004","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5694\/j.1326-5377.2011.tb04141.x","article-title":"The prevalence and diagnosis rates of Klinefelter syndrome: an Australian comparison","volume":"194","author":"Herlihy","year":"2011","journal-title":"Med J Aust."},{"issue":"1","key":"2021121114455000700_CIT0005","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13023-018-0976-2","article-title":"Changes in the cohort composition of turner syndrome and severe non-diagnosis of Klinefelter, 47,XXX and 47,XYY syndrome: a nationwide cohort study","volume":"14","author":"Berglund","year":"2019","journal-title":"Orphanet J Rare Dis."},{"issue":"9430","key":"2021121114455000700_CIT0006","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0140-6736(04)16678-6","article-title":"Klinefelter\u2019s syndrome","volume":"364","author":"Lanfranco","year":"2004","journal-title":"Lancet."},{"issue":"1","key":"2021121114455000700_CIT0007","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/jsm.12277","article-title":"Is testosterone replacement therapy in males with hypogonadism cost-effective? 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