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These better results may be due to an overall higher dosing paradigm of GH employed, younger age at the beginning of treatment, and/or better genetic potential in the Netherlands.69 It is clear that GH therapy is beneficial to the height of girls with TS and, thus, guidelines for the treatment of patients with TS almost universally include treatment with GH
Recent studies have also indicated sex-specific effects, with males potentially being more susceptible than females [159163]
As shown by animal studies, insulin may also play a crucial role in promoting melatonin synthesis in the pineal gland
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